Simon Pimstone
Analyst · Jefferies. Your line is now open
Many thanks Jody and good afternoon everyone. I'll start with some overall perspective on 2017, focusing on our proprietary CNS-focused product candidates and our prospects for 2018, and then provide some additional color on our treatments-to-date and anticipated milestones for the near future. The last six months have been a period of important focus for Xenon and we've made excellent recent clinical progress with our product candidates. Our neurology-focused development pipeline is at a very exciting juncture with key milestone events over the next three to six months. XEN1101 and XEN901, our two proprietress epilepsy products that are currently in clinical development. Both have unique mechanisms of action and we believe they have a number of additional attractive properties that could represent important therapeutic advances and differentiation from existing anti-epileptic drugs. In addition, today, we're very excited to announce the addition to our pipeline of a novel neurology-focused ion channel inhibitor XEN007, a CNS acting calcium channel modulator believed to be without cardiovascular effects, containing the active ingredient flunarizine. We have received FDA orphan-drug designation for XEN007 for the treatment of hemiplegic migraine, a rare and severe form of migraine with a strong heritable components. To potentially expedite the development of XEN007, we have entered into certain agreements that provide us with access to clinical and regulatory data and manufacturing support, which may allow us to advance this product candidate either on our own or in partnership directly into a Phase 2 clinical trial which we believe could start in 2018. Now, I would like to provide more color on our achievements and anticipated milestones in our proprietary CNS-focused development programs. We are very pleased with our progress in advancing XEN1101, a Kv7.2 potassium channel opener being developed for the treatment of epilepsy, including treatment-resistant adults and pediatric focal seizures, orphan epilepsy disorders such as Lennox-Gastaut syndrome or LGS, and rate ultra-orphan pediatric forms of epilepsy such as EIEE7, an early infantile epileptic encephalopathic associated with mutations in the KCNQ2 gene that cause loss of function in the Kv7.2 potassium channel, and potentially other neurological disorders as well. In October 2017, we initiated a randomized double-blind placebo-controlled Phase 1 clinical trial to evaluate the safety, tolerability, and pharmacokinetics of both single ascending or SAD and multiple ascending or MAD of XEN1101 in healthy subjects. The XEN1101 Phase 1 clinical trial includes Phase 1a and Phase 1b components including a pharmacodynamic biomarker read-out from transcranial magnetic stimulation or TMS study designed to assess XEN1101's ability and potency to modulate cortical excitability, thereby demonstrating activity in the target CNS tissue. We are pleased to report that we have now completed Phase 1a pilot TMS study in eight healthy subjects and based on the data, we have already initiated a double-blind placebo-controlled randomized crossover Phase 1b TMS study in 15 healthy subjects which we expect to complete in Q2. We are very excited to be presenting an interim Phase 1 results including preliminary pharmacokinetic, tolerability, and safety data from 42 subjects along with a read-outs from the Phase 1a pilot TMS study at the 14th EILAT Conference on New Antiepileptic Drugs and Devices to be held in Madrid, Spain in May 2018. Preclinically, XEN1101 has demonstrated significantly improved potency and selectivity when compared to the first generation Kv7.2 modulator ezogabine. XEN1101 also showed an improved pharmacokinetic profile in in-vivo testing and a far better predicted human PK compared with ezogabine. We anticipate that XEN1101 has the potential for once daily oral dosing, which we believe is a major advantage over the three times oral daily dosing regimen of ezogabine and because of this, could yield improved CNS tolerability for XEN1101 over what was observed with ezogabine. Furthermore, XEN1101 is chemically stable, does not form chemical dimers and does not undergo a color change on oxidation, unlike ezogabine. Therefore pigmentation changes observed with ezogabine are not expected with XEN1101. The TMS data will be an important PD read-out up for XEN1101. Certain other anti-epileptic drugs including ezogabine have shown an effect in the TMS model, that's a positive TMS read-outs we provide a preliminary indication of a pharmacodynamic effect and validation that XEN1101 is getting to the intended target in the brain. For these reasons, we believe that our interim Phase 1 data package to be presented in May represents an important derisking points in our XEN1101 program and will provide critical information to shape future clinical development. We expect to follow with the release of the complete XEN1101 Phase 1 results including the Phase 1b crossover TMS data in the second half of 2018. We anticipate at that time initiating a Phase 2 proof-of-concept trial in an adult focal seizure or possibly LGS indication by year end. At the same time, we also intend to explore a parallel plan to advance the XEN1101 into rate ultra-orphan pediatric forms of epilepsy as soon as feasible thereafter. We are equally excited about the progress we are making on XEN901. XEN901 is a potent, highly selective Nav1.6 sodium channel inhibitor being developed Xenon for the treatment of epilepsy including treatment-resistant adults and pediatric focal seizures, orphan disorders such as LGS, as well as rate ultra-orphan pediatric forms of epilepsy such as EIEE13, an early infantile epileptic encephalopathy caused by gain of function mutations in the SCN8A gene that encodes the Nav1.6 sodium channel. We presented preclinical data in a poster at the American Epilepsy Society Meeting in December that suggests that Nav1.6 is the primary driver of efficacy for voltage-gated sodium channel targeted AEDs. By selectively targeting Nav1.6, it is anticipated that XEN901 may achieve the efficacy conferred by non-selective sodium channel AEDs, but with an improved therapeutic index. As we recently announced in February, we initiated a randomized double-blind placebo-controlled Phase 1 clinical trial to evaluate XEN901 safety, tolerability, and pharmacokinetics in both single and multi-ascending dose cohorts of approximately 64 healthy subjects in total. The first cohort has now been dosed. Upon completion of the Phase 1 clinical trial, a read-out of results is anticipated in the second half of 2018 followed by a Phase 2 proof-of-concept trial evaluating XEN901's efficacy as a treatment for adult focal seizures or possibly LGS. We also intend to pursue a parallel plan to advance XEN901 into rare ultra-orphan pediatric forms of epilepsy such as EIEE13 as soon as feasible thereafter. We believe that XEN901 is the only highly selective Nav1.6 sodium channel inhibitor currently in the clinic and could provide robust clinical efficacy with an improved safety profile over other sodium channel blocker AEDs. With two anti-epileptic therapeutics in clinical development, each highly validated and with novel mechanisms of action, we believe we are advancing our strategy to become a leader in the development of therapeutically-differentiated alternatives to the anti-epileptic medications currently available including for orphan and ultra-orphan epilepsy indications. Non-selective sodium channel inhibitors are broadly used for the treatment of focal seizures and first generation ezogabine was also approved for focal seizures. But these drugs have been limited by the narrow therapeutic window. We anticipate that XEN1101 and XEN901 could represent important new treatments for epilepsy with better therapeutic indices due to the improved target selectivity. In addition to XEN1101 and XEN901, within our preclinical discovery team, we continue to build upon the knowledge amassed from these clinical candidates and are doing extensive work with ion channel drug targets to advance promising neurology candidates. In addition to working on Nav1.6 backup compounds with unique chemistries for our XEN901 program, we are also exploring the benefits of an Nav1.6, Nav1.2 dual-acting inhibitor program that has the potential to be another unique and differentiated mechanism for the treatment of epilepsy. In addition, we're leveraging learnings and our understanding of the underlying genetics of severe childhood epilepsies to develop a Nav1.1 potentiometer, which we believe could present a potential treatment for Dravet syndrome. We anticipate this preclinical work could yield new development candidates in 2018 or 2019 and we look forward to keeping you apprised of our progress as we seek to build an industry-leading pipeline of highly differentiated and mechanistically-driven epilepsy assets. In addition to XEN1101 and XEN901, we are announcing today that we have added a third proprietary product to ion channel based CNS clinical portfolio; XEN007, the active ingredient of which is flunarizine is a CNS-acting calcium channel blocker that directly modulates Cav2.1, which is a critical calcium channel implicated in the pathophysiology of hemiplegic migraine or HM, a rare and debilitating neurological disorder afflicting approximately 60,000 people in the U.S. flunarizine has been used outside of the U.S. in the prevention of chronic migraine and it's been reported to have clinical benefits in a number of hemiplegic migraine case studies as well as in vertigo. A calcium channel Cav1.2 is the target for XEN's 007and is one of three genes that have been implicated in hemiplegic migraine, all of which promotes excessive glutamatergic excitatory neurotransmission leading to cortical spreading depression which mediates the progressive symptoms characteristic of hemiplegic migraine. Our clinical development plans include a proposed strategy to develop XEN007 as the first treatment specifically approved for hemiplegic migraine anywhere in the world. Xenon has received orphan-drug designation from the U.S. Food and Drug Administration for XEN007 for the treatment of hemiplegic migraine. In addition, we have entered into certain agreements in order to access regulatory files and manufacturing support to potentially enable the accelerated clinical development of XEN007 directly into a Phase 2 clinical trial. I'd like to take a moment to provide some more detail on the genetics of hemiplegic migraine supporting the mechanism of action of XEN007 for the treatment of this disorder. Hemiplegic migraine patients may have mutations in one of three causal ion channel genes with the most common being mutations in CACNA1A, the gene that encodes for Cav or Cav2.1. These mutations cause gain-of-function in Cav2.1, increasing its activity, and thereby, enhanced excitatory neuro transmission. This increase in Cav2.1 activity is therefore thought to play a causal role in hemiplegic migraine. In contrast, the suppression of the channel activity by XEN007 both in hemiplegic migraine patients with or without mutant Cav2.1 has the potential to dampen the excessive excitatory neuro transmission and treat hemiplegic migraine. These genetic causes of hemiplegic migraine support the XEN007 as a well-suited molecule and potential treatment for hemiplegic migraine. And this has been confirmed by multiple hemiplegic migraine case study reports including numerous subjects treated with flunarizine as well as our [ph] reports from prescribing KOLs. We are currently examining various development strategies for XEN007 with key opinion leaders and leading clinicians. We have built a strong network of relationships in the HM community and are synthesizing their inputs in order to finalize the clinical protocol and prepare for regulatory submissions and feedback. In addition, we have developed an online forum of hemiplegic migraine patients now consisting of over 300 patients who are teaching us about this orphan disorder and providing data which we intend to leverage in support of our clinical trial plans. In addition to hemiplegic migraine, we believe there may be other neurological disorders where a calcium channel blocker may be beneficial and we are considering these future development ideas in both adults and in pediatric populations. While we are developing plans to advance this product into a potential Phase 2 trial ourselves, we are also exploring options for potential partnerships for XEN007. In summary, we intend to continue to progress in 2018 with a sharp focus on advancing our proprietary pipeline of novel CNS-focused product candidates. Looking ahead to key clinical data points, we expect to present interim XEN1101 Phase 1 data and a read-out from our pilot TMS study in May. As noted, we believe that the Phase 1 data package for XEN1101 represents an important point of validation as we hope to have both PK and PD validation to support our future development plans in patient populations in support of XEN1101 Phase 2 clinical trial initiation by year end. In the second half of this year, we also anticipate having completed the XEN901 Phase 1 clinical trial to be followed by a Phase 2 proof-of-concept trial. In addition, we continue to evaluate opportunities to expand our pipeline of novel ion channel modulators to both our internal research efforts and our ongoing assessment of promising external product opportunities. In our partnered programs, our ongoing collaboration with Genentech focused on developing novel inhibitors of Nav1.7 for the treatment of pain is continuing. Genentech has completed a Phase 1 clinical trial for GDC-0310, which is an oral selective Nav1.7 small molecule inhibitor developed for the potential treatment of pain. Guidance around the future clinical development of GDC-0310 will be updated once ongoing preclinical studies are completed and the final results are analyzed by Genentech. Overall, we believe we've made excellent progress so far this year and we look ahead to a number of value creating milestone events in the near-term. Now, I'd like to turn this over to Ian to summarize our financial results for 2017 and discuss other corporate matters. Ian?