Steven Shallcross
Analyst · Alliance Global Partners. You may proceed with your question
Thanks, Chris. Good afternoon, everyone and thank you for joining our 2021 year-end investor conference call. We are extremely pleased with the significant advances over the past year that propelled our business forward, offer dual opportunities to enhance our existing pipeline and positioned us at the forefront of oncolytic virus development for cancer indications with high unmet needs. I'd like to begin by highlighting the recently completed acquisition of VCN Biosciences, a privately held clinical-stage biotech company focused on developing a new oncolytic adenovirus or OV platform. With the VCN acquisition, the newly combined company is developing a portfolio of systemically administered selectively replicating adenovirus therapies designed to break down the tumor stroma which is a protective barrier that limits the efficacy of many cancer therapeutic agents. Breaking down this stroma is intended to increase tumor access by OVs, chemotherapies and immuno-oncology products, ideally improving their antitumor effects. Importantly, degrading the stroma can also expose tumor antigens, turning cold tumors hot and enabling a sustained antitumor response by the patient's immune system. I'd like to now provide an overview of our pipeline and walk you through key updates. Our lead oncology product, VCN-01, is a next-generation OV designed for intravenous, intratumoral and intravitreal delivery. VCN-01 has been administered to 72 cancer patients in Phase I clinical studies to date with a focus on pancreatic ductal adenocarcinoma, also known as PDAC and retinoblastoma. VCN-01 was granted orphan drug designation in 2011 by the European Medicines Agency for the treatment of PDAC. It was granted an orphan drug designation by the FDA in February this year for the treatment of retinoblastoma. If approved, orphan drug designation provides critical marketing exclusivity and we plan to take full advantage of the development benefits to which we are eligible under the drug's orphan drug designation. We are highly encouraged by the regulatory support and the promising clinical safety and efficacy data generated to date. Building on this, in the second half of 2022, we plan to initiate an international multicenter Phase II clinical study of intravenous VCN-01 in combination with standard-of-care chemotherapy, gemcitabine and nab-paclitaxel is -- are the two chemos that we plan to use in this clinical trial as first-line therapy in newly diagnosed metastatic PDAC patients. The study will be led by Dr. Manuel Hidalgo, an internationally renowned physician, scientists and academic and Chief of the Division of Hematology and Medical Oncology at Weill Cornell Medicine, New York Presbyterian Hospital as well as a member of the Board of Directors at Bristol-Myers Squibb. The proposed Phase II clinical trial comprises a randomized, open-label study to be conducted at sites across the U.S. and Europe. The study is projected to enroll up to 92 adult patients with first-line metastatic PDAC for whom established clinical standard-of-care therapy is chemotherapy. The proposed study which has not yet been agreed to by regulators, is expected to have two treatment arms. In arm 1, patients will receive standard-of-care chemotherapy. In arm 2, patients will receive VCN-01 administered seven days prior to standard-of-care chemotherapy. It is proposed that two doses of VCN-01 will be administered approximately three months apart. If this study design is agreed to by regulatory agencies, we believe that will be one of the first clinical trials to include repeated systemic dosing of an oncolytic virus. Primary endpoints for the proposed study may include overall survival and safety and tolerability. Additional endpoints may include progression-free survival, objective response rate and measures of biodistribution [indiscernible] reapplication and immune response. Since this is anticipated to be a two arm open-label study, we plan to monitor the study's progress very closely and may conduct an interim analysis as supported by the emerging data. Now, moving to our planned clinical study in advanced retinoblastoma. We believe VCN-01 holds tremendous promise as a novel rescue therapy for patients who fail standard therapy or is an adjunct to chemotherapy to improve outcomes for these patients. We are working closely with key opinion leaders and regulatory agencies to finalize the protocol for a Phase II/III pivotal study of intravitreal VCN-01 as either an adjunct chemotherapy or a potential rescue therapy in pediatric patients with advanced retinoblastoma. In addition to the planned company-sponsored studies in PDAC and retinoblastoma, VCN-01 will also be evaluated in a number of investigator-sponsored studies, including a study at the University of Pennsylvania combining VCN-01 with mesothelin-directed CAR-T cell therapy in pancreatic and ovarian cancer patients and separate studies at the University of Leeds and University of Navarra evaluating VCN-01 in patients with brain tumors. We look forward to a number of potentially exciting upcoming milestones from the planned diverse VCN-01 clinical programs over the next 12 to 24 months. Our next product candidate, VCN-11, is a modified version of VCN-01 that incorporates a proprietary albumin binding domain in the virus's outer shell. VCN-11 was designed to improve systemic delivery by enabling the virus to code itself with host serum albumin and prevent inactivation by antiviral neutralizing antibodies. IND-enabling studies are being planned and are expected to commence following the completion of ongoing preclinical studies and CMC activities. In parallel, while we drive our OV programs forward, clinical development for SYN-004 and SYN-020 continue to progress. Washington University continues to screen and enroll patients in our Phase Ib/IIa clinical study of SYN-004 ribaxamase and allogeneic hematopoietic cell transplant or HCT recipients for the prevention of acute graft-versus-host-disease in bone marrow transplant patients. The Phase Ib/II study is designed to assess the feasibility of using SYN-004 in this specific patient population and to provide key information requested by the FDA regarding the safety and tolerability of SYN-004 in patients with impaired intestinal barrier function. Last year, we announced the enrollment in patient dosing has commenced in the first of three sequential antibiotic cohorts that will each be administered a different IV beta-lactam antibiotic to treat fever following conditional therapy. In total, eight participants in each cohort will receive SYN-004 and four will receive placebo. To date, we have dosed 15, 10 that are considered available patients in this study. If enrollment proceeds as planned, we may be positioned to announce as many as three interim data readouts during the next 12 to 18 months with the first one anticipated from this first antibiotic cohort towards the end of the first half of 2022, pandemic conditions permitting. We have also advanced our SYN-020 intestinal alkaline phosphatase program. The Phase I placebo-controlled multiple ascending dose study of SYN-020 in healthy volunteers has completed dosing and follow-up and patient samples are undergoing pharmacokinetic and pharmacodynamic analysis. We expect to report top line data during the second quarter of 2022. Results from this study and the previously completed Phase I single ascending dose clinical study of SYN-020 will guide the clinical development of SYN-020 across multiple potential clinical indications that may include radiation neuropathy, celiac disease, nonalcoholic fatty liver disease and NASH. As part of our strategic transformation into an oncology-focused company, we are exploring value-creating options around SYN-004 and SYN-020. SYN-004 and SYN-020, both have significant potential opportunity in non-oncology related indications. We are currently evaluating the best path forward for these assets and whether to advance these programs internally or by out-licensing or partnering them. As we look to the year ahead, the projected progress of our newly combined clinical development pipeline is expected to deliver numerous upcoming milestones that have the potential to drive significant value for shareholders. Key near term clinical milestones over the next six months include: the initiation of VCN-01 dosing in an investigator-sponsored study of brain tumors at the University of Leeds, the initiation of VCN-01 dosing in combination with mesothelin-directed CAR-T cells in the investigator-sponsored study of pancreatic and ovarian cancer at the University of Pennsylvania, a data readout from the first cohort of the SYN-004 study in allogeneic HCT patients and top line data from the multiple ascending dose study of SYN-020 in healthy volunteers. During the second half of 2022, we expect to initiate key clinical trials, including the Phase II study of VCN-01 in PDAC patients and possibly a Phase IIa study of SYN-020. Additionally, we anticipate the initiation of a Phase IIb/IIIa pivotal study of VCN-01 in retinoblastoma either by the end of the year or very early in 2023. Now, I'd like to turn briefly to our financial results for the year ended December 31, 2021. General and administrative expenses increased to $6.5 million for the year ended December 31, 2021, from $5 million for the year ended December 31, 2020. This increase is primarily comprised of consulting and legal costs related to the VCN acquisition, higher insurance costs, audit fees and public relations expenses. Research and development expenses increased to $7.8 million for the year ended December 31, 2021, from $5.1 million for the year ended December 31, 2020. This increase was primarily the result of increased clinical trial expenses as we continue dosing patients in the Phase Ib/IIa clinical trial of SYN-004, the dosing of healthy volunteers in the SAD and MAD Phase I clinical studies for SYN-020 and higher indirect program costs for the year ended December 31, 2021, including an increase in manufacturing costs for SYN-020. Turning briefly to the balance sheet. We ended 2021 with over $67 million of cash on hand at December 31, 2021 which we believe will provide a significant runway to build support our existing programs as well as help accelerate the development of VCN clinical pipeline, including VCN-01 and VCN-11 through the end of 2023, during which time we expect to achieve a number of important milestones, as I mentioned earlier. As previously announced, the VCN transaction was structured to preserve our strong balance sheet and enable the planned advancement of our combined clinical development pipelines. As previously disclosed, we acquired 100% of the outstanding equity of VCN which will now operate as a wholly-owned subsidiary of Synthetic Biologics. The upfront consideration for the acquisition was $4.7 million in cash plus the assumption of $2.4 million of VCN liabilities. In addition, certain VCN shareholders received 19.99% of the total outstanding shares of Synthetic Biologics common stock as of December 14, 2021. The balance of the VCN purchase price includes up to $70.25 million in future payments contingent upon the achievement of specific Phase II and Phase III clinical and regulatory approval milestones. There will be no additional royalties or commercial sales milestones to the sellers. Assuming we meet these milestones, we believe the value created for shareholders will far exceed the payments made to VCN. With an advanced clinical pipeline and a strong cash position, we are more excited than ever about the outlook for the newly combined company. We believe the VCN acquisition will be truly transformational and we look forward to providing further updates as we continue to advance our combined technologies and products. With that, we're happy to take some questions.