Paul Moore
Analyst · Stifel. Your line is open
Thank you, Leone. So I'd like to start off by talking about some of the preclinical work Leone mentioned earlier in the call, which we presented last week at the ENA conference in Barcelona. For ZW220, we were pleased to share data which demonstrates that 220 exhibits robust activity across a wide range of NaPi2b expression levels in vitro and then showing also significant antitumor efficacy in patient derived xenograft models of ovarian, endometrial and non-small cell lung cancer. In these preclinical models, 220 was highly active at a single dose of 6 mg per kg across the models tested. In these studies, we evaluated between four and eight models per indication and based on tolerability data, the 6 mg per kg is actually considered a conservative dose for 220, suggesting room for dose optimization in future preclinical studies. Importantly, 220 also displays bystander mediated killing activity as shown in this slide in two different in vitro models. First, on the bottom left of the slide we observe bystander activity against the NaPi2b negative cell line in a classic 2D culture model system with 220 which incorporates our proprietary Topo1 payload at DAR4, demonstrating bystander activity comparable to that observed with version of 220 incorporating DXd at DAR8. Furthermore, 220 also effectively inhibits the growth of heterogeneous NaPi2b expressing 3D spheroid models comprising a mix of NaPi2b positive and NaPi2b negative tumor cells. This demonstration of strong bystander killing in vitro we believe is a critical attribute of 220 when targeting tumors with potentially non-uniform expression of NaPi2b. Our ADC also demonstrates a well differentiated safety profile. Compared to higher potency Topo1 inhibitor ADCs such as dosing incorporating Exatecan, 220 has shown a more favorable safety profile in preclinical toxicology studies with a maximum tolerated dose of greater than 90 mg per kg in non-human primates and greater than or equal to 200 mg per kg in rats. This indicates the potential for high dosing in humans which could further enhance its therapeutic impact. Taken together, we've incorporated several key features to optimize the efficacy and safety of 220. The low drug to antibody ratio and moderate stability of the antibody linker provide a good balance between tolerability and antitumor activity, minimizing potential on target or off tumor toxicities. The strong internalizing antibody we've developed ensures efficient tissue penetration and cellular trafficking, improving our antibody tumor activity especially in tumors with lower NaPi expression. Lastly, the Fc gamma receptor silenced antibody design minimizes the risk of off target toxicities, particularly from uptake by normal macrophages. This design contributes to the overall safety profile of 220 which as I showed has been well tolerated in both non-human primates and rats. All of the features discussed above related to the design of 220 provide a clear differentiation from other NaPi2b ADCs in early development and gives us confidence in the potential of 220 to be best-in-class as we transition 220 from preclinical development into early stage clinical studies next year. We remain on schedule with our preclinical development of 220 to support an IND filing and form applications in the first half of 2025. Moving onto other data presented at the Triple meeting or the ENA on ZW251, another ADC incorporating our 519 payload. That data continues to demonstrate significant potential for 251 addressing unmet needs in hepatocellular carcinoma and other GPC3 expressing tumors. 251 is designed to selectively bind, internalize and kill GPC3 expressing tumor cells or glypican-3 expressing tumor cells. This precise mechanism of action coupled with the antitumor efficacy we've observed reinforces its potential as a targeted therapy for glypican-3 expressing cancers. One of the most promising aspects of 251 is its robust antitumor activity observed across a broad panel of hepatocellular carcinoma xenograft models, including both cell line derived xenografts and patient derived xenograft models. Importantly, 251 demonstrates a dose responsive antitumor effect with a single 8 mg per kg dose showing activity in 5 out of 6 cell line derived models and 9 out of 12 PDX hepatocellular cancer models. This includes models with lower or heterogeneous glypican-3 expression, underscoring the breadth of its therapeutic potential in targeting tumors with variable antigen presentation. Our team selected the drug to antibody ratio or DAR4, but this ratio provides an optimal balance between safety and therapeutic impact. In fact, the DAR4 molecule has demonstrated a compelling breadth of antitumor activity in vivo which is crucial for maximizing its efficacy across diverse tumor types. This broad target mediated activity across this range of hepatocellular cancer models continues to validate the strength of our ADC platform. In terms of safety, 251 has been well tolerated in repeat dose toxicology studies in non-human primates exhibiting dose proportional pk. This positive safety profile along with its robust preclinical efficacy positions 251 well for clinical advancement. Looking ahead, we expect our preclinical development to support an IND submission in the second half of 2025 and we believe 251 has the potential to provide a much needed therapeutic option for patients with hepatocellular carcinoma and other GPC3 expressing tumors. We're excited to continue developing this promising candidate and help make a meaningful impact in oncology. By the end of 2025, we expect to have all three of our 519 payload ADCs in early clinical development. We look forward to understanding how the design of our optimized antibody and proprietary payload might translate these promising preclinical findings into clinical efficacy for our ADC candidates. At Zymeworks, the time and care to ensure we have a deep understanding of target biology allows us to innovate on elements of our ADC which we think could make a meaningful difference for efficacy but importantly also for tolerability. Together, we believe that these design features could allow us to optimize at higher protein doses than other ADCs, ultimately maximizing the potential of these therapies to improve the standard-of-care for patients. Increased tolerability would also allow us to explore combination regimens for our candidates with the hope that we can reach first line patients to really make a difference and extend progression free survival and overall survival for these patients. Notably, we made a conscious decision not to repurpose existing molecules like Exatecan for our ADCs. Instead, we aim to create a proprietary Topo1 payload with characteristics ideally suited for an ADC, potentially allowing our candidates to outperform efficacy seen today with drugs that utilize a repurposed payload. These characteristics include moderate potency which we believe could have a two-pronged effect of one, enabling protein dose and bystander activity to enhance potential efficacy, while two, also limiting damage where conjugated drug accumulates in some normal tissues and therefore, increasing also tolerability. By reviewing ADCs that have been explored in the past, we believe our design philosophy is consistent with learnings from prior clinical data. We have observed that increased potency of other repurposed payloads such as Exatecan seems to limit its maximum tolerated dose relative to moderate potency Topo1 inhibitor payloads, which may limit the potential of the higher potency payloads to get into the efficacious dose range. Another feature we have factored into our design to potentially maximize tolerability and efficacy of ADCs is linker stability. Historically, increased antibody linker stability has demonstrated improvements in preclinical therapeutic index, but these findings have not translated into the clinic. We believe that moderate linker stability as employed in most clinically approved ADCs will limit normal tissue exposure to conjugated drug, also contributing to improved tolerability. Regarding DAR and drug antibody ratio, we studied both DAR4 and DAR8 versions of all three of our 519 payloads before carefully selecting the most appropriate DAR for each base -- each molecule based on our understanding of target biology, the targeted patient population and the results of our preclinical studies. Lastly, and importantly, our efforts have been concentrated on optimizing the antibody properties, particularly internalization and tumor penetration. We firmly believe that the key to ADCs being effective and tolerable and ultimately reaching those early lines of therapy is ensuring an appropriate protein dose. We have also carefully considered the potential benefit of incorporating HepC mutations on our antibodies based on the target population and that data supported -- and data supported by preclinical studies. From our preclinical work and empirical review of clinical data over the past 40 years, we believe that our approach is differentiated from other ADCs currently under development. We believe the primary factor is ensuring an appropriate protein dose within the optimal range. Together, we believe that these design features could allow us to optimize at higher protein doses than other ADCs, ultimately maximizing the potential of these therapies to improve the standard-of-care for patients in both monotherapy settings and for combination therapy as well as in earlier lines of treatment. We are very much looking forward to evaluating these novel design features and their effect on tolerability and efficacy using against relative to clear benchmarks from peers and highly validated targets. The first of which will be our Phase 1 clinical trial of our ADCs ZW191. Based on the encouraging preclinical findings, we are moving forward to validate these results in the clinical setting. We anticipate dosing the first patient this year in our Phase 1 open label multicenter study of 191 registered under NCT06555744 on clinicaltrials.gov. The study is actively recruiting and aims to enroll 145 participants with advanced solid tumors including ovarian, endometrial and non-small cell lung cancers across North America, Europe and the Asia-Pacific region. The study is designed to evaluate the safety, tolerability, pharmacokinetics and preliminary antitumor activity of ascending doses of 191. Part 1 of the study will evaluate the safety and tolerability of 191. Part 2 of the study will evaluate safety and explore the potential of antitumor activity of ZW191 according to the RECIST evaluation criteria while continuing to evaluate the safety and tolerability. Criteria includes pathologically confirmed ovarian cancer, endometrial cancer, non-small cell lung cancer and or progressive disease refractory to all standard-of-care that confer clinical benefit measurable disease per resist. We look forward to reporting first patient dose in the near future and discussing progress in the coming earnings calls. Regards to 171 or ZW171. As Leone mentioned earlier in the call, it was only in August that we were announcing the FDA clearance to move forward with Phase 1 clinical trials for 171. The speed of efficacy in our team's ability to move 171 forward to first patient being dosed in such a short time as a credit to the dedication and collaboration of our global hubs. Since we last presented our earnings, we have been working towards activating sites in North America, Europe and the Asia-Pacific region in our Phase 1 trial for 171. In this slide you will see that we have made progress here with clinical sites activated in North America. As a reminder for our clinical trials for 171, we expect to recruit 160 patients globally which we anticipate will present us with a high level of diversity in patient characteristics including expression levels across tumor types. We believe this diversity should result in higher quality data sets and hopefully more conclusive results will retrospectively determine expression cutoffs. We look forward to talking more about the work our team conducted to support selection of the starting dose for 171 at SITC next week. As we have previously communicated, internally we have a very clear target product profile for our candidates, and so the ability to initiate dosing closer to the expected efficacious dose means that it provides the potential to understand signs of efficacy as well as tolerability more clearly early on in the study. This is especially important as we continue to keep financial and scientific discipline within the organization in order to focus on the candidates that have the best chance of success in being meaningful treatment options for patients. Our R&D engine is continuing to work in the background on the next wave of innovative modalities in therapeutic areas where patients with significant unmet needs are lacking effective treatment options. With this in mind, we will continue to advance assets that have the highest potential to change the standard-of-care or to move on to other promising candidates where we can innovate further with the hope for better patients -- for better therapies for patients. Finally, I'm also pleased to share an update about our upcoming R&D Day where we will provide in-depth updates on our growing portfolio of solid tumor targeting antibody drug conjugates and T-cell engager molecules. This will be a unique opportunity for us to showcase the progress we've made in advancing our innovative pipeline, and we are thrilled to be joined there with several key opinion leaders from the oncology field. Together with our management team, these experts will discuss the latest developments in our ongoing R&D and clinical activities, underscoring our commitment to delivering transformative therapies for patients. One of the highlights of the day will be the formal nomination of the latest product candidate from our 5 by 5 portfolio, a tri T-cell engager -- Trispecific T-cell engager. This will mark the final nomination in our ambitious 5 by 5 R&D strategy with a projected IND filing in the first half of 2026. This nomination is a major milestone for us, reinforcing the strength of our T-cell engager platform. We'll also discuss our strategy for our continued focus in solid tumors, while also expanding into new therapeutic areas, particularly in hematological cancers and autoimmune inflammatory diseases. These areas represent a natural extension of our core strengths and we see tremendous potential to apply our technology platforms to these new indications. Lastly, we'll provide updates on our preclinical development progress, which includes potential IND filings for new product candidates in 2026 and beyond. This progress is a testament to the innovation happening within our labs and positioned us well for continued growth of an exciting R&D portfolio in the years ahead. We were excited to share these developments at our R&D Day and look forward to highlighting the advancements that will drive the next chapter of our company's growth. And with that, I'll hand it to Ken for closing remarks.