Bill Marshall
Analyst · Oppenheimer & Company. Please proceed with your question
Thank you, Dan. Good afternoon, everyone, and thank you for joining us for our corporate update call for the first quarter 2020. I'm joined today by Diana Escolar, our Chief Medical Officer, and Jason Leverone, our Chief Financial Officer. We entered 2020 with a streamlined and more focused development strategy that we believe will help drive long term shareholder value. Over the course of the past couple of months, Miragen along with the rest of the world has had to face the far-reaching effects of the ongoing COVID-19 pandemic. In March, the Miragen leadership team was proactive in implementing steps to protect the health and wellbeing of our team, including practicing social distancing by having our administrative employees work from home and staggering shifts for essential lab employees. Our team has been quick to adapt to this new structure and I appreciate all their hard work and dedication to the continued advancement of our programs. However, as we look ahead, COVID-19 is or is expected to have some degree of impact on patients in our studies, certain clinical sites, external analytical functions and potentially regulators. As a result, we cannot confidently predict when we will achieve certain milestones. With that said, let me take this opportunity to provide an update on our lead programs and provide more detail on what might impact each program's specific milestones before handing the call over to Jason to provide a review of our financial results. Starting out with our most advanced clinical program, cobomarsen cutaneous T-cell lymphoma or CTCL, we began the first quarter with enrollment complete for the SOLAR Phase II clinical trial at a total of 37 patients per the modified trial design introduced in the fourth quarter of 2019. These patients will continue to be evaluated for safety and clinical response. We plan to assess the rate of an objective response in the skin that is durable for 4 months, defined as 50% or greater improvement in the severity of a patient's skin disease over the entire body as measured by mSWAT. The decision to assess skin response as opposed to overall response was driven by the fact that patients allowed into the trial only have skin disease and are verified not to have blood, nodal or visceral involvement at trial entry. Improvements in skin disease are thus intended to reflect efficacy of the drug, whereas progression in skin disease reflects lack of efficacy. We've 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. As a result of the COVID-19 pandemic, we have seen an impact on clinical activities at some sites where the SOLAR trial is being conducted. Some patients have missed or are at risk for missing doses or in-person site visits for collection of primary endpoint patient data. To avoid missing doses for those patients who could not receive the infusions at their clinical sites, we have implemented home infusion services for this trial. This is intended to mitigate some of the impact of the COVID-19 pandemic on the SOLAR trial. Also worth mentioning, that under the trial's protocol, patients can miss up to a month in dosing. However, due to the nature of the primary endpoint in this trial, the collection of patient data cannot be performed remotely. In-person visits at clinical trial sites are required to collect mSWAT data and to demonstrate a patient's objective response for 4 consecutive months. There are two factors that may require some patients to have additional time on trial. Considering these disruptions, we are actively monitoring the impact the COVID-19 pandemic is having on the SOLAR trial. While over half the patients have been in the trial for a sufficient period of time to provide topline data prior to the escalation of the COVID-19 pandemic, we believe it is important to collect interrupted endpoint data with consistent dosing in the remaining patients. However, due to the impact on the trial caused by the pandemic, we cannot predict at this time when we will be able to do so. Accordingly, we are not providing guidance at this time. As part of our broader strategy to assess the potential of cobomarsen to treat miR-155 elevated blood cancers, we are evaluating cobomarsen in a first-in-human Phase I expansion indication trial in patients with adult T-cell leukemia/lymphoma or ATLL. At the beginning of the first quarter, 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. In this trial, cobomarsen was observed to prolong disease stabilization and median survival team in aggressive ATLL patients with persistent residual disease after chemotherapy and other therapies. The disease stabilization in these patients is marked by a decrease in biomarkers of tumor cell activation and proliferation, providing evidence of the biological mechanism of action 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, especially considering that these patients have historically had a very poor prognosis. Our next step for this program is to explore a potential expedited development path for cobomarsen in ATLL. This quarter we plan to request a meeting with the FDA. While we would normally expect this meeting to take place in Q3 of this year, the FDA is currently prioritizing its efforts on COVID vaccines, therapies and trials. While we have not been notified that the FDA is likely to deviate from its meeting protocol, we know that prioritizing COVID-19 is important and must take priority. As such, we are uncertain if our request for a meeting on ATLL will occur on the standard FDA timeline. Therefore, we cannot provide assurance that the meeting will occur as originally expected in the third quarter of 2020. Turning to our fibrosis programs that are centered on the replacement of microRNA-29, which is found at 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 fibrosis. We believe that increasing the levels of microRNA-29 by administration of our proprietary microRNA mimics could provide benefit to patients with excessive fibrous connective tissue deposition, which has become extreme or pathological in an organ or tissue. We are currently developing 2 distinct microRNA-29 mimics, remlarsen and MRG-229, for the treatment of various forms of pathological fibrosis. In December 2019, we announced that our pipeline development efforts will be primarily focused on the development of MRG-229 as a potential treatment for patients with idiopathic pulmonary fibrosis or IPF. We believe that the efficacy and safety profile of MRG-229 positions it as a potentially differentiated approach for IPF. This program is supported in part by a grant in collaboration with the National Institutes of Health and Yale University. During the first quarter of 2020, we made progress in our preclinical studies leading to the release of additional funding by the NIH in April of 2020. We expect to report this additional preclinical safety and efficacy data for MRG-229 during the second quarter of 2020. I want to restate that we are grateful for their continued support of this important program. Our Phase II trial assessing remlarsen for safety, tolerability and activity in the potential prevention or reduction of keloid formation in patients with a history of keloid scars, a form of pathological scarring, is progressing as planned. Currently we are working to complete the analysis of the one-year primary endpoint data. However, due to the potential impact of the COVID-19 pandemic on clinical sites, we cannot accurately predict when we'll be able to report this topline data which had previously been expected in the second half of 2020. We are also evaluating remlarsen in ocular fibrotic conditions such as corneal injury and keratitis. In preclinical studies we have previously observed that topical administration of remlarsen to an injured rat cornea resulted in faster healing of the cornea with reduced scarring and hazing. Remlarsen has also been observed in in vitro studies to regulate microRNA-29 pharmacodynamic biomarkers in the cornea. We intend to seek a collaboration partner for the future development of remlarsen in cutaneous and ocular fibrotic conditions. In summary, our pipeline continues to advance and we see tremendous opportunities for each of our programs. And while the COVID 19 pandemic has created uncertainty in our ability to accurately guide on the timing of certain milestones, we remain confident in our ability to deliver important results from these programs. With that, I will now turn the call over to our Chief Financial Officer, Jason Leverone.