Paul Moore
Analyst · Evercore
Thank you, Chris. Before I move on to our early stage programs, I’d like to spend a few minutes first talking about data highlights from this quarter on our lead candidate zanidatamab shown here on this slide. Data presented by our partners Jazz and BeiGene at the European Society for Medical Oncology Annual Congress highlight zanidatamab’s continued efficacy and tolerability. Two abstracts were presented. The first described clinical results from the ongoing global open-label Phase 1b/2 study for zanidatamab plus chemo and tisle, an anti-PD-1 monoclonal antibody for first line treatment of HER2-positive gastric/gastroesophageal junction adenocarcinoma. With an overall response rate exceeding 75%, this study resulted in encouraging data for the triplet regimen, with a median duration of response of 22.8 months and a median progression free survival of 16.7 months. The second abstract described quality of life outcomes from the Phase 2b HERIZON-BTC-01 study evaluating patients with zanidatamab treated HER2-positive biliary tract cancers in patients with centrally confirmed HER2-amplified tumors. We previously reported data from this Phase 2b study where zanidatamab as monotherapy in this patient population had a confirmed overall response rate of 41.3% and 51.6% in the IHC 3+ patients, as well as a median progression fee for survival of 5.5 months. As we continue to monitor other development stage candidates for GEA, we have yet to see data reported in first line GEA patients comparable to the Phase 2 data for zanidatamab on chemo with or without a PD-1 inhibitor. We believe the differentiated mechanism of action from our bispecific HER2 antibody zanidatamab is responsible for the encouraging and durable patient responses we have seen in our GEA study conducted to date. Having reviewed the current results from other development candidates, including those presented at ESMO, we believe that the potential for positive outcomes from HERIZON-GEA-01 could dramatically change the standard of care for GEA patients in the first line setting. Unlike data seen from development – other development candidates, we see the potential for clinically meaningful benefit for both PD-L1 positive and PD-L1 negative patients in our study, with the potential for additional clinical benefit as seen in our recent Phase 2 study in patients with high PD-L1 scores. We believe that zanidatamab’s tolerability profile allows for combination with other agents, including chemotherapy and immuno-oncology agents, that may help achieve patient responses not achievable with monotherapy approaches. As I said, both zanidatamab presentations at ESMO provide continued positive efficacy, safety and tolerability data for zanidatamab, used in both GEA and BTC. The outcome of the current randomized study is widely anticipated among KOLs in the GI community, and we look forward to that top line pivotal data in 2024. I’d like to now turn to the next slide and talk a little bit about our R&D focus for our preclinical programs, which you have probably heard us refer to as our 5 by 5 pipeline. The idea behind this starting in 2022 was to nominate and initiate five – clinical trials and five new molecules by 2027. Today, I’m pleased to announce the nomination of our fourth candidate, ZW251, which I will discuss in more detail shortly. Overall, we are very pleased with the speed at which our team has been able to identify opportune targets and develop quality candidates, something achieved thus far ahead of our own expectations for the first four slots and we hope to nominate the final IND candidate for a 5 by 5 pipeline during 2024. To reach this goal, we begin by using an integrated internal R&D engine for both antibody drug conjugates or ADCs and multi-specifics. Technologies, we believe will continue to be extremely valuable for us in the long-term. And we do this with a commercial focus around what kind of target product profile will support a substantial increase in the standard of care for patients in commercially attractive markets, especially in the U.S. where we would seek to eventually become a commercial company. Essentially, our approach is quite straightforward. We select difficult to treat cancers, validated targets or pairs of targets from those cancers. We have a range of technologies available to us internally to decide which product mortality to pursue and how to design those. The result of those platforms is either an innovative antibody conjugate, as you’ll see with our latest IND candidate, ZW251 or an innovative multi-specific antibody. As I mentioned, our candidates must meet both a very rigorous R&D and commercial business case before we begin development. Our teams look at each aspect of the candidate’s potential, which includes development complexity, commercial opportunity, competitive landscape, probability of success, as well as investment and partnering of potential. We have a strong focus on finding opportunities for ADCs and multi-specific antibodies to be used throughout the continuum of care for patients with difficult to treat cancers, both as monotherapy and in combination with other agents currently approved as standard of care. This requires a strong focus on both efficacy and tolerability to ensure the potential for combination therapy and is important consideration in the selection of targets of interest and product formats. Finding a way for ADCs and multi-specific antibodies to be used in earlier stages of therapy in combination with standard of care may be the best approach to make breakthroughs in patient outcomes in these difficult to treat cancer indications. The last point, we recently have seen the benefits of partnerships with significant transactions in ADC space, validating Zymeworks’ focus on developing IND candidates in the growing area of topoisomerase 1 inhibitor ADCs. These candidates provide us with multiple opportunities beyond zanidatamab to advance compelling therapeutics, focusing on targets of interest into clinical studies as soon as next year. So now I’d like to move and introduce ZW251, our latest IND candidate, which is a potential first-in-class GPC3 targeting topoisomerase inhibitor ADC for the treatment of hepatocellular carcinoma. Liver cancer, both in the U.S. and worldwide, presents a substantial health burden. Globally, HCC is the third most common cause of death from cancer. This burden has been on the rise due to factors such as the increasing prevalence of alcohol consumption, obesity and lifestyle induced HCC. Despite progress, in improving the prognosis of many cancer, liver cancer continues to have a dismal survival rate. This unmet need fits with our strategy to develop therapies in such areas. The limited treatment options available for HCC further reinforce our commitment to this disease. Historically, mainline treatments primarily relied on multi-kinase inhibitors, but more recently, there has been a shift to focus on antiangiogenic agents and checkpoint inhibitor combination therapies. Liver cancer is challenging to treat with various modalities showing only partial effectiveness, while cytotoxic chemotherapies demonstrate some response, better outcomes are achieved with local regional therapies such as transarterial chemoembolization or TACE versus systemic therapies. Despite recent approval of these agents, we’ve only seen a modest overall increase in survival for HCC patients. Systemic chemotherapy has been investigated to treat HCC in the past, and older trials investigating chemotherapy show objective responses in the rate achieved by multitargeted tyrosine kinase inhibitors and immune-oncology combinations. Moreover, TACE is used to treat intermediate stage HCC and often employs DNA damaging chemotherapies like doxorubicin and cisplatin. We interpret this as demonstrating HCC is indeed chemosensitive, provided enough drug can be delivered and we can reasonably expect to reach the same doses as things such as deruxtecan conjugates based on our preclinical toxicology studies. If we reach those same doses of the deruxtecans being 5 milligrams per kg or more, we believe that we can deliver sufficient payload to potentially shrink the tumors. So guiding our approach, leveraging the ADC modality to enhance the efficacy of cytotoxics in liver cancers offers a new dimension to treatment to enable the delivery of such cytotoxics. The potential to improve efficacy with an ADC and expand on limited targeted therapies in HCC provide an opportunity for us to develop a potential first in class candidate for this patient population. The focus of interest on TOPOs has been due to the notable clinical success of TOPO1 inhibitor bearing ADCs against solid tumors. Further, topoisomerase inhibitors as systemic treatment to HCC have found to be active but yield mixed responses and there remains room for improvement. Meanwhile, novel therapies like CAR T cells, while promising, face challenges as they must overcome the strong immunosuppressive environment of HCC. Moreover, engineered cell therapies are more costly than the off-the-shelf options like ADCs and are not suitable for patients that cannot tolerate high intensity conditioning regimens. The range of available treatments yield fairly low responses and medium progression pre-survival rates as shown in the right hand side of the slide, with later lines of treatments being an exercise in combining limited approved regimens, piling the need and opportunity for new treatments with a lack of competition for ADC in this area. If we can develop an effective and tolerable ADC to be used as both monotherapy and in combination with other approved agents, we may be able to provide a new treatment option for patients throughout the continuum of care of HCC, including in early lines of treatments which may provide the ability to transform survival outcomes for these patients. Next slide, like to talk a little bit more about target. So what is the target that we’re targeting, GPC3 or glypican-3? And what makes it a good target? So GPC3 is considered an oncofetal glycoprotein, which is important in fetal development but down regulated in adult tissues. This key attribute of minimal expression in normal healthy tissues while showing frequent and high expression in HCC, has been corroborated then by multiple groups. This profile makes GPC3 a validated and highly selective approach to treat HCC, which has also been seen in the clinic. For example, studies with radiolabeled versions of the anti-GPC3 condrituzumab demonstrated rapid and selective uptake into liver cancer lesions in a study of HCC patients, reinforcing our hypothesis that antibody targeting of GPC3 is a good way of specifically targeting HCC. We believe this level of selectivity makes GPC3 a really exciting target and a potential turning point for treating liver cancer. The next slide, what we have laid out here are some of the key characteristics of ZW251, which we believe make it a fitting candidate for targeting GPC3 and HCC. The antibody itself was selected for strong binding specificity and internalization foundational features for all our ADC programs. We then combined this quality antibody with our own proprietary TOPO1 payload with the desired and appropriate balance of stability, potency, tolerability and bystander activity. TOPO1 based technologies show meaningful clinical benefit in a wide range of solid tumors, including hard to treat solid tumors, and have been validated with other targets. We are therefore optimistic about the combination of a GPC3 targeting antibody and TOPO platform for the treatment of HCC. As for our standard development process, a DAR 4 and a DAR 8 ADC were evaluated to let us make data-driven decisions on the next steps, and it was determined that we will be taking forward a DAR 4 molecule in line with our philosophy to balance efficacy and tolerability. Altogether, we see ZW251 as a unique asset and to the best of our knowledge, no other liver cancer ADCs are being actively developed against GPC3. Switch to a data slide, which highlights two key features of ZW251. On the left are examples of anti-tumor activity against patient derived xenograft model. We’ve demonstrated this in multiple models at conferences. And equally important, on the right hand side demonstrates the tolerability of ZW251 in non-human primates, where we’ve gone up to 60 mg/kg and 120 mg/kg on repeat doses for a DAR 8 and DAR 4, respectively. So turning to the next slide. You’ll see the expected then IND, progression of INDs from the 5x5. We expect to see – we’re on track for submissions for 171 and 191 in 2024, followed by ZW220 in the first half of 2025 and ZW251 in the second half of 2025. We’re then hopeful to be able to nominate our fifth product candidate in 2024 with a planned idea IND filing in 2026. Given our improved R&D productivity over the course of 2022 and 2023, this would accomplish our 5x5 portfolio nomination about one year ahead of schedule. So we’re beginning to strategize and plan on a longer-term R&D strategy beyond the 5x5 development pipeline. On this next slide, what we’ve done is to provide a perspective on the coverage, the tumor coverage of our nominated 5x5 programs overlaid together with our clinical stage development programs, zanidatamab and zanizov that reiterates again our focus on cancer types with the poorest overall five year survival. This tumor landscape, this focus will form the basis also of new programs moving forward. We’re already thinking about the next – and we’re already thinking about what the next advanced pipeline could look like, and we’ll share that vision in subsequent slides. Taken together, we believe this portfolio construction gives us a diverse range of targets with multiple opportunities for success in the coming years. I’d like to now switch to our longer or thinking beyond the 5x5, where we believe still that the antibody based platform technologies at Zymeworks disposal, both in drug conjugates and protein engineering, has us well positioned to continue pursuing the development of cutting edge multifunctional biologics where we can weave into a single molecule multiple mechanism of actions to overcome complex disease states that will require a multi-targeted approach to provide patient benefit. With our infrastructure and talent in place, combined with the diversity and approaches our platform technologies afford, we believe we are well positioned to deliver two INDs – two IND ready molecules annually. While there is obviously clear need to improve the outcome for oncology patients, particularly in the cancer types with poorer survival, such as liver cancer as described today, we also see opportunity in other disease states to leverage our technology. In particular, we see opportunity in autoimmune inflammatory disease where multi-specific technology lends itself to blocking dual pathways or leveraging key signal pathways. Importantly, we also have the internal personnel with experience in developing such molecules from concept to clinic, and the infrastructure in place from preclinical through manufacturing and clinical development that can be leveraged. Financially we believe this goal will be sustainable through a combination of internal funding and external partnerships to take molecules forward into the clinical – into clinical development. So the next slide I wanted to just share, give you a flavor of this what we’re calling our advanced portfolio and some additional details on that which we see taking shape beyond our 5x5. Again where we see the ADCs and multi-specific molecules as the platform technologies we leverage and evolve to meet the challenging of addressing complex disease states and really making impactful change to patients. Within the ADCs, we see great opportunity in combining Zymeworks bispecific technology with drug conjugates, something we have deep experience with in the field with zanizov, a biparatopic ADC. In particular, we see opportunity through both biparatopic or dual epitope binding molecules and bispecific or dual antigen targeting molecules to broaden responses in cancer types, to enable broader and deeper responses. That’s on the antibody targeting side of the molecule. On the payload drug linker side, we also see need for alternative payloads and our chemists who generated our novel TOPO payload are already at work on additional payload strategies to complement TOPO and MTI payloads already in our toolbox. Within the immune cell engagers, we have our first in-house T cell engager for which we expect to file an IND in 2024, employing a novel low affinity anti-CD3 and targeting mesothelin using an optimized 2+1 structure enabling anti-tumor activity models not observed with other designs or formats, including prior clinical stage programs. We will be building on that. And if you have been following our recent presentations at AACR and SITC, you’ll be aware we are advancing trispecific T cell engagers where in one version we incorporate into the T cell engager, a conditional CD28 costimulatory arm. Importantly, CD28 engagement has been engineered to bind and trigger signal only upon synapse formation between the tumor cell and the T cell, resulting in a more productive T cell response than observed with CD3 engagement alone. Moving forward, we see potential utility of CD3, CD28 based trispecifics across multiple cancer types to prove the breadth, depth and length of responses to T cell engagers. We have additional design thoughts in T cell engagers to enhance response by incorporating additional functionality beyond costimulation, such as checkpoint inhibition in addition to the dual tumor antigen and targeting to enhance potential therapeutic window. Beyond immune cell engagers, there is a metric platform also affords opportunities in immunooncology outside of immune cell engagers, including cytokine engineering combined with masking, something we have presented on previously as an example, an affinity modulated masked IL-12 design to agonize immune system enhanced tumor responses in addition to opportunities such as simultaneous blockade of multiple checkpoint inhibitors. Finally, as alluded to on an earlier slide, outside of oncology, we’re excited about opportunities in the autoimmune and inflammatory disease space where we can leverage our multi-specific platform to block multiple drivers of disease, including multiple cytokines. For the past five years, we have had an ongoing development collaboration with LEO Pharma in the AI and eye disease area has provided us an opportunity to gain experience and insight regarding the potential utilization of our technology platforms outside of oncology. With the recently announced change in this collaboration, we now have sole unencumbered rights to a number of preclinical products in AI and eye, and we are actively evaluating incorporating certain of these preclinical products candidates into our advanced R&D strategy. So to wrap up in just over two years from now, we are anticipating to have five IND submissions with early clinical data being generated from a number of these product candidates and potential additional quality IND candidates coming out of our R&D organization from 2027 and beyond. We’re already working on the future beyond the 5x5, but not losing focus on making sure we translate these 5x5 preclonical programs into the clinic in a way that’s quick, that’s valuable and that’s meaningful in terms of the data that’s created, while also starting to work on a longer-term R&D strategy. We look forward to updating you on these developments in the coming months and expect to schedule another R&D Day in the fourth quarter of 2024 to reflect on the progress with the 5x5 portfolio and to discuss the longer term R&D strategy for the company in more detail. We believe a lot of hard work has been done in 2022 and 2023 to craft and execute a focused and cohesive R&D strategy around two key areas of interest, ADCs and multi-specific antibody therapeutics supported by an appropriate financial and partnering strategy. We’re ahead of our schedule with 5x5 portfolio construction, while maintaining financial discipline on R&D investments with an expected cash runway to fund our planned operations through at least the end of 2026 and potentially beyond. In addition, we believe the company is well positioned for a series of important milestones to be achieved in 2024 and 2025, especially potential initial regulatory approvals for zanidatamab in BTC and the top line data from the Horizon GAA1 study with zanidatamab, which will be available next year. These are expected to be significant events in the company’s history and we’re really looking forward to reporting on this progress. As we continue to develop unencumbered product candidates from our focused R&D engine, we will continue to evaluate the potential to be co-developed with partners in order to broaden and accelerate respective development programs in an ever increasingly competitive environment. With these development programs, we will continue to seek attractive economics with upfront payments and committed development payments to help fund development of our in-house candidates, as well as attractive royalty, commercial milestones and/or retained commercial rights to such product candidates in the United States. With that, I’d like to thank everyone for listening to our prepared remarks, and I’ll turn the call to the operator to begin the question-answer-session. Operator?