Kevin Boyle Senior
Analyst · Cantor Fitzgerald. Your line is now open
Thank you, Alex. And as we finish this Veterans Day weekend, I just want to thank you to all those folks that have served our country. Good morning to everybody today. We appreciate you joining us for an update on the remarkable progress we have made over the past year. As you can see on slide four, our team has worked diligently to transform our promising technology, and research and development efforts into meaningful clinical progress. We are very pleased to report that we achieved the first in-human confirmed partial response in our clinical trial for a patient treated with Sleeping Beauty TCR-T cells. It is even more impressive that this response happened at the first dose level. We have been gaining momentum in our TCR-T Library Phase 1/2 trial as we are working closely with our investigators to identify patients at MD Anderson, who have a match to one of our TCRs in our library. I am pleased to say that we anticipate treating our next patients before the end of this year. In our manufacturing suite, we have updated our standard operating procedures and hired additional personnel so we can manufacture multiple products at the same time, increasing potential throughput in our state-of-the-art cGMP suite. We have consistently produced high quality TCR-T cells at clinical scale and have successfully manufactured our product at the second dose level. We continue to advance our hunTR program, identifying new TCRs to add to our library, thereby increasing the addressable market for our TCR-T cell therapy. We remain committed to being strategic and prudent with our cash spend. I believe we have demonstrated our good stewardship of shareholder capital as our highly engaged team of employees continues to advance our programs, while spending less than half compared to last year. On slide five, we remind you of our pipeline. The company’s success is not based on a single product. Alaunos is a promising solid tumor platform. We are differentiated from other TCR-T companies and that we target hotspot mutations with T cells that have been transposed with TCRs using our proprietary non-viral Sleeping Beauty technology. Our lead program is the TCR-T Library Phase 1/2 trial. It is a basket trial, targeting hotspot mutations across six solid tumor indications, lung, colorectal, endometrium, pancreas, ovary and bile duct cancers. We are actively enrolling patients at MD Anderson Cancer Center with one of these six cancers based on matching mutation and HLA pairings that are available in our TCR Library, which currently consists of 10 TCRs, four KRAS, five TP53 and one EGFR. Three of these 10 TCRs have been associated with confirmed partial responses in a clinical setting, giving us great confidence in the power of TCRs to treat solid tumors. We will speak in a moment about the confirmed partial response we saw in our trial at the first dose level in a patient treated with a KRAS TCR, as well as provide an update on this patient at the six-month mark. A second TCR we have in our library was the subject of a case study in the New England Journal of Medicine, involving a pancreatic cancer patient with our partial response to one of our KRAS TCRs. The third TCR yielding a clinical response was reported by the NCI and was a breast cancer patient treated with the same TP53 TCR as our second patient. We will now provide an update on our clinical program. Recently, we had the honor of being invited to showcase early data from our Phase 1/2 trial in a proffered talk at the CRI-ENCI-AACR Sixth International Cancer Immunotherapy Conference or CICON 22 for short. As we turn to slide seven, we will share our great enthusiasm and excitement over the early clinical data from this trial. The findings presented at CICON 2022, to our knowledge, represent the very first time that an objective clinical response was observed using a non-viral TCR-T cell therapy in a solid tumor. The team is very excited to be among the leaders in the field and the team is working hard to achieve even greater accomplishments. We are pleased to disclose data from our first two patients who were treated at dose Levels 1 and 2, respectively. Moving from dose Level 1 to dose Level 2 in the first two patients, highlights the strength of our adaptive clinical trial design and robustness of our manufacturing platform. We observed a manageable safety profile in both patients with no dose-limiting toxicities. We are also able to detect TCR-T cell persistence out to six months. Most excitingly, our product is efficacious, achieving a confirmed partial response in the first patient at the lowest dose level. This early clinical validation has reinforced our belief that we are taking the right approach targeting tumor-specific hotspot mutations using our commercially scalable, non-viral Sleeping Beauty technology. We have produced evidence that our technology is safe, the cells persist and our product is efficacious. Now I used to live in Horse Country in Louisville, Kentucky and we would call this a winning trifecta. We are very excited about the promising results and the buzz created by this early data, generating increased interest from patients and clinicians alike. We are actively working with our investigators at MD Anderson to screen and enroll additional patients into the trial and we anticipate the next patient being treated in the fourth quarter. I’d like to provide an in-depth review of the results that we presented at CICON, in addition to highlighting six-month follow-up data from patient number one. On slide nine, you can see that the first patient dose was diagnosed with non-small cell lung cancer, had previously progressed on multiple prior lines of treatment and was refractory to checkpoint inhibitors. The patient had HLA-A11 and a KRAS G12D mutation, matching one of the 10 TCRs within our library. This patient received standard Cy/Flu lymphodepletion prior to an infusion at the first dose level of 9 billion TCR-T cells, which were produced by our employees using Sleeping Beauty at our in-house cGMP manufacturing facility. The potential power of our TCR-T cells is supported by these scans, with the patient experiencing complete resolution of the non-small cell lung cancer target lesion in their right lower low shown in red circles through week 24. There was also significant and durable reduction of non-measurable disease in the right lung, as noted in the orange circles. Moving to slide 10, you can see that the patient also experienced a sustained reduction in the right upper lobe lesion reflected in the red circles through week 24. What a visual these images provide of the potential benefit of our TCR-T cell therapy to the patient as demonstrated by significant clearance of this target tumor. On slide 11, we have the third set of images for patient one. The right hilar lymph node, target lesion in the red circle was reduced relative to baseline at all time points, including six months post-infusion. The patient also had large non-measurable disease in the right long at baseline shown in the orange circle. This area of disease was also reduced out to week 24 relative to the baseline. However, there was some perceived growth of this non-measurable disease at week 24 relative to the 12-week scan. That prompted the investigator to biopsy this area. The pathology report confirmed that tumor cells were present in this non-measurable disease and the patient is now off study as a result. The overall progression-free survival for this patient one was six months, which is encouraging result for the first patient at the lowest dose level. Overall, as you can see on slide 12, the results in this first patient are extremely promising. We believe that the results give us an early look into the potential of our TCR-T cell therapies to effectively kill large established solid tumors even at the lowest dose levels. The patient achieved an objective partial response with a regression of 46.3% in target lesions at six weeks, which subsequently deepened to 51.2% at week 12 and the reduction in measured lesions was sustained at 46.3% at 24 weeks. Persistence of TCR-T cells was observed in the blood of approximately 30% of all T cells at 24 weeks. We also observed infiltration of both helper and killer TCR-T cells in the progressing tumor, suggesting that our TCR-T cells can home to the tumor microenvironment. The KRAS G12D mutation and HLA-A11 were detected in the progressing tumor, indicating that the target remained intact and was not lost. Collectively, these results support our belief that the patient received significant clinical benefit from the administration of our TCR-T cell therapy. A six-month progression-free survival, which is what patient one achieved, is competitive with the only approved KRAS targeted therapy, a KRAS G12C specific small molecule that has a six and a half month progression-free survival. And there are no approved targeted therapies for KRAS G12D or KRAS G12V, both of which are in our library and both with the potential to benefit a large patient population. Next, we will take a look at the second patient treated under our study, a colorectal cancer patient. On slide 14, we summarize patient two. This patient was diagnosed with colorectal cancer and had previously progressed on standard-of-care treatment. The patient had H11-A02 and a TP53-R175H mutation and received standard Cy/Flu lymphodepletion prior to an infusion at the second dose level of 64 billion TCR-T cells. The patient achieved a best overall response of stable disease at six weeks, but was determined to have progressed -- progressive disease at the 12-week scan and went off study. TCR-T cell persistence was observed in the blood of approximately 20% of all T cells at 12 weeks, which continues to demonstrate the potential of our TCR-T cells to continue to work long after being administered. Following an independent radiology report, it was determined that disease progression was due to new lesions in the liver and the lung. We were able to detect the TP53 mutation in the progressing lesion, suggesting that the target was retained. Of note, this particular TCR has previously been used by the NCI in a patient with metastatic breast cancer, achieving a partial response with cell persistence out to six months. So we remain confident in targeting TP53 mutations and look forward to enrolling more patients with this TCR and other TCRs in our library. Now before turning over to Abhi for a manufacturing update and details on the product characteristics of the TCR-T cells for the first two patients, I will summarize why we are so encouraged by the early clinical data. Here on slide 16, you can see some of the key takeaways from this initial clinical data. In both patients, the TCR-T cell therapy was well tolerated and presented a manageable safety profile with no dose-limiting toxicities. TCR-T cell persistence was observed at relatively high levels in both patients until their last follow-up. The ability of our TCR-T cells to be a living drug and survive in great concentration is quite encouraging in -- for the prospects of a durable response And most importantly, evidence of efficacy was observed in both patients with tumor infiltration, suggesting that our Sleeping Beauty manufactured T cells can survive in the hostile tumor microenvironment. Additionally, these data also provide proof of concept that we can successfully manufacture TCR-T cells for both KRAS and TP53 mutations as sufficient doses at our in-house cGMP manufacturing facility. Overall, we are really excited about these early findings, which highlight the potential of Sleeping Beauty TCR-T cell therapy to achieve measurable regression in solid tumors, even at the lowest dose levels. Based on the early responses seen in the clinic, there is excitement building among clinicians and patients are being referred to MD Anderson specifically for consideration of enrollment in this trial. We are working closely with our investigators to continue to screen and enroll patients at the second dose level. We anticipate dosing our next patient into the study in the fourth quarter. We look forward to presenting an update on the trial in 2023. Now as I turn the call over to Abhi to review the robust and repeatable manufacturing process, I want to say what a great addition Abhi has been to Alaunos. His NCI training and familiarity with the TCR-T cell program has enabled him to be an immediate contributor. Abhi?