Earnings Labs

Autolus Therapeutics plc (AUTL)

Q1 2022 Earnings Call· Sun, May 8, 2022

$1.48

+3.87%

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by and welcome to the Autolus Therapeutics First Quarter 2022 Financial Results Conference Call. [Operator Instructions] I would now like to hand the conference over to your speaker today, Olivia Manser, Director of Investor Relations. Please go ahead, ma’am.

Olivia Manser

Analyst

Thank you and good morning or good afternoon everyone and thank you for joining us to take part in today’s call on the operational highlights and financial results for the first quarter of 2022. I am Olivia Manser, Director of Investor Relations. And with me today are Dr. Christian Itin, our Chief Executive Officer, and Dr. Lucinda Crabtree, our Chief Financial Officer. Before we begin, I would like to remind you that during today’s call our discussion will contain forward-looking statements. Please make sure you are familiar with our disclaimer, which is on Slide 2 of the presentation. On Slide 3, you will see the agenda for today, which is as follows. Christian will provide an overview of our operational highlights for the first quarter of 2022. Lucinda will then discuss the company’s financial results, before Christian will conclude with upcoming milestones and any other concluding comments. Finally, of course, we will welcome your questions.

Christian Itin

Analyst

Thank you, Olivia and good morning to you all. Thank you for joining us. It’s my pleasure to review our progress for the first quarter of 2022. Please move to Slide 4. For those of you who are new to Autolus, and as a fresher for those who know us well, we are building a fully integrated CAR T company. Building on our broad platform of cell programming technologies, we are generating CAR T products that are tailored to the specific tumor setting. Illustrating this approach are obe-cel, with its focus on physiological engagement of leukemic cells, maximizing potency while improving safety and persistence. AUTO4/5 with a unique targeting approach for T-cell lymphomas and AUTO6NG, a CAR T product candidate building on a clinically validated CAR through GD2 and adding programming modules to render the CAR T-cells insensitive to checkpoint and TGF data inhibition, while increasing CAR T-cell persistence. For manufacturing, we are using common platform and process design principles to generate products that are highly active and persisting in patients. Our current operations for clinical trial supplies, working in 4 shifts, 7 days a week, in what we are anticipating to be very close to our commercial manufacturing model. The commercial manufacturing facility designed for 2,000 products per year is under construction in the UK, about a mile away from our clinical trial manufacturing site and expected to be ready for GMP supply by middle of 2023. Moving to Slide 5, we had a successful quarter with obe-cel clearing the pre-planned futility analysis in the FELIX trial and enrollment continuing to plan. In addition to the primary morphological cohort in the FELIX trial, we are expanding the MRD or minimal residual disease cohort to up to 50 patients. In clinical practice, patients that get evaluated on a regular basis…

Lucinda Crabtree

Analyst

Thanks, Christian and good morning or good afternoon to everyone. So moving to Slide 20, it’s my pleasure to review our financial results for the first quarter to March 31, 2022. On the journey to transitioning Autolus into a fully integrated CAR T company, we continued in the first quarter of 2022 to focus our research and development efforts on our lead product obe-cel and our pipeline assets addressing cancers with limited treatment options. So, starting with R&D expense for the 3 months ended March 31, 2022, research and development expenses increased to $34 million from $30.7 million for the 3 months ended March 31, 2021. Cash costs being the biggest component of our R&D expense were relatively flat at $30.6 million this quarter from $30.7 million for the quarter ended March 31, 2021. The small decrease in research and development cash cost to the tune of $0.1 million consisted primarily of a $2.8 million decrease in compensation and employment related costs, which was due to a combination of lower retention, severance payments and the timing of salary mix of new employee hires. A $0.9 million decrease in facilities costs related to the termination and excess of our U.S. manufacturing facility in the prior year and shift in our manufacturing strategy and a $0.2 million decrease in research and development costs related to cell logistics. These decreases in R&D cash costs were offset by an increase of $2.9 million in clinical costs and manufacturing costs, primarily related to our obe-cel clinical product, $0.8 million increase in legal fees and professional consulting fees, in relation to our research and development activities, and a $0.1 million increase, related to information technology, infrastructure, and support for information systems, relating to the conduct of clinical trials and manufacturing operations. Non-cash costs increased to $3.4…

Christian Itin

Analyst

Thanks, Lucy. Moving to the final Slide #22. Finally, next steps; we believe we have an exciting year ahead of us, with obe-cel running through the pivotal study in adult ALL, delivering initial clinical data from this pivotal study later this year, and full data expected in the first half of 2023. We plan to provide clinical updates from four of our programs at EHA this June, and this is in addition to progress across the pipeline that we alluded to as well, as we went through the presentation. In particular, with obviously also looking at AUTO6NG expecting to enter the clinic in the second half of this year. Finally, as a result of our collaboration with Blackstone, we’re in a strong financial position with cash runway, including project financing payments from Blackstone into 2024. With that, we’re happy to take questions.

Operator

Operator

[Operator Instructions] Your first question comes from the line of Matt Phipps from William Blair. Your line is open.

Matt Phipps

Analyst

Good morning, Christian and Lucinda. Thanks for the call. I was wondering, Christian, if you could maybe help us set the stage a little bit for the AUTO4 results? We have seen other CAR targets, we can see some malignancies for the CD-5, CD-7, do see some responses, a lot of patients maybe go to transplant, but I guess are you expecting a lot of patients in the AUTO4 trial, to go on to transplant, if they do achieve a complete response? And then I actually am also looking at things like viral infections will be another key data point for this program and the first update?

Christian Itin

Analyst

Good morning, Matt, thanks for joining. Very good question. So, as you pointed out, obviously T-cell lymphoma is a very cough disease to go after; there are a number of approaches that have been tried. What you refer to is programs like CD-5 or CD-7 have sort of a limited application. CD-7 is mostly present on acute leukemia – T-cell acute leukemia, rather than T-cell lymphoma. It’s only a very small subset of T-cell lymphomas that carry CD-7. When you look at CD-5, that’s a general activation marker for T-cells, so any T-cell that gets activated, including our CAR T-cells, would actually become CD-5 positives, which obviously creates a number of challenges. And if you go after more general CAR groups, like CD-4, as an example, you run the risk that you’re actually eliminating the compartment, as you’re trying to attack and trying to tackle the disease itself, with consequences for the patient’s ability to actually maintain a healthy T-cell median immune response. So what we’re looking to do with AUTO4, and then also with the sister program, AUTO5, is really targeting a subset, on the one hand, the disease itself, but then also only a subset of healthy T-cells, so that at least half of the remaining T-cells, in theory, would not be targetable with a CAR-T, with that sustained T-cell mediated response over time. What we’re looking to do, and what we’ve been doing in the trial that we’re going to be updating on, is obviously dose escalation; it’s a wide range of doses starting at very low levels to elevated levels. And, what we’re looking to see are several points; number one, one to understand the safety profile, number two, obviously, do we have an ability to induce complete remissions in these patients? Number three, do we see any evidence that we’re impacting the broader T-cell compartment in these patients, which obviously would be a concern from an overall safety perspective? As we’re in a dose escalation, we have varying degrees of follow-up, and we will need to see and gain more experience, to see whether indeed some of these patients may need to receive transplant in the future, or whether just the therapy on its own will be sufficient to sustain long-term remissions. That is too early to tell, but I think we’re going to get a very good understanding; it’s a novel target, it’s a novel approach. It’s first in my own experience, and I think it will give us a very good initial experience and understanding, of the potential of this approach.

Matt Phipps

Analyst

Thanks, Christian. And, if I could ask one additional question; recent data from Stanford Group at ACR, with the GD2 CAR showed some encouraging results in a tough glioma setting, but also did use ICV infusions. I’m wondering if that’s something you would look at, any kind of intracranial infusions with the AUTO6 program?

Christian Itin

Analyst

Right? So, the specific indication that the Stanford group went after, is a form of glioma, which is obviously a cancer that is localized in the brain. And, there are various ways in how we can think about accessing that, whether you access the brain through an infusion of CAR T-cells into the bloodstream, and then have the CAR T-cells migrate across the blood brain barrier into the brain, and then have an ability to target the glioma. That’s one approach you can take, and what the Stanford team has done, is take the ultimate approach as literally going directly into the brain, and frankly, delivering product directly onto the lesion, in those patients. Obviously, that’s an approach that’s workable, as we’re seeing obviously, we will hopefully have data for obe-cel and primary CNS lymphoma, where we also do approach the dosing from the systemic side, so from the blood side. And, I think we can start to see and think that both sides are possible and are usable. For our own CD2 CAR program, we would envisage a normal systemic approach, because the disease they are treating, neuroblastoma, is a kidney associated tumor that it can actually very well access, just through standard administration into the bloodstream.

Matt Phipps

Analyst

Alright. Thank you.

Christian Itin

Analyst

Thanks, Matt.

Operator

Operator

Your next question comes from the line of Nick Abbott from Wells Fargo. Your line is open.

Nick Abbott

Analyst

Hello, good morning, thanks for taking my question. And yes, lots of things going on here team, and I apologize today, I had to join the call late. But the first question is on what we might expect as a benchmark for primary CNS lymphoma; the MGH Group just published in blood, some experience with [indiscernible]. I think what was quite surprising to me, at least, was low grade ICANS, Grade 1, Grade 2, Grade 1 CRS, and they reported a 60% response rate, 50% CR, with three of those complete responses showing significant durability of greater than 6 months, at least. So, I’m wondering what we should be expecting for primary CNS lymphoma and whether you think this is a good benchmark.

Christian Itin

Analyst

So first of all, thanks for joining Nick. On primary CNS lymphoma, what we’re planning to do is provide obviously initial information on the early patients that we have in the trial. Obviously, that gives us an initial view. I don’t think we’re at the point where we’re going to be - I think where we can easily benchmark, given the number of patients that we’re able to report on at this point. I think in general, seeing a, give or take 50% CR rate in these patients, I think is very encouraging. And, I think it certainly would be a good outcome for patients with this disease, considering also frankly, the lack of any suitable other options.

Nick Abbott

Analyst

Okay. Thanks, Christian. And then I noticed that you mentioned that AUTO8 has been initiated now. When do you think you’ll be able to present some initial data from that trial?

Christian Itin

Analyst

I would assume this is a Phase 1 clinical trial, and I would assume that we will have to look at the second half of next year for early clinical data.

Nick Abbott

Analyst

Okay. Great, thanks a lot, Christian.

Christian Itin

Analyst

Thanks a lot, Nick. Appreciate it.

Operator

Operator

Your next question comes from the line of Mara Goldstein from Mizuho. Your line is open.

Mara Goldstein

Analyst

Great. Thanks so much for taking the question. I wanted to ask just on the AUTO4 program, I think the upper dose limit has been raised there to 900 million cells. Can you talk a little bit about that, and that dynamic? And then lastly, just on obe-cel and the new MRD cohort, maybe you can talk a little bit about, what are the challenges in that cohort, and why obe-cel may be appropriate there?

Christian Itin

Analyst

Yes, happy to do that, Mara. Thanks for joining. So first, with regards to AUTO4, as I indicated AUTO4 that we ran through, a dose escalation started at relatively low levels, the initial dose that we had in I think highlighting clinical trial, our cutoff was 225 million cells. And we created an opportunity to go further than that. We will obviously provide an update on kind of the upper dose range that we went to; we didn’t go all the way to 900. And you’ll see obviously overall kind of the efficacy and safety profile that we’re starting to achieve at the higher dose levels. With regards to the MRD cohort for obe-cel, I think the importance of the MRD cohort is several fold; first off, we do have a bit of a discrepancy between the regulatory data package that we need to get to an approval, versus the data and the treatment that we actually – treatment algorithm that we do see, taking hold at clinical centers. Most clinical centers also based on the experience with Blincyto in patients with minimal residual disease are preferring to start treating patients where they have a first inkling of the disease coming back. And, what normally happens with these patients is, at periodic intervals, you take bone marrow biopsies, you run those bone marrow biopsies, typically on flow, and you look for the presence of leukemic cells. The sensitivity of that methodology gives you somewhere in the range of 10 to the minus 4, 10 to the minus 3 resolution, and very reliably. And that compares to a 5% level that you would have to cross the boundary to become a morphological patient. So, you do discover, as you actually look at that, in the clinic for these patients, and you…

Mara Goldstein

Analyst

Alright. Thanks so much.

Christian Itin

Analyst

Thank you.

Operator

Operator

Your next question comes from the Gil Blum from Needham. Your line is open.

Gil Blum

Analyst

Good morning everyone and thanks for taking our questions. So, maybe here, clarification on the MRD population? So, are current approved CAR-Ts used in patients that are MRD positive?

Christian Itin

Analyst

Good morning Gil. Thanks for joining. What we do see is that certainly in the pediatric patients that the physicians have been moving to treating the kids very early on, typically when we have mineral residual disease. So, that’s an observation that we certainly see across, I think many of the centers, within this disease setting, and where you would start using a particular chemo [ph] very early on. I think in general, there is a view that you would like to actually treat early. And I think the best visibility at this point we have from the pediatric population, because it’s also where obviously the CAR-T therapy is probably most established.

Gil Blum

Analyst

Okay. Thank you. And maybe another question on…

Christian Itin

Analyst

Sorry. Gil, the second part obviously, of the answer is, that the experience that physicians have gained with Blincyto, also with adult patients, also moves quite significantly towards patients with mineral residual disease, rather than waiting for the patients to develop full blown morphological disease. The difference in response rate is quite significant, you have about 43% to 44% CR rate in a morphological disease of Blincyto, but you do have about 78% CRS, in molecular CRS, if you go into the MRD population for Blincyto.

Gil Blum

Analyst

Alright. So, it makes sense to have earlier treatment. Maybe a question on AUTO1/22, you said Kymriah eligible, can you remind us if any of these patients that are being enrolled, have experienced CAR-Ts in the past?

Christian Itin

Analyst

Right, so AUTO1/22, obviously, which is a dual targeting CAR. We treated in the Phase 1 experience now, kids that are ineligible for Kymriah, and you can be ineligible for Kymriah for a set of reasons. One is that you already have Kymriah and you cannot get a second dose. And that is obviously part of the population that we have enrolled. Secondly, it can be that the disease is localized in an area where you actually have to exclude patients from the treatment of Kymriah, and in particular, a localization, obviously, would be CNS localized disease. So, it’s typically related to either prior therapy with Kymriah, and not being eligible anymore for a second go, or having disease that is basically extra medullary disease, disease outside of the marrow that actually would disqualify you from being offered Kymriah as a therapeutic option.

Gil Blum

Analyst

Right. So maybe a follow up there, will the presented data be stratified based on patients who have experienced previous CAR-T therapy, or more of like a mixed bag?

Christian Itin

Analyst

We will have both categories of patients. Obviously, it’s a Phase 1 experience, so it’s a limited number of patients, but we have both patients who either have relapsed post Kymriah, or patients that have disease outside of the normal localization.

Gil Blum

Analyst

Alright. And maybe a last one, I know you guys are showing a bunch of the really interesting new technologies, modular technologies coming up with ASGCT considering the current laser focused on obe-cel, are you guys considering out licensing some of these technologies to other firms?

Christian Itin

Analyst

I think there is with – I mentioned the fact that we have a very broad portfolio with about a hundred patent families covering the various inventions. There clearly is opportunity for that, and opportunity for out-licensing. Part of that is what you saw us do last year, with the collaboration we put in place with Moderna, and there is additional opportunity with some smaller licenses we have granted as well, over the years, to aspects of technology. So, there is clearly opportunity for that, outside of another portfolio that we are pushing ourselves.

Gil Blum

Analyst

Alright. Thank you for taking all our questions.

Christian Itin

Analyst

Thank you. Gil, I appreciate it.

Operator

Operator

Your next question comes from the line of Asthika Goonewardene from Truist. Your line is open.

Unidentified Analyst

Analyst

Hi. Thanks for taking our questions. This is Bill on for Asthika. We were wondering if the MRD cohort, would that data be ready for the first half 2023 update? And then also subsequently, we are just wondering in your hands and your experience, on average, how many multiple myeloma cells are double positive for CD19 and BCMA? Thanks.

Christian Itin

Analyst

Thanks for joining Bill. First question related to data becoming available from the MRD cohort, whether that’s going to be coinciding with the main data release from the morphological cohort, that’s something we need to look at. Obviously, we will have a range of follow-up on these patients, and one of the determinations we will need to make is how much of a minimal follow-up we want to have in that patient group. But there may be possibility to include some of that data, at least on the initial experience in that group from a safety and a basic activity perspective. So, we will see how that progresses. I think there is an opportunity, but in general, what you would like to have at the MRD cohort is a longer follow-up, and actually see how these patients do over time. Not only in terms of the initial response you can induce, and their safety profile associated with that treatment.

Unidentified Analyst

Analyst

Thanks. And the CD19 and BCMA double positives, in the multiple myeloma population.

Christian Itin

Analyst

Right, so there are two aspects of that. So, BCMA is the main target that you would find on multiple myeloma cells. The interest from CD19 is sort of twofold. Number one, there is what is believed to be a driving population of multiple myeloma that is CD19 positive. That’s one aspect. So, it’s a smaller number of cells, but having a key role in driving the disease. And secondly, the fact that if you have your therapy and you have an ongoing activation of your compartment using – with the de novo generation of CD19 positive cells, not myeloma cells, but generally positive cells, that that probably is going to be helpful to actually sustain activity of the CAR T-cells over time as well. So, there are likely two elements there that play into the rationale for choosing the targets.

Unidentified Analyst

Analyst

Thanks so much.

Christian Itin

Analyst

Thank you.

Operator

Operator

Your next question comes from the line of Kelly Shi from Jefferies. Your line is open.

Unidentified Analyst

Analyst

Hi, Good morning. This is Dave on for Kelly Shi. Just a couple of questions for me. One is on futility analysis, can you provide more color, whether it’s safety or efficacy analysis, or how many patients were in that analysis? And second is dual CAR, what kind of bar do you think will be suitable to move that program into next step? Thank you.

Christian Itin

Analyst

Alright. Thanks a lot Dave. Appreciate it. So, the futility analysis, that was a predesigned analysis point, obviously for the study, and as you typically do in futility analysis, you look at primary aspects of the program. One is the likelihood of the program to succeed. And that’s basically a certain statistical power, you want to see that the program is going to succeed. And secondly, also as you look at the overall adverse event profile and you want to make sure that the profile of that product is as expected. And you do not pick up any undo adverse events in the program. So, that was pre-specified and ultimately it’s driven by the statistical analysis on your likelihood of success in the program as well. With regards to AUTO1/22, obviously the start of the Phase 1, as indicated in Kymriah eligible patients is obviously the initial dataset that we are getting. Ultimately, this type of product, you would like to position at the same level of Kymriah, so you do not actually want to have sequential CAR-T therapy that would not be a smart thing to do, but actually have a product that has an ability to overall improve the ultimately event free, as well as overall survival, in that patient group, by minimizing relapses, due to antigen loss. And that’s ultimately what you would be looking at. When you look at the space, you see that about the event free survival, at 1 year for pediatric patients, is around 50%, so that’s the number that you would like to actually look to improve and see improved, in a product now with a dual targeting approach in pediatric patients.

Unidentified Analyst

Analyst

Got it. Thanks. And just to follow-up on the BCMA CD19 CAR, so what would be the bar for that product, because of this changing treatment paradigm of the multiple myeloma?

Christian Itin

Analyst

Right, you have to really postulate a very high bar for the program to proceed into the next steps of development. We do see obviously a very good profile for the JNJ program, and we see good, sustained activity on the BMS program. I think what you would want to see is, you want to see very deep molecular CRs that you can induce. And you also would like to see an improved pattern with regards to persistence, as well, in the product. I think those are two parameters that I think are give you – can be picked up relatively early in the evaluation of the program. And I think those are certainly two of the parameters we would be tracking very carefully.

Unidentified Analyst

Analyst

Got it. Thank you.

Christian Itin

Analyst

Thank you.

Operator

Operator

Your next question comes from the line of Simon Baker from Redburn. Your line is open.

Simon Baker

Analyst

Thank you very much for taking my questions. I have three, if I may, generally of some more general nature. I just wondered if you could give us your latest observations on the normalization of enrollment rates as we start certainly in parts of the world to emerge from the pandemic. Are we close to normal or is there still some distance to go? Secondly, on the Stevenage facility, you talked about the capacity of 2,000 batches per year. is that from second half 2023, or is there a ramp up? And could you give us some idea of the scope to expand? You talked about the option, I wonder if you could give us an idea of how much it could be expanded by. And then finally, a couple of weeks after your full year results, the FDA published their draft industry guidance document on CAR-T development. I just wondered if you could give us your perspectives on that document, and the direction the FDA is moving in, now that you had a good chance to review it. Thanks so much.

Christian Itin

Analyst

Thanks for joining us, Simon. So, the first question was related to the enrollment and frankly, the ability of clinical trials centers to support clinical trials. And as I think many of us have seen, obviously, during the peak of the pandemic, many of the institutions were impacted heavily. Not only by a lot of workload, but also as a consequence of losing a substantial amount of staff, or a number of staff, that are particularly in those individuals were active in the ICU entities, etcetera. So, that’s been certainly a significant issue. We have seen a lot of that normalize. There is still some geographic differences, but the vast majority of centers are back in a normal mode of operation, certainly for patients that have the level of medical need, as we are seeing here with obe-cel, in patients with acute leukemia that actually do have to get treated, you cannot wait to treat those patients, and we are seeing a normalization, certainly for those patients. I think for some of the less life threatening diseases that may still actually take a bit more time. But I think that’s where we are. A big chunk is actually – or a big aspect is going to be the training of nurses and frankly, both the hiring and training of nurses, which will take time. And it certainly will be a significant effort, we see all across both the U.S., as well as Europe and UK. Second question was related to the capacity at Stevenage. The capacity at scale at the new facility will be 2,000 batches. We are obviously going to ramp up that capacity operationally as we are rolling out the product and as we are sort of growing the product. It doesn’t make sense to actually have a full standing operation for that level of capacity and then not fully using that. So, that needs to be an adapted approach, as you go up the design of the facility, set-up of the facility, supports, about 2,000 products a year. The scope to expand actually would allow us to actually expand physically the facility, and with that increase the capacity overall. And then, the last question was related to the CAR-T guidance document that was coming out from the agency. I think an important aspect is that obviously we are in a relatively new field still. There is a lot of learning going on. And I think having that type of learning and best practices sort of starting to be consolidated and sort of agreed upon, I think is very helpful. And so we are I think – glad to see that we are seeing some of that guidance to be more formalized as it is outlined now in that directive.

Simon Baker

Analyst

Great. Thanks so much.

Christian Itin

Analyst

Thank you.

Operator

Operator

Your next question comes from the line of Eric Joseph from JPMorgan. Your line is open.

Unidentified Analyst

Analyst

Hi. Thanks. This is Sean on for Eric Joseph. So, sorry, my line was dropped for a little bit. I apologize if it’s a repeat of the question. So, we are basically wondering of the follow-up question on the futility analysis. So, whether you can talk about some more details on the statistic assumption of patient numbers comprising that analysis, and having passed it, is there a minimum CR rate or duration of response that can be inferred from that?

Christian Itin

Analyst

Thanks for joining Sean. And yes, indeed, the question has been asked before. So, the futility analysis again, is basically my thought is we obviously haven’t communicated, but a difficult one to know is whether the study actually is in a position to reach the design primary endpoint that you have set, and the statistical outcome that you have set for the overall study. And that is what you want to make sure that indeed the program can reach that outcome. And, that’s typically what you do in your futility analysis, and as indicated, it’s primarily based on the clinical activity side. And in our case, the primary endpoint being the complete remission rate. But then also, obviously, looking at the overall safety, which is obviously going to be taken into account as well. So, those are kind of the key parameters, we haven’t actually given more detail and more resolution on that. Obviously. we nicely passed that point, and we are progressing well with the program.

Unidentified Analyst

Analyst

Alright. Thank you.

Christian Itin

Analyst

Thank you.

Operator

Operator

There are no further questions at this time. I would now like to turn the conference back to Mr. Christian Itin.

Christian Itin

Analyst

Alright, well, thank you very much all for joining today. Obviously, an exciting first quarter. We are really looking forward to the second quarter with seven abstracts to be presented in the upcoming weeks. And we also will take the opportunity in particular, to write the EHA data, to give you a more in-depth update around the conference as well, and also put the data in context as well, outside of just a pure clinical data perspective. Alright. With that, I would like to thank you all for joining and wish you a great day. Thank you.

Operator

Operator

Ladies and gentlemen, this concludes today’s conference. Thank you for your participation and have a wonderful day. You may all disconnect.