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spk06: Good morning, ladies and gentlemen, and welcome to the Curious Provides Second Quarter 2024 Business Update Conference Call. At this time, all lines are in listen-only mode. Following the presentation, we will conduct a -and-answer session. If at any time during this call you require immediate assistance, please press star zero for the operator. This call is being recorded on Thursday, August 1, 2024. I would now like to turn the conference over to Deantha Deval. Please go ahead.
spk01: Thank you, and welcome to Curious' Second Quarter 2024 Business Update Call. Before we begin, I would like to encourage everyone to go to the Investors section of our website at .curious.com to find our Second Quarter 2024 Business Update press release and related financial tables. I would also like to remind everyone that during the call, we will be making forward-looking statements, which are based on our current expectations and beliefs. These statements are subject to certain risks and uncertainties, and actual results may differ materially. For additional details, please see our SEC filings. Joining me on today's call are Jim Denzer, President and Chief Executive Officer, and Jonathan Zung, Chief Development Officer. We will also be available for a -and-answer period at the end of the call. I'd now like to turn the call over to Jim. Thank
spk04: you, Deantha. Good morning, everyone, and welcome to Curious' Second Quarter Business Update Call. Let's start with our T-game lymphoma study, which is evaluating M. avusertib in combination with ibrutinib in relapsed refractory PCNSL patients that have failed after treatment with a BTK inhibitor. These patients have generally seen methotrexate, chemo, and radiation in the front-line setting, followed by ibrutinib in the second line. As patients progress on ibrutinib, they're eligible to enroll into our study where we add M. avusertib to their ibrutinib regimen. The scientific thesis for this combination is that blocking both of the pathways driving NHL, the TLR pathway with M. avusertib and the BCR pathway with ibrutinib can enable patients to achieve an objective response even after they have progressed on ibrutinib in monotherapy. We presented data for the first five patients in this study at the ASH Conference last December, where we reported an objective response rate over 50 percent. These data were early but very encouraging, especially given the high unmet need in this population. We have continued to enroll patients in this study, and as we noted in our press release this morning, have recently initiated discussions with regulatory authorities to gain alignment on the registrational path for M. avusertib in combination with ibrutinib in primary CNSL. It goes without saying that defining the registrational path is a critical next step in M. avusertib's development, and I'm pleased with our most recent engagement with FDA. I look forward to communicating the outcome of these discussions at the appropriate time. Discussions are also progressing in Europe, where we're pleased to report that M. avusertib has been granted orphan drug designation for primary CNS lymphoma by the European Commission. This designation provides several benefits, including 10 years of market exclusivity, reduced fees for protocol and scientific assistance, as well as marketing authorization applications, and a central application process for marketing authorization with the European Medicines Agency. While these regulatory discussions are ongoing, we continue to make excellent progress on the operational front as well, and expect to reach our target number of 30 clinical sites in the U.S. and Europe, and have initial data for 15 to 20 patients by year end. Now let's move to our K-gain leukemia study. Which is evaluating M. avusertib in monotherapy in patients with relapsed refractory AML. At ASCO and EHA earlier this year, we provided updated data for two patient populations in this study. Patients with a splicing factor mutation, and patients with a FLIT3 mutation. In the splicing factor mutation, four of 18 evaluable patients achieved an objective response, including one complete remission, or CR, two CRs with partial hematologic recovery, or CRH, and one morphologic leukemia free state, or MLFS. In the FLIT3 population, six of 11 evaluable patients achieved an objective response, including three CRs, one CRH, and two MLFSs. Also of note, three of the patients were naive to treatment with a FLIT3 inhibitor. All three of these patients achieved objective responses. And three of the remaining eight patients, those who had failed prior treatment with a FLIT3 inhibitor, were able to achieve an objective response with M. avusertib. We believe these data support M. avusertib's novel mechanism and its potential as a treatment for patients with relapsed refractory AML. In the frontline setting, you may remember that preclinical data demonstrate a synergistic effect when M. avusertib is combined with azositidine and venetoclax, the standard of care in frontline AML. We recently initiated a study of this triple combination, that is M. avusertib in combination with azositidine and venetoclax in frontline AML. We expect to have initial safety data from this study later this year. Overall, I'm very pleased with the progress in both our take-aim leukemia and take-aim lymphoma studies, and I look forward to providing additional updates as the year progresses. With that, I'll turn the call over to Diantha for the financial update.
spk01: Thank you, Jim. CUREs reported a net loss of $11.8 million, or $2.03 per share, as compared to a net loss of $12 million, or $2.47 per share, for the same period in 2023. CUREs reported a net loss of $23.7 million, or $4.08 per share, for the -month-ended June 30, 2024, as compared to a net loss of $23.5 million, or $4.87 per share, for the same period in 2023. Research and development expenses were $10.3 million for the second quarter of 2024, as compared to $10 million for the same period in 2023. Research and development expenses were $19.9 million for the -month-ended June 30, 2024, as compared to $19.2 million for the same period in 2023. General and administrative expenses were $4.8 million for the second quarter of 2024, as compared to $4.2 million for the same period in 2023. General and administrative expenses were $9.7 million for the -month-ended June 30, 2024, as compared to $9 million for the same period in 2023. The increases in both research and development and general and administrative expenses are primarily attributable to higher employee-related costs. CUREs' cash, cash equivalents, and investments totaled $28.4 million, and there were approximately 5.9 million shares of common stock outstanding. We expect that our existing cash, cash equivalents, and investments should enable us to maintain our planned operations into the first quarter of 2025. With that, I'd like to open the call for questions. Operator?
spk06: Thank you. Ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press the star button followed by the number one on your touchtone phone. You will hear a prompt that your hand has been raised. Should you wish the decline from the polling process, please press the star button followed by the number two. If you are using a speakerphone, please lift the handset before pressing any keys. One moment please for your first question. Your first question comes from the line of the L.J. of the late law. Please go ahead.
spk09: Good morning, and thanks for taking the question and congrats on all the progress. I've got two here. The first one is that in terms of the PCSLS readout toward the end of the year, what you consider to be the bar for advancing the program forward. In other words, what would be the guidepost that you were looking for? Then I have a follow up.
spk04: Just as a reminder, thank you by the way for calling in for the question. As a reminder, we're looking to treat patients who have failed the BTK inhibitor. Let's put this into perspective. They failed first line treatment. They failed the BTK inhibitor. If we re-treated them with the BTK inhibitor, which is really that same choice over again, of course they wouldn't respond. What we're looking to see is if we can get objective responses, period. I realize the data has been a lot better than that so far, but I think the bar for patients is can we show that the thesis holds? Even if you've failed on a BTK inhibitor, adding M of assertive to it fundamentally changes the efficacy of that regimen. That's what we're really looking for.
spk09: Okay. Of course, in a larger
spk04: number of patients, right? Of course.
spk09: Absolutely. You anticipate about maybe 15, at least 15 patients roughly at the time when you report the data? That's right. Okay. Maybe the follow up question here is that in terms of the leukemia, congrats on all the data that the positive data reported earlier. I believe you have mentioned just different options you can pursue going forward. Obviously, depending on the data to be reported in the near future, some of the options in terms of flip through you could have either for the naive patient or extremely experienced patients, as well as for the FFM, you would obviously have experienced the patients on that only. How would you consider different optionality or maybe you want to take that all heading to 2025?
spk04: Sure. As you know, in leukemia there's more optionality and that's a fortunate consequence of the design of the molecule. The molecule hits IRAC4, which is
spk07: expressed in nearly every patient. Ladies and gentlemen,
spk05: I would like to inform you that the speaker has been disconnected. Please wait a while. Thank you.
spk07: Operator, this is Jonathan Zung
spk03: from Chiris. Jim is trying to dial back in. We're back in, Jonathan. Okay.
spk07: Thank you very much.
spk04: Not sure what happened. We got disconnected from the call. I was answering Yale Jen's question. Yale, perhaps you can help me with where I got cut off. Sure.
spk09: Not a problem. The second question is that for the leukemia, you have different options to contemplate in terms of whether for flip 3, you will treat targeting either the naive, treatment naive or extremely experienced, as well as for the FFM that you would have the only treatment experience. Among the three options, I guess, whether you want the two, one, two or all.
spk04: Yeah. A couple of thoughts. Let's first talk about frontline therapy, which would be combination and then separately monotherapy with flip 3. Then within flip 3, of course, breaking it out into the separate groups for naive and for experienced. Sure. As you know, one of the things that makes the molecule more attractive in the leukemia setting is that it hits IRAC4 and flip 3. IRAC4 being expressed in nearly all patients with AML. Then also flip 3, where the flip 3 mutation we know is present in roughly a third of the population. Because it has that unique targeting, we think it could have a monotherapy application in leukemia, as opposed to frontline, where we think it will be available to all comers in combination with AIDS, AIDS, and the like. Of course, in non-conscience when it combines with that group. In the flip 3 subpopulation, as we look at monotherapy, you're exactly right. It could be appropriate for both naive patients and experienced patients. It would be ideal, of course, with infinite resources to chase after all of those populations. I think one of the discussions we're going to have at the end, as we report a more full reading of the data set at us, is of course, which of these populations are we going to prioritize for moving forward most aggressively. I would say stay tuned for that discussion, but all of those opportunities are in front of
spk09: us. Okay, great. That's very helpful. Maybe just make it one more, which is in terms of the IRAC4 symposium, what might be the highlight for the upcoming ones and effects?
spk04: Yeah, I think the IRAC4 symposium, we're very pleased to be doing that again this year. As you know, the level of interest in IRAC4 as a whole has gone up in the academic community every year since we first started publishing about IRAC4's utility and oncology. We've got, I think, a really great cross-section of people involved this year looking at leukemia experts, lymphoma experts, and also highlighting work in solid tumors. The clinical data that Kira has been focusing on today and in our public forums is really in leukemia and lymphoma because that's where our clinical data are. We've also got five ISPs ongoing in solid tumors, and there is a wealth of really interesting preclinical data, and several of them are initiating studies now into patients as well. So I expect in the months, quarters, and years to come, that's going to become an increasingly important and interesting part of the story. Okay, great.
spk09: That's very helpful, and congrats on the profit. Look forward to
spk07: Ash for more details. Thank you very much.
spk05: Thank you. Your next question comes from the line of Ed White of HCC Wayne Wright.
spk06: Please go ahead.
spk03: Good morning. Thanks for taking my question. Jim, you mentioned when you were discussing KKM lymphoma that you recently met with the FDA to discuss those registrational paths. I just wanted to know your thoughts on what your ideal regulatory path would be. Thanks.
spk04: Well, I think we would like to move as expeditiously as we can, of course. You know, the typical path in drug development is to conclude your phase one to study and have an end of phase meeting and then talk about with the FDA how do you design the pivotal study. I think in this case, because the unmet need is so clear, obviously the data that we put out last December looked very compelling, and I think we thought it was appropriate to initiate these discussions a little ahead of schedule, and we're grateful that the regulatory authorities were amenable to having those discussions. So we're in the middle of them now, and of course I can't comment on ongoing discussions, but we would look forward to working with both FDA and EMA on the most expeditious path to get this drug available
spk07: to patients who sorely need it. Okay, Jim, thanks for taking my question. You bet. Thank you. Operator?
spk05: Thank you for that. Our next question comes
spk06: from the line of Sue Mitroy. Please go ahead. Hi, good morning, Jim and
spk08: everyone. Sorry, I was a little delayed and missed the first few minutes of your prepared remarks. Are you still pursuing the relapse refractory path for FLIC-3 or Spitosome with EMA monotherapy going forward? Is that the FDA conversation about?
spk04: Yes. So there was a similar question from Yale, from Yale Genet Laylaw about that. Thank you, Sue Mitroy. So as you know, we've got opportunities in leukemia in both monotherapy and combination, and of course the combination opportunity in NHL. The NHL one is probably in the foremost of people's minds because that appears to be the one that's farthest along. You know, as I say, we're already in discussions with regulatory authorities on what that registrational design ought to be. I think with AML, FLIC-3 and Spitosome as monotherapy, those data look really interesting. We're going to have a readout of that data set of roughly 20 patients in each group by year end. And then of course the combination, which we would expect, if it does mirror what we saw in the lab, we would expect this could be a really interesting add to frontline, to current standard of care in that setting. I think for FLIC-3 and Spitosome, as we see those mature data, we'll have that conversation at that time when it comes out. And of course the initial readout, even though it's just a safety readout, there are a lot of people interested in that as well. We're going to have a high-class headache in front of ourselves to prioritize which of these studies we focus on first and fastest. But hold that thought.
spk08: Okay. So is it fair to expect these FDA meetings would be held post-ASH, maybe first quarter of 25?
spk04: For any cell, those discussions are already in process. For FLIC-3, we would wait to see what the data look like before we would reach out to FDA. I think in AML, the landscape is more crowded. In primary CNS lymphoma, as you know, there are no drugs approved. In the third line setting, I realize our data are early, but it's showing the kind of result that there isn't a comparable result in that setting for these patients. So I think given the clear unmet need and given the data that we've seen to date, we think there's an opportunity to get a treatment to patients that appears to be in these early days very promising. So we want to move on that as aggressively as we can. And as I said, we're grateful that the regulatory authorities agreed to pick up that discussion earlier than we would normally do it.
spk08: Got it. By any chance, you mean the CNS? Yes. Okay. Yes. Yeah. And are you seeing any specific, when you are approaching the physicians for the enrollment, are you seeing any specific comments like are they reluctant or there is no other options for these patients, so it's an easy pitch to use AML in this setting?
spk04: No. Unfortunately for the patients, but fortunately for the study, I think the unmet need in this population is, frankly, it's horrible for those patients. There are no drugs approved. Frontline, as you know, it's really high dose methotrexate, chemo, and whole brain radiation. Once they progress on that, they typically go on ebbing and then after that, there really is nothing. You know, we hope to be part of a solution for these patients that in bringing this new treatment, it looks as though early days, early data, but it has the potential to be very promising. And so as I say, we continue to enroll. We have a lot of enthusiasm among the community. I know when you went to the conference, you were able to catch up with several of the investigators yourself. You know, enthusiasm is really quite high. Early days, we know, I always want to be careful to mention that, but, you know, I have to say we're very excited by what we're seeing. Our physicians are very excited. And we're glad that the regulatory authorities were interested in entertaining the discussions a little ahead of schedule, which was, of course, very encouraging for us.
spk08: Right. As we saw with Gilead's CAR-T also in PC-NSL, it's a fairly high ICANN event. So small molecule in your safety profile certainly allows it. Another question, maybe a little bit aside from the blood cancer, in the solid tumor, do we have any visibility if the bladder cancer trial, when it will start recruiting another investigator run trial with Ketruda and Amavizatunev? Any thoughts would be appreciated.
spk04: Sure. So as you know, we've got five investigator-sponsored trials going on right now in solid tumors. We've been focusing on the NHL study and, of course, the leukemia study, because those are the ones that are company-sponsored, and those are the ones where we've got clinical data. But we've got studies going on in pancreatic and gastroesophageal, melanoma, urofilial, and bladder cancer and colorectal as well. All of those studies have really nice preclinical data that have been published at various conferences over the last 12 to 24 months. And we're now at the point where they're moving into the clinic, which is really exciting. I hope we'll be in a position to see results from some of these studies in 2025. But again, these are ISTs. They're investigator-sponsored trials. They're not company-sponsored. So, of course, we don't actually have control over either the enrollment or the reporting of data from those studies. But we're watching them with great interest and, of course, very appreciative of the collaboration with each of these study sponsors.
spk08: Thank you again for taking all the questions and congrats
spk07: on the progress. Thank you very much.
spk05: Your next question comes from the line of Lee Weideck from Canter. Please go ahead.
spk02: Hey, good morning, guys. Sorry if I missed it earlier, but, Jim, maybe just a teacher question in terms of how you view the opportunity in lymphoma versus the ML. It sounds like the need there in lymphoma is a little bit higher and maybe less competitive. So how are you thinking about maybe prioritize lymphoma versus AML? Are you waiting for some maybe regulatory input to make a decision?
spk04: Yeah, thank you, Lee. Thanks for calling in. Thanks for the question. So in NHL versus AML, there are a couple of ways to answer that question. Of course, I think the interest in NHL is partially because that's the most recent data and that's the one where we're in discussions, of course, with regulatory agencies. Across the landscape of NHL, it's obviously a much larger market as well. So BPK inhibitors in 2023 had revenue of $11 billion. It's just a massive space that hasn't had any novel drugs enter into it. Excuse me, in recent years. And if our recent data hold, we, of course, would look to move very aggressively in primary CNS lymphoma. And then with those data in hand and those processes underway, we would go across NHL to all of those other indications. I think that's really building the excitement from investors and why we focus on that more. In leukemia, I think the excitement is, while it is a more competitive space, as you note, the molecule really seems to be fortuitously designed for an AML setting. I mean, it was obviously deliberately designed as an IREC-4 inhibitor. And as you know, we deliberately designed key oncology targets of interest. But because it hits IREC-4 in set three, it really has the ability to offer an unusual benefit, a unique and independent targeted benefit for patients in that setting. So, yes, I think the excitement on NHL is partially because of the advanced state of the data within the context of the unmet need and the regulatory progress. But AML also very, certainly very high on our radar screen.
spk02: Okay, and then, yes, appreciate the color. And then maybe a question on the front line, AML combo strategy. I'm just curious if there's a plan to maybe stratify by IREC-4 long-dress and maybe have a step plan built around that as well as for our commerce.
spk04: Yeah, so thank you. I think we're thinking in leukemia, as you note, or certainly as you're implying, that there is a separate strategy for monotherapy versus combination. So, with split-three as an additional target, I think that offers the ability, given that the drug targets both IREC-4 and split-three, offers the potential for -in-class therapy among the split-three inhibitors, which is a third of the population in AML. And again, I know you know this, but for the benefit of others on the call, the research that we're pointing to, originally published with the Melgar paper, showed that the reason why patients on a split-three inhibitor don't do better than you might expect on a split-three inhibitor is the escape path is IREC-4. It's specifically toll-like receptor path signaling through IREC-4. So, by blocking both split-three and IREC-4, we're blocking both the primary driver, primary path of the disease and its escape path. And that really, in our view, even though the data are early, it explains why the data look to be better than other split-three inhibitors. So, monotherapy there, I think, is a really exciting alternative. In front line, we just started that study, so we need to see whether or not it'll pan out. But the preclinical data are clear. IREC-4 is expressed in nearly every patient with AML in all commerce. And we know azazitin and vanetococci, which is the current standard of care, don't hit it. So, the preclinical data showed that when you added M-lucoceratin to standards care, when you added M-lucoceratin to the A-ZN doublet, there was a significant increase in efficacy. And we hope to see that in patients, and we just started that study, but stay tuned.
spk07: I
spk04: hope that helps.
spk07: Thanks. Yep.
spk05: Once again, ladies and gentlemen, should you have a question, please press the star button, followed by the number one on your touch phone,
spk06: and then you will hear a prompt that
spk07: your hand has been raised. There are no
spk06: further questions at this time. I'd now like to turn the call back over to Jim. Please go ahead.
spk04: Thank you, operator. And thank you, everyone, for joining today's call. And as always, thank you to the patients and families participating in our clinical trials, to our team at CURIS for their hard work and commitment, and to our partners at OroGene, the NCI, and the academic community for their ongoing collaboration and support. We look forward to updating you again soon. Operator?
spk06: Ladies and gentlemen, this concludes your conference call for today. We thank you for participating and ask that you please disconnect your lines.
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