Michael Weiss
Analyst · Cantor Fitzgerald. Please proceed with your question
Great. Thanks, Sean, and thanks, Jenna. Thanks, everyone, for joining us this morning. 2019 was an exciting year for us, and 2020 is off to a great start with multiple impactful catalysts on the way. But before I review all the great accomplishments of 2019 and what's in store for 2020, I want to start with an update on UNITY-CLL, which, of course, is on top of everyone's minds. So let me remind everyone that the UNITY-CLL clinical trial is a randomized study of U2 versus the combination of the chemotherapy, chlorambucil, plus the CD20, obinutuzumab, which is marketed as GAZYVA. This combination is referred to as GC. The primary endpoint is progression-free survival, and the trial is being conducted under a special protocol assessment with the FDA. This is an event-driven trial, meaning can only end once a certain number of PFS events occur. A PFS event is when a patient dies or their disease progresses. With that as a background, the quick update is that we have not yet hit the requisite number of events. To us, this is a very positive sign and further reinforces our confidence in a successful outcome, because the longer it takes for the events to occur, should point to a greater than expected benefit for the U2 arm. Based on our original projections, we would have expected a significant ramp in events over the past several months, which did not occur. Accordingly, we believe we are either on the verge of a significant uptick in events or that the U2 arm is providing greater benefit over GC than originally modeled. That, of course, assumes that the GC performance is relatively fixed within its historical range. However, since we are fully blinded to all the efficacy data, other factors, including GC performance - outperformance could explain the slower-than-expected event rates. For a number of reasons, we believe that it's less likely, but it certainly can't be ruled out. So where does that leave us in terms of timing from here? The short answer is relatively unaffected as a result of some additional good news we'd like to share with you. To protect against the scenario where U2 is outperforming, and because of that, the results are unnecessarily delayed, we reached an agreement with the FDA to conduct an interim efficacy analysis, which would allow us to stop the study early for greater-than-expected PFS benefit. So despite the slower-than-anticipated event rate, we are still positioned to deliver data reasonably close to the time lines we have been discussing with a target to reach the necessary events over the next 30 to 60 days, and then ideally, no more than 30 days thereafter to the analysis and announcement. As importantly, assuming this time line to data is maintained, our overall submission time line remains intact, which is to complete an NDA/BLA submission by the end of this year. As you can tell, we're excited about the prospects for a successful PFS outcome for the UNITY-CLL trial. We also greatly appreciate the FDA's willingness to work closely with us on including a PFS interim efficacy analysis, and we look forward to bringing the study to a conclusion if the data supports that. With that, let's do a quick recap of some of our major accomplishments over the past 12 months. Our UNITY-NHL trial stole the spotlight in 2019, first, with the positive data from the marginal zone lymphoma, or MZL, cohort and later with the follicular lymphoma cohort. As a reminder, both of these cohorts evaluated umbralisib, our dual inhibitor of PI3K delta and CK1 epsilon used as a monotherapy in relapsed or refractory MZL or follicular patients. For the MZL cohort, we announced we received breakthrough therapy designation and presented preliminary data during oral presentations at AACR, ASCO and ICML demonstrating approximately a 50% overall response rate and approximately a 20% complete response rate with a generally well-tolerated safety profile. We also received orphan drug designation for umbralisib to treat MZL. For the follicular lymphoma cohort, we announced towards the end of the year, that it too met the primary endpoint of 40% to 50% overall response. And importantly, for both cohorts, we initiated a rolling submission of a new drug application for umbralisib. Initiating our first-ever NDA was a major milestone for us. And we're extremely pleased by the FDA's guidance to include both MZL and follicular in a single submission. I want to thank our NDA team and our clinical sites for the incredible effort and dedication they have committed to completing this submission as quickly as possible. In addition to the tremendous progress we had with the UNITY-NHL program in 2019, we also had multiple data releases, presentations and publications, including the publication of the Phase I triple therapy combination of ublituximab, umbralisib, U2, and ibrutinib published in Lancet Hematology; and the Phase I/Phase Ib combination trial evaluating U2, which was published in Blood. We also announced that after almost 4 years of follow-up, our GENUINE study demonstrated that ublituximab in combination with ibrutinib improved PFS over ibrutinib monotherapy in patients with high-risk relapsed/refractory CLL. We plan to share the data with the FDA to determine if there is any regulatory use for such data and plan to present the data at a future medical conference. And at the end of the year at the ASH conference, we presented two sets of triple therapy combination data. The first was the triple combination of U2 plus venetoclax, where we presented early data that showed an 87% overall response rate after just 3 months of U2 therapy. That was prior to the introduction of venetoclax. This is in heavily pretreated patients with relapsed/refractory CLL, some of whom were BTK refractory. And then after we added venetoclax for a treatment period of an additional 9 months, we reported a 100% overall response rate with a 100% undetectable MRD in peripheral blood and a 78% undetectable MRD in bone marrow. While small patient numbers, these preliminary results suggest that this triple therapy combination has significant potential in these heavily pretreated patients. We look forward to more data from this study, including additional patients through a longer follow-up. The second presentation at ASH was the first-ever clinical data from TG-1701, our BTK inhibitor, including the first-ever proprietary triple therapy data from U2 plus TG-1701. This study is particularly important to us as it represents a significant step forward in our mission to develop novel therapies that can be used in combination with each other. This is the first triple combination study conducted where all the pieces are proprietary TG drug candidates, something that we believe will be a vital component to making these combinations accessible to patients, if approved. Finally, on the early clinical side, we initiated Phase I first-in-human clinical trial of TG-1801, our anti-CD47/CD19 bispecific antibody, and also presented first preclinical data for that compound. This mechanism of action seems to be generating some excitement recently, and we are excited to move this compound into combinations with U2 as soon as possible. With that recap of 2019, let me conclude my prepared remarks with a brief recap of our ULTIMATE-MS program and some highlights of what to look for in 2020. As a quick reminder, our ULTIMATE 1 and 2 Phase III trials in relapsing forms of MS are 2 independent, global, randomized, multicentered, double-blinded, double dummy, active-controlled trials comparing ublituximab to oral teriflunomide. The primary endpoint for each study is annualized relapse rate following 96 weeks of treatment and designed to support submission for full approval of ublituximab in relapsing forms of MS. These trials are fully enrolled and being conducted under special protocol assessment with the FDA. We are targeting top line data from these trials in the second half of this year. The CD20 class plays an important role in the treatment of MS, with the only CD20 approved for MS seeing its usage growing quickly and reaching approximately $4 billion in global sales in 2019. We believe CD20 usage will continue to grow as more physicians utilize the class earlier in the treatment paradigm. We also believe ublituximab's profile will be very competitive in this market, providing significant value to patients with MS, by offering a shorter 1-hour infusion at a competitive price. As you can see, 2019 was an exciting and impactful year for us, but we believe 2020 is the year for TG to really shine. Our hard work over the past 8 years has brought us here, and we look forward to an exciting 2020 where we should see pivotal data for UNITY-CLL, followed by completion of our MZL, FL NDA submission, all of which we are targeting for the first half of this year; followed in the second half by pivotal data from our ULTIMATE-MS clinical trial, possibly our first NDA approval; and if all goes well with UNITY-CLL, an NDA/BLA submission for CLL before year-end. No doubt, an action-packed and data-rich 2020 is on the way. With that, I'd like to turn the call over to the conference operator to begin the Q&A session, following which I will return to make some concluding remarks.