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spk05: Good morning. My name is Alan, and I will be your operator today. At this time, I would like to welcome you to the Immunon Third Quarter 2023 Financial Results Conference Call. All lines have been placed on mute to prevent any background noise. Following the speaker's prepared remarks, there will be a question and answer session. At that time, you may press star 1 on your phone to ask a question. Please keep in mind, if you are using a speakerphone, you must release your mute function to allow the signal to reach our equipment. Again, that's star 1 to ask a question during the Q&A session. I would like now to turn the call over to Kim Golodets. Please go ahead.
spk01: Thank you. Good morning, everyone. This is Kim Golodets with LHA. Welcome to Immunon's 2023 Third Quarter Financial Results and Business Update Conference Call. During today's call, management will be making forward-looking statements regarding Immunon's expectations and projections about future events. In general, forward-looking statements can be identified by words such as expect, anticipate, believe, or other similar expressions. These statements are based on current expectations and are subject to a number of risks and uncertainties, including those set forth in the company's periodic filings with the Securities and Exchange Commission. No forward-looking statements can be guaranteed, and actual results may differ materially from such statements. I also caution that the content of this conference call is accurate only as of the date of the live broadcast, November 14th, 2023. Immunon undertakes no obligation to revise or update comments made during this call, except as required by law. With that said, I would like to turn the call over to Dr. Corinne Lagoff, Immunon's President and Chief Executive Officer. Corinne?
spk02: Thank you, Kim, and good morning, everyone. Joining me today is Jeffrey Church, our Chief Financial Officer. In addition, Dr. Kirshen Enver, our Chief Science Officer, will be available during the Q&A session at the end of our prepared remarks. Immunose growth and development is dependent on four pillars. Last quarter, I spent the bulk of our time on the development of our placebo-prophylaxis vaccines modality as an out-licensing and partnership opportunity. While I will certainly update you on this modality, and we did have some interesting developments, first I'd like to highlight IMNN001, our DNA-based interleukin-12 immunotherapy for the localized first-line treatment of advanced ovarian cancer in combination with the standard of care chemotherapy, and it's currently in Phase II clinical development. Recall that in September 22, we reached full enrollment of 110 patients, And this year, in September 2023, we reported an additional set of interim more mature data showing promising progression-free survival and overall survival data. In the intent to treat population, we demonstrated a delay in disease progression in the treatment arm of approximately 33% or more than three months benefit. And preliminary overall survival data followed a similar trend, showing an approximate nine-month improvement in the treatment arm over the control arm. The hazard ratio of 0.78 approaches the protocol-defined value of 0.75, set at an 80% confidence interval for the ATT population. Since Ovation 2 is an exploratory study with a total, so control plus study arms, of only 110 patients, it was not powered to a P inferior to 0.05, and the current trend looks promising. Recall that this study is evaluating the dosing safety, efficacy, and biological activity of intraperitoneal IMNN001 in combination with neoadjuvant chemotherapy, or NACP. And this in patients newly diagnosed with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer. NACT is designed to shrink the tumors as much as possible for optimal surgical removal after three cycles of chemotherapy. And following NACT, patients undergo interval debulking surgery, followed by three additional cycles of chemotherapy to treat any residual tumor. And IMNN001 is administered weekly during the course of NACT. So we also reported for the first time data on new subset of patients treated with PARP inhibitors. When we began the Ovation 2 Phase 2 trial, the PARP inhibitors were not part of the first-line maintenance treatment in ovarian cancer. Now they form an important part of the patient's treatment plan. A subgroup analysis of patients who received IMNN001 and post-chemo maintenance therapy with PARP inhibitors versus PARP inhibitors alone in the control group shows positive impact. The median PSS in the PARP inhibitor plus NACT group was 15.7 months. Yet, PSS in the PARP inhibitors plus NACT plus IMNN001 group was 23.7 months or 8 months longer. In addition, the median OS in the PARP inhibitors plus NACT group was 14.6 months, and median OS, overall survival, has not yet been reached in the PAP inhibitor plus NSCT plus IMNN001 group. So although these data are from a small number of patients, they are intriguing. We also saw continued benefits in secondary endpoints, including a 20% higher R0 tumor resection score and a doubling of of the CRS3 chemotherapy response score to approximately 30% in treatment arm versus 14% in the control arm. A complete tumor resection or R0 is a microcosmically margin negative resection in which no growth of microscopic tumor remains in the tumor bed. Chemotherapy response score is considered a good prognostic indicator in ovarian cancer. So that's why those endpoints are important to look at. And safety analysis continue to show good tolerability of IMNN001 in this setting. Now, enrollment in our second Phase II study, which, if you remember, is done in collaboration with the Breast Cancer Foundation, has begun with the first patient treated at MD Anderson Cancer Center, LASMO. The study is evaluating MNN001 in combination with Bevacizumab. All in, the study is expected to enroll 50 patients with stage 3-4 ovarian cancer at several sites, including Memorial Sloan Kettering and Benef Arbor. The trial's primary endpoint is detection of minimal residual disease, or MRD, by second-look laparoscopy, and the secondary endpoint is PSS. Initial second-look laparoscopy data are expected within a year following the completion of enrollment, and final PSS data are expected approximately three years following enrollment completion. This trial would include a wealth of translational endpoints and that understanding the clonal evolution and immunogenomic features of the MRD phase of ovarian cancer. that is currently undetectable by imaging or tumor markers. We will keep you updated as sites are added. And as a reminder, much of this trial is being funded by Breaks Through Cancer. So we are now six to seven months away from seeing the final readout data of our Ovation 2 program. And this is an incredibly exciting time for immunology. If positive, this data would be transformational to the field and would confirm our hypothesis of IL-12 being a potent immunomodulator for cold, solid tumors. We will consult with the FDA on the potential regulatory path forward. Our small phase two is showing promising trends in the ITT population and a strong benefit to standard maintenance PARP inhibitors therapy, which could inform a registration study. PAP inhibitors are known to significantly increase PFS, but the improvement in overall survival is not yet established. And resistance to PAP inhibitor therapy is a concern, which warrants novel combination approaches, such as with the immune agent AMNN001. Let's now turn to Placine, a proprietary monovalent or multivalent DNA vaccine-based on a DNA plasmid that controls the expression of pathogen antigens and a non-viral synthetic DNA delivery system. Plastin is currently being evaluated for the development of next generation vaccines, or as we call them, the vaccines of the future. We continue to bolster our preclinical data set with Plastin, which suggests this asset has been de-risked and is performing as anticipated. Our first pressing product is IMNN 101, which is in final stages of preparation for an IND, Investigational New Drug Application, to the FDA. IMNN 101, which we view as a proof of concept, is designed to protect against SARS-CoV-2 Omicron XBB15 variant in accordance with the FDA's Vaccines and Related Biological Products Advisory Committee, the VRPAC committee, announcement that's been made in June, 2023, and that established a framework for updated COVID-19 doses. IMINON is targeting the first quarter of 2024 for submitting the IND and then enrolling the first subject in a phase one trial in April, 2024, with rapid advancement into phase two trial by mid-2024. So we are excited about the body of preclinical data, and we have been active in presenting this data at various conferences, both in the U.S. and Europe. For example, last month, Dr. Enver presented at the Third International Vaccines Congress, highlighting immunogenicity data and the development status of IMN 101. Dr. Enver's presentation described the multiple advantages of Placine over current commercial vaccine platforms, including more durable antigen expression and T-cell responses versus protein and mRNA vaccines. In addition, preclinical studies show that Placine elicits better antibody response kinetics following a single dose and demonstrates better shelf life of at least 12 months at 4 degrees Celsius and at least two weeks at very high temperatures of 37 degrees Celsius. These characteristics suggest superior commercial handling and distribution properties compared with mRNA vaccines, as well as greater manufacturing flexibility. Compared with viral or other DNA vaccines or protein vaccines, Placine vaccines have advantages in key cell responses, safety compliance, and manufacturing flexibility. Dr. Enver's presentation also describes the versatility of the Placine modality, demonstrating activity against Marburg and influenza viruses in collaboration with the Wister Institute, and activity against Lassa virus, which is being evaluated at the NIH NIH. I remind you that during the third quarter, we entered into a cooperative research and development agreement with the NIAID. This is a three-year agreement under which the NIAID will evaluate the immunogenicity and efficacy of two immuno-DNA-based Lassa virus vaccine candidates. The agency will assess the efficacy of placebo-DNA constructs against Lassa virus in the genetic and non-human primate disease models. including both prime and prime-boost vaccine strategies. We also announced our collaboration with WSTER in January of this year, and the WSTER Institute Vaccine and Immunotherapy Center is uniquely positioned to advance new vaccine formulations to facilitate further expansion and development of the vaccine. Collaboration with outside partners, particularly those that will provide some or all of the funding of the research, are a key pillar of our growth strategy. Now later today, Jean Boyer, our Vice President of Research and Development, will be presenting at the Vaccine Summit in Boston. Dr. Boyer's presentation describes preclinical T cell responses and notes that the induced immune response in vaccinated mice were persistent without decay for up to 14 months after vaccination. So as you might think, we are very pleased with the duration of response. So we believe that our placebo therapy is revealing itself as an important potential option in addressing not only pandemic response, but also a seasonal vaccine option. its stability at regular refrigerator temperatures of 12 months, room temperature stability of at least one month, and stability at high temperatures for at least two weeks, plus the immune response duration and the plug-and-play model using the plasmid DNA backbone has shown excellent preclinical results that are so important to a commercial vaccine product. And this is particularly important as many pathogens such as Lassa virus may arise in geographies where there are challenges with refrigeration storage and distribution networks. In addition, our ability to rapidly switch out antigens and load multiple antigens into the same vaccine should be instrumental in addressing the spread of disease. So in addition, our plasmid modality uses a DNA plasmid and a non-viral synthetic DNA delivery technology for the expression of pathogen antigens. And our DNA-based vaccines can be administered using a standard syringe and IM injection and are independent of viruses or specialized devices for delivery like electroporation. Last quarter, I touched on our work to develop tumor modalities as logical extensions of our prophylactic vaccine modality. Sixth class concerns the application of our DNA technology to produce universal cancer vaccines, also called tumor-associated antigen cancer vaccines. We have initiated preclinical work to develop a trip to an NYSO1 tumor-associated antigen cancer vaccine in melanoma, which we call AMNN201. This work is in a very early stage, and I look forward to admitting you as it progresses. We are also in early discovery of our fourth modality, INDIPLAS, for personalized neoantigen cancer vaccines, and we plan to enter into new collaborations that focus on developing AI-powered computational approaches and state-of-the-art cell sequencing technologies to identify tumor antigens in patient samples and create the next generation of personalized cancer vaccines. And as we stick flags, we'll update you as our development work progresses. Importantly, recall that we manufacture our vaccines at our own CGMP facility in Alabama. And our decision to manufacture in-house offers us many strategic benefits, but notably the control on costs, quality, and timelines. So now I will turn the call over to Jeff Church, who will discuss our financial results. Then I'll come back and provide a review of upcoming milestones and activities. Jeff?
spk06: Thank you, Corinne. Details of Immunon's third quarter 2023 financial results were included in the press release we issued this morning and in our Form 10-Q, which we filed today before the market opened. Immunon ended the quarter with $19.5 million in cash and investments. Our net cash usage for operating activities was $4.5 million for the third quarter of 2023, down slightly from $4.6 million for the comparable prior year period. Cash provided by financing activities of $100,000 resulted from equity sales at the market facility. If we combine the $1.8 million of planned future sales of Immunon's State of New Jersey NOLs, we believe we have sufficient resources to fund operations at least 12 months from the filing date of our 10-Q, which we just filed. Let me now turn to a review of our financial results. Immunon reported a net loss for the third quarter of 2023 of $3.5 million, or 37 cents per share. This compares with a net loss of $6.1 million, or 87 cents, for the third quarter of 2022. Operating expenses were $3.9 million in the current quarter, down 38% from the $6.3 million in the third quarter of 2022. Breaking down these items by line item, research and development expenses were $2 million, a decrease of $400,000 from the prior year's third quarter. More specifically, R&D costs associated with development of our Plastine DNA vaccine modality increased to $800,000 from $500,000 a year ago. Clinical costs decreased to $400,000 from $1 million in the third quarter of last year. as a result of completing enrollment of the Ovation 2 study last September, which Corinne mentioned in her earlier comments. Other preclinical development costs were $300,000 compared with $600,000 in the prior year. Our CMC costs increased to half a million dollars from $300,000 a year ago. This reflects the development of the in-house pilot manufacturing capabilities for DNA plasmid and nanoparticle delivery systems and the manufacture of supplies for IND-enabling studies, as well as the Phase 1-2 clinical trial for our COVID vaccine. General administrative expenses were $1.9 million in the third quarter of 2023, compared to $3.9 million in the comparable prior year period. This $2 million decrease was due to lower non-cash stock compensation expense, professional fees, primarily legal costs, Employee-related costs and insurance. Other non-operating expenses were $400,000 in the third quarter of this year compared to $26,000 for the prior year. This increase was due to higher interest income from the company's short-term investments. I'll just briefly touch on our financial results for the first quarter. I'm sorry, for the first nine months of the year. For the nine months ended September 30, 2023, we reported a loss of $14.6 million in or $1.64 per share. This compares with a net loss of $22.7 million, or $3.42 for the same nine-month period of 2022. Operating expenses were $15.1 million in the first nine months of 2023, an 18% decrease from $18.4 million for the same period of 2022. Cash used for operating activities was a little over $15 million, for the first nine months of 2023. This compared to $18.1 million for the same period of 2022. The decrease was primarily due to a one-time payment of $4.5 million in interest expense resulting from the sale and subsequent redemption of $30 million of Series AB convertible redeemable preferred stock in the year-ago period. Cash used by financing activities of $3.7 million during the first nine months of 23 resulted from the early repayment of the company's loan facility with Silicon Valley Bank that totaled $6.4 million, which was offset by $2.8 million of sales of equity under our at-the-market facility. We also received net proceeds of $1.6 million from the sale of unused New Jersey NOLs in the first quarter of 2023. And as I mentioned earlier, We have an additional $1.8 million of NOL sales that we anticipate this year and next. Our projected cash utilization for the balance of 2023 is approximately $4 million for the fourth quarter. The majority of expenses are related to the development of our Placine modality, including the development of in-house pilot manufacturing capabilities mentioned earlier. I'll now turn the call back to Corinne.
spk02: Thank you, Jeff. Immunon is tightly focused on harnessing the power of the immune system. Our goal is to provide more potent and durable immunity for millions of people with cancer or infectious diseases, while creating significant value for our shareholders. Collaborations are a key component of our strategy, and we are committed to ensuring that Immunon has the most talented advisors available to help us achieve our goal. To that end, we are delighted to extend our scientific advisory board with the additions of Dr. Patrick Ott, clinical director of the Melanoma Disease Center and the director of clinical sciences at the Center for Immuno-Oncology at the Dana-Farber Cancer Institute, and Dr. Sachet Shukla, assistant professor in the Department of Immunology, Division of Basic Science Research at MD Anderson, where he also serves as director of computational biology, ECLIPSE, or Evolution of Cancer Leukemia and Immunity Project. The third quarter and recent weeks were exceptionally busy and full of achievements with more expected milestones to come. Among them, we reported compelling interim data with MNM001 in the Ovation 2 study in advanced ovarian cancer, particularly in a subset of patients taking part inhibitors in combination with chemotherapy and IMNN-001. Our next milestone from this study is to report top-line data in mid-2024. We de-risked our placebo modality across several pathogens of interest by demonstrating the immunogenicity and safety of our vaccines. We generated compelling data in SARS-CoV-2 and IMNN-101, our next generation COVID-19 seasonal booster, will be in the clinic in April with human clinical data expected in the second quarter of 2024. And we also generated excellent immunological response against pathogens of concerns, specifically monkeypox, flu, Lassa virus, and Marbury virus. We unveiled a state-of-the-art manufacturing site in Huntsville to Alabama to reduce our reliance on others. which is intended to give us control not only on qualities of material, but also quality and cost. And we entered into collaborations to advance our technology with more to come and to build capabilities for the development of cancer vaccines. Before we take your questions, I want to mention that we will be available for one-on-one meetings with the investment community the week of January 8th in San Francisco. concurrent with the annual JP Morgan Healthcare Conference. So please contact our investor relations firm, LHJ, if you would like to schedule a meeting. With that, I open up the call to your questions. Operator?
spk05: We will now begin the question and answer session. To ask a question, you may press star, then one on your telephone keypad. If you're using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star, then two. At this time, we will pause momentarily to assemble our roster. The first question comes from Emily Bodnar of HC Wainwright. Please go ahead.
spk00: Hi, good morning, and thanks for taking the questions. I wanted to ask on ovation to the recent data that you had. So obviously, you talked about the benefit you had with PARP inhibitors and assumingly also benefit in BRCA-positive patients. But you had a previous interim data readout where you mentioned that you had a benefit in BRCA negative patients. So curious if you can maybe speak to why you think you might be seeing the switch there and why you think there is synergy with PARP inhibitors. And then just discuss how you're thinking about next steps, whether you're planning to evaluate IMNN001 broadly or not. specifically a combination of PARP inhibitors. Thanks. Thank you very much, Emily.
spk02: So I will start, and maybe I'll also let Urqoshiz answer your questions. So you're absolutely correct. If you remember last year, we did a preliminary data cut with very immature data, and we show benefits in the BRCA-negative population. uh now that we have more patients and more events uh so this difficult was with uh 70 events across uh both arms we are showing a benefit in the itt population uh and we specifically decided to look at patients treated with pop inhibitors because um the the uh the molecular signature with bracket doesn't give the full answer uh as you know um Patients receive PARP inhibitors if they are BRCA positive. Even BRCA negative patients get PARP inhibitors, as it has been demonstrated that it can increase progression-free survival in HRD-positive patients. And so we wanted to be a bit more accurate in our description in designing the subgroup of patients we wanted to look at. And as you know, HRD, which is homologous recombination deficiency, is very common. 50% of women with advanced ovarian cancer have tumors that test positive for HRD. And only half of these are BRCA mutations. So it's very interesting to look at patients treated with POPs, regardless of their BRCA status. to get the granularity and we'll get this data as we get to the top line data. So what is our assumption here in terms of what's happening with the PARP inhibitors? So we call that the PARP inhibitors are administered after the chemotherapy. We discussed this with our advisors and their hypothesis is that IL-12, so IMN001, kind of sensitizes the tumor for the PARP inhibitors. So that's what they are thinking, which makes sense if you want. And because our hypothesis is that IL-12, as being a very potent immunomodulator agent, can turn a cold tumor into a hot tumor. So as we progress, of course, we'll talk to the regulators. We want to discuss with them the regulatory path, and we should do this sooner than later in anticipation of the top-line results in June. Maybe, Khrushchev, if you'd like to add to what I have said?
spk03: Yeah, I mean, I think you covered pretty much, Corinne, but I just wanted to start with Emily's Last part of the question, we should just kind of address that potential mechanisms. So Emily, as you know, back in phase one study, we did report change in the tumor microenvironment from the treatment, where we saw increase in CD8 positive cells to immunosuppressive marker ratio. That suggests that the environment was transitioned from immunosuppressive to more immunostimulatory. So that itself, as Corinne said, You have this environment now, before PARP come in, your tumor environment has changed to be more fighting against tumor. That could be one potential mechanism. In other words, you sensitize the tumor for PARP. As you know, PARP causes cell death. DNA repair doesn't happen. and that releases antigen, and if you have a good immune-stimulatory environment, that release antigen will potentiate the immune response. That's a potential mechanism, and I think that's it, but I think that potentially theoretically it makes sense. Now, first part of your question was about BRCA negative, and Corinne did eloquently point that out as well, that that was early data, but also the molecular signature-wise, it's a lot more to learn in ovarian cancer. Initially, we defined it as BRCA positive, BRCA negative, That's more of a somatic, but in tumor also you have this homologous recombinant deficiency. And that's a lot of variability, variety there. There's several enzymes, some are deficient in some patients, some are not deficient in other patients. So we're also trying to look into the database to better understand the molecular signature, not just BRCA positive, BRCA negative, but for the subtypes as to really what's the extent of deficiency and see if we can make some correlate. If you do that, then you really lower the sample sizes because You already have about 70 and now you're going to further break down. But I think that's what we're trying to look into further, understand these results, understand the mechanism, maybe through some pre-conflict studies. But also what's next type of broad application you ask or maybe more limited to. I think PARP combination certainly directs us to a specific type of application. But as you learn more about molecular signature from this ongoing study, more data will come in. Perhaps that will shape up our future direction strategy.
spk00: Very helpful. Thank you.
spk05: Thank you. Our next question comes from James Malloy of Alliance Global Partners. Please go ahead.
spk04: Hey, guys. Thank you for taking my questions. I just want to get your thoughts on, you know, the Ovation 2 data coming out here mid-next year. Can you walk through what the potential Phase III, I know much of it depends on how the data looks, what a potential Phase III or Phase IIB trial design or next steps on trial design might be from that? And then on the Avastin trial, the Phase I and II Avastin trial, the interim data coming up here, what should we be anticipating here in the second quarter for that, the interim look?
spk02: Thank you, James. As I mentioned, for the Innovation II program, we'll be discussing with the FDA on the potential regulatory pathway. We notably would be very interested in breakthrough designation that could shorten considerably the development timelines. So that's something that we are working on. And you can imagine that what What we have in mind is we could continue enrolling in the current Phase II. As we mentioned, this Phase II program is only exploratory with 110 patients, so we would need to increase the number of patients included in the trial. And certainly, we would look at the subpopulation of treated with PARP inhibitors. So that's what we have in mind right now. But unless we speak with the regulators, we don't have, until we speak with the regulators, we have not confirmed any development plan at this stage. And Krisha, do you want to comment on this point before I address the MRT study?
spk03: No, I think you've covered it. I think that's exactly, we're just still in formulating our strategy and perhaps health firm agency or feedback will be important.
spk02: And on the MRD study, right, so what we expect is like a year from enrollment, you know, we would have already some interesting data. So maybe, Christian, do you want to comment on this and what we expect from this study, which also has in the protocol design a number of translational data accounted for that, you know, I think would be super informational for us. Do you want to comment on the MRD study? Yeah, no, absolutely.
spk03: Of course, of course, thank you. James, yeah, so as you said, maybe second quarter next year, what kind of information is anticipated from MRD study? So the MRD study, this is the first time we will be testing imidon-01 with Avast in humans. We have never done that before. So Avastin is now in a new adjuvant setting. It's been approved. So I think the first lead phase one part of the study is to really look at the safety with Avastin. So that's, I think we want to get that out of the way. We don't anticipate an issue. So that's something I guess will be to move on from a safe combination and then open up the study into that population. Now, what to anticipate is certainly more enrollment by that time, second quarter. But down the road, as Corinne said, this study is really important because when patients get cytoreductive surgery after three cycles of chemo, tumor burden is surgically removed, and then you get another three cycles of chemo, and then nothing happens until maintenance therapy. But now we'll be looking at the... peritoneum again after the surgery and one month after, and we anticipate that by, you know, one, a vast number of, we have pretty clinical data to show benefit, would reduce the burden, the residual disease, and lower the residual disease will be anticipated with longer survival. So we expect to see maybe some patients, I can't promise in second quarter we'll have that, like I said, safety plan has to complete. But what you anticipate down the road will be the second look at proscopy, how many patients have, you have seen those residual disease versus what's known, which is about 70% of patients have residual disease minimal versus we're trying to get it down to about 35%. So we might see some of that data coming in, but also we are collecting a lot of translational research, understand the tumor biology, That is probably will be done when all the patients have sort of all the samples have been collected. So I think safety plus some maybe update on minimal residual disease and obviously PFS data, our zero data secondary endpoints, as with OVSEN2, we have been updating the community over the years, over different time periods. So we'll probably do some of that, but clearly this study will have a lot of translational component to it. to understand the combination.
spk04: Great. Thank you for that. And I see also you guys signed a cooperative R&D agreement, the NIAID, or you're talking about it here in the third quarter, the Lassa virus. Does Lassa virus have that potential for priority review voucher down the road?
spk02: Yeah. So that's, thank you, James. That's a good question. So, you know, as I mentioned with the development of the placebo therapy, you know, we, uh, would look at partnerships to develop vaccine candidates. And if NIH is interested, why not? But maybe, Krish, do you want to elaborate on this agreement that we have with NIH?
spk03: Yes, of course. So, James, initially, of course, I mean, Placine is a new platform, as you know. The history suggests that we have, you know, in just a couple of years, we have kind of embarked on that. So our goal has been to demonstrate proof of concept or application in as many indication opportunities we can. Some we have facility like biosafety level for some viruses. There you would need some collaborations and IAD is looking at LASA. They have looked at LASA with different approaches in the past. They have ground force in West Africa, including Mali, where they have done some clinical trials. So as commercial potential for the company, as Corinne said, may not be as today, you know, it doesn't look very new, but it's increasing. There's a report on LASA that come out where there's more incidents coming in South America and perhaps also heading West. So who knows, but certainly in IAD, if the results are positive in animal studies, then in IAD is interested in pursuing LASA in West Africa. And that would be another sort of proof of concept approach for our technology to see the different kind of virus. So as such, company-wise, again, I defer to Karin on that, but certainly that's not our big sort of commercial aspect, but through collaboration, proof of concept, and if an IAD wanted to do that further, why not? Would the company be taking a lead role at some point? I think Karin may comment on that. But right now we're focused on SARS-CoV-2.
spk04: Okay, great. Last question then just for Jeff. Jeff, OpEx has been kind of trending down the last few quarters, doing a good job shepherding cash. Is this the level we should anticipate going forward, or do we start seeing OpEx perhaps bumping up going through 2024?
spk06: We anticipate our cash utilization in sort of the low $4 million a quarter range, and we'll manage to that. The big driver will be the Phase 1-2 study. But as we mentioned, the Ovation 2 is fully enrolled. We're doing just a follow-up on that. And then the Breakthrough Cancer Program with the Avastin is being funded largely by that foundation. So we're going to manage to, you know, a quarterly cash utilization of, you know, $4 to $5. four and a quarter million.
spk04: Great. Thank you for taking the questions.
spk05: The next question comes from Kemp Dolliver from Brookline Capital Markets. Please go ahead.
spk08: All right. Thank you, and good morning. So I have a couple of questions about the – I am – and then 001 trial in combination with Avastin. First, when do you expect to activate Dana-Farber and MSK?
spk02: Thank you, Kent. Yes, very soon. We have not announced it yet, but we're expecting that there'll be a case MSK will be on board pretty soon. Christian, do you want to give a bit more color to my answer?
spk03: Yes. Exactly, Corinne is right. We did a site initiation call with them a couple of weeks ago. We did respond to their IRB question standards. So I think they could be very soon activated. The other one is Johns Hopkins for Phase 1 PARP. But Dana-Farber had, from the very beginning, they would participate from the Phase 2 part of the trial. As Karin said, MSK should be, there's no hiccups unexpected. We should be making that announcement. They should be coming on board. A lot of paperwork has been completed with them. It's basically setting up the contract, all the different approvals from the committees. We have made good headways in that direction. So MSK is very likely coming up soon.
spk08: That's great, thank you. And this trial is using um i believe carboplatin as in the comparator arm and you know that's been in short supply how have you been able to manage that in terms of a both avail you know availability but then also cost yeah i mean uh that's a good question we did run into this issue back in 2012 with doxil if you remember that was a big issue but no we haven't i mean the centers that we are uh doing our studies are really big names so
spk03: The investigators and MD Anderson has not brought that to attention in terms of the cancer center having any deficiency. And you're right, this chemotherapy is carboplatin and paclitaxel. So we haven't really heard from the sites yet, certainly these big centers, having any deficiency issues. Cost-wise, it's the standard of care normally given to patients, but cisplatin is another of course, you know, a platinum-based drug is used. So I'm not forecasting that you may use cisplatin, but I haven't heard anything about any problem with these cancer centers. So I don't anticipate, but cisplatin is always available there as another platinum drug. So I probably don't want to say more here because you did point out something, and we haven't been really told that would be a concern with these centers. Maybe a lot of small centers, perhaps that could be an issue as There was the docs and then we had about 25 sites or so. So we had about four sites so far and names. So I don't know. I'll look into that. Certainly we haven't been told by the sites yet, any issue down the road, certainly.
spk02: Yeah. And the costs of syndromes are paid by the Breast Food Cancer Foundation.
spk08: Right. So two questions. I apologize. The first one is going to require you to repeat some information, but I just want to be sure I understood for this trial the timing of anticipated completion of enrollment and availability of the first set of interim data you'll provide because I think the line was breaking up and it wasn't clear how those line up together.
spk02: All right. So, I will stop and I'll let Chris continue. You know, we anticipate that enrollment will be done cautiously for the first phase of the trial, which is the safety analysis of the combination of 001 and Avastin, at least that's what the investigators are telling us. And, of course, you know, as more centers come on board, you know, you will see an acceleration in their enrollment. But, Krzysztof, please, if you could answer the second part of the question.
spk03: Right. I apologize if there was a signal issue. So what we had said in response to, I believe, James' question, that initial set of the data would be safety, of course, because it has not been combined with Gen 1. So we hope to finish that phase one part of the study out. I mean, It all depends on the enrollment. Four sites have been put into place initially, but we are trying to expand that. And I would think second quarter would be more of a safety clearance that indeed this new combination is safe in patients. And then from second quarter on, if we get more sites on board, we can probably get more enrollment and begin to update on the second laparoscopy results over time. and perhaps maybe in quarterly update or so. But in terms of completing that study, I would say, Corinne and even Jeff can chime in here, I would say at least about two years to complete the enrollment and at least with these three sites plus a couple more sites. So I think immediate is the safety data and some efficacy data may be trickled down. We can update this open-label study. I would say within two years, maybe some significant data. But overall, survival is a longer endpoint. That will probably take a long time to mature. But certainly secondary lacrosse could get within two years some meaningful data, hopefully. Again, this is what we are anticipating, and we'll also get faster with more sites.
spk02: Right. And, Kim, at this stage, we cannot give very precise timelines. We're waiting for more centers to enroll. It's a preliminary assessment, really.
spk08: Correct. No, that's super. Thank you. And just the last question is for Jeff, and it relates to the trial and the breakthrough cancer reimbursement. Will those essentially, the reimbursements just net against your R&D expense, or will those show up as, you know, grant revenue?
spk06: It'll be the former, as we anticipate. We'll just treat what we're going to be paying as R&D expense.
spk08: Fabulous. Thank you very much.
spk05: The next question comes from David Bouts from Zach's Small Cap Research. Please go ahead.
spk07: Hey, good morning, everyone. Thanks for the update this morning. I just have a A question on the COVID seasonal booster vaccine plan for the Phase 1-2 trial. So I'm assuming that the Phase 1 trial is going to be a safety study and healthy volunteers, but then will you look to do an efficacy study in Phase 2?
spk02: David, thank you for your question. Yes. So in vaccine development in Phase 1 already, we will have immune response data, right? So you have the neutralizing antibody data. that you get quite rapidly after the injection of the vaccine. So the phase one will already give us that data. And that's why in the design of our program, we are looking for phase one slash two. So we'll simply continue enrolling in a phase two program with the chosen dose.
spk07: Okay, and then will the phase two have an efficacy outcome?
spk02: Yeah, efficacy outcome and immunogenicity, reactogenicity as well.
spk03: Yeah, so as you know, vaccine trials, efficacy is really not challenging human being, right? So it's really the titers of the antibodies, neutralizing antibody, really, that's what you look at above baseline. So I think that's essentially maybe what you're probably referring to, efficacy part. So in phase two, we'll be looking at that, that some of the titers from baseline have gone up against this particular variant that we are targeting and the variant of the, you know, concern at that time. So basically neutralizing antibody titers above the baseline, that's the measure of efficacy, you know, in vaccine studies typically, as opposed to the therapeutic marker, right, in cancer. So, yeah, we will be looking at that in phase two.
spk07: Okay, great. Thanks for taking the question.
spk03: You're welcome.
spk05: Thank you, David. This concludes our question and answer session. I would like to turn the conference back over to management for any closing remarks.
spk02: Thank you. So we believe that our technology holds excellent promise in immunology as our work in providing options to women with ovarian cancer looks very interesting. And we are excited about reporting phase two data around next spring, next summer. We've also been using the phrase vaccine of the future to describe our work, and that's exactly what our vision is, to be the provider of safe and effective vaccines that are superior to current vaccines in terms of durability and breath of protection, are stable at workable temperatures, can be manufactured rapidly to respond to evolving pathogens, and offer better compliance for mass immunization with no need for device or virus. We very much look forward to keeping you informed of our progress. Have a very nice afternoon.
spk05: The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.
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