Michael Weiss
Analyst · Ladenburg Thalmann. Please proceed with your question
Thanks, Sean and thanks Jenna, and thanks everyone for joining us this morning. While 2016 continues to be a very challenging year for our stock price, which many of you I am sure are keenly aware. Fundamentally we believe the company is stronger than ever with a lot of great progress made in the first half of 2016. Some of those highlights included the issuance of Composition and Matter Patents in the US for both TG-1101 and TGR-1202, providing protection through 2029 for TG-1101 and 2033 for TGR-1202. In both cases, plus up to an additional five years under the rules of patent term extension. At the American Association for Cancer Research (AACR) Annual Meeting scientists from the Moffitt Cancer Center presented preclinical data describing the differential regulation of human T-cells by TGR-1202 as compared to other PI3K-delta inhibitors and close to presentation that may partially explain why we are not seeing the same autoimmune like effect with TGR-1202 as seen with other PI3K-deltas. We also announced the commencement of the company’s first clinical trial of TG-1101 in multiple sclerosis, opening an entirely new area of potential value for the company. We also entered into a global collaboration to develop and commercialize novel BET inhibitors for the treatment of hematological malignancies. We also enrolled our first patient in our registration-directed UNITY Diffuse Large B Cell Phase 2b clinical study, and finally we presented an integrated safety and efficacy analysis of 165 patients treated with TGR-1202 both alone and in combination with TG-1101 at the American Society of Clinical Oncology (OTC:ASCO) Annual Meeting as well as at the European Hematology Association (EHA) Annual Congress. Some highlights from this presentation included that TGR-1202 alone and in combination with TG-1101 continued to demonstrate a favorable safety profile. Discontinuations due to TGR-1202 adverse events were limited at 8%, and to put that into perspective data presented also at ASCO this year on the combination of [Indiscernible] in previously treated CLL, stood at 39% discontinuation rate due to adverse events. Additionally grade 3, 4 adverse events most commonly associated with PI3K-delta inhibitors were relatively rare with pneumonia at about 5%, pneumonitis at less than 1.5%, ALT, AST elevations at approximately 3%, and colitis below 1.5%. This equates to two cases of colitis, both of which occurred at doses exceeding the Phase 3 dose and did not appear to be time dependent, one instance occurring at four months and the other at 24 months after the initiation of therapy. Overall of the 155 patients treated with TGR-1202 between the two studies, 80 patients were on drug for greater than six months, 43 patients were on for more than 12 months, and the longest patients have been on daily TGR-1202 for greater than three years. The presentation also showed encouraging efficacy, particularly at the Phase 3 dose of 800 mg, including an 88% overall response rate in the 16 patients with CLL, including two CR, plus an PR in an ibrutinib refractory patient; 57% overall response in seven patients with Diffuse Large B Cell, and a 53% overall response in 17 patients with follicular and marginal zone lymphoma. Additionally from a safety standpoint, specifically for the 800 mg Phase 3 dose, grade 3, 4 adverse events, most commonly associated with PI3K-delta inhibitors, was similar to the entire safety population, and continued to be relatively rare with pneumonia at about 2.5%, penumonitis at 0%, ALT, AST elevations at approximately 5%, and colitis at 0%. These data were not presented at ASCO or EHA, but were developed in response to some questions we received at and after the conferences. We are highly encouraged by the data presented, which further confirms our belief that TGR-1202 has a unique and differentiated safety, tolerability and activity profile as compared to other deltas. With the recent high-profile setbacks that [Indiscernible] we believe more than ever there is the need for a PI3K-delta with a wider therapeutic index. We recognize that some investors and possibly some clinicians are not yet convinced. They are firm to paint all deltas with the same negative brush. We will continue to update our safety profile on a regular basis with the goal of elevating those concerns. In the meantime, let me provide some positive news from our Phase 3 clinical trials. I'm happy to report that we currently have over 60 US sites open to enrollment in our UNITY-CLL study. Our plan is to open approximately 100 sites in the US and approximately 50 sites in Europe and Israel by the end of this year. I'm also extremely pleased to report that enrollment into UNITY-CLL study is tracking well and meeting our expectation. As anticipated, enrollment seems to be easier than in GENUINE and with enrollment already strong and many high enrolling sites soon to be initiated, we are feeling extremely optimistic that we can meet or exceed our enrollment goals for the UNITY-CLL study. With that let me turn to our GENUINE Phase 3 trial, which is evaluating TG-1101 in combination with ibrutinib in patients with high risk CLL. We launched this study with the hope and intention that this would be a fast and straightforward approach to getting TG-1101 approved. Recall at the time we designed this study, we were very uncertain of what the FDA would require to get two novel drugs approved simultaneously. As a result, we only started discussing with the FDA the concept of a UNITY-CLL study after we completed our SPA discussions for GENUINE. We still believe that GENUINE’s goal of improving on ibrutinib therapy represents an important treatment goal. There is no question that ibrutinib is a very good drug, but few if any patients are cured with single agent ibrutinib. Our Phase 2 study demonstrated increases in overall response as well as a deepening of responses with 25% of the patients on the combination of ibrutinib plus TG-1101, obtaining either a complete response and/or MRD negativity. Any time you leave residual disease you enhance the chance of the cancer mutating and advancing. Based on early [PFS] curves with single agent ibrutinib, we believe the patients that might benefit the most from this multi-modality approach were those with high-risk disease. We continue to believe that it is a worthwhile approach. But as we have highlighted in our recent calls, recruiting these high-risk CLL patients has posed a greater challenge than expected. One issue we identified was that many of our sites were not screening for high risk features on relapse. To address this issue we implemented a very simple screening protocol, which we have previously described. We believe this screening protocol has solved this problem and we have seen an up tick in screening. However, we are still finding that the patient population is more challenging to enroll than we originally thought. Our plan is to continue to work on ways to accelerate the trial for use as an early registration pathway for TG-1101 as it was originally intended. The positive enrollment trends we are seeing in the UNITY-CLL study are extremely encouraging, and may provide a more rapid path forward for approval of TG-1101 and TGR-1202 than we originally anticipated. This in turn is having the unexpected effect of lessening in a very positive way some of our original rationale for running the GENUINE study in the first place, i.e., to get that rapid early approval. With that I would like to switch gears and discuss a very exciting new area for us. In May, we announced the launch of our MS program. We are excited about broadening our pipeline into autoimmune disease and think there a significant market potential for our compounds in MS, which has a prevalence of approximately 400,000 cases in the US and approximately 2.5 million cases worldwide. As noted on our last call, B-cell depletion therapy has proven to be highly efficacious in the treatment of both relapsing and progressive forms of MS, and we feel confident from our experience on the cancer side that TG-1101 is a potent B-cell depleting compound with a favorable safety profile and we believe TG-1101 to remain an exciting differentiated treatment option for patients with MS. While we have a substantial data set for TG-1101 in oncology patients, we have recently launched Phase 2 dose finding study. This is designed to determine the optimal dosing regimen for TG-1101 in MS patients. Patients will be monitored for safety and tolerability at each dosing cohort and we will be evaluating B-cell depletion as well as establish MS efficacy endpoints. The study will also evaluate accelerated dosing regimens to reduce infusion times similar to the way we have done in our cancer studies. While very early enrollment into this trial is running ahead of schedule and we do anticipate completing enrollment in the pre-specified cohorts, excluding any extension cohorts before year-end. Over the next six months or so we believe we will have enough data from our MS phase 2 study to commence our Phase 3 registration program in the first half of next year. Towards that end, we have already begun a dialogue with the FDA to understand their expectation and believe that that process should conclude in the same approximate time frame. Finally, we have noted in the past that we have received interest in this program from potential partners and we can say that there is continued interest and discussions are ongoing. However, whether or not we enter into the transaction is subject to many variables, importantly we do believe we can add significant value to the program over the next six to nine months as we demonstrate activity directly in patients with MS and demonstrate an ability to infuse TG-1101 safely in a shorter infusion time than competitor products. And finally as we define the regulatory pathway, which could lead to study designs that are highly manageable for us to execute on a go alone basis. With that, let me now turn the call back over to the conference operator to begin the Q&A session, following which I will return to make some concluding remarks as well as reiterate our goals for the remainder of the year.