Michael Weiss
Analyst · Brean Capital. Please state your question
Thanks, Sean, and thanks, Jenna. I want to thank all of you for joining us this afternoon. 2015 was a busy and exciting year for us. As we solidified the foundation of the Company by announcing our second Phase 3 clinical trial to UNITY-CLL trial for the proprietary combination of TG-1101, plus TGR-1202, or as we refer to the combination TG-1303. This trial marks a major set forward for our Company, and if successful, should provide 1303 with a broad label for the treatment of CLL. 1303 become only a few -- only one of a few novel non-chemotherapy doublet combination therapies approved for CLL and positions us as a leader in the future development of wholly owned novel triple and quad combination therapies, which has been our vision from the beginning of TG and brings us closer to the goal of developing in short for CLL. 2015 also provide us the opportunity to expand our clinical development programs to include new triple combination therapies, broaden our disease focus into Non-Hodgkin's lymphoma and autoimmune diseases, expand our product portfolio and strengthen our balance sheet for the prudent and well executed use of our ATM facility. Primarily some of the notable achievements in 2015. In the first quarter, we expanded our product portfolio through a global collaboration with Checkpoint Therapeutics to develop and commercialize anti-PD-L1 and anti-GITR antibody research programs from Dana Farber Cancer Institute and hematological malignancies. Also in the first quarter, we commenced enrollment into the GENUINE Phase 3 clinical trial, which is now opened at over a 150 sites throughout the U.S. In the second quarter, we presented the first data from the triple combination study of TG-1101, plus TGR-1202, plus ibrutinib. So not only the combination was well tolerated, but produced 100% overall response in patients with high risk, CLL and SLL and a 75% overall response in Indolent Non-Hodge lymphoma. In the third quarter, we obtained an SPA UNITY-CLL Phase 3 clinical trial and in the fourth quarter we announced key data updates at ASH, which I will review shortly. We also launched a new Phase 1/2 triple therapy study of TG-1101 plus TGR-1202 plus the PD-1 checkpoint inhibitor pembrolizumab, which is the first clinical trial to evaluate the safety and efficacy of the triple combination of a PI3K delta inhibitor with an anti-CD20 monoclonal antibody and an anti-PD-1 checkpoint inhibitor. With that, I’d like to provide some brief highlights from the data presented during the ASH conference this past December. We presented four clinical posters and one preclinical oral presentation. Some of the highlights included a 94% overall response rate for TGR-1202 in CLL, including both PRs and PRs with lymphocytosis was reported. In those -- in that study, 94% represents again both PRs and PRs with lymphocytosis, which as many of you’re aware now most of our competitors report their data in that way. We typically only report that data as true partial responses. In this study, we reported at the conference, if 59% overall response rate for the iwCLL 2008 criteria. Additionally, we observed a 24-month median progression for survival with single agent 1202 and patients were relapse/refractory CLL. Next we presented updated data on our TG-1303 combination which showed an 80% overall response rate in patients with CLL and SLL, all responses again by iwCLL and the case of lymphomas Cheson criteria, including one CR and seven PRs. In addition, the 35% overall response rate was observed in patients with Diffuse Large B-Cell and Richter's transformation, including three patients who achieved a complete response. TG-1303 showed a median progression free survival that had not been reached for both the CLL and Indolent non-Hodgkin lymphoma patients with follow-up now beyond 20 months. We also presented final data from the Phase 3 trial of TG-1101 in combination with ibrutinib, in patients with Mantle Cell Lymphoma which showed an 87% overall response rate, including 33% complete response rate, which compares favorably to historical [indiscernible] ibrutinib data, which has shown a 66% overall response rate and a 17% complete response rate. And then our final clinical update. We presented data from the Phase 1 trial of TGR-1202 in combination with obinutuzumab commercially known as Gazyva plus chlorambucil which showed a 100% overall response rate in treatment of naïve CLL patients with a 33% complete response rate and 47% of the patients achieving minimum residual disease negativity. For these front line patients, a PR test has not been reached with the longest patient on study almost two years. We believe this study set the stage for what we might expect to see in front line patients taking 1303 in our UNITY Phase 3 trial. And lastly, we finished up ASH -- the ASH conference with an oral presentation delivered by Dr. Deng from Columbia University, which reviewed some very exciting preclinical research, identifying novel mechanism of TGR-1202 which was distinct from other PI3K delta inhibitors and might indicate a senior targeting mechanism of TGR-1202. We’re highly encouraged by the data we’ve seen thus far from our trials and are particularly enthusiastic about the efficacy and safety given TGR-1202 as a single agent and the TGR-1303 combination. As of December 2015 ASH update, in studies of TGR-1202 as a single agent or in combination with TGR-1101 or TGR-1202 in combination with Gazyva plus chlorambucil, we had more than 80 patients exposed to TGR-1202 for over six months and another 42 patients on drug for more than one-year with no cases of colitis being reported. As I’ve stated in the past, I think the take home message here is not that we will never see colitis, but that specifically speaking the conference intervals around 0% colitis reported at that time with that many patients treated, it is the high-level of comfort that the rate of colitis will be significantly less than reported with other PI3K deltas. Additionally, grade 3/4 liver tox remains minimal with less than 4% being observed with TGR-1202 and a single agent and in combination with TG-1101. With that, let me quickly review our current Phase 3 clinical trial. I will begin with the GENUINE Phase 3 trial, which is evaluating TG-1101 in combination with ibrutinib in patients with high-risk CLL which now has over 150 sites participating in the study. I’d like to first thank my team for their extraordinary effort in launching the study. This is a large U.S only study and they’ve worked tirelessly identifying and enlisting both academic and major community centers around the country. Starting trials is hard enough, but starting the Company’s first major Phase 3 program is always -- it’s a little more challenging. But the team rose to the occasion and in 2015 we built a fantastic network of clinical collaborators which we believe will pay significant dividends not only just for the GENUINE study, but as we expand into our UNITY program across CLL and NHL. And beyond that to our triple and quad registration trials that we hope to follow. With 2015 spend building our trial site network, 2016 is a year of enrollment for us. We’ve been pleased by the early adapters into the GENUINE study, including several major academic centers as well as the few large community networks. In the broader community, we found that testing for high risk CLL was not routinely done and since few front line patients have high risk features, many patients at the time of relapsed were not being receptive. We are in the process of launching a separate screening protocol that will enable sites to more easily screen all relapsing patients. As expected, we’re finding that about half of the patients that are screened, few have high risk features, which is consistent with our projections. Again, we believe the screening protocol that we’re launching now will certainly streamline the process and accelerate enrollment. With so many great sites on board, we believe we’re nearing that key inflection point where these types of studies accelerate dramatically. When that occurs, we will be able to provide more clear guidance as to when the study will be completed, but until then we’re continuing to target the end of year to complete enrollment with data in early ’17. Moving on to the UNITY CLL study, our Phase 3 clinical trial of TG-1101 plus TGR-1202, again as we [indiscernible] referred to as 1303, combination in front line and importantly in previously treated patients with CLL, which is also being run pursuant through a special protocol assessment. We are excited to announce that we’ve now enrolled our first patient in the study. From a site engagement perspective, its still early days. We’ve currently -- have eight sites opened in the U.S with a goal of having over 50 up and running by the end of May and over a 150 sites internationally by year-end. Early on we’re targeting sites for the study that are also participating in the GENUINE study and are also opening the newly discussed screening protocol. These types provide us incredible operating efficiencies. They’re easier to engage, because of our existing trial agreements. They’re easy to monitor, because we’re already visiting those sites for the GENUINE study. And most importantly and excitingly, is that the power of the screening protocol to ensure that every relapsing patient that they screen is captured into one of our two protocols. Though the 50% of the patients that screen is high-risk will of course continue to go into GENUINE and those that don’t won't be loss as they are today but then go into UNITY. We believe this approach will enhance enrollment into both studies. Finally before wrapping up today’s call, I want to mention how excited we’re about moving forward with our autoimmune disease program, and we expect to launch our first trial in multiple sclerosis in the next 30 to 60 days. Our first study will be a Phase 2 dose finding study. For this study, we planned out 8 to 10 sites and enroll up to 24 patients in several cohorts with flexibility for additional cohorts to optimize dosing a schedule. Given the reasonably straightforward path established in this area, but others develop -- developing B-cell target therapies for MS, we believe we can move rapidly, through this program and into Phase 3 sometime next year. For us understanding the B-cell depletion effect of TG-1101 at different doses and schedules is our goal prior to moving forward into Phase 3. We believe, B-cell depletion is highly correlated with GAG [ph] lesion reduction, which in turn is highly correlated with the Phase 3 endpoint of annual relapse rate. We will have B-cell depletion data before the end of 2016. Our plans to open-up a dialogue with the FDA relatively early in the process to better understand their Phase 3 expectation. With that, let me now turn the call over to the conference operator, to begin the Q&A session, following which I’ll return to make some concluding remarks.