Gamida Cell Ltd.

Q3 2021 Earnings Conference Call

11/15/2021

spk05: Gentlemen, thank you for standing by. Welcome to the Gameta Sales Conference call for the third quarter, 2021 financial results. My name is Henry, and I'll be your operator for today's call. Please be advised that this call is being recorded at Gameta Sales Request. Now I would like to introduce your host for today's conference, Mr. Josh Hammermesh, Chief Business Officer. Sir, please go ahead.
spk09: Thank you, Henry, and good morning, everyone. Welcome to today's call during which we will provide an update on the company and review our financial results for the third quarter of 2021. Earlier this morning, we issued a press release summarizing our financial results and progress across the company, which is available on our website at www.gamedacel.com. Here with me on our call today are Julian Adams, Chief Executive Officer, Ronit Simontov, our Chief Medical Officer, Michelle Corfin, Chief Operating Officer and Chief Commercial Officer, Shai Lankrey, Chief Financial Officer, and additionally, Jazz Uppel, our Chief Regulatory and Quality Officer, will join for the Q&A session following our prepared remarks. During this call, we may make forward-looking statements about our future expectations and plans, including in respect of the timing of initiation and progress of and data reported from the clinical trials of our product candidates, anticipated regulatory filings, including the submission of the BLA for Omidubacil to the FDA, commercialization planning efforts, the potentially life-saving or curative therapeutic and commercial potential of Omidubacil, and our expectations regarding our projected cash to be used for operating activities and cash runways. our actual results may differ materially from what we project today due to a number of important factors, including the impact of COVID-19 on our operations, the scope, progress, and expansion of our clinical trials, and cost impact thereof, clinical, scientific, regulatory, and technical developments, and those inherent in the process of developing and commercializing product candidates that are safe and effective for use as human therapeutics. And in the endeavor of building a business around such products, as well as those considerations described in the risk factor section of our most recent annual report on Form 20F and other filings that we make with the SEC from time to time. These forward-looking statements represent our views only as of today, and we caution you that we may not update them in the future, whether as a result of new information, future events, or otherwise. Now, I'd like to turn the call over to Julian.
spk01: Thank you, Josh. And thanks to everyone for joining us this morning. This was an important quarter for GametaCell as we continue to advance our mission of bringing potentially curative cell therapies to cancer patients. We are at a crucial inflection point in the field of cell therapy, where we are starting to see multiple development programs that offer the potential for clinical benefit for patients with hematologic malignancies and serious blood disorders. I am proud that GametaCell is at the forefront of this research with our two advanced clinical stage NAM-enabled cell therapy programs, Omidubacill and GDA201. We also recently expanded our pipeline of genetically modified NAM-enabled NK cell constructs and we are excited about sharing new data and developments on our cell therapy pipeline at multiple major international medical meetings this quarter. Let me start today's call with an update on our lead program, Omidubicel, which has breakthrough therapy designation and the potential to be the first FDA-approved cell therapy for hematopoietic stem cell transplants. Omidubacil is supported by a robust body of evidence, including positive Phase III results, demonstrating strong efficacy and important benefit to patients in need of a bone marrow transplant. We recently had a pre-BLA meeting during which the FDA requested that Gametacel provide revised analysis of the analytical data generated by at GametaCell's wholly-owned commercial manufacturing facility in Israel to demonstrate comparability to the Omidubacill batches that were produced at the clinical manufacturing sites for the Phase III study. We are confident that we can execute the analytical comparability that the FDA has requested in a timely manner to enable a BLA submission in the first half of 22. It is also important to note that the FDA did not request additional clinical data to initiate the BLA submission once analytical comparability is demonstrated. In collaboration with the FDA, we will work towards our BLA submission to bring Omidubacill to patients as soon as possible. Moving to our NK cell pipeline, it is extremely exciting to be at the front at the forefront of the cutting edge research that is being conducted in the emerging field of NK cell therapy. NK cells have tremendous promise for treating cancer. NK cells are the body's first line of defense, providing innate immunity and have immune privileged properties that obviate the requirement for donor matching, which can lead to a cryopreserved off-the-shelf product for patients. The most advanced candidate in our NAM-enabled NK pipeline, GDA201, leverages our proprietary NAM technology platform in the expansion of NK cells to enhance their functionality, direct tumor cell killing properties, and antibody-dependent cellular cytotoxicity, or ADCC. GDA201 has produced truly remarkable results in a phase one investigator-sponsored study where we have seen very high and durable responses in both follicular lymphoma and diffuse large B-cell lymphoma. As we have previously reported, the phase one study had an overall response rate of 74% and 68% complete response rates. And an impressive duration with several patients maintaining their complete responses for over two years after treatment. During the third quarter, we submitted an IMD application to the FDA for a Phase I-II trial with cryopreserved formulation in patients with diffuse large B-cell lymphoma and follicular lymphoma. Before initiating our clinical study, we must address the clinical hold by responding to the FDA's questions about donor eligibility procedures and sterility assay qualification. We believe these questions are addressable, and we plan to respond expeditiously to enable IND acceptance and patient enrollment. Due to the clinical hold, the initiation of the Phase I-II trial will occur in 2022. We will provide an update and additional guidance on timing when we have further clarity from the FDA. This quarter, we made progress advancing our genetically modified NAM-enabled NK cell therapy programs, which utilize CAR and CRISPR-mediated strategies to increase targeting, potency, and the persistence against hematologic malignancies and solid tumors. We were excited to highlight these new programs at an R&D day in October. Importantly, we are pleased to announce a research collaboration with the Dana-Farber Cancer Institute for our GDA601 cell therapy, which is a CD38 CRISPR knockout combined with a CD38 CAR-NK cell construct that has demonstrated promising preclinical results against multiple myeloma cell lines. Together with Dana-Farber, we will be studying the great potential of GDA601 in multiple myeloma. Our NAM-enabled NK product candidates hold tremendous promise for both hematologic cancers and solid tumors, and we look forward to advancing our work in this very important field. I want to conclude my introductory remarks by expressing my gratitude to our employees for their dedication and hard work towards driving forward our important mission. Their continued determination and focus on patients have brought us to where we are today. And with that, I will turn the call over to Ronit Simintel, our Chief Medical Officer.
spk04: Thank you, Julian, and good morning, everyone. Thank you for joining us on our call. I'm excited to join you this morning and describe the recent data we presented at the Society for Immunotherapy of Cancers, or CITES, 36th Annual Meeting. Additionally, I will provide a preview on what we will be presenting at the upcoming 63rd Annual Meeting of the American Society of Hematology, or ASH. The data presented at SISI provided extensive characterization of the activity of GDA201 by examining the phenotype, killing capacity, and antitumor activity of the cell. The data showed that GDA201 features a unique phenotype characteristic of a rejuvenated NK cell or non-exhausted phenotype, according to classical lineage stages, retaining potent anti-tumor effects in in vitro and in vivo assays. We also presented data where we used artificial intelligence to analyze differentially expressed genes and metabolites in GDA201 or NAM-enabled NK cells. The data illustrated the network of interactions associated with the enhanced biological function of NAM-enabled NK. with increased cytotoxicity, ADCC, homing, and superior in vivo anti-tumor abilities as compared to NK cells that were expanded without NAM. These data give us key insights into the mechanism of action of NAM-enabled NK cell expansion, which is important as we move GDA201 into the next phase of clinical development and relevant to the cell therapies in our expanding NK cell pipeline. We're also very much looking forward to the presentations that we have coming up at the ASH meeting, which will be held from December 11th to the 14th. For Omidubacil, we will have an oral presentation on immune reconstitution, as well as two poster presentations, one with long-term follow-up data in patients treated with Omidubacil, and one on hospital and healthcare resource utilization. Additionally, for GBA201, we will have a poster presentation with two-year follow-up data from the phase one study. Data we plan to present demonstrate that patients treated with omadubacil had more rapid recovery of a wide variety of immune cells associated with a lower risk of infection. Additionally, omadubacil-treated patients had significantly shorter durations of hospitalization, intensive care unit time, consultant visits, procedures, and transfusions. In an analysis of outcomes of patients with hematologic malignancies treated with Omidubacil over a 10-year period, patients showed long-term sustained bone marrow function and immune recovery. Taken together, these data provide further evidence of the strong clinical benefit associated with more rapid and lasting hematopoietic recovery with Omidubacil. For GDA201, we will share a two-year follow-up analysis from the investigator-led study in patients with non-Hodgkin lymphoma. demonstrating a median duration of response of 16 months and 78% overall survival of two years, with reported toxicities in line with those seen previously. These data further strengthen our confidence in the safety and activity of GDA201. There are further details about each of the presentations in the press release we issued this morning, and we plan to provide further updates during ASH. Regarding the clinical program in GDA201, Colleagues on my team are preparing for the initiation of our multi-center study in patients with non-Hodgkin lymphoma, with operational activities and meetings with investigators and thought leaders ongoing. We continue to hear from experts that there is a high unmet need among patients with lymphoma who have active disease after previous treatment. Investigators are enthusiastic about beginning to enroll patients in this study and treating patients with GDA201. I'll now turn the call over to Michelle Corfin, our Chief Operating Officer and Chief Commercial Officer, who will talk more about our commercial opportunity for Omidubacil. Michelle?
spk00: Thank you, Ronit, and good morning, everyone. We remain excited about the opportunity for Omidubacil to provide an important option to patients who need a bone marrow transplant and do not have a suitable matched donor. In the U.S. alone, there are over 40,000 patients per year with hematologic malignancies who consider a bone marrow transplant. Unfortunately, only approximately 10,000 patients are able to make it to transplant for a variety of reasons. We have done extensive research in collaboration with the Center for International Blood and Marrow Transplant Research, or CIBMTR, conducted independent market research and and spoken to hundreds of transplanters to fully assess the unmet need. Based on these commercial insights, the opportunity for Amadubacil can be summarized into two key categories. The first one is increasing access for patients, especially those who are eligible for transplant and cannot find a match. And second, improving outcomes based on the unmet clinical needs with current donor sources that can be addressed by Amadubacil. One specific area of advantage for Amadubacil is that it has a less stringent matching criteria for patients as compared to graph sources from match-related or unrelated donors. This is particularly important for patients of non-Caucasian descent who tend to have a more challenging time finding a suitable matched donor. Data from Be The Match highlight that a patient's ethnic background greatly impacts his or her ability to find a match with some patient groups facing only approximately a 20% likelihood of finding a match in the public matching database. In the Omidubacil phase 3 trial, over 40% of the patients enrolled were not Caucasian, illustrating the important need for a suitable graft source in this patient population. Upon FDA approval or potential FDA approval, We believe Omidubacil will provide a timely and attractive option for a suitable graft source to patients in need of a bone marrow transplant who would otherwise undergo a search for a match donor that could take several months, causing high levels of anxiety and uncertainty for patients with cancer who are at high risk for relapse. In our clinical trials, we consistently delivered Omidubacil to sites within 30 days of cord blood unit selection. Based on our extensive assessment of the market opportunity, we anticipate there will be approximately 2,400 patients receiving Amadubacil each year once we reach peak market share, which would be about three years after launch. We anticipate this peak market share to be between 20% to 25% of the addressable patients. We continue to have active dialogue with physicians and payers, and feedback on the value proposition of Amadubacil has been highly encouraging. Specifically from payers, they are encouraged by the potential for faster time to neutrophil engraftment, decreased infections, decrease in hospitalization, and less graft versus host disease as compared to published literature for other graft sources. Now, in my role as Chief Operating Officer, let me transition to discuss the ongoing activities to address the FDA's feedback about our analytical comparability data to enable the Amadubacil BLA submission. Under the leadership of Vladimir Melnikov, our Senior Vice President, Global Manufacturing and Operations, we have completed the production runs for BLA readiness, and the team is now conducting the revised analysis that FDA has requested to demonstrate that the amadubicel-produced and gametacel's wholly-owned commercial manufacturing facility in Israel is analytically comparable to the amadubicel that was produced at the clinical manufacturing sites for the Phase III study. We feel that the analysis that the FDA has requested is addressable, and we look forward to working with the FDA to complete the requirements to enable the BLA submission. Transitioning to GDA201, there is a great unmet need for relapse refractory patients with lymphoma. In the U.S. and U5, there are approximately 40,000 patients who reach at least their third line of treatment. During our discussions with both U.S. and EU physicians, they were consistent with the challenges they see with their current treatment options and relaxed refractory lymphoma. These included the need for therapies that balance efficacy, especially complete responses, with a tolerable safety profile. In addition, physicians discussed the importance of new therapies with improved duration of response. GDA201 clinical data received positive feedback from physicians and payers in a global assessment, including the balance of encouraging overall and complete responses and the safety data that included no cytokine release syndrome and no neurotoxicity, which are often seen with other cell therapies. Although there have been advances for patients with lymphoma, there are still significant unmet needs in relapsed refractory patients that GDA201 could address. In summary, we are excited by the potential of Omidubacill to be the first FDA-approved cell therapy for bone marrow transplant, and we are encouraged by the clinical data and feedback from physicians and payers. Finally, we are confident that we could address the FDA's feedback from our pre-BLA meeting to enable the BLA submission in a timely manner. We are also very encouraged by the initial GDA201 data that Runeet discussed and recognize the opportunity to further develop a new therapy for patients with relapsed refractory lymphoma. Thank you, and I will now turn the call over to Shai to review our financial results.
spk08: Thank you, Michelle, and good morning, everyone. Today, I will summarize our financial results for the third quarter of 2021. As of September 30th, 2021, our total cash position was $120.8 million compared to $127.2 million as of December 31st of last year. As far as our total expected cash use for this year and the cash runway going forward, I can share that we are actively reassessing our financial expenditures and previous financial guidance due to the updated timing of the OMIDUBCL BLA submission. And we will be updating our previous financial guidance. Research and development expenses for the quarter were $12.4 million compared to $10.5 million for the same period in 2020. The increase was mainly due to Omidubisol commercial manufacturing readiness activities and the advancements of the GDA 201 program, including broadening scientific capabilities and talent. Commercial expenses in the quarter were $6 million compared to $1.9 million for the same period last year. The increase was mainly attributed to progress with Omidubisol commercial readiness activities Going forward, following the FDA recent feedback, we are reassessing our commercial readiness expenditures. General and administrative expenses were $4.8 million for the third quarter of 2021, compared to $2.7 million for the same period in 2020. The increase was mainly due to professional expenses and the hiring of key management positions to support the business growth. Finance income net was $3.5 million for the quarter compared to $0.3 million in the same period last year. The increase was primarily due to non-cash income resulting from revaluation of warrants offset by convertible note interest expenses. Net loss for the quarter was $19.6 million compared to a net loss of $14.8 million for the same period last year. We look forward to providing an update on our financial guidance as soon as we are able to do so. With that, I will turn the call back over to Julian.
spk01: Thanks, Shai. I'm proud to be part of a team that is working towards a very important mission to develop cures for patients with hematologic malignancies and blood disorders. We're excited for the opportunity to continue to leverage our unique NAM-enabled platform across a broad range of cell therapies so that we can fulfill our promise to deliver potentially curative approaches to cancer patients in need. With Omidubacill, we are working towards our BLA submission in the first half of 22 and continue to prepare to be launch ready at the time of approval. We are excited about the potential for GDA201 and are working with the FDA to resolve their issues and initiate a Gametacel sponsored clinical study. Lastly, we are excited by our genetically modified NK cell products and look forward to providing further updates. Now, we will open up the call for questions. Operator?
spk05: Thank you. As a reminder to ask question, you will need to press star 1 on your telephone. To withdraw your question, press the pound key. Your first question comes from Ted Tenhoff of Piper Sandler. Your line is now open.
spk02: Great, thank you so much for taking my question. And I just wanted to ask with respect to the comparability analysis, how big of an issue is this, appreciating that there's no additional clinical requirements or anything along those lines? But, you know, again, with the understanding that your anticipation is to file in the first half, is this pretty routine stuff? Maybe you can give us a little bit more color. Thanks so much, Carson.
spk01: Ted, thank you for your question. It's a pretty technical answer to get into details, and we won't get into the FDA direct feedback. But at a higher level, we do not have to do additional experiments. We just have to reanalyze our data. And I think from where I understand the FDA, it's that it's a pretty routine situation for them.
spk02: Great, thank you. And then just to get a sense with respect to the Israeli manufacturing facility and bringing everything in-house, what kind of supply would you be able ultimately to deliver from Israel? And would that be both Omidubasil and ultimately GDA-201? Thanks so much.
spk01: Yeah, thank you for your question. We have built a state-of-the-art facility in Israel with room to expand. And let me ask Michelle to further elaborate on the state of this facility.
spk00: Thank you, Julian, and good morning, Ted. So, yes, as Julian indicated, the Israeli facility is state-of-the-art, and we built it in a modular approach, so we have the ability to add additional cores as needed. So from the standpoint of addressing the demand, we feel confident that we'll have the capacity because we do have that ability to be modular and add cores. And we built the facility with the vision for both Amaduba Cell and the NK platform. So Amadou Basel, as we've discussed, we're in the process of finalizing our BLA readiness requirements for Amadou Basel and then getting ready for commercial manufacturing. The production team is also working very closely with the R&D team to initiate the technology transfer from our research facility to our facility in Israel, the commercial manufacturing facility for the NK platform, initially first GDA 201. So that was the vision for the facility was both Amadou Basel and the NK platform.
spk02: Thanks, Michelle. Thanks, Julian.
spk10: Pleasure.
spk05: Your next question comes from Jonathan Miller of Evercore. Your line is now open.
spk10: All right. Thanks so much, guys, and congrats on the progress. It still seems odd to me that the FDA would clear the IND and then issue a hold prior to patient dosing. So maybe could you give some color on what interactions you've had since the hold came on, maybe get some clarity on what the official status of that IND is at the moment. And I seem to recall a few weeks ago in the R&D day, you said you thought that this would be a relatively quick process to give them the analysis that they wanted. So I just wanted to check on what your progress was there. And then secondly, on Omiduba, so I noticed the Hior abstract at Ash, which I always love to see. But of course, this is being pulled, it looks, from allele, so it's just versus cord blood. Can you give us some color on what here you've done for OMI versus other graft sources that maybe in the U.S. and the EU are responsible for a greater proportion of overall HSCT? Thanks.
spk01: Okay, John, I will try to address all three of your questions, but in such a way as let me invite Jazz to comment on this. what we can share with the FDA interactions vis-a-vis the GDA201 clinical hold.
spk03: Thank you, Julian. So we just received the hold letter. We are confident that we will be able to progress soon, given the progress that's already been made towards resolving the FDA concerns. The assays have now been qualified for the drug product per FDA's request. And also a new lab has been identified that will help address FDA's comment regarding donor eligibility. So there's been very good progress been had. Ronit, perhaps you can also share a clinical update.
spk04: In terms of the clinical update, yes. So we are continuing to work with the site to move forward with the clinical protocol and the operational activities needed to initiate the sites officially so that once the IMD hold is lifted, we can just move forward to site initiation and then patient enrollment. So from a clinical protocol point of view, we have no other changes that we're making at this point, and we're just proceeding with the operational pieces.
spk01: And, Ronit, since we have you on the line, can you also comment on the HEOR changes Question the abstract and what can we extrapolate that to other modalities?
spk04: Yeah, absolutely. So we are doing HEOR analyses. The first one that will be presented at ASH is a utilization analysis that looks at resource utilization in patients who were on the study. And the patients on the study, as you correctly mentioned, are Omidubacil versus standard cord. And so those direct data from our study could be analyzed and quantified, and that's what will be presented at ASH. Now, at the same time, we are doing additional HOR analyses using CABMTR databases and other sources of information. to look at the broader context of the HUR benefit, potentially from Omidubacil. Those will be presented at a later date in additional meetings that we'll update you about when we're able to.
spk01: Thanks, Rudy. All right. The final part of your final question, maybe turn it to Michelle.
spk00: In regards to... To HUR, Julian?
spk01: I'm sorry, Jonathan, you had a third part of your question. Have we answered?
spk10: I think you got to most of it, guys. Thanks so much. I mean, I guess in detail on HUR, what I was hoping for was some color around what you already knew versus other graph sources. But I'll look forward to seeing this presentation when they're available.
spk01: Okay. Thank you. Welcome.
spk05: Your next question comes from Jason Butler of JMP Securities. Your line is now open.
spk07: Hi, it's Roy on for Jason. Thanks for taking our questions. I guess the first one, just to stay on the Omidubacill BLA, I guess we thought the FDA was looking for clinical comparability as part of the request. Did they change their mind, and did they explain why they changed their mind if they did? And did you show the agency any clinical data from the commercial product?
spk01: Okay, I'll begin. Yes, they did change their guidance to us, and I'll ask Jazz to elaborate. I don't think they justified why they changed their mind, but I think it's commonly understood and expected that if you have analytical comparability, that should lead to clinical comparability. and we do have an expanded access program, so we will continue to collect data, and obviously all those data will be shared with FDA in real time. Jaz, do you have anything further to add?
spk03: Thank you, Julian. So, yes, absolutely. Comparability is a really important topic, and it's key for moving forward in a new manufacturing facility. As such, we have planned proactively for this topic – with the FDA and had justified to them that clinical data should not be required from the facility. FDA has come back and agreed with our proposition that clinical data are not required for submission of the BLA, but they have asked us to represent the analytical comparability data via new analysis.
spk07: Okay, great, thank you. The CITSE poster for GEDA 201 with the machine learning component is pretty interesting. It sounds like you can apply some of that to inform development of the future NK candidates. Can you give us any specifics on how you might apply those results? And then as far as the ASH two-year follow-up for GDA 201, any changes in how you see that product potentially fitting in the treatment paradigm, particularly with the duration? Thanks.
spk01: Okay. Let me take the first part with AI learnings. So what we really have done is detailed transcriptional profiling and metabolic profiling. And then there's a program called Ingenuity, which is an AI learning tool, which classifies pathways and does pathway analysis. And in so doing, we can inform the transcriptional data into this machine learning approach, which surveys all literature, all references, et cetera, and builds on the development of the different biochemical pathways in the cell as well as the metabolite pathways. So, yes, it can be applied and should be applied to every cellular product because there are a lot of things going on during the cell culture period, and particularly with our NAM-enabled activity, we are drastically affecting gene expression in a positive way to make the cells more potent and more useful. Let me turn it to Ronit to talk about ASH.
spk04: Yes. And if I could add something to your comments about the artificial intelligence-mediated analysis, the entire platform of NK cells that we've been discussing is based on the NAM-enabled NK product. And so understanding the mechanisms of the differential expression induced by NAM helps us in the development of all the genetically modified NK constructs. So specific information will be used in the development of those constructs. With respect to the ASH presentation on GDA201, we continue to update the information on these patients. So we had patients who have been treated now up to a little over three years. And so what we will show in the presentation will be information patient by patient of where those patients are after treatment. And this gives us further confidence in the duration and potential efficacy of GDH01 with our company-sponsored study in the cryopreserved formulation. So it just gives us further confidence in the product.
spk07: Great. Thank you.
spk05: Your next question comes from Gregory Renza of RBC Capital Markets. Your line is now open.
spk11: Good morning, Julian, team. Thank you for the update, and thanks for taking my question. Julian, certainly in light of the Amaduba cell delay and a lot going on for Gameta cell, I'm just curious if you could comment on how these developments do affect your overall approach to the larger portfolio, certainly with Amadou Bissell and GDA 201 through 601. What are you looking at? What inputs are you either waiting for, just as far as how you're planning to allocate resources? And you certainly mentioned the reassessment of spend planning. But as far as you're thinking around the portfolio in totality, any comments would be appreciated. Thank you.
spk01: Yeah. Obviously, First and foremost, we have to redress the FDA comments and get back on track with our submissions and the conduct of future trials. As we consider all of this, we still have a strong cash position. And first and foremost, it's going to be dedicated towards the enablement of Omidubacillin GDA201. For programs that are further back and not yet in preclinical development stage, the expenses can be very easily managed. It's not a burdensome process. process for us to be able to prosecute those. But, of course, as we said, we're still reassessing and still need to determine our timelines and our allocation of capital in a responsible way.
spk11: That's helpful. Thank you. Maybe just one last one as you think about capturing value for Amadou Bissau. I'm just curious if you could provide us an update on where your thinking is as far as partnerships or regulatory advancements in those regions. Thanks again.
spk01: I'm glad for this question because we have actually studied the ex-U.S. territories. And let me turn it over to Michelle to provide some insights.
spk00: Thank you very much. So Amadeva Cell ex-U.S. has a very encouraging commercial opportunity in Parts of Western Europe and in Asia, specifically Japan, although we do see an opportunity for Amadubacil to improve outcomes across all graft sources, for Japan in particular, you see about a third of the patients utilizing cord blood as their transplant. So when Japanese physicians saw the head-to-head data versus cord for Amadubacil, they were very, very encouraged. So in both Western Europe and Japan, we see an encouraging opportunity. And, you know, we continue to partner very closely with Josh Hammermash, who's our chief business officer, and others on our team around what's the appropriate way for patients to get access to Amadubacil outside of the U.S. But I think probably the key takeaway is just the opportunity is there, and now how do we move forward in terms of allowing patients to have access. Jazz and her team have had good dialogue with EMA already, so we're We understand the regulatory path forward, so we look forward to continuing to advance those plans around allowing patients to eventually access Amaduba Cell outside of the U.S. following regulatory approvals.
spk01: And I would add to that, Michelle, that since we conducted the Phase 3 as an international study with sites in Europe, I think we have the ability to file in Europe without additional studies for the adult population. Japan is always a little bit trickier because there are unique laws in Japan that would have us required to do a potential bridging study, but all of those are just technical issues and can be addressed.
spk11: That's helpful. Thanks, Julian. Thanks, Michelle.
spk05: Your next question comes from Nishant Gandhi of Dedum and Company. Your line is now open.
spk06: Hi, good morning. Thank you for taking our questions. I'm on for Bill Bloom. I have a question related to the GDA201 data presented at CITC. The results show that there's a decrease in CD16 expression with NAM cultivation compared to the standard NK cells. Will this be a potential issue for GDA201?
spk01: Yeah, let me begin and then turn it over to Ronit as well. First of all, the decrease in CD16 is very modest. We still see high levels of CD16, but to address this and to mitigate this variability in CD16 expression, we are proposing quite high doses in terms of cells per kilo. to overcome the donor-to-donor variability. Ronit, do you have anything to add?
spk04: Yeah, I would reiterate that it was a minimal decrease. In addition, in the context of an overall active, non-exhausted phenotype, the cells are quite active, and so that mitigates any of the somewhat slight decrease in CD16s. in terms of killing potential, et cetera.
spk01: Thank you. And again, we extrapolate that that was borne out in the Minnesota data, and obviously we will look for the same activities as we see comparably potent and active NK cells in the cryopreserved formulation.
spk06: Great. Thank you.
spk05: As a reminder, to ask a question, you will need to press star one on your telephone keypad. Next question comes from Mark Rittenback of Oppenheimer. Your line's now open.
spk12: Hey, good morning, guys, and thanks for the update. Just a quick one from me with regard to the BLA filing. Can we reasonably assume that another Type B meeting will have to be scheduled with the FDA before a submission Or is it kind of a situation where you can do the analysis and provide the data you need and then just submit the BLA without a separate meeting? Thanks.
spk01: Yeah, I think we have a very good perspective on that. And let me ask, sorry, Jess, to talk about our filing approach. Okay.
spk03: Thank you, Julian. So, yes, we have requested a Type B meeting to discuss the analytical comparability data. And thereafter, we're not anticipating an additional Type B meeting equivalent to a pre-BLA. FEA have guided us that we just need to submit an amendment to the IND rather than a Type B meeting for that particular outcome.
spk12: Okay, super helpful. Thank you.
spk05: No further questions. I would like to turn the call back to Mr. Julian Adams.
spk01: I want to thank everyone who joined us on the call today. It is really a pivotal time for Gametacel. We have had FDA issues, no doubt. They're very technical in nature. and very addressable, and we're working hard to attend to that. Over and beyond that, I think the team is extremely dedicated and hardworking, and I can't express enough gratitude to the whole Gameta Cell family for their dedication. Additionally, and I also want to thank patients and their families who have participated in our clinical studies and have really donated to the benefit of our medical knowledge that I hope will prove extremely beneficial to the medical community going forward. And thank you all for your attention this morning.
spk05: This concludes today's conference. Thank you everyone for joining.
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