Corvus Pharmaceuticals Inc (CRVS) 2020 Q1 法說會逐字稿

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  • Operator

  • Good afternoon, ladies and gentlemen. Thank you for standing by, and welcome to the Corvus Pharmaceuticals First Quarter 2020 Business Update and Financial Results Webcast. Please note, today's conference is being recorded. (Operator Instructions)

  • It is now my pleasure to turn the conference over to Zack Kubow of Pure Communications. Please go ahead, sir.

  • Zack Kubow;Pure Communications;Investor Relations

  • Thank you, operator, and good afternoon, everyone. Thanks for joining us for the Corvus Pharmaceuticals First Quarter 2020 Business Update and Financial Results Conference Call. On the call to discuss the results and business highlights for the first quarter of 2020 are Richard Miller, Chief Executive Officer; Leiv Lea, Chief Financial Officer; and Mehrdad Mobasher, Chief Medical Officer. The executive team will open the call with some prepared remarks followed by a question-and-answer period.

  • I would like to remind everyone that comments made by management today and answers to questions will include forward-looking statements. Forward-looking statements are based on estimates and assumptions as of today and are subject to risks and uncertainties that may cause actual results to differ materially from those expressed or implied by those statements, including the risks and uncertainties described in Corvus' quarterly report on Form 10-Q, which was filed today with the SEC and other filings the company makes with the SEC from time to time. The company undertakes no obligation to publicly update or revise any forward-looking statements, except as required by law.

  • With that, I'd like to turn the call over to Leiv Lea. Leiv?

  • Leiv Lea - CFO

  • Thank you, Zack. I will begin with a quick overview of our first quarter 2020 financials, and then I'll turn the call over to Richard for a business update. At March 31, 2020, Corvus had cash, cash equivalents and marketable securities totaling $68.7 million as compared to $78 million at December 31, 2019. Research and development expenses in the first quarter of 2020 totaled $10.2 million compared to $9.4 million for the same period in 2019. The increase of $0.8 million was primarily due to a $1.3 million increase in CPI-006 clinical trial expenses partially offset by a $0.9 million reduction in CPI-818 drug manufacturing costs. The net loss for the first quarter of 2020 was $12.9 million compared to a net loss of $11.6 million for the same period in 2019. Total stock compensation expense for the first quarter of 2020 was $1.8 million compared to $2 million for the same period in 2019 (sic) [2018].

  • I would like to note that we continue to carefully manage our expenses especially in light of the COVID-19 pandemic. Enrollment in our trials with our 3 programs has been strong, in some cases, ahead of schedule. This allows us to focus on monitoring and follow-up that makes us less dependent on new patient enrollment, which has been affected by COVID-19.

  • As Richard will discuss, we believe the overall impact of this slowdown will have a minimal impact on our ability to continue advancing our lead program ciforadenant. Given the COVID-19 situation and our advancement of the ciforadenant program with over 300 patients enrolled to date, we intend to deepen our focus on our lead asset as we develop our registration strategy and head towards a planned pivotal trial.

  • As a result, we now expect full year 2020 net cash used in operating activities to be between $29 million and $31 million. This is an approximate $10 million reduction compared to our previous expectations of net cash used in operating activities of between $39 million and $42 million.

  • I'll now turn the call over to Richard.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Thank you, Leiv, and good afternoon, everyone. Thank you for joining us today for our first quarter 2020 business update. In the first quarter, we continued to advance our pipeline of precisely targeted oncology therapies, enrolling patients in our ongoing studies and presenting updated data on ciforadenant, the Adenosine Gene Signature, and CPI-818 at medical meetings. At the same time, COVID-19 being a global pandemic that changed the daily lives for most people, health care providers, patients and businesses in the United States. At Corvus, the health and safety of our employees, clinical partners and the patients they serve is our highest priority. Accordingly, we have worked quickly to communicate and collaborate with our clinical trial sites to adapt our protocols to accommodate potential disruptions for patients enrolled in our studies. The updates we made were in line with FDA's guidance for conducting clinical trials during the COVID-19 pandemic and focused on ensuring patient safety and maintaining the integrity of the studies.

  • In addition, we have been in regular communication with our manufacturing partners, and there is currently no significant impact on our drug supply. I would like to thank our clinical trial sites for their partnership during this difficult period, and I am pleased that there has been a minimal impact to our study so far. To date, we have not received any reports of major treatment or follow-up interruptions for patients already enrolled in our studies. Specifically, we have no instances of missed disease assessments and no significant variances in safety monitoring. There has been an impact on special studies such as detailed pharmacokinetic assessments and on on-treatment tumor biopsies as clinical sites shifted toward preparing and caring for the potential surge of COVID-19 patients.

  • There has been an impact on enrollment of new patients in some of our studies. However, we believe the overall impact of COVID-19 on Corvus has not been significant to date. Prior to the emergence of COVID-19, we had very robust rates of enrollment in all of our trials, positioning us now to focus primarily on monitoring and planning for subsequent trials. CPI-006 is an excellent example. Following on the presentation of positive initial results from the study at ASCO last year, we saw an increase in interest and enrollments.

  • As a result, we are tracking ahead of our internal enrollment plans for this program, having moved into the third and fourth arms of the study with CPI-006 in combination with pembrolizumab, which is now fully enrolled, and the triplet arm in combination with ciforadenant and pembrolizumab, both ahead of schedule. With ciforadenant, we have already completed enrollment of a 25 patient study designed to confirm activity in our biomarker positive population. So overall, our current efforts are now focused on patient follow-up and on monitoring with the aim of collecting data, analyzing results and designing follow-up studies. Of note, we will be analyzing our ciforadenant data in renal cell cancer in preparation for a meeting with FDA later this year to discuss our registration strategy and a pivotal trial.

  • Turning to an update on our programs. Starting with ciforadenant, which is our small molecule inhibitor of the A2A receptor, we are now approaching a very exciting period for this program. We have a key abstract accepted for presentation at ASCO in late May. This data will provide an update on ciforadenant in combination with atezolizumab for the treatment of renal cell cancer and the role of the Adenosine Gene Signature as a potential predictive biomarker for patients most likely to respond to this therapy. Our confidence in the biomarker signature is enhanced by independent work from other groups that confirm its potential, including an abstract that will be presented at ASCO from a leading academic institution.

  • In that study, the prognostic value of the adenosine signature in renal cell cancer is confirmed. We plan to meet with FDA in the third quarter to discuss the study design and plans for a ciforadenant randomized pivotal study in second third or later line renal cell cancer using the Adenosine Gene Signature biomarker. We will also be exploring the potential for a single-arm study based on the adenosine signature. As you recall, the signature identifies a very unfavorable group of patients, a new subset of renal cell cancer. And we believe positive biomarker-identified patients will do better with ciforadenant and do poorly with standard therapies. This provides a potential option in an area of unmet need.

  • Moving to CPI-006. Our B-cell activating anti-CD73 antibody. We continue to be enthusiastic about this novel immunomodulatory antibody, which has demonstrated dramatic effects on circulating immune cells with B-cell and T-cell mobilization and redistribution. We are not aware of any other agent, antibody, small molecule, targeting CD73 or any other target that has exhibited these properties. As we have previously reported, CPI-006 has profound effects on B-cells, leading to activation, transformation to plasmablast and secretion of IgM and IgG antibodies. In total, we have enrolled over 75 patients to date in our CPI-006 study, which is evaluating the antibody alone in combination with ciforadenant, in combination with pembrolizumab and a triplet combined with ciforadenant and pembrolizumab. We intend to present an update on this work at the SITC meeting in November later this year. One tantalizing new area is the potential to use CPI-006 as a therapy to enhance antibody responses. We have seen anti-tumor antibodies produced in some of our cancer patients treated with CPI-006.

  • Last, on CPI-818, our ITK inhibitor, we have established its safety, pharmacokinetics, receptor occupancy and optimal dose, along with early signs of anti-tumor activity. Based on patient responses from the first portion of the Phase I/Ib study, we plan to move forward with the next portion of the study with an initial focus on cutaneous T-cell lymphoma. So far, this trial has succeeded in providing important information about the dose, selectivity, PK and target occupancy. This now positions us well for future studies, not only in lymphoma, but also in autoimmune diseases.

  • In summary, we continue to make good progress with our pipeline. We have accomplished this with a very efficient use of capital across 3 programs in the clinic. Importantly, we have the potential to initiate a pivotal study of ciforadenant used with the Adenosine Gene Signature in renal cell cancer in early 2021. We'll make an important step towards this with the presentation of latest data on the program at ASCO. We look forward to providing an update at that time.

  • I will now turn the call over to the operator for questions and answers. Operator?

  • Operator

  • (Operator Instructions) Our first question today will come from Mara Goldstein with Mizuho.

  • Mara Goldstein - MD of Equity Research Department

  • Can you hear me now?

  • Operator

  • Yes.

  • Mara Goldstein - MD of Equity Research Department

  • Sorry about that. Just a couple questions. And the first is just on the ITK inhibitor. When you think about sort of advancing into next -- and the clinical path for that drug, what would be the most likely scenario in terms of clinical trial and understanding that you might not have a comparator, but how it fits in to the treatment paradigm? And I'm just curious about in the triplet combination for CD73, ciforadenant and pembrolizumab. Is that one fully enrolled yet?

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Is that -- I didn't catch the end of that? Is it what?

  • Mara Goldstein - MD of Equity Research Department

  • Is that one fully enrolled yet? In that ciforadenant [and pembrolizumab], can you just kind of give us a sense of...

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Okay. The treatment is almost fully enrolled. I think we still have 1 or 2 patients to go in it, but they've all been identified. That will be fully enrolled, and Mehrdad jump in here if I'm missing something, within the next week or 2. So the...

  • Mehrdad Mobasher - VP & Chief Medical Officer

  • No, you're accurate.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Yes. So that's done. I hope that addresses that. The doublet has been fully enrolled. Now the question about ITK and how to think about it. So first of all, the patient -- so the patients who have been enrolled in our study to date have been patients who failed everything, every approved agent for those diseases. So any activity we see in the T-cell lymphoma patients and in cutaneous T-cell lymphoma patients in our studies is noteworthy because there are no other therapies for these patients. These patients are quite sick. Just to put that a little bit, elaborate further. As you know, there's a lot of therapies for lymphomas. Some have curative for these kinds of lymphomas, but they have some minimal activity. And it is recent patients coming on our trial with most of them. In fact, with greater than 5 lines of prior therapy.

  • So these patients are pretty [dedup]. So we think that activity -- any activity in the patients that we've been treating is noteworthy. Of course, the aim of our Phase I study of the portion of the trial we've done, which is important to emphasize has been to determine dose and safety and target occupancy and effects on immune system and things like that. And we've -- the trial has succeeded along these lines, and I say every aspect. We've learned tremendous about this target and our drug. And in particular, there has never been, to our knowledge, a specific ITK inhibitor, and we are learning on what the impact of very specifically blocking that target is. So that's one on that.

  • Mara Goldstein - MD of Equity Research Department

  • Okay. And just to confirm, are you -- your -- the dose selection is 450 still?

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • So we're going forward with 600 milligrams of [DID].

  • Mara Goldstein - MD of Equity Research Department

  • Okay. And just do you have a sense of the size of that control given CTCL that patient population to begin with and the fact that you had -- these patients are going to have failed so many therapies around what size study you'll be looking for.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • So one thing we try to -- well, first of all, we're still in the Ib part of this. So we're going to treat some more patients. We're going to get a feel for the activity, and then we'll design the new trial and go from there. The nice thing about 818 is that it's been very safe so far. And some patients have been on this treatment for every day for months now, several months. And so it's very attractive now to think about this not only as a single agent. But as you know, Mara, most of our lymphoma therapies are combinations. And so we're also beginning to think now about what kind of therapies to put it together with, how we move it up earlier in the treatment paradigm, et cetera.

  • Operator

  • Your next question will come from Tony Butler with ROTH Capital.

  • Charles Anthony Butler - MD, Senior Equity Analyst & Head of Biotechnology Research

  • Richard, a couple of questions as well. I want to go back to the CPI-006 study. And correct me if I'm wrong, in clinical trials, there were actually 6 cohorts. Is that correct? And within the presumption of 378 patients to be enrolled, is that divided equally among those is cohort 1a through c and, of course, cohort 2a through c. So that's the first question.

  • And then the second question, again, from the registration -- of the presumed registration trial for ciforadenant, which you hope to start next year in second, third or fourth line RCC. So I'm curious, how do you -- what form do you think that takes? Is it just previous failures, as you know, Atezo and/or a PD-1 have been -- or increasingly been used frontline. Will you simply use standard of care plus cifo? Or would you throw Atezo in conjunction? I'm just curious how you think about that from both a control standpoint and also from a registration standpoint. And this is regardless of what you do with the single on trial. And obviously, those patients will be all having adenosine signatures.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Okay. So Mehrdad, do you want to handle actually both of those questions?

  • Mehrdad Mobasher - VP & Chief Medical Officer

  • Sure. The second question in terms of the landscape, you're right. Almost all patients now do get immunotherapy in frontline, PD-1s in frontline. But remember, what we have shown with the signature is that this signature identifies the patients who are not going to do well to the immunotherapy. So what we are doing is that we are giving them ciforadenant and the idea is that it will be in combination with the PD-1, PD-L1, given what we know also from the mode of action and resistance mechanism for those. And that's how these patients will be rescued. The study will be powered for signature positive patients. Did I answer your second question?

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • So Mehrdad maybe just...

  • Charles Anthony Butler - MD, Senior Equity Analyst & Head of Biotechnology Research

  • Go ahead, Richard.

  • Mehrdad Mobasher - VP & Chief Medical Officer

  • Keep going with answers.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • No. No. Go ahead. I think you did answer it. That's fine. (inaudible) So the first question, if I gather -- because I can't exactly remember anything up on clinicaltrials.gov. But basically, Tony, and we added some cohorts to this after it was started. So basically, there were 4 cohorts. There are 4 cohorts in the study. 006 monotherapy, 006 together with ciforadenant, the idea being that you blocked 2 adenosine merge in the pathway. The third arm was a doublet of 006 with pembro. And the fourth arm is all 3 together, 006, cifo and pembro. We've enrolled all of those except for the final cohort now the triplet, which is almost enrolled, as we mentioned earlier.

  • So after funding there were dose escalation in each of those cohorts, because you have to establish safety in each of the monotherapy and the combinations, although they were staggered a bit, but we went from 1 milligram per kilogram up to 24 milligrams per kilogram. We found 18 milligrams per kilogram IV every few weeks to be the right dose for all across the board. So that's the base we're using for each of the 4 cohorts. Now within each of those cohorts, there are -- there's the ability to expand, to look at renal cell and lung and prostate, and I think there's an other category.

  • So there's sort of like 4 buckets for each of the 4 arms. And we have enrolled many of those. But as we've been conducting the trial, we've tended to shift patients over because -- and that's one of the beauties of this trial is that we can fund our patients over to maybe getting -- maybe looking more carefully at the combination versus the monotherapy. So we're not going to show up every bucket of every 4 cohorts. Because we don't think that's necessary, and we've seen evidence that maybe some of the combinations are more important.

  • Charles Anthony Butler - MD, Senior Equity Analyst & Head of Biotechnology Research

  • Agreed. And if I may just continue on that theme. Correct me if I'm wrong, but I believe it is actually the triplet, which had demonstrated some of the better data that we've seen [often] in small population to date. So I can understand why you shift patients, but I just want to confirm that, that was what you were seeing as well.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Well, the triplet is -- we don't have enough data yet. The triplet is the last of the cohorts that we've been enrolling. So that has the least mature data. And the least number of patients at this point in time. But that, of course, will mature as we go on. The -- there are something like over 30 patients on this trial now, still on active therapy. So this is a work in progress. And one of the things that Leiv emphasized in his introduction, and I tried to emphasize is we've really -- because our enrollment and our execution has been so good over the past year or 2. We've really now loaded -- stack the -- loaded the fuel tank.

  • And so now we can run and treat these patients and start to look at the safety and efficacy data and the biomarker data and start to make some decisions. And that's why I don't think this COVID pandemic has impacted us very much because we have really gotten most of what we needed from enrollment, unfortunately, before that happens. And so now it's a matter of letting this data mature. We have a lot of patients on therapy now across our trials. Now it's a question of likely data mature, analyze it. And as I said, go to the next steps after we figure out the answers. Does that make sense?

  • Charles Anthony Butler - MD, Senior Equity Analyst & Head of Biotechnology Research

  • Yes, it did.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • So if you ask me, which is -- so if you ask me, which of the 4 cohorts is better yet, I mean, there's a suspicion that the combination did better. But I wouldn't say there's proof of -- there's no proof of any of that. But one thing that is absolutely no question, no -- absolutely no question now is the impact on the immune system. We believe in a very positive way. The impact on B-cells on lymphocyte trafficking on humoral immunity is profound. It's really, really amazing. And that occurs even at a dose of 1 milligram per kilogram.

  • There's new biology here that has never been described before, and it's not about adenosine. I can't rule that out, but we see these effects in vitro even when we take adenosine out of the equation. This is not going to be seen. We have other antibodies to CD73 that also block adenosine production react with different episodes. It's not about that. This antibody 006 is reacting with a different part of the CD73 protein that has an immunostimulatory effect, which, by the way, was first described back in the 1990s. And we knew that. So we don't think anybody that, to our knowledge, we don't think any small molecule or any other antibody that we've heard about or seen has this property.

  • Operator

  • (Operator Instructions) Our next question will come from Swayampakula Ramakanth with H.C. Wainwright.

  • Swayampakula Ramakanth - MD of Equity Research & Senior Healthcare Analyst

  • I have couple of questions. Since I've been jumping between calls, you might have answered this, but nevertheless, let me ask you this. So on the ciforadenant program in the Phase Ib/II study, there was some data expected at ASCO. So what sort of data should we expect at that conference?

  • And also, what's the path forward beyond the Phase Ib/II study that you're talking about? The second question is on the 818 of Phase I/Ib study. What's the time line for data there? And what is the expectations for the next -- for the development process from here?

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Okay. So let me start with the ciforadenant, and then I might ask Mehrdad to comment as well. So recall that we published in January in cancer discovery, Larry Fong from UCSF was the first author. He published data on 68 patients with advanced refractory, mostly PD-1 failure, renal cell cancer. And in that paper, we showed in patients who were adenosine signature positive, there was a 17% response rate by resist criteria. There were also many patients who didn't quite use the criteria for PR that had substantial tumor regression. We also showed that there was a nice plateau, a long-lived plateau on the progression-free survival curve. And that was statistically significantly associated with adenosine signature and was not -- nobody responded, 0, in the adenosine signature-negative population.

  • When we -- of course, we knew about this data before the publication in January, and we said, okay, let's prospectively, this is an observation, now let's prospectively corroborate that. And so we set out to enroll approximately 25 patients. I think we've enrolled 26 or so. And those 26 additional patients are both adenosine signature positive and negative. But again, we have to confirm the data not only for the positives, but for the negatives. And those additional patients with the follow-up that we have, again, some of the follow-up are short on those additional 25, 26 patients. That is going to be the subject of our ASCO abstract. And I can -- I mean, it's not going to be a surprise. The data is holding up. And we expected it to hold up. It's holding up very nicely.

  • In addition, at ASCO, as I mentioned in my remarks, there's very nice paper by workers at Sloan-Kettering, I guess, I can say the name, in hundreds of patients, where they basically looked at the adenosine signature independent of us and said, what's the prognosis of these patients, and they find exactly what we do. That if you're adenosine signature positive, you have a very bad outcome. And if your -- and those -- of course, the Sloan-Kettering patients are not treated with invention antagonist. That's – they’re given the standard therapy. So we feel pretty good about the signature now. Now in terms -- so that sets us up for a biomarker-defined trial.

  • Now I should say that we've also found -- in our initial work, we found about 60% of patients with renal cell cancer are adenosine signature positive. I think our most recent data is like 68%. So it's in the same neighborhood. So it's probably 60% or 2/3 or so of patients are signature positive. So it's a substantial fraction of the patients. And they do very poorly. Our work, Sloan-Kettering work and work of other companies that we've talked to. I don't think there's any question that we've identified, frankly, a new disease because they do so poorly. And this is the population that our drug is active in. And this is -- sets us up for a very nice trial where we can -- where we have some options now.

  • We can take everybody and do some sort of hierarchical analysis, so we can just focus on, on the signature positives. And those are the things that we'll be deciding in the coming months. But Dr. Mobasher is working with the experts, top people in the field in renal cell cancer. They're well on their way. There's a protocol. There's -- that would define and a pivotal randomized trial. So I'll let him comment some more on that. Mehrdad, do you want to then just talk about generally what our plans are on that.

  • Mehrdad Mobasher - VP & Chief Medical Officer

  • Yes. Yes. As you mentioned, the plan based on the initial data that we have identified this COVID patient population that they actually need new treatments. And based on our data, we think these are the patients who would benefit from our treatment. So we have formed steering committee. We are working on our pivotal data that will be powered in signature patients. And that's the path that we think is a meaningful path. That will be discussed [at ASCO].

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • All right. Now on the -- you also asked about 818 time line. So the 818 time line is we're going to enroll some more. We're following the patients that are on the study now. We're going to enroll some more patients with cutaneous T-cell lymphoma only because we think that's a very appropriate disease for this drug, frankly, you could make an argument to enroll more patients with the other T-cell lymphomas as well, but we're trying to focus a little bit here. We're also getting very, very interested as other people are in some of the other immune disease applications. And we're starting to look at that. We think this might be a very interesting disease in autoimmunity. We don't work in that area so much ourself, but we've begun collaborating with certain people at NIH, for example. So I think ASH meeting might be a good place for us to give an update on that, but we'll see how things go there.

  • Operator

  • Next, we'll hear from Gabriel Fung with Mizuho Securities.

  • Kar-Bow Fung - Research Associate

  • Yes, this is Gabriel from Mizuho Securities, actually in addition to Mara. Congrats with -- on the team. It's good to hear a pivotal program around the corner. And just a follow-up on what was you said on the pivotal study. Do you think that will be required for a ciforadenant -- sorry, for outcome results to be compared directly to adenosine signature selected arm? And how do you think that will change the market opportunity? I mean you mentioned already that it will be 68% -- approximately 68% of the patients are adenosine positive. How do you think this could actually maybe be used in earlier lines, if that's the -- given that this works, Mehrdad?

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Mehrdad, do you want to take that?

  • Mehrdad Mobasher - VP & Chief Medical Officer

  • Sure. In terms of whether the -- a better study would be enrolling every one or would be enrolling just signature positive patients. All that data until now suggest that signature positive patients are the ones who have objective responses. And as Richard mentioned earlier, they have actually pretty long duration of progression-free survival that has given us a tail in that curve. From the operational perspective, both are viable options. And that is what we are trying to actually fine-tune in collaboration with our steering committee and also with the health authority. I think that was the first part of your question. That’s the way I answered it.

  • And for the second part, we think this would be a perfect treatment in terms of treatment landscape for second-line and third-line patients because these are the patients that are getting immuno-oncology treatment. And based on again, mode of action, we believe these are the patients who would not respond and they will respond well to our treatment. But in oncology, typically, you want to rescue patients in early on. There is a potential to move this treatment in combination with ciforadenant whatever the background will be is frontline as well, but that is not our focus now. But that's something we're looking into in the future.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • So that's a good point, Mehrdad. I would like to -- just to add to that. One of the nice things about ciforadenant and we now have data like over 350 patients. We have patients who've been taking this drug now for over a year. I think we have some over 2 years every day...

  • Mehrdad Mobasher - VP & Chief Medical Officer

  • 3 years.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • 3 years -- sorry, you're older than I thought, Mehrdad. So this drug, and we've already been asked about this, would be very, very easy to combine from a safety standpoint with frontline stuff. So there's no question that like many drugs, we try to get approval in the late-line and then we move it up earlier. Now renal cell cancer is changing a lot. Obviously, the landscape is changing very quickly. Patients are living longer. They make it the second, third, fourth, fifth lines of therapy. It's becoming somewhat like a chronic lymphomas in a sense. And that expands. And now you're in the point when you start to think about [not insurance] of the disease, but the prevalence. The prevalence is probably going to increase. And this is something we actually had predicted 3 or 4 years ago.

  • Now in terms of the market, so I think the market for us for renal cell would be very, very good. Certainly, as a small company, it's attractive. But don't forget the adenosine signatures in other tumors. And we've been looking at that. In fact, we have a paper that was just submitted for publication by Stephen Willingham and Drew Hotson, that is looking at -- that has looked at that and shows the distribution of the adenosine signature from TCGA data. And it is present in other tumors. So it leads us to identify which tumors or drug will be applicable to the -- based on the use of that signature. So that's more work to be done in the future. But I wouldn't -- I think it would be wrong to just limit this or think of this just as a renal cell cancer [fight]. The biology is very, very similar, very similar for all those.

  • And one of the things you'll see on our ASCO day -- and it's in our abstract, I guess, the abstracts haven't published yet. If the adenosine signature is just related to other things and other cell infiltrates, myeloid cell infiltrates. Other people refer to this independently as myeloid signature. And we've identified those myeloid cells, that's going to be in our ASCO presentation. So those myeloid cells are not just for the renal cell cancer, there are many other cancers as well. So I would say the upside of this is the potential application in tumors outside of renal. But just to back up a second. Identifying a new subset of the disease based on a biomarker, it doesn't happen every day.

  • And so I'm very proud of my team, scientific and clinical team and biometrics team, identifying a new category of a disease is a big deal, and that makes a career. In academic medicine, that's a career-making move. And you think about that, you think about these other cancers and how we now talk about squamous versus non-squamous. Well, there was a day when we could differentiate those or Hodgkin's lymphoma and non-Hodgkin's lymphoma. Again, there was a day when we didn't know what the difference was or diffuse large B-cell lymphoma from follicular lymphoma.

  • Again, it took real breakthroughs like this to determine to differentiate these diseases that we didn't guide the therapy that gave greater opportunity to develop drugs because then you know what the differences were in these diseases and what you're going to look for. Otherwise, you're treating a bunch of different things with different biological, morphologic and clinical characteristics. So that's a big, big deal. Now we've got to try to make drugs that cure it. And that's what we're trying to do.

  • Kar-Bow Fung - Research Associate

  • Awesome. Actually that leads me to a really quick follow-up because I know you have also programs, they are not wrapped around cancer and prostate. What are your plans -- what are you -- would like to hear from those?

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • So well, prostate, we just presented data on that a couple of months ago. We see activity in prostate. I think other people are reporting some activity in prostate. We’ve got our patients on that trial, we're following them. We're looking -- we're interested in what the long-term outcome is on those patients. We'll probably do more work in that area, but I'm not sure what that is right now. Again, we're looking for prostate to competitive area. There's lots of good treatment. So it's not good enough to just be active. You have to have some advantage.

  • So -- and on the lung cancer, we're following patients on the MORPHEUS program with Genentech. I think there's some plans to maybe present that data at ESMO. I'm not sure about that. It's a small number of patients, so I don't really know what to expect from that.

  • Operator

  • And at this time, we have no further questions in our queue. I'll turn the conference back over to our speakers for any additional or closing remarks.

  • Richard A. Miller - Co-Founder, President, CEO & Chairman of the Board

  • Okay. Thank you, operator. First of all, thank you very much for joining us today. This is unusual time. We're happy that all of you could participate in this call. I enjoyed speaking with you, and we look forward to giving future updates, some very soon at ASCO and beyond that. Thank you very much.

  • Operator

  • Thank you. And that does conclude our conference for today. We thank you for your participation.