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Edited Transcript of ZIOP earnings conference call or presentation 5-Mar-19 9:30pm GMT

Q4 2018 ZIOPHARM Oncology Inc Earnings Call

NEW YORK Apr 25, 2019 (Thomson StreetEvents) -- Edited Transcript of ZIOPHARM Oncology Inc earnings conference call or presentation Tuesday, March 5, 2019 at 9:30:00pm GMT

TEXT version of Transcript

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Corporate Participants

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* David Connolly

ZIOPHARM Oncology, Inc. - VP of Corporate Communications & IR

* David M. Mauney

ZIOPHARM Oncology, Inc. - President

* Laurence James Neil Cooper

ZIOPHARM Oncology, Inc. - CEO & Director

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Conference Call Participants

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* Eric William Joseph

JP Morgan Chase & Co, Research Division - VP & Senior Analyst

* Reni John Benjamin

Raymond James & Associates, Inc., Research Division - Senior Biotechnology Analyst

* Sean Lee

H.C. Wainwright & Co, LLC, Research Division - Equity Research Associate

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Presentation

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Operator [1]

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Good day, ladies and gentlemen, and welcome to the Ziopharm Fourth Quarter 2018 Earnings Call. (Operator Instructions). As a reminder, today's program may be recorded.

I would now like to introduce your host for today's program, David Connolly, Vice President of Corporate Communications and Investor Relations. Please go ahead.

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David Connolly, ZIOPHARM Oncology, Inc. - VP of Corporate Communications & IR [2]

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Hi. Thank you. We're starting a few minutes late this afternoon as there was a last minute rush of callers. We wanted to give a few minutes to let folks actually get engaged on the call. And earlier today, we issued a press release with our financial results for the fourth quarter and the year-end of 2018, and that press release is available on our website, www.ziopharm.com.

We'll discuss these results today and company highlights during this call, and representatives of the company will make a number of forward-looking statements that are -- including statements regarding the potential of therapeutic candidates in our development pipeline. Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond our control, including the risks and uncertainties described in our 10-K -- or SEC filings.

And moving to Slide 3. There is one housekeeping item for today's call before we begin. For those of you following along online, you are now in control of advancing the slides, not us and the folks on this side of the phone call.

And speaking on today's call are Dr. Laurence Cooper, CEO and Director for Ziopharm Oncology; and Dr. David Mauney, our company President. After their remarks, we'll open the call to take any questions you may have. And with that, I'll turn the call over to Dr. Mauney.

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David M. Mauney, ZIOPHARM Oncology, Inc. - President [3]

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Thank you, David, and thanks, everybody, for joining us on the call today. We'll start on Slide 5 and we'll touch on it briefly. However, we ended 2018 with a very strong quarter, a quarter that truly transformed our company's ability to achieve immediate and longer-term success. As a quick reminder, we secured a new licensing agreement, we eliminated $157 million in convertible preferred stock, we raised $50 million and established 2 new partnerships and collaborations. We are in our strongest position ever to execute in 2019 and have already demonstrated success in most of these efforts.

We have noticed considerable change across the organization now that we have full operational and clinical control over our platforms. From a qualitative viewpoint, I can tell you that we have increased our operating efficiency in just about every category. We have seen dramatic increase in interest from a recruiting perspective, and with regards to outreach to potential partners, analysts and investors, we have seen a considerable change in posture, and in some cases, noticeable surprise and renewed interest in our story. We will obviously push this trend as strongly as we can going forward.

We have also made considerable progress in adding and promoting within our organization, and we continue to build a world-class team in every area with particular focus and active external recruiting efforts to expand our C suite and manufacturing capacity in Houston. In addition, we now enjoy an almost entirely revamped Board of Directors, having changed 4 of the 6 occupied seats and naming a new lead director. We have one open seat remaining, and a very active outside search is ongoing to fill it with a seasoned leader who will bring valuable and unique skills to our table.

With demonstrable success seen in multiple areas over the last 1.5 quarters, we believe this is an excellent time to be a shareholder in Ziopharm. We are tightly focused on continuing this strong momentum, in turn bringing more value to our investors, and most importantly, bringing much needed therapy to patients.

Now to Slide 6. We are fortunate to enjoy world-class partners, and with each existing partner, we are expanding those efforts. First, we believe Regeneron represents a best-in-class entrepreneurial partner for our Controlled IL-12 platform, and we could not be happier with their commitment to our efforts. Our teams are thoroughly engaged across multiple levels, and we are excited for our efforts to bear more fruit throughout 2019 and beyond.

Second, we enjoy a meaningful relationship with MD Anderson Cancer Center and have over $27 million in prefunded capital to put to work there. While the initial work has been focused on CD19, we now are actively working with senior administrators and an expanded group of physician leaders there to broaden this relationship for the years to come.

Our CAR-T based relationships also extend to James Huang and the teams at Panacea Healthcare Venture, TriArm Therapeutics and Eden BioCell, and up to $35 million in financial commitments they've made to our CD19 CAR programs in China. James spent years looking for best-in-class technology to solve clinical and commercial needs of the China CAR-T marketplace, and we could not be more delighted and appreciative of his intellectual and financial commitment to us.

Lastly, Dr. Steve Rosenberg and his team at the NCI have committed tireless work in bringing some of our most important technology towards the clinic. We are pleased to announce today that we have extended the CRADA, the Collaboration Research and Development Agreement (sic) [Cooperative Research and Development Agreement], with the NCI for 2 more years, a sign that both parties are committed to and excited to be developing Sleeping Beauty TCR T-cell therapies to treat solid tumors. We are delighted to continue our work for the years to come with Dr. Rosenberg and his team.

Importantly, we affirmed today that our Sleeping Beauty TCR T-cell therapy will be in the clinic in mid-2019. It should be noted that all facets of the regulatory work to allow us to be in the clinic is done entirely by Dr. Rosenberg's group at the NCI. Historically, the NCI does not issue press releases or make public notifications to highlight regulatory submissions to the benefit of companies like ours. However, since we reaffirmed that we will be in the clinic in the middle of 2019 -- and we remind you, this guidance is in conjunction with and supported by the teams at Ziopharm and the NCI, we remain on track with our 2019 time lines. As a publicly traded company, of course, we look forward to being able to share with you material progress related to the trial as appropriate.

The NCI's process to assemble the IND involves many steps, which we understand have all now been achieved. Let me provide some granularity and assurance surrounding some of the critical work the NCI has done thus far. They have shown, for example, that the Sleeping Beauty system can express high levels of TCRs targeting more than one neoantigen, that these T cells can be grown to numbers needed in prior trials infusing TIL for solid tumors and that the produced T cells meet anticipated release criteria. The standard operating procedures, the documents that govern the production of the Sleeping Beauty modified T cells have all been written. All this material has passed the internal scrutiny of the NCI and is the basis of the IND application to the FDA. As we said before, the NCI is responsible for this process, and we are very confident in their abilities as we move to the clinic.

As we also said in November, our use of Sleeping Beauty is a first of its kind for TCRs and, with a non-viral means to gene transfer, could be a key to targeting solid tumors of all types and, most importantly, could enable truly personalized autologous therapies with multiple targets per patient. We see this path as nearly impossible to commercialize with today's viral-based manufacturing process. The team at the NCI has reported back that the Sleeping Beauty system could be a terrific solution for this complex process, and rest assured, Ziopharm and the NCI are both poised to enter the clinic with a high degree of confidence in this approach.

Slide 7, please. Ziopharm enjoys very significant markets for each of the 3 pillar programs. TCRs, for example, have the ability to target solid tumors. Let me remind you how significant of a market this is. According to the latest statistics from the American Cancer Center (sic) [American Cancer Society], there are 1,762,450 new cancer cases every year in the United States and 606,000 cancer deaths. We now know that the vast majority of these deaths are caused by metastatic, epithelial or solid tissue cancers. Said another way, the solid tumor market represents billions of dollars of potential opportunity, even at very modest penetration rates. For CD19 lymphomas and leukemias, there are approximately 130,000 new cases each year, and we know well that companies with CAR-T therapies have seen multi-billion-dollar valuations, even with the prospect of modest commercial penetration. And Controlled IL-12 has a clear market for recurrent glioblastoma with more than 11,000 cases in the United States each year and more than 13,000 in Europe. In fact, the global glioblastoma multiforme, or GBM, market is estimated to reach $1.15 billion by 2024, fueled by the increasing occurrence of cancer in the central nervous system among the aging population. We have seen past precedent that even with modest improvements in survival, extremely large valuations on drug approval for this indication alone can follow. Ziopharm, thus, has an immense chance to make a huge difference in the lives of so many people suffering from liquid and solid cancers, and the summary is we now have a clear and independent path forward, and we have 3 amazing pillars to build upon with our technologies in TCR, CD19 CAR and IL-12.

Slide 8. Now to update you on our current financial status. As we detailed on our press release this afternoon, we have approximately $61.7 million in cash at Ziopharm as of December 31, 2018. This is the primary source of cash for our Controlled IL-12 platform, the work with the NCI as well our G&A, which is primarily in Boston, and this cash takes us into the second quarter of next year. In addition, there is $27.8 million at MD Anderson prepaid to cover our clinical and preclinical development work done there. These resources cover all of our existing CD19 work planned at MD Anderson well into 2020 as well other important initiatives we are exploring now in partnership with them.

As we now turn a new leaf and execute in 2019, we are filled with confidence as the changes in our ability to execute and build are absolutely tangible, and we are on the cusp of having all of our technologies in the clinic this year. Indeed, we believe now is an excellent time to be a shareholder in our company.

And with that, I'd like to turn over the call to Laurence and Slide 9. Thank you.

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [4]

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That's right, and well said, David. Thank you. We're a different company from years past. After we restructured the license agreements in October of 2018, we gained autonomy and operational independence, which allows us to go in a direction that is beneficial to us and to our shareholders, and as David detailed, we are well on our way in that direction.

We have continued support from our investors, mutually beneficial relationships with partners of the highest caliber, and we're enhancing and expanding these relationships. We are building and expanding our in-house capabilities and expect to have manufacturing and laboratory facilities as well as infrastructure and programs developed in Houston. This will enable us to broaden the number of patients who can benefit from our programs.

Slide 10. We are on the cusp of treating patients with solid tumors with our neoantigen-specific TCR T cells, a therapy designed to be unique to each patient. This a long sought-after goal by many, and it is Ziopharm that will be in the clinic with this mid-year. This is a huge milestone for our company.

In addition, we expected the off hold and in the clinic in the second half of this year with a very rapid manufacturing of genetically modified CAR T cells to produce patient-derived CD19-specific CAR-T in 2 days or less. We have made significant strides in our engineering work for improved cell viability for this third-generation Sleeping Beauty trial. Furthermore, having recently come back from China, I can tell you our partners at TriArm are already fast at work to bring our CD19 therapy into the clinic as soon as possible.

Lastly, we are seeing excitement with our Controlled IL-12 program as we expand our clinical footprint in the treatment of glioblastoma over the last quarter or so. Our immunotherapy for this brain tumor has captured the interest of clinicians, potential partners and patients alike, as there is optimism about our data which is showing improved survival.

With that overview, let us dive into each of our 2 platforms: Sleeping Beauty and Controlled IL-12. So moving to Slide 11. Let me begin with our Sleep Beauty platform and an update on our TCR-T program and specifically the timing of the launch of the first-in-human trial using a non-viral gene transfer event for TCR therapies targeting neoantigens in solid tumors. This work is being undertaken in collaboration with the best in the field, Dr. Steven Rosenberg, and his continued enthusiasm to get this started is a huge validation of our efforts.

As we said before, Dr. Rosenberg and his team have 2 approaches to genetic modification of T cells to express neoantigen-specific TCRs. We understand that this process at the NCI from identifying the antigens to selecting the TCRs targeting these antigens is similar for Gilead and Ziopharm. However, the important primary difference is the gene transfer event itself to integrate the introduced TCR is where we diverge because Ziopharm has a non-viral process.

We use the Sleeping Beauty system and Gilead uses retrovirus. We feel our non-viral approach is a better pathway to commercialization of TCR-T targeting solid tumors. We know that to cure solid tumors, one must infuse T cells against multiple neoantigens. This places added burden on programs that have decided to use virus to reprogram T cells as one needs not just one retrovirus to express one TCR per patient but multiple retroviruses per patient, depending on the number of targets. To us, this is not commercially feasible. Simply put, DNA plasmids from the Sleeping Beauty system are advantageous in that they are scalable to meet the needs of targeting multiple patients and multiple neoantigens within a single patient.

We note the investment community reacted with applause late last year when it was revealed that the first 2 patients had been dosed at the NCI based on expression of TCRs using retrovirus. We anticipate having the same success enrolling and treating patients at the NCI using Sleeping Beauty and look forward to announcing similar news mid-year.

Slide 12. Moving on to the CAR-T program, also built on the Sleeping Beauty platform, is our work to very rapidly manufacture CD19-specific T cells. This is now advancing on 2 continents, in Greater China and in the United States. There are international markets for low-cost, less complex CAR-T therapies targeting CD19-expressing leukemias and lymphomas. CAR-T therapy that costs $300,000 to $400,000 or more per patient just for the drug and not including the ancillary costs is unsustainable, and we are seeing that reality play out. We believe using the body itself to propagate the infused effector cells is the best solution to the problems plaguing the CAR-T space.

Our system is centered on DNA plasmids from the Sleeping Beauty system. This enables us to genetically modify resting T cells from the blood without the need to propagate them with the associated expense and time of placing them for lengthy periods in tissue culture. With our proprietary membrane-bound IL-15 for CD19-specific CAR, we have a built-in go signal into the T cells, enabling them to sustain growth after infusion. Indeed, this may one day also take away the need for lymphodepleting chemotherapy. Furthermore, we expect to be able to infuse far fewer T cells compared to competing CAR-T therapies, which we believe can benefit patients with reduced risks of cytokine release syndrome.

We remain confident that we will be in the clinic in the second half of this year as we've been working to improve cell viability levels. This required an engineering solution with improvements in cell processing, efforts for which we have made great progress. As you recall, this effort in the United States will be initially performed at MD Anderson, and their clinical team is primed to move this forward. And we look forward to updating you when we're off hold.

We also expect to advance the same very rapid manufacturing of CD19-specific CAR-T therapy into the clinic with Eden BioCell in Greater China. The teams have met multiple times both in the United States and in China. Together with TriArm, we'll have the infrastructure and personnel to undertake this approach to CAR-T and are thrilled with this relationship. Under the joint venture structure with Eden BioCell, we will have the flexibility to build our own enterprise with its own operating and clinical plans and look forward to updating the market as future plans take shape.

Slide 13. Turning from Sleeping Beauty to our second platform, which is Controlled IL-12. We have witnessed a dramatic increase in clinical interest in the programs which -- with brisk enrollment of patients with recurrent GBM. Regarding our expansion substudy, we recently announced that we exceeded our plan total of 25 patients by enrolling 36 patients in less than 6 months. We attribute this to the compelling data on overall survival, particularly in patients who received 20 milligrams of veledimex and low-dose steroids.

As a reminder, we showed data at the Society of Neuro-Oncology last November where the median overall survival for that subset of 6 patients reached 17.8 months, which is quite remarkable compared to historical controls of 7 to almost 10 months. We now have more than 50 patients in the 20 milligrams of veledimex cohort with the expansion study completed, and we expect approximately half of those will be treated with low-dose steroids. We look forward to providing an update this year.

Our decision to focus on combining IL-12 with PD-1 inhibition is supported by other studies that recently reported a potential survival benefit to PD-1 blockade in patients with recurrent GBM. Recent studies have shown immune checkpoint inhibitors can have a positive impact on brain cancers in select patients. Investigators in a multicenter study published data in Nature Medicine last month demonstrating the subset of those patients with recurrent GBM who receive PD-1 inhibitor, pembrolizumab or Keytruda, when administered before tumor resection achieved a median overall survival of approximately 13.2 months. The reason that PD-1 inhibition appeared to work is activation of the immune system and the associated production of gamma interferon in the tumor microenvironment. As a reminder, our IL-12 monotherapy data in a subset of patients demonstrated 17.8 months of median overall survival. And our biopsy data, which we have talked about before, revealed production of interferon gamma. Thus, we remain optimistic about survival of patients that receive both Controlled IL-12 and PD-1 inhibitors.

Slide 14. We are now combining our Controlled IL-12 platform with immune checkpoint inhibitors, enrolling patients with recurrent GBM. We have 2 combination trials with PD-1 inhibitors. In our Phase I dose-escalating trial, in combination with Opdivo or nivo which began dosing in June of 2018, we have commenced the third cohort combining Opdivo with IL-12. We expect to complete enrollment in that trial in the second quarter, and then we will open a Phase II trial to evaluate Ad-RTS-IL-12 plus veledimex in combination with Regeneron's Libtayo or cemiplimab also in the second quarter of 2019. Regarding the combination with cemiplimab, since this is a Phase II trial without the constraints of pauses in enrollment due to multiple cohorts, we expect this checkpoint combination trial to accrue quite rapidly.

Slide 15. In summary, we have multiple shots on goal with each program in the clinic this year. For our Sleeping Beauty platform, we stand poised to treat patients with solid tumors with a first-in-class, non-viral TCR-T therapy that can be scaled to target individual antigens in solid tumors. In CAR-T, we're advancing the very rapid manufacturing of CD19-specific therapy in the United States and in China, bringing a solution to the cost and complexity issues that are standing in the way of commercial success for approved CAR-T. For our Controlled IL-12 platform, we've expanded our monotherapy and combination data with PD-1 inhibitors, and we are set to begin a Phase II trial with Regeneron.

We have multiple opportunities for the investor at Ziopharm, and we see tangible changes inside and outside of our company. We have done much to improve during these last several months, and we are excited for the year ahead.

With that, we thank you for your support and return the call to the operator for our questions.

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Questions and Answers

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Operator [1]

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(Operator Instructions) Our first question comes from the line of Ren Benjamin from Raymond James.

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Reni John Benjamin, Raymond James & Associates, Inc., Research Division - Senior Biotechnology Analyst [2]

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Maybe just to start off with with the NCI, Laurence, can you talk a little bit about what this Phase I trial could look like? I see it will be an all-comers, but any sort of color regarding what sort of tumor types you'll be going after, the vein-to-vein time as it exists right now? And do you ever see a point-of-care product potentially coming into play in the TCR setting? Or is that just not something that could work out in the near future?

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [3]

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Sure. So thank you, Ren. Those are very helpful questions to us. So the NCI, and indeed Ziopharm, as the trial opens for enrollment, we'll give further details and clarifications on the trial design. And just to kind of give you some of my excitement about the types of learnings that I think we will find, the first is that the patients on this trial, as is typical for the referral pattern to Dr. Rosenberg's program, will have advanced solid tumors -- metastatic solid tumors. These are some of our nation's sickest patients and obviously highly motivated to find new treatments. In some ways, these are sort of the toughest of the tough, but we fully expect to be able to treat those patients. The second is there's really going to be a multiple of opportunities here. And I won't go into exactly what tumor types are going to be addressed, but to give you a sense, the technology that we're in partnership with the NCI is designed by nature to be in some ways agnostic of the solid tumor type. We can go after really multiple solid tumors because we're going after the neoantigens, in other words, those genetic mutations that gave rise to the tumor. So I think what you'll see as we get into the details later this year is that there's really an opportunity for across the solid tumor spectrum. The vein-to-vein time obviously is important, but it actually is perhaps a little less pressured than when you're treating fast-growing liquid cancers like leukemias and lymphomas. There, it really is a foot race between the ability to get the product made and the patient to be medically stable to receive those cells. In solid tumors, there's a windowing really of opportunity and a little bit longer, if you would, for the cells to be made. So that's probably as far as I can take it there, Ren, on that part. And then last one is a really interesting question, and that is explain a little bit more about point of care, if you would, or very rapid manufacturing in the TCR space. And so I think for you, Ren, and for the investors alike, Ziopharm at the moment has carefully calibrated its programs to give you 3 enticing lines of investment: our TCR program, our CAR program and our IL-12 program. But rest assured, in my mind, as I map essentially the future of Ziopharm, these programs will all essentially have opportunities to synergize together and to build a cohesive story that is actually the summation -- more than summation of its parts. And more importantly still, we have rights to all of those 3 programs, and you'll see essentially us building upon that in the months to come.

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Reni John Benjamin, Raymond James & Associates, Inc., Research Division - Senior Biotechnology Analyst [4]

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And just kind of sticking with the TCR program and thinking about multiple antigens, I think during the prepared remarks, you mentioned that the NCI has already kind of established and has gone through utilizing multiple antigens, utilizing the Sleeping Beauty system. How do you control for I guess the equivalent expression of multiple antigens in this process? And how do you decide from patient to patient how many antigens to use?

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [5]

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Yes. Yes, again, sophisticated questions here. So in terms of the relative pattern of expression of the antigens, so here, the T cells actually act in your favor in this respect. In the dialogue of the T-cell receptor, for instance, against antigen A that's very highly expressed versus the dialogue of a T-cell receptor against antigen B that has a reduced level of expression, the T cells will respond to that level of threat. The A antigen-specific T cells will expand a number and can recycle their effectual function to knock out the more dominant A expressing cells. And the B one, by -- essentially by analogy here, will have less of that drive, less of essentially need, if you would, to propagate within the tumor microenvironment because the B antigen load is less. So there is a built-in mechanism in the T cells to essentially solve some of the heterogeneity of antigen level of expression. But your second question is also very important, and that is what is the answer to the heterogeneity of antigens that are more than one, in other words, how is it that you're going to target more than one antigen. And this is really where the Sleeping Beauty system will separate itself from the pack because it's just simply not feasible to be able to make product and make more than one product per patient when one's using a viral-based approach. The only way I know to be able to do this is using a non-viral system because it's the plasmids -- it's really the simplicity of using plasmids and the cost reduction of using plasmids that allows you to make multiple products per patient. Picking those products, picking those antigens then is the next step. And here, we have partnered with the best in the business. We already know from Dr. Rosenberg's work that the -- essentially the picking process, if you would, the identification of the neoantigens and the selection of the right T-cell receptor has put patients into remission using non-genetically modified T cells, using TIL, if you would, TIL that are grown up and expanded and put into patients. The issue there, of course, is that those TIL, while when they work, work with a real sense of wonder and excitement, it's just simply not scalable or reproducible because the TIL themselves, the effector function of those T cells, they run out of gas. So you have to graft -- you have to graft the T-cell receptor into these fresh, young T cells. And the Sleeping Beauty system, with essentially its scalability, can do that.

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Reni John Benjamin, Raymond James & Associates, Inc., Research Division - Senior Biotechnology Analyst [6]

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Got it. And then just one final one for me, just regarding Eden BioCell. I know you mentioned multiple trips to China. Can you talk a little bit about maybe an estimate as to when we might see the studies to begin or when the manufacturing might be complete, any sort of color?

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [7]

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Yes, yes. And that will all come really through the remainder of the year here. Let me just say this that going to China and witnessing essentially the progress since we have started this joint venture to basically to today, it is remarkable how much progress could be made in such a short time frame. People have been hired, people have been training, infrastructures going into place, GMP's coming online, all basically within a blink of an eye. And so if that momentum keeps going, I think Eden BioCell and its partners with TriArm will be well positioned to test that point of care sooner rather than later.

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Operator [8]

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Our next question comes from the line of Eric Joseph from JPMorgan.

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Eric William Joseph, JP Morgan Chase & Co, Research Division - VP & Senior Analyst [9]

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Just a couple on the IL-12 program. I guess with the monotherapy expansion study fully accrued, I'm just wondering if you can elaborate a little bit more on the rationale design. What feedback you got from docs on -- what's the latest feedback was from docs on the use of a low-dose or steroid-free regimen? And maybe if you can just sort of set the stage a little bit in terms of the number of evaluable patients and duration of follow-up when we see preliminary data later this year and sort of how does that inform next steps, particularly in relation to the ongoing PD-1 combo studies.

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [10]

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Yes. Thanks, Eric. So just to take in the questions in order here. In terms of the steroid-free -- or a low-dose steroid, this is something we are very anxious to test with our clinician partners because as the -- as you know and I think the investors know, we had 6 patients that have had low-dose steroids with the 20 milligrams of veledimex. And those patients really tell a very interesting story. They're living 17.8 months now at last check.

And that gave us essentially a playbook for what we think is the magic recipe: 20 milligrams of veledimex, the activator ligand and low-dose steroids. So when we guided the -- and collaborated with the physicians, we were anxious to share that 17-month survival story, and we were anxious to share with the physicians that we think the magic recipe is, as I've said, the low-dose steroids. That met with a lot of head-nodding and acceptance. And we're really just delighted, Eric, because the patients that are now on the trial in the substudy, at least half of them have low-dose steroids. So this is completely feasible now for patients to undergo neurosurgery, to have a direct injection of the adenovirus into their brain, to have received 20 milligrams of veledimex and to essentially receive low-dose steroids. And we're very optimistic for those patients. In terms of the reporting of the data, we started that study -- that expansion substudy basically last quarter, September or so of last year, and it's already accrued. And if you would, Eric, the clock is now ticking on those patients. So that bolus of patients now are marching through this year, and we'll get to update the investors on essentially the overall survival of those patients toward the end of this year. In terms of the PD-1 data sets, those data sets have also -- essentially are in hand. As you heard on our call, we have 2 cohorts now treated in the Phase I trial with nivo, and that data started accumulating in, I think, June of last year. So for some of those patients, the data is actually maturing quite nicely. And we just opened the third cohort -- dosing cohort for that. Again, that data set will mature in terms of their overall survival, and we look forward to updating the Street also this year as we begin to look at the overall survival of those patients.

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David M. Mauney, ZIOPHARM Oncology, Inc. - President [11]

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Yes. I'll just add one comment, Eric. This is David. I mean I think when you're looking at -- for qualitative feedback from physicians and hospitals, I mean one thing you just have to look at to get a quantitative answer is look at our enrollment rates. I mean if you look where we were a little more than a year ago when I started at Ziopharm, the biology was a bit unknown. It was a bit untested. We were just into the 20 milligrams of veledimex. Since then, we've gotten some biology, some biopsy data. We've gotten more information on the low-dose steroids. And as a result, it's not by accident that our enrollment rates have gone up dramatically and with that obviously comes inbound interest for the technology and for what we're going to do this year. So I think if you just look at the momentum we have across all 3 programs, it should be pretty telling.

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Eric William Joseph, JP Morgan Chase & Co, Research Division - VP & Senior Analyst [12]

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Yes, that's helpful. I guess I'm just curious to understand whether you -- I guess given the interest that you have on the monotherapy expansion cohort, how much more information you -- whether you might wait -- whether, in fact, you might still need to wait for the PD-1 combination data before moving forward with a potential registration study or is it -- is there actually a kind of a waiting consideration here to kind of move forward with both approaches potentially?

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [13]

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Yes, that's -- I mean that's a great question. The way I think about it is that we have 2 shots on goal for registration. We have monotherapy, and if the data holds around the 17-plus months of survival with this expanded dataset, that would give a lot of enthusiasm for a monotherapy registration trial. But to double down on that, we have this compelling rationale to combine IL-12 with PD-1. And so as that data plays out -- and it'll come roughly around the same time we'll start to essentially see both sets of data coming out, we'll have essentially that second look, if you would, that second opportunity in the design of the registration study.

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Operator [14]

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Our next question comes from the line of Sean Lee from H.C. Wainwright.

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Sean Lee, H.C. Wainwright & Co, LLC, Research Division - Equity Research Associate [15]

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I just have a quick one on the IL-12 program. For the upcoming Phase II study with Libtayo, could you compare and contrast that a little bit with the ongoing studies with Opdivo in terms of patient populations, treatment regimen? And how do you expect those 2 to play out?

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [16]

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Yes. Thank you, Sean. So the Phase I data with nivo is very important to us because the first time that folks have been able to put a PD-1 inhibitor with IL-12 and by guiding the Street now that we're in the third dosing cohort really gives reassurance that this is a safe combination. You can put these 2 powerful immunotherapies together and to do so in patients with recurrent GBM. That data directly feeds into now the Phase II trial with cemiplimab. And that learning essentially of the dosing of the IL-12, the dosing of the PD-1 inhibitor, the ability to treat basically all-comers with recurrent GBM who then have a surgery, that allows us to essentially have a direct line of sight to how the Phase II trial is built. And so it's going to look, in terms of the patient population, very similar, but it'll be accelerated in terms of its accrual pattern. Because basically, we figured out all of the, if you would, the mechanics of how to put these 2 drugs together on the Phase I study.

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Sean Lee, H.C. Wainwright & Co, LLC, Research Division - Equity Research Associate [17]

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I see. Would we see some information regarding the different dosing and that from the Opdivo study this year?

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Laurence James Neil Cooper, ZIOPHARM Oncology, Inc. - CEO & Director [18]

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Yes, I think that's fair to say. We will give an update on that this year in terms of the cohort dosing and the safety data and begin to give some initial data on the Opdivo study in terms of overall survival in this year.

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Operator [19]

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Thank you. And this does conclude the question-and-answer session as well as today's program. We thank you, ladies and gentlemen, for your participation. Everyone, have a great day.