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Sangamo Therapeutics, Inc. (SGMO)

Q2 2019 Earnings Call· Tue, Aug 13, 2019

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Transcript

Operator

Operator

Good afternoon, and welcome to the Sangamo Therapeutics teleconference to discuss Second Quarter 2019 Financial Results. The call is being recorded. I will now pass over to the coordinator of the event, McDavid Stilwell, Vice President of Corporate Communications and Investor Relations. The floor is yours.

McDavid Stilwell

Management

Hello and thank you for joining us. As we begin, I'd like to point out that we have posted our updated corporate presentation to the Sangamo website, and we'll be referencing several of these slides today. A link to the slide presentation may be found on our website, sangamo.com, on the Events and Presentations page of the Investors and Media section of the site. I'd also like to remind everyone that the projections and forward-looking statements that we will discuss during this conference call are based upon the information that we have available today. Forward-looking statements include, but are not limited to, statements related to the timing and scope of Sangamo's genomic medicine platform and products; the potential for Sangamo's product candidates to provide clinical benefit to patients; Sangamo's development and manufacturing plans; and Sangamo's expectations regarding its financial performance. Actual results may differ substantially from what we discuss today and no one should assume at a later date that our comments from today are still valid. These forward-looking statements are not guarantees of future performance and are subject to certain risks, uncertainties and assumptions that are detailed in documents that the company files with the Securities and Exchange Commission, specifically in our most recent annual report on Form 10-K and in our most recent quarterly report on Form 10-Q. The forward-looking statements stated today are made as of this date, and Sangamo undertakes no duty to update such information, except as required under applicable law. With me this afternoon on the call are several members of the Sangamo senior management team, including Sandy Macrae, Chief Executive Officer; Adrian Woolfson, Head of Research and Development; Gary Loeb, General Counsel; and Ed Rebar, Chief Technology Officer. And again, as a reminder, during the call, we will refer to several slides in our corporate presentation. And the slides are to be found on the Events and Presentations page of the Investors and Media section of the site. Now, I'd like to turn the call over to Sandy.

Sandy Macrae

Management

Thank you, McDavid, and good afternoon to everyone on this call. Thank you all for joining us. At Sangamo, our mission is to translate our ground-breaking science into genomic medicines that transform patients' lives. We are realizing this vision by developing capabilities that allow us to design therapeutic approaches to resolve the underlying genetic causes of disease using whatever technology is best suited to deliver that treatment, including gene therapy, ex-vivo gene-edited cell therapy, in-vivo genome editing and gene regulation. We are accelerating near-term opportunities with gene therapies because gene therapy is tractable now and has defined regulatory pathways and well-documented manufacturing processes and because it can provide immense value to patients. It also leverages our extensive experience in transgene and cassette engineering. We continue to advance ex-vivo gene-edited cell therapy because we've shown that we can do it well with our foundational HIV cell editing studies. It has a relatively straightforward application that builds on the science of our core ZFN platform technology and because it's an emerging approach with a defined regulatory pathway and significant therapeutic potential, which is understood by both the medical and the patient communities. Finally, we're building momentum towards in-vivo genome editing and gene regulation as we believe that they are the therapeutic approaches that will define the future and transform the practice of clinical medicine. We are continuously learning from our experience and improving our technology and believe that we will solve the technical challenges associated with efficient delivery that are likely to be necessary to achieve successful in-vivo editing. Given the tremendous diversity and optionality inherent to our platform, we're sometimes asked how to prioritize our indications. The answer is that we select potential indications to satisfy four key criteria: firstly, that they address a significant unmet medical need; second, that the…

Adrian Woolfson

Management

Thank you, Sandy, and thanks to everybody on the call for joining us today. I want to start by elaborating on the SB-525 hemophilia A gene therapy results that we recently presented at ISTH. And that was a meeting that I was fortunate enough to attend. And while in Melbourne, Australia, I was really struck by the palpable excitement in the room about the potential of gene therapy and by the way in which it provides such enormous improvement over the standard of care for hemophilia A patients and especially by the intensity of the medical communities’ interest in our clinical data. And it's really remarkable to see how gene therapy, even in these earlier stages, has already transformed patients’ lives. And it makes us more and more motivated to work with Pfizer to get the product into the market as swiftly as possible. At the Alta study data are presented at ISTH by our [indiscernible] results in 10 patients treated across four different ascending dose cohorts. These were 9e11, two patients treated; 2e12, two patients treated; 1e13, two patients treated; and the 3e13, four patients treated. SB-525 was generally well tolerated, and unlike other studies, patients on the Alta study were not treated with prophylactic steroids. A single treatment-related serious adverse event was reported, but this patient experienced hypotension and fever six hours after completing the SB-525 infusion but is fully resolved with treatment and the patient was discharged as planned within 24 hours of the onset of the event. And we've not seen any similar grade 3 hypotension events subsequently. Treatment-related adverse events in the study are detailed on Slide 14. Patients treated with SB-525 had a loss of Factor VIII expression associated with an alanine aminotransferase elevation. In the 3e13 cohort, two subjects experienced a transient grade…

Ed Rebar

Management

Thank you, Adrian, and good afternoon, everyone. At Sangamo, one of our foundational and most enduring commitments has been to advancing the science of genomic medicine. We feel strongly that the most impactful medical advances results not only from the scope or use of current knowledge, but also by the application of new capabilities and insights developed through innovative research. This past quarter, we published two manuscripts that exemplify this philosophy and that demonstrate how scientific advances can enable new therapeutic opportunities. For my comments today, I will provide a brief overview of each. I hope that you will be as excited as I am by their implications. I’ll begin by describing the work of my colleague, Jeff Miller, who has developed a fundamentally new strategy for optimizing the specificity of gene editing nucleases. This work titled, "Enhancing gene editing specificity by attenuating DNA cleavage kinetics," was published just this last week in Nature Biotechnology. In the paper, Jeff and colleagues showed that zinc finger nucleases may be optimized for highly specific function via the novel approach of engineering their catalytic domain to slow down its cleavage rate. In pursuing this approach, Jeff identified single-residue variants of the catalytic domain that could fully preserve on-target activity while globally suppressing off-target cleavage. By combining these substitutions with others within the zinc fingers’ affinity Jeff developed ZFNs for a therapeutic target gene, T cell receptor alpha, that could mediate essentially complete editing with no detectable off targets under highly sensitive assay conditions with a median background signal of less than 0.1%. This work has substantially improved our ability to rapidly engineer highly specific ZFNs for clinical use. More generally, the principles that Jeff has elucidated will likely find broad utility beyond the field of gene editing for optimizing the performance of other…

McDavid Stilwell

Management

Thank you, Ed. I’m filling in for our interim CFO and EVP of Corporate Strategy, Stéphane Boissel, who has obligations overseas today and is consequently unable to join us on the call. Detailed financial statements were included in the press release that we issued this afternoon and in the Form 10-Q that we filed just prior to this call. Accordingly, I will only address the highlights. Revenues for the second quarter ended June 30, 2019, were $17.5 million compared to $21.4 million for the same period in 2018. The decrease was primarily due to a decline of $3.7 million in revenues related to our agreement with Pfizer and was due to a change in an estimate as a result of the expansion of the project scope of the hemophilia A collaboration. As anticipated, operating expenses increased in the second quarter ended June 30, 2019, reflecting the company’s growth through the acquisition of TxCell, increased U.S. headcount in support of growth of the preclinical pipeline and clinical development programs and manufacturing readiness activities. Total operating expenses for the second quarter ended June 30, 2019, were $51.1 million compared to $40.6 million for the same period in 2018. Research and development expenses were $36.5 million for the second quarter of 2019 compared to $29.3 million for the same period in 2018. The increase in R&D spend was primarily due to manufacturing and clinical trial expenses. General and administrative expenses were $14.6 million for the second quarter of 2019 compared to $11.3 million for the same period in 2018. The increase was primarily due to increased compensation costs due to headcount growth and increased facility expenses related to our new Brisbane and San Francisco Bay Area facility. Construction of our in-house manufacturing capability in Brisbane is proceeding on schedule, and we expect to commence GMP qualification procedures early next year. As of June 30, 2019, the company had cash, cash equivalents and investments of $450.3 million. As for our financial guidance for 2019, we continue to project operating expenses of $210 million to $220 million for the year. Regarding our cash runway, we need to project the current cash; cash equivalents and investments should provide funds for operations through year-end 2021. And with that, I’ll now turn the call back to Sandy for some closing remarks.

Sandy Macrae

Management

Thank you, McDavid. I would like to close by saying that we’re very pleased with the various accomplishments this quarter and excited about the future. Clinical data from our hem A gene therapy candidate continues to be promising, and we’ve made significant progress – process in initiating the transfer of the clinical program to Pfizer and in progressing registrational trial discussions with regulators. Pfizer is committed to taking the study into late-stage development, and we anticipate that this will result in our first licensed product. The favorable hem A data portends well for our gene therapy program in Fabry, for which the first clinical site was activated this quarter. We are also proud of our two publications in Nature Family journals that help define the basis of our enhanced next-generation ZFN gene editing platform and illustrate the exquisite selectivity of our gene regulation platform that enables us to constantly address challenging CNS indications of high unmet medical need that affect large patient populations and have to-date provide intractable using conventional medicines. We look forward to continuing to show updated data and to progressing new programs based on our discoveries into the clinic as part of our next wave of INDs. As mentioned, we, in parallel, continue to push ahead with our strategy to initiate our next in vivo genome editing trial that addresses perhaps the most challenging area of gene editing. It is important that we evaluate the potential improvements to our in vivo genome editing technologies, which is, we believe, the first step on the journey to successful in vivo gene editing that will help define the future of clinical medicine. We look forward to updating you further on the key catalysts and milestones ahead. I would like to thank you once again for joining us on the call today. We’ll now turn to your questions. Operator?

Operator

Operator

Thank you, sir. [Operator Instructions] Our first question in queue will come from the line of Gena Wang with Barclays. Please go ahead. Your line is now open.

Gena Wang

Analyst

Thank you very much for taking my questions and congratulation on all the progress. So just first question regarding the beta update, you mentioned like Q4 of this year, both hemophilia A and beta-thalassemia will have update. Should we expect this at ASH. And then we – if yes, will we see some meaningful disclosure in the abstract?

McDavid Stilwell

Management

It’s McDavid. Thanks for the question. So we’re not going to commit to that conference until we’ve actually had our abstracts accepted at the conference, but that would be a logical place to present the data.

Sandy Macrae

Management

And we are emphasizing, Gena, that the patients, particularly patient 3 or 4, would have very little data acquired by that time by the end of the quarter. And that this feels – it seems like from the bluebird experience, this may take some time before we fully understand the benefit to the patients.

McDavid Stilwell

Management

You’re referring to beta-thalassemia.

Sandy Macrae

Management

Yes, exactly.

Gena Wang

Analyst

Regarding beta-thalassemia, did you enroll any more ß0/ß0 patient?

McDavid Stilwell

Management

We haven’t discussed the patients that we’re enrolling.

Gena Wang

Analyst

Okay. And then just a quick question regarding the hemophilia A and the Fabry disease programs. So just wondering, for the Factor VIII level, when we look at the initial first combination it seems like the Factor VIII level continue increase. Just wondering if you have any scientific mechanisms or understanding that could explain the continued increase of the Factor VIII level in the first six months.

Sandy Macrae

Management

I’m not sure we see that. I’m looking at the graph, which slide number is it?

McDavid Stilwell

Management

Number 16.

Sandy Macrae

Management

16. We feel looking both at the – looking at the chromogenic, both at the linear and the logarithmic that within 10 to 12 weeks, are plateauing out. Do you see it still increasing at that point?

Gena Wang

Analyst

I see. So like if you look at Slide 15, that one stage assay and then maybe 16, also on the left side, kind of – okay. So we will see – like so you expecting this should plateau out, right? So basically, later this year, if we see a longer follow-up, we should see the protein level should stabilize, around 150 if we’re using chromogenic assay or one stage assay will be like within 200 to 200 – like 150 to 200 range, right?

Sandy Macrae

Management

I’m going to pass you on to Adrian in a moment, but we focus on the chromogenic assay. And more importantly, we just need to let this data play out over the course of the year to give everyone comfort and confidence in the levels that we’re achieving. Adrian, do you have some comments?

Adrian Woolfson

Management

Yes. I mean, just to say, Gena, when I look at the data, I mean, one never likes to say it’s plateaued but it’s looking a little bit like that to me. When you look at it closely it kind of moves up and down around a kind of mean, if you like, for each patient, but that’s kind of an intrinsic probably a biological variability of having this episomal expression. But overall, at least when I look at the data, I’m not seeing an upward turn. I’m seeing a stabilization within the high normal range. So this is kind of like complete correction as far as I see it. And they kind of stabilized out. And that’s what I’m seeing. Of course, by the end of the year, we’ll have a minimum six-month data for all patients in that cohort and up to around a year for the one who was first treated. So we’ll know better, but that’s how I see it, Gena, at the moment.

Gena Wang

Analyst

Great. And then one last very quick question regarding the Fabry disease. So based on the hemophilia A clinical data and also preclinical data for both hemophilia A and Fabry, could you remind us your first dose for Fabry disease? And are you aiming to achieve minimal – if effective minimal – within minimal [indiscernible] window the low effective dose for the gene therapy?

Sandy Macrae

Management

Gena, we haven’t set what that dose would be. So we will reveal more of that as the study evolves.

Adrian Woolfson

Management

I’ll just say one thing, though, and this is something we have talked about and actually you probably remember Gena, we presented some data at ASGCT in the glyco knockout model, which is the GLA knockout. And these mice like alpha-Gal A activity and they accumulate large amounts of substrate in the plasma and tissues, and then we use the same AAV2/6 encoding the human GLA with a lipo-specific promoter, and it was manufactured in the exact same way. Based on the clinical scale production method that we’re currently using. And what we saw there is that we got a 1,500 fold increase in alpha-Gal A activity. So really pronounced expression. So as we said, just previously, we’re expecting that all the learnings that we’ve obtained from our work in hemophilia A, which I hope you will agree really is an exemplary example of how gene therapy should look, right? We’re hoping and expecting that those learnings will effectively transfer to Fabry and the preclinical data we saw in the glyco model to a really large extent, makes us confident that, that’s the case. And we’re also, of course, in that same data set that we presented at the ASGCT shows that we see the substrate reduction in all the key tissues like liver, heart and kidney. So we’re really confident about where we’re going here in Fabry.

Gena Wang

Analyst

Thank you.

Operator

Operator

Our next question in queue will come from the line of Maury Raycroft with Jefferies. Please go ahead, your line is now open.

Maury Raycroft

Analyst

Hi, everyone. Good afternoon and thanks for taking my questions. So, I think Adrian mentioned earlier that Pfizer had submitted a lead-in study for the Phase III to clinicaltrials.gov. And so I’m just wondering if you can talk more about that study and what the purpose of it is. And as a follow-up for the Phase III design, what are some of the most likely scenarios that could happen with the Phase III? And how likely is it that an accelerated approval path will be an option there?

Sandy Macrae

Management

We – so Maury, I thank you for your question. We rely on our friends at Pfizer to talk about this. We had hoped that the submitted clinicaltrials.gov thing would be live by now, and it’s in the process, and you’ll be able to see more of it when it becomes visible on the website, that they will be the ones, who would talk about the Phase III study. They like us are excited by the data. And I think the fact that they are initiating this lead-in study is a sign of their commitment to this.

Adrian Woolfson

Management

Yes. And as I said, we’re actually expecting that to post literally even today actually, that they submitted it to clinicaltrials.gov a couple of days ago and we literally expect it to post in the next day or two.

Maury Raycroft

Analyst

Got it. And as far as the registrational study goes, any thoughts on whether that would look similar to valrox Phase III study? Or any perspective there would be helpful.

Sandy Macrae

Management

We have an agreement, and in these kind of partnerships you have an agreement about, who talks about what. And so they prefer that we don’t talk about it and they lead those discussions, but I just want to reassure everyone, we speak to all of our partners on a regular basis. We have regular steering committees and clinical development committees. And we are – with Pfizer and the excitement over the hemophilia A results, we’re very aligned in where this is going and doing everything to help them move forward promptly.

Maury Raycroft

Analyst

Got it. Okay. And I’m just wondering if you – now, that you’re talking more about the Kite-037 program, and that’s likely to advance in 2020. If you can just compare and contrast how that would look versus other allogeneic approaches out there.

Sandy Macrae

Management

So again, the agreement with Kite-Gilead is that they talk about that piece. So, we have an ongoing relationship with both Kite and through Kite with Gilead, where we provide the editing capabilities to help them design the most effective allogeneic assets. And when they get that into the IND stage and beyond, I’m sure they will be openly talking about what editing has been done to meet this effect.

Maury Raycroft

Analyst

Okay. And then maybe the last question, just on the TxCell trial, if you can comment on that design and a number of patients that you plan on getting into that study. And if you’re going to be using donor patients for the cells there? Any perspective there would be helpful.

Sandy Macrae

Management

We really haven’t said much about this trial. We will – once the CTA is submitted and approved, and as we start to move into it, we’ll talk more about the design of this trial. I really – I’m sorry, Maury, that I can’t be more helpful with the information. There’s – we’re just very careful about how much planning and design we give out at this stage.

Maury Raycroft

Analyst

Understood, understood. Thanks for taking my questions. And I’ll hop back in the queue.

Sandy Macrae

Management

Thank you.

Operator

Operator

Okay. Thank you, sir. Our next question in queue will come from Ritu Baral with Cowen. Please go ahead, your line is now open.

Leila Weinstein

Analyst

Hello, thank you for taking our question. This is Leila on for Ritu. I just want to follow up on the transfer of 525 to Pfizer. You said that it’s been initiated. And I was wondering if you could provide any more color on how long the overall tech transfer process will take. And maybe, any sort of guideline of when you think they’ll start producing the products for the Phase III trial? Thank you.

Sandy Macrae

Management

Leila, I’m afraid I have to refer you to my previous answer with Maury. Let me assure you that we’ve been talking with Pfizer about the transfer of this for months, if not years, as we plan for how this would look when the project moves over. The whole process has become more energized by the pleasure that they and we see in the results. They have been talking with – they have been designing their manufacturing plan for some time. So, it is seamless. They have plans for the IND transfer for the clinical trial, for the regulatory strategy. And I wish I could say more, but it’s up to them to share that with you.

Leila Weinstein

Analyst

Okay, thank you very much.

Operator

Operator

Our next question in queue will come from the line of Whitney Ijem with Guggenheim Securities. Please go ahead, your questions please.

Evan Wang

Analyst

This is actually Evan Wang on for Whitney. First, I had a question on genome editing. How can we expect updates for that program or as progress progresses? Do you plan to share updates into the preclinical data?

Adrian Woolfson

Management

Well, yes, we’ll share the information as we have more specific details about these plans. So just please stay tuned. As we said, we expect to initiate this next study towards the end of next year.

Sandy Macrae

Management

And to be explicit, we have the – we’ve already manufactured ZFN 2.0, but if we’re to add in some of the additional advantages that we gained from what we have learned from hem A AAV6, it would take another manufacturing campaign, and it’s really that, that drives the time line. But just to step back a little from it, we are very grateful for the help we’ve had from the lysosomal storage disease community. We feel an obligation to these patients to make sure that they have the best possible asset. And while I could rush ahead and go in with ZFN 2.0, which we all have great belief in, if I can add an extra chance for them for this to be successful, I think that's the right thing to do. And I am sure all of you on the phone would agree.

Evan Wang

Analyst

Understood. And then I had a question on Huntington's. It seems like you guys said that – you and Takeda are still kind of working on further designs. I thought at ASGCT that they chose a target, has that changed?

Sandy Macrae

Management

That's another one that is – I'm sorry, if we left any confusion in this. That's Takeda's to drive forward and they're – as we understand, they're in IND-enabling studies, which would suggest that they have – they know what they're taking forward. Again, they will be able to talk to you more about that.

Adrian Woolfson

Management

There's obviously a huge excitement about that data and I don't know if you saw the paper that Bryan authored at Sangamo. It's a truly remarkable paper. I mean it was almost binary switching off of the expression of the mutant Huntingtin gene with complete preservation of the wild type allele. And as you know, at the molecular level they're very similar, it's just the different numbers of the repeats, and yet, we were able to design zinc fingers just to discriminate between those different numbers of repeats. And I think that really speaks to the extraordinary diversity and optionality of the platform. And I can't imagine any other platform being able to deliver such a complex solution – solution for such a complex problem so efficiently. And it obviously opens up a load of other possibilities for us with other repeat diseases and as a generalized proof-of-concept for the remarkable behavior that these reagents that Ed and his team has managed to bring to bear on these problems of these really intractable CNS diseases. So we're really, really excited by this, as are Takeda, as you'd imagine.

Evan Wang

Analyst

Got it. And then we have one last question on the partnership with Kite. Have you had any regular interactions or have you met with Christi after she's become CEO? Any kind of changes in partnership or nature of the partnership there?

Sandy Macrae

Management

So we talk regularly with the team at Kite. And we talk with them through the various changes in their leadership. And my understanding is she just started this week. So I'm expecting to meet with her soon and work out how we can work as closely together. And she comes with a very good reputation. So we look forward to meeting her.

Evan Wang

Analyst

Thank you.

Operator

Operator

Thank you. Our next question comes from the line of Eric Joseph with JPMorgan. Please go ahead. Your line is open.

Eric Joseph

Analyst · JPMorgan. Please go ahead. Your line is open.

Hi guys. Thanks for taking the question. Just a couple on Fabry with ST-920, and then we took a peek at the clinical trial posted on clinicaltrials.gov. I'm just curious to get a sense of the type of patient history or you're seeking to recruit in the dose escalation portion in terms of phenotypes severity or mutational background? And also whether you can at this point talk a little bit about how background ERT is going to factor into I guess, patient monitoring post infusion. I guess, really specifically, how you're going to be delineating alpha-Gal A expression by the transgene versus any background ERT use.

Sandy Macrae

Management

Eric, it was a little difficult to hear you. But Adrian, did you manage to make out enough?

Adrian Woolfson

Management

I think so yes. So we're basically taking patients into the study who've either been previously exposed to cyprosine or replagal. We're excluding patients who've been on chaperones. And they have to have a formal diagnosis of Fabry disease. And one of three other key parameters, which we haven't disclosed, but which are in the protocol, but I mean, I can tell you, angiokeratoma is one of them, and hidrosis, GI symptoms acroparesthesia; they have to have at least one of those four symptom – sign, sorry, physical signs. And classic Fabry, as defined by the plasma alpha-Gal A levels and one or more of those characteristics. So that's the kind of key inclusion/exclusion. We'll be looking, obviously, at safety is the key endpoint, and then we're going to be looking at plasma alpha-Gal activity as one of the key secondaries, Gb3 substrate levels in plasma, lyso-Gb3 and plasma in urine. Obviously, you asked about ERT, so yes, obviously, we're going to be looking at ERT frequency of use. And after four weeks of treatment, we're going to be looking at – and, of course, the goal of all this is the ERT withdrawal. So if we see alpha-Gal A levels going up and Gb3 substrates and lyso-Gb3 substrate going down, that will make the patient eligible for ERT withdrawal at four weeks. And we're also obviously going to be looking at estimated GFR as referenced by their creatinine levels in the blood. So I hope that answers your question. I didn't quite hear everything you said. But I'm hoping that will answer most of your questions.

Eric Joseph

Analyst · JPMorgan. Please go ahead. Your line is open.

That's great. That's very helpful actually, yes. I'm also curious, Sandy, I guess, with all the progress that you made with the encouraging data that you've presented with 525. And really the kind of the read-through validation for the vector, I'm curious to get a sense of sort of the strategic interest with ST-920.

Sandy Macrae

Management

Eric, it's very, very difficult to...

McDavid Stilwell

Management

He asked about the level of strategic interest for ST-920.

Sandy Macrae

Management

So you mean as in partnerships?

Eric Joseph

Analyst · JPMorgan. Please go ahead. Your line is open.

As in, yes exactly, having partnerships, whether it's – whether at this point, just internally, how are you thinking about advancing the program, go it alone versus seeking partnerships and at what point if partnerships were on the table, at what point you might look to do that? Thank you.

Sandy Macrae

Management

So that's an important and complex strategic decision. We are – we want to build a fully integrated company. We want to take products through to patients and eventually through to the market. ST-920 is our lead asset now that is wholly owned. Just as an aside, the hemophilia A asset although it's partnered with Pfizer will bring a significant return to Sangamo, more than many people's wholly-owned ultra rare disease. That's the advantage of partnering on a common disease like hemophilia A. Of course, there's many people interested in a Fabry program, but we are at this moment are committed to driving it over to finding the clinical effect of this and hopefully bringing it to patients and to – as an aside as well on our partnering. We are very pleased with the partnerships we have with Pfizer, Sanofi, Gilead and now with Takeda. In the coming year, we will hand off the product to Pfizer then hopefully, the product to Sanofi. And we are always open to new partners for people that share our love for the science and the drive to make these into medicines for patients.

Eric Joseph

Analyst · JPMorgan. Please go ahead. Your line is open.

That’s all. Thank you for taking my questions.

Operator

Operator

Thank you, sir. [Operator Instructions] Our next question comes from the line of James Birchenough with Wells Fargo Securities. Please go ahead. Your line is now open.

Yanan Zhu

Analyst · Wells Fargo Securities. Please go ahead. Your line is now open.

Hi, thanks for taking the questions. This is Yanan Zhu dialing in for Jim. So firstly just wanted to ask about the next-generation in vivo gene editing program. You mentioned, I think that you are in manufactured ZFN 2.2. So the question is, have you finalized all the improvements that you're going to put into the next-generation program into ZFN 2.2. And if that's finalized, then also I was – I'm interested in how long an IND-enabling study might take.

Sandy Macrae

Management

So thank you for your question. And I realize I sometimes let people get confused about second-generation of the ZFN assets and the new generation zinc fingers themselves. Let me see if I can tease that out for you. The work that Ed describes in the paper, that he spoke about is a new generation of zinc fingers where the zinc fingers themselves, we have enhanced their binding capability and also reduced their off target. And that – all that technology is described in a couple of papers that have been published in the past six months. The second-generation of the ZFNs are appropriate for the albumin locus IVPRP. Using the new technology, but more importantly, they alter the five prime and the three prime of the cassette that deals with the transcription and the transduction of that set of zinc fingers. And our original plan had been to go into patients simply with that as the change from the previous IVPRP studies, and we had manufactured them, and they were ready to go. As we learned more from the hemophilia A study, we realized that the problem was most likely to be in delivery, not in editing. When we use our technology to edit in mouse, monkey or human cells, the editing is very reliable. So our belief is that the results we saw earlier this year, where there was some editing, but insufficient to provide enzyme from the patient was as a result of not having enough of the AAV transducing the cell. And the data points are both the hemophilia A study where it certainly becomes very effective between 1 and 3e13 and also the effect we saw in one patient, in patient six in the study itself. So we're looking at ways that we can increase the amount of zinc of AAV that we give either by simply increasing the dose or by increasing the effectiveness of AAV, and we haven't spoken about how we've done that, but we will in due course. Or about changing the ratio of the various AAVs that are part of this cocktail. And what we want you to think about is, although each one only improves the effectiveness by a few fold when you multiply together these four different improvements, it becomes much more significant, and we feel gives us confidence and gives us – gives the patient’s confidence more importantly, that this truly will make a difference. So we can agree if we use the new – sorry, just to be absolutely explicit. Using the new improved AAV-6 that we will talk about at a later date will involve some manufacturing and, therefore, drives the time line for this project.

Yanan Zhu

Analyst · Wells Fargo Securities. Please go ahead. Your line is now open.

Yes. So to meet the goal for going into clinic by the year – by year-end 2020, is there a time that you need to nominate the candidate for that next-generation program?

Sandy Macrae

Management

I would reassure you that Adrian and his team are looking at that time line all the time, and we would have – we feel we can meet that. There's always things that can go wrong in science. For us to say that we think we can get there suggests that we are – we believe that is doable with the manufacturing schedule that we use.

Yanan Zhu

Analyst · Wells Fargo Securities. Please go ahead. Your line is now open.

Got it. And then just want to ask a couple of questions on the CAR and Treg program. Looking at the diagram on Slide 32, it makes me think this might be an autologous candidate because the TCR was shown as a impact on the cell. You didn't knock it out. So can you confirm this is an autologous T cell product. And also…

Adrian Woolfson

Management

Yes.

Yanan Zhu

Analyst · Wells Fargo Securities. Please go ahead. Your line is now open.

Got it. Yes. Thanks for confirming that. And also in terms of the Treg lineage, how do you achieve making a cell truly Treg? Is it transgenic expression of Fox G3. And also is there a risk of doing damage to the transplant, in case some of the cells are not truly Treg, but rather effector – T effector cells?

Adrian Woolfson

Management

Thanks for the question. I'm going to be quite circumspect in how I answer because we've not disclosed a lot of the things you're asking. But I'll just simply say that, yes, you're very astute in noticing that this is certainly an autologous therapy. These are natural CAR-Tregs, which we transduce. I'm not sure that we've disclosed how we transduce them. Yes, I don't think we've disclosed that, so I won't say that, but I'll – how we do it, but they're natural Tregs which we purify from the patients and transduce. And we're basically looking at renal transplant on HLA-A2 mismatch. And that's probably as much as I'll say at this point. But you're absolutely right this is an autologous play at the moment.

Sandy Macrae

Management

And your question is fair, and one that we've thought of carefully and taking advice on because a renal transplant is a precious thing. And we don't want to do anything that puts the patient's safety or the longevity of the transplant at risk. So we're working very closely with some really smart renal centers to make sure that we do this carefully and well.

Adrian Woolfson

Management

Yes. And we're really – and I'm pleased you brought this program up, because we don't talk about it too much, because I don't think folks are really still that aware of what we're doing. But we're really excited by this. But we see this as potentially being a really groundbreaking platform. We're the first people to be putting Tregs into humans. So we're at the head of the pack and we're leveraging all of the experience that we've gained over the years in both our HIV editing but also through other projects that we're doing, obviously. And we're really confident that we can do something medically important. And this is a really good place to test the hypothesis of the CAR-Tregs as therapeutic agents and look at the safety, but also the localization of those cells into the grafts. And to look at the number of different biomarkers, and potentially to see if we can reduce the immune suppression that the patients get with steroids and MMS and tacrolimus. So this is going to be a very exciting study, and it's a kind of a case of watch the space, as it's going to be unfolding as a narrative next year.

Yanan Zhu

Analyst · Wells Fargo Securities. Please go ahead. Your line is now open.

Yes. Thanks for all the color, yes, CAR-Treg is certainly a very exciting area and congratulations on all the progress. Thanks for taking the questions.

Adrian Woolfson

Management

Thank you. And then you'll remember that Science actually published a review on CAR-Tregs actually stating it as the next frontier for engineered cellular therapy. And we see ourselves as really pioneering this field.

Operator

Operator

Thank you, sir. And with that, this concludes our time for questions. I'd now like to turn the program back over to Sandy Macrae for any additional or closing remarks.

A - Sandy Macrae

Analyst

Thank you again to everyone for joining the call and for your questions today. We are pleased with the progress we've made in our clinical and preclinical programs and look forward to keeping you updated on future developments. Have a great...

Operator

Operator

Thank you presenters, and thank you to all of our attendees for joining us today. This concludes today's call. You may now disconnect, and have a wonderful day.