Q4 2023 CytomX Therapeutics Inc Earnings Call
Participants
Chris Ogden; SVP, Finance and Accounting; CytomX Therapeutics Inc
Sean McCarthy; CEO & Chairman; CytomX Therapeutics Inc
Joe Catanzaro; Analyst; Piper Sandler & Co
Anupam Rama; Analyst; JPMorgan Chase & Co
Presentation
Operator
Good evening, and thank you for standing by, and welcome to the CytomX Therapeutics Fourth Quarter 2023 financial results conference call. At this time, all participants on a listen-only mode the speakers' presentation, there will be a question and answer session to ask a question. During the session, you will need to press star one on your telephone.
You will then hear an automated message advising your hand is raised. To withdraw your question, please press star one again. Please be advised that today's conference is being recorded. I would now like to turn the conference over to your speaker for today, Chris Ogden, Senior Vice President, Finance and Accounting. Please go.
Chris Ogden
Thank you. Good afternoon and thank you for joining us. Before we begin, I would like to remind everyone that during this call, we will be making forward-looking statements. Because forward-looking statements relate to the future. They are subject to inherent uncertainties and risks that are difficult to predict and many of which are outside of our control. Important risks and uncertainties are set forth in our most recent public filings with the SEC at SEC.gov.
We undertake no obligation to update any forward-looking statements, whether as a result of new information, future developments or otherwise.
Earlier this afternoon, we issued a press release that includes a summary of our 2023 full year financial results and highlights recent progress at Cytokinetics. We encourage everyone to read today's press release and the associated materials, which have been filed with the SEC. Additionally, the press release, a recording of this call and our SEC filings can be found under the Investors & News section of our website.
With me on the call today is Dr. Sean McCarthy, CytomX as Chief Executive Officer and Chairman. Sean will provide introductory comments on three topics is progress and key milestones before we cover our pipeline progress and financials for the fourth quarter and expectations for the year ahead.
With that, I'll now turn the call over to Sean.
Sean McCarthy
Thank you, Chris, and good afternoon, everyone. Thanks for joining us for an update on CytomX, its continued progress, the promise of masking and conditional activation strategies to improve the therapeutic window for potent biologics like ADC. T cell engagers and Cytokinetics continues to be an important and exciting frontier in cancer R&D and our leadership in this field as Cytomedix derives from more than a decade of innovation with the Probody therapeutic platform.
Our foundational clinical work with the Probody platform has achieved many firsts in demonstrating how marketing strategies can be effective in cancer patients. So we have opened a broad field in which progress continues to accelerate. The cytokines team is highly focused on delivering on the promise of conditional activation for the benefit of patients. We're currently advancing a generation of product candidates that span multiple modalities, leveraging validated oncology targets, potent effector mechanisms and tailored marketing strategies.
Each of our candidates is designed to address large commercial markets and major unmet medical need in cancer, we've had a highly productive start to 2024. We remain on track for initial CX nine oh four Phase Ia dose escalation data in the second half of this year. And we're busy launching Phase one clinical trials for our newest therapeutic candidates, CX 2051 and CX. 81, with initial Phase Ia data anticipated in 2025.
Let me now provide additional context and detail for our lead programs. I'll start with our with CX nine oh four, our Probody T-cell engager targeting EGFR and CD3 T-cell engaging bispecific antibodies have enormous potential for the treatment of cancer and first demonstrated meaningful clinical benefit in hematologic malignancies.
Looking across the T cell engager landscape for solid tumors has taken time to see meaningful clinical results, but we're now starting to see important breakthroughs generating great excitement for whom successes include immune, of course, debenture first in uveal melanoma, the first approved T cell engager for solid tumors and more recently Amgen style at I-Mab targeting DLL3, which has demonstrated impressive results in small cell lung cancer.
The development of these and other programs has not only provided long awaited proof of concept, but this important work has also helped to increasingly define a road map and key considerations for how to optimally develop this emerging class of potent therapies, including optimization of dosing paradigms. However, for this modality to fully breakthrough in solid tumors, there are still significant challenges to overcome T-cell engagers, bring very high potency and this potency can lead to toxicities in normal tissues where the tumor antigen of interest may also be present. In fact, this is very often the case on normal tissue target expression is widely acknowledged to be a limitation on the development of T cell engagers with solid tumors.
Furthermore, another well acknowledged limitation for T cell engagers cytokine release syndrome, resulting from systemic binding to CD3 on T-cells. At CytomX, we have a broad based program focused on masking T cell engagers to decrease tumor antigen binding in normal tissues and CD3 binding in the periphery, thereby improving therapeutic index. We're working with partners, Amgen, Astellas, Regeneron and Bristol-Myers Squibb in this exciting space.
Our lead program is CX nine oh four. The targets that you've ratcheted EGFR and CD3 on T-cells. It's nine oh four is designed to address the principal challenges of developing an EGFRCD. three T cell engager with the goal of delivering antitumor activity at tolerable systemic doses. This program is partnered with Amgen on a global co-development collaboration. The market opportunity for CX nine oh four is broad. There are hundreds of thousands of EGFR positive patients with metastatic tumors across a wide range of cancer types that could potentially be addressed by this therapy.
Cytomx is currently conducting an ongoing Phase 1a study in late-stage unselected patients with advanced solid tumors generally known to have EGFR expression. Our principal goal for this Phase Ia study is to evaluate safety and to identify doses and schedules for detailed evaluation in specific EGFR positive cancer types in Phase Ib. More specifically on safety, we're looking to keep CRS and the typical EGFR mediated toxicities at manageable levels in order to achieve doses in the predicted therapeutically active range.
The selection of Phase Ib tumor types will be driven by a combination of factors, including observations from Phase 1A, unmet medical need and commercial potential, including fit with our partners' strategic interests. We're making steady progress in the clinic, having now advanced through multiple dose cohorts and above those levels that would be expected to be tolerated with an unmasked EGFR T-cell engager in late 2023.
We also began to backfill certain dose levels to more fully explore the profile of this drug candidate. We expect to share initial Phase 1a dose escalation data in the second half of 2024 with our partner, Amgen and also to present these data in an appropriate setting externally, these data will inform a potential decision to initiate Phase Ib in 2025.
Moving now to our continued work in the antibody drug conjugate space. There's a tremendous progress in ADCs in the past few years, and the impact for patients has driven significant strategic interest in this field. Cx 2051 is our first-in-class EpCAM directed Probody ADC our IND application for CX 2051 was cleared by the FDA in January clinical study.
Start-up activities are in progress, and we expect to initiate Phase one dose escalation in solid tumors generally known to have EpCAM expression, including colorectal cancer in the near term outcome as a high-potential oncology target due to its high cell surface expression in many cancer types indeed at Cabela's, what are the first tumor antigens to be characterized more than three decades ago.
And it has has been implicated in many roles in cancer progression and the EpCAM therapeutic strategies have shown potent anticancer activity in preclinical models, and this has been translated into clinical activity. But to date, clinical success has been limited to local administration because EpCAM is present in so many normal epithelial tissues.
It was to generate a systemically administered. Anticancer therapeutics have not been successful to date due to toxicities at epithelial tissues, including the GI tract our innovative drug candidate, CX. two zero five one is tailored to optimize the therapeutic index for Abcam expressing epithelial cancers by masking the antibody to reduce binding in normal tissues but to allow activation in tumor tissue, we have on the antibody with a cytotoxic payload based on capital season.
So if I summarize one inhibitor, a class of drug that has shown potent clinical anticancer activity in the ADC context, but multiple targets leading to dramatic advances for patients. Cs 2051 has demonstrated a wide predicted therapeutic index and strong preclinical activity and tolerability in multiple preclinical models, including colorectal cancer like EGFR discussed previously, CS 2051 could also potentially address a large patient population that TAM is highly expressed across many indications, including colorectal, gastric, endometrial and ovarian cancers.
Our Phase one trial will follow an adaptive design and is intended to demonstrate rapid clinical proof-of-concept to inform a potential decision to move into dose expansion studies in 2025. We're really excited to see what this unique and first-in-class ADC can do for patients.
Turning now to CH. eight oh one, our Julie masked conditionally activated interferon alpha 2B, which we believe has the potential become a cornerstone of combination immunotherapy for a wide range of tumor types. The INDEPCFH. one was cleared by the FDA in January, and we expect to initiate Phase one dose escalation in solid tumors, including melanoma, renal cancer and head and neck squamous cell carcinoma in the first half of 2024.
Interferon Alpha is a powerful cytokine with the ability to potently drive tumor antigen presentation and activate antitumor immunity. He's demonstrated clinical activity and gained regulatory approval many years ago in multiple cancer types, including melanoma, renal cancer and bladder cancer. However, interferon therapy is well known to be associated with significant systemic side effects and its use has been superseded by checkpoint inhibitors and other therapeutic approaches.
It's also been shown that interferon can potentiate the clinical effects of PD-1 in metastatic melanoma, but again, this approach has been limited. Why systemic toxicities, interferon therapy has recently returned to focus with Ferring Pharmaceuticals approval in 2022 of us delivering an interferon alpha 2b and coding gene therapy indicated for the treatment of localized BCG nonresponsive non-muscle invasive bladder cancer, reaffirming that this potent cytokine could indeed achieve robust antitumor responses in patients based on the preclinical profile of Series eight oh one as well as prior clinical experience with interferon therapies.
We see eight oh one as a potential new centerpiece of combination cancer immunotherapy. Our preclinical data and most recently presented at 60 2023 demonstrates synergy for our mass interferon alpha with PD-1 inhibition, both in terms of antitumor activity and in activation of the tumor inflammatory microenvironment. Moreover, we've also shown the systemic activity of our mass and Spirit is significantly reduced and overall tolerability is markedly improved compared to the unmatched cytokine in animal models.
We anticipate the opportunity. The opportunity for CX data one will be in combination with checkpoint inhibition where it could serve as a potent immune modulator to both increase the frequency and durability of responses in IO sensitive tumors, but potentially to establish or restore efficacy in IO resistant for cold tumors. Our Phase one dose escalation trial being initiated in the first half of 2024 will utilize an adaptive design to evaluate safety and signs of clinical activity for eight of our monotherapy and advanced rapidly combination with checkpoint inhibition.
Before moving to financials, I'd like to provide updates on our partnerships and starting with an update on our long-standing collaboration with Bristol-Myers Squibb. We were informed on March sixth of BMS intention to discontinue BM S nine eight six two eight, the CTLA-4 program. This unexpected decision followed a broad internal portfolio review at BMS. We continue to work with BMS to gain more visibility on the data from this program and the factors that led to this decision moving forward.
The BMS collaboration continues to be very active and will now focus primarily in the field of T-cell engagers where together we have initiated several new programs over the last two years. Notably, this shift in focus within the BMS alliance now means that the majority of our partner programs are now focused on T cell engagers, reflecting strong strategic interest in this area and showing that this modality modality is emerging as a key application of masking and conditional activation continuing the T-cell engager theme. Given our ongoing progress with enrollment to the CX nine oh four Phase 1a study, I'd like to outline some of the key terms of our strategic alliance with Amgen.
Under the terms of our agreement, Cytokinetics and Amgen are co-developing CX nine oh four. Cytomx is responsible for early-stage development, and Amgen will be responsible for late-stage development with the transition occurring after completion of Phase Ib by Cytomedix within the CX nine oh four agreement, Cytokinetics has an option to participate financially in the global co-development of CX nine oh four with Amgen.
If we exercise our co-development option, we opt into a significant US profit share and we are eligible for up to $460 million in development, regulatory and commercial milestone payments and ex U.S. royalties in the low double digit to mid teen percentage. We see this collaboration as having substantial potential to build long-term value for Cytokinetics and we look forward to making additional progress with our partner on this program.
Moving now to our other drug discovery stage partnerships. We continue to make progress in our alliances, including with our newest partners, Regeneron and Moderna across our alliances. We have more than a dozen active discovery programs. Cytomedix holds significant commercial rights on a number of these assets, and we have multiple near and long-term milestones that we're working towards. Chris will review in a few moments the financial benefits that continue to accrue to us from our partnerships as we run the Company in a very capital efficient way.
With that, I'll hand over to Chris to provide a financial update.
Chris Ogden
Thank you, Sean.
I'm pleased to be able to share an update on our 2023 financial results with everyone today, electronics entered 2024 with a strong balance sheet with $175 million in cash, cash equivalents and investments as of December 31, 2023, compared to $194 million at the end of 2022. We expect our cash balance will fund the operations of the company well into the second half of 2025.
This cash guidance does not assume any additional milestones from existing collaborations or any new business development, both of which like Tomax has a strong track record of attaining our cash position reflects our focus on controlling costs and efficient capital allocation as well as our consistent track record of funding the Company through a mix of both strategic business development and equity financing.
Over time, our partnerships have consistently been a strategic pathway for value creation and financing opportunities that allow us to generate non-dilutive capital while increasing the reach of our platform. Our partnerships continue to advance and have generated more than $500 million of incoming cash to date, and we see near term opportunities for additional milestone payments in 2024 and 2025.
Despite a challenging macro environment in 2023, we maintained a strong balance sheet position and executed executed efficiently to position the Company to create potentially significant value inflections that will be realized over the next 12 to 18 months.
Now moving to revenue and operating expenses for the year. Total revenue was $101.2 million for 2023 compared to $53.2 million for the corresponding period in 2022. We saw an increase in revenue due to a higher percentage of completion for research programs in the Bristol-Myers Squibb collaboration and the recent collaborations with Regeneron and Moderna operating expense for Q4 2023 was $27.2 million compared to $29.6 million in the fourth quarter of 2022.
R&D expenses decreased by $34.3 million from last year to $77.3 million compared to $111.6 million in 2022. General and administrative expenses decreased by $13.1 million for the year ended December 31, 2023, to $29.8 million compared to $42.8 million ffor the corresponding period in 2022. Overall, our prudent financial management company and focused capital allocation priorities has resulted in continued balance sheet strength as we progressed our pipeline.
Now I'll hand the call back to Sean for closing remarks.
Sean McCarthy
Thank you, Chris, and thanks, everyone, for your time this afternoon. And for your interest in Cytokinetics 2024 promises to be an exciting year for us. And the longer-term outlook for 2025 and beyond is also very compelling as we make progress across our multimodality pipeline, the field of antibody masking and conditional activation is continuing to accelerate, and we remain very well positioned to build on the depth of our experience as a leading innovator in this area, we are leveraging our multimodality Probody therapeutic platform to discover and develop new cancer therapies based on T cell engagers, ADCs and cytokines, each of which represents a highly relevant and timely area of strategic interest across the industry. The Cytomedix team is intensely focused on delivering an innovative pipeline for the benefit of people living with cancer. And I'd like to close by thanking everyone involved for their commitment to our vision.
With that, operator, let's go ahead and we can open up the call to Q&A.
Question and Answer Session
Operator
Thank you. As a reminder, if you would like to ask a question, please press star one one on your telephone. We also ask that you wait for your name and company to be announced before proceeding with your question one moment. While we compile the Q&A roster. Sir, our first question today we'll be coming from Peter Lawson of Barclays. Your line is open.
Peter Lawson, Barclays. Your line is open.
One moment.
Chris Ogden
Operator, maybe we can we can put Peter back in the queue and go to the next question.
Operator
Yes, thank you. Our next question will be coming from Joe Cotara of Piper salmon. Your line is open.
Joe Catanzaro
Everybody, and hopefully you can hear me. Okay. Thanks for taking the questions and the update here. So I know we saw recent data from a competitive masking program and they showed looks like near zero detectable unmasked antibody in circulation.
Just maybe can you remind us what you've historically seen with Probody programs around this metric, whether you're tracking it for nine oh four and what your expectations would be? And then maybe my follow-up question is on the safety side in preclinical tox work for nine oh four. I know you've reported some data around CRCR., but in GLP work with it was the CD. three mediated talks or EGFR mediated talks that showed up first and which was dose limit?
Sean McCarthy
Yes. Yes, Joe, thanks for the questions. And yes, so we're tracking obviously all innovations in the field and all progress and ARM. I think I think we conclude we can conclude from multiple recent datasets from several companies that, first of all, something that I think we've shown quite some time ago, that market works masking antibodies and other modalities is clearly having shown the ability to decrease systemic target engagement and depending upon target and format to also improve tolerability.
So we're excited to see this progress across across the field. What we've shown over the years pretty consistently with multiple programs, whether it was our PD-L1 Probody or up 29 to 18 nine, some of our earlier programs, which we've learned. So much. And we've shown that the vast majority of the circulating entity, the Probody therapeutic is is in masked form. And that again, it has translated into what we interpret as the successful decreasing of target engagement.
So that builds come a long way, and we're excited to see now in the hands of others, these types of approaches also beginning to gain some traction in terms of our work on on EGFRCD. three and 9.04 a.m. We have presented quite honestly, we haven't presented a lot of data on this program for various competitive reasons, but we did share an early iteration of our EGFRCD. three program with pretty extensive characterization in syngeneic animal models and in Cyno.
And we focused in large part on the cytokine induction in those monkey studies showing a dramatic shift with the masking a dramatic shift in terms of the ability to induce cytokine, but we haven't shared a whole lot of data on the actual CX. nine oh four molecule yet that will come in the future.
Joe Catanzaro
Okay, thanks. That's helpful. Thanks for taking my questions.
Sean McCarthy
Feel very welcome.
Operator
Thank you. One moment for the next question. Our next question will be coming from Japan Rama of JPMorgan. Your line is open.
Anupam Rama
Thank you so much for taking the questions is actually Malcolm cooler on for auto parts. So what is the size and scope of the Phase one dose escalation data that we should be thinking about in in 2H 24 for CX nine oh four. And on that winter, we get a better sense of more a more granular time. Thank you.
Sean McCarthy
Yes, thanks, for the question, um, so we remain on track with nine oh four to share data in the second half. As I mentioned in my prepared remarks, our principal objective at this moment in time is to build the dataset to share with our partner Amgen in the second half of the year. And then that would result in presentation externally in an appropriate setting.
We were not so on guiding to any specifics at this point in time. Obviously, what we're looking for, though in Phase Ia is two, demonstrate the and really fully explore the safety profile of nine oh four in terms of CRS, in terms of EGFR mediated toxicities, obviously look for any early evidence of antitumor activity. I would expect the update in the second half would be a meaningful number of patients, but so far, and that's really all that we're ready to say at this moment in time.
Anupam Rama
Great. Thank you.
Operator
Thank you. At this time. If you would like to ask a question, please press star one one on your telephone. There are no more questions in the queue. Thank you so much for joining the conference call today. Everyone may disconnect.
