Bill Marshall
Analyst · Wedbush Securities. Please proceed
Thank you, Dan. Good afternoon everyone. Thank you for joining us for our corporate update call for the fourth quarter and full-year 2019. I'm joined today by Diana Escolar, our Chief Medical Officer, and Jason Leverone, our Chief Financial Officer. miRagen was founded to discover and develop innovative RNA based therapeutics and is dedicated to translating microRNA discoveries into breakthrough therapies that improve human health. Our extensive knowledge of microRNA biology and chemistry has enabled us to identify and develop microRNA targeted drugs that are designed to regulate gene pathways to return disease tissues to a healthy state. Over the past decade, we've developed a broad pipeline, including three clinical stage product candidates, which we believe have the potential to benefit patients across a number of disease areas, such as blood cancer, pathologic fibrosis, and tissue repair. We’re encouraged by the promising safety and tolerability profile of our product candidates to date and excited by the preliminary efficacy we've observed for our microRNA targeting product candidates in human clinical testing. Over the years, we have both embraced and have been humbled by the challenges of developing a new class of therapeutics. In December of last year, we announced the implementation of a streamlined and more focused development strategy that we believe will allow us to deliver important milestones this year. While we see tremendous promise in many of our programs, we believe that narrowing our development pipeline in order to focus on these programs will help drive shareholder value. With that as a foundation, let me walk you through each program and provide an outlook for 2020 before handing the call over to Jason to provide a review of our financial results. miRagen’s most advanced clinical asset is cobomarsen, which we believe has the potential to become a treatment option for patients suffering from microRNA-155 elevated haematological malignancies. As part of our streamlined corporate strategy, we introduced a revised development plan for cobomarsen in Cutaneous T-cell Lymphoma, or CTCL, which includes delivering interim clinical data in 2020 from our modified SOLAR Phase 2 clinical trial. Under this modified trial design, we stopped the enrolment of new patients, and we'll conduct an analysis of top line clinical response this year. This analysis will provide controlled data to assess the potential observed benefit of cobomarsen based on disease response in the skin in comparison to vorinostat. We have enrolled a total of 37 patients in the SOLAR study. These patients will continue to be evaluated for safety and clinical response in the coming months. We plan to assess the rate of an objective response in the skin that is durable for four months, defined as 50% or greater improvement in the severity of a patient's skin disease over the entire body or mSWAT. The decision to assess skin response as opposed to overall response was driven by the fact that patients allowed into the study only have skin disease and are verified not to have blood, nodal or visceral involvement at study entry. Improvements in skin disease are less intended to reflect efficacy of the drug whereas progression in skin disease reflect lack of efficacy. We reserved the ability to obtain follow-up analysis for blood, nodal or visceral disease as we deem necessary, based on the results obtained using mSWAT. We believe that obtaining controlled clinical data from this cohort of patients may allow for a better assessment of the clinical potential of cobomarsen and provides important de risking for cobomarsen as a potential therapeutic in this indication. We intend for the controlled clinical data from the study to form the basis of determining what additional clinical investigation of cobomarsen in CTCL is warranted and what would be required to potentially obtain regulatory approval. Top line data from this Phase 2 trial of cobomarsen in CTCL is expected to be announced in the third quarter of 2020. As part of our broader strategy to assess the potential of cobomarsen to treat miR-155 elevated blood cancers, we're evaluating cobomarsen in a first in-human Phase 1 expansion indication in patients with Adult T-cell Leukemia Lymphoma or ATLL. Earlier this year, we were pleased to announce positive data from this trial, specifically in a subset of ATLL patients with residual disease after chemotherapy or other treatments. The trial enrolled 15 patients with aggressive subtypes of ATLL, who were treated with cobomarsen by intravenous infusion. Of these 15 patients, we reported interim data for nine patients who are actively relapsing at the time of screening, and six that had residual nodal or circulating leukemic disease after chemotherapy or other systemic therapies. We believe the data from the six patients with residual disease supports the continued development of cobomarsen in ATLL. For these six patients, the duration of cobomarsen treatment range from 4.5 to 23.7 months with a median treatment time of 11 months. Median survival time of these patients was 26 months, compared with 7.4 months median survival time from a large retrospective, external historical cohort based on a Meta analysis of peer reviewed literature, which included a series of studies with ATLL patients treated with standard of care over the past 10 years. These studies included more than 6,000 ATLL patients. In addition, we are also encouraged by the biomarker changes observed in the interim clinical trial data showing that disease stabilization is marked by a decrease in biomarkers of tumor cell activation and proliferation providing evidence of the biological mechanism of cobomarsen on disease stabilization. We believe that the overall survival biomarker and safety data we observed for cobomarsen provide a basis for its continued development in patients with aggressive ATLL. We believe that this is an area of unmet medical need considering that these patients have historically had a very poor prognosis. Based on these data, we have focused our cobomarsen expansion indication efforts on ATLL and expect to meet with the FDA in the third quarter of 2020 to explore a potential expedited development path for cobomarsen in ATLL. Turning now to our fibrosis programs that are centered on the replacement of microRNA-29 which is founded abnormally low levels in a number of pathologic fibrotic conditions. MicroRNA-29 is believed to play an important role in the regulation of certain processes that contribute to the fibrosis. We believe that increasing the levels of microRNA-29 by administration of our proprietary microRNA mimics could provide benefits to patients with excessive fibrosis connective tissue deposition, which has become extreme or pathological in an organ or tissue. We’re currently developing two distinct microRNA-29 mimics remlarsen and MRG-229 for the treatment of various forms of pathological fibrosis. In the fourth quarter of 2019, we reported interim data from a Phase 2 trial assessing the safety, tolerability and preliminary clinical response for remlarsen in patients with a history of keloid scars a form of pathological scarring. These data suggests that remlarsen was generally safe and well tolerated. Treatment had no negative effect on healing reported and initial volume reductions and treated keloids compared to placebo in a subset of patients were observed. We will continue our analysis of patient data at the one-year primary endpoint of the clinical trial and intend to report final observations from the study in the second half of this year. Remlarsen has also been shown to reduce scarring and hazing after a corneal injury in preclinical studies and is further been observed to regulate miR-29 pharmacodynamic and mechanistic biomarkers in the cornea and retina. We believe that this data expands the potential application of remlarsen to a variety of ocular fibrotic conditions. Consistent with our revised strategy, we may seek a collaboration partner interested in the future development of remlarsen for the potential treatment of cutaneous and or ocular fibrosis. As we announced in December of last year, we plan to focus our preclinical pipeline development efforts, primarily on the development of MRG-229 for the treatment of patients with idiopathic pulmonary fibrosis or IPF. In 2019, we reported data in which systemic administration of MRG-229 appear to efficiently reduce extracellular matrix deposition in a series of preclinical studies. We believe that these data coupled with previous observations in humans with IPF, support the role of microRNA-29 in pathologic fibrosis in the lung. We believe that the potential efficacy and safety profile of MRG-229 positions as a potentially differentiated approach in IPF. Looking ahead, we plan to report additional preclinical safety and efficacy data during the second quarter of 2020. As a reminder, the development of MRG-229 for IPF is supported in part by a grant in collaboration with the National Institutes of Health and Yale University. We’re grateful for their support of this important program. With regard to MRG-110, during the fourth quarter of 2019, we announced data from two Phase 1 clinical trials in normal human volunteers in which administration of MRG-110 was observed to increase angiogenesis as demonstrated by increased perfusion and histological markers of neoangiogenesis as well as reduced alpha-smooth muscle actin expression, which has been shown to correlate with activation of Myofibroblasts. A total of 65 subjects were exposed for up to three weeks in these studies and MRG-110 was shown to be generally safe and well tolerated with no evidence of unwanted distal angiogenesis, acute inflammatory toxicities, or significant abnormalities in the liver, kidney or blood, and no injection site reactions. We believe that MRG-110 may have the potential to be used for the treatment of heart failure and other conditions where patients may benefit from increased vascular flow and accelerated healing, such as in patients with high risk for wound closure. While we've not announced future development plans for MRG-110, we may seek a new development collaboration for this product candidate in the future. Before I turn the call over to Jason, I want to say that I'm very proud of the work that everyone on the miRagen team including our employees, advisors, consultants, service providers, and vendors have put in developing a pipeline of clinical stage microRNA targeted product candidates, which we have observed to be generally safe and well tolerated with proof of mechanism data in humans, and in some cases preliminary clinical proof of concept. We continue to believe that this generates miRagen’s technology and demonstrates the capabilities of our team to develop microRNA targeted product candidates. With that, I will now turn the call over to our Chief Financial Officer, Jason Leverone.