Good morning, welcome to PCI Biotech's Q1 presentation, held here at Oslo Cancer Cluster Innovation Park. My name is Ronny Skuggedal, and I'm the CFO of the company. Unfortunately, I need to inform you that our CEO, Per Walday, is acute ill, so I need to take this presentation on short notice. That's of course, unfortunate, but I will do my best. Before we start with the presentation, please note our important notice and disclaimer. At the end of the presentation, we will have a Q&A session open both through a telephone conference facility where you can dial in for questions, but you can also, as usual, post questions through the webcast console. We will start the Q&A sessions with the telephone conference facility, and you can find the details both in the slides and in the invite for the presentation.
First, a couple of intro words about PCI Biotech. We have an enabling technology, enabling intracellular delivery. We use this platform technology for three different programs. fimaChem, our lead program, now in pivotal phase with the RELEASE study. fimaVACC, our therapeutic cancer vaccine program, completed phase I and recently published results in a scientific journal. The fimaNAc program, our preclinical asset, where we have a collaborative approach to try to bring this asset into the clinic. Very briefly about the mode of action of our technology. It's a triggered endosomal release technology where we have a molecule named fimaporfin, which is designed to attach to the inside of the endosomal membranes inside cells. When we apply light, this molecule takes up the energy from the light, generates the photochemical reaction, destabilizes the endosomal membranes, and the trapped molecules are released into the cells.
That's why the intracellular delivery. With this technology, we believe that we have the potential solution for key challenges for several modalities. For fimaChem, we enhance the effect of gemcitabine for bile duct cancer. For fimaVACC, we enhance cellular immune response, important for therapeutic vaccines. For the NAC program, we are providing a delivery solution which is a major hurdle for nucleic acid-based therapeutics. Highlights for fimaChem. During Q1, we have seen increased screening and enrollment into the RELEASE study, and this is seen after implementation of the amended protocol and opening of sites in Asia. However, we do not expect to see the full effect of these optimization initiatives until the COVID-19 situation improves further. In April, meaning after the balance sheet event, the first patient was enrolled into the RELEASE study in April.
Going forward, we will continue with focus on enrollment into the RELEASE study, of course. Now the focus will be more on regular trial management, meaning performance evaluation and replacement of underperforming sites. This process is already initiated, so we have already started to wind down underperforming sites, both to save costs but also to make sure that we focus our efforts towards sites that show real interest for the study. The timelines are retained as previously communicated. For fimaVACC, the successful phase I proof-of-concept study was in early January this year, published in a high impact immunological journal, "Frontiers in Immunology." These data demonstrate fimaVACC to enhance the immune response for peptide and protein-based vaccines in healthy volunteers, and we will come back to some of the data there.
The focus going forward for the vaccine program will be utilizing these published data in partnering efforts and also planning for a clinical proof-of-concept study in a disease setting. For fimaNAc, the encouraging data of enhanced delivery of mRNA for various medical application was presented in February at a U.K.-based virtual conference focusing on RNA therapeutics. Another after balance sheet date event in May, a couple of days ago, we announced that we had entered into a preclinical research collaboration with a South Korean company named OliX Pharmaceuticals, a leading developer of RNAi therapeutics. I will go more into the details for our lead program first. fimaChem, important here to notice that or to understand that this is a first-line treatment for an orphan indication. We have positive early clinical results from our phase I study.
We have had interactions with regulators both in U.S. and Europe, so the pathway to market is settled. The ongoing pivotal study with registrational intent is ongoing, and we foresee to have approximately 50 sites open across U.S., Europe, and Asia. Now, the number of sites will now start to fluctuate from quarter to quarter since we are implementing this trial management process with focusing on the high-performing sites and the potential underperforming sites, which do not show a real interest for the study will be wound down. Yes. Our technology here for bile duct cancer has an excellent fit with the medical need and the existing treatments for bile duct cancer patients. We have encouraging early results from the phase I study. The technology is easy to use. The illumination can be done through standard endoscopic methods.
We are enhancing the recommended first-line chemotherapy gemcitabine. We boost the effect locally, it's easy to understand the potential benefits with the treatment. We have orphan drug designations in both EU and U.S. The competition pipeline is limited. The reason for that is that the competitors are mainly focusing on intrahepatic CCA, meaning bile duct cancer inside the liver, while we are focusing on extrahepatic bile duct cancer. That's due to the light application. Also competitors are not necessarily focusing on first-line treatment. Being an orphan indication, there is a premium price potential. Here on this slide, I do not intend to go into details for this slide. I think most of this information is fairly well-known.
Here we have a map of the European sites, I'm sorry, the European countries we are active in, and also U.S. and in Asia, South Korea and Taiwan. Now we have by end April, there were 46 sites open, one less than last quarter. As I said, that's due to this trial management procedures. We have nine sites open in Asia, and the first Asian patient was enrolled in October last year. We have six sites open in the U.S., and the first U.S. patient was enrolled in April. U.S. has been difficult, but we hope that we now with the first patient enrolled, also can get up to speed in the U.S. We have implemented several initiatives to recoup the COVID-19 delays, and most important being increased number of sites also going into Asia, protocol amendments, and to expand the eligibility criterias.
Study progress going forward. As I said, we have seen increased screening and enrollment in first quarter, but we do expect to see even further increase when the COVID-19 situation improves. Focus going forward, regular trial management, replacement of underperforming sites, and also monitoring of the study-specific risks, meaning adherence to study procedures and eligibility criteria to make sure that we have a solid data package when we approach the authorities. As I said, expected timelines for interim read retained as previously communicated. Further, some endpoints, milestones, and timelines. I do not go into details here, but I can draw the attention to the center of the slides regarding the IDMC. We plan to have a seamless safety review by an independent data monitoring committee when eight patients have undergone two fimaChem treatments, and we foresee that to happen in second half of 2021. fimaVACC.
As I said, we have compelling preclinical results, particularly strong CD8 T-cell immune responses. We have successfully translated the technology into humans through the healthy volunteer study, which has recently been published. The platform is versatile, meaning that it can potentially be used with several modalities, including nucleic acid-based technologies. The results from the phase I is well-known. I will just draw the attention to the highlights here, that we saw increased number of responders in the study, enhanced T-cell responses, and improved T-cell functionality. Going forward for fimaVACC, we are growing robust evidence with the phase I study now published in an high impact journal. We are actively exploring and preparing for a potential clinical proof-of-concept study for therapeutic vaccination, both on the collaborative path, but also looking at opportunities we have for in-house development.
Here we are also working with international experts and having considerations around how to take this further in a best possible way, and you can see further details around these considerations in the report. For fimaNAc. Here we are targeting to solve one of the major issues for nucleic acid-based therapeutics, meaning the intracellular delivery issue. It's still a major challenge for this type class of drugs. We have compelling preclinical results, strong data, and also we see that the fimaNAc technology works in synergy with several vehicles, meaning other types of technologies to achieve the same intracellular delivery. We are addressing the major hurdle here, with fimaNAc, we foresee that we are able to provide high payloads into the target cells. Here we have a collaborative approach, and we have several collaborations with players in the field, and most recently with a South Korean company.
The strategy here is to continue with a targeted business development approach for taking this asset into the clinic. These collaborations provide important knowhow for us, and has also provided encouraging results. Currently, we have five collaborations, and we see strong potential for further development of fimaNAc, not least within the field of mRNA, based on the recent successes mRNA-based therapeutics have had in the pandemic. We actively center our efforts towards the most attractive fimaNAc opportunities, meaning that we also in-house look at what potential synergies we see with our potential collaborators. For the compelling results, I'm not going into details on this slide, but I draw the attention to the figure here, and the figure shows fold increase of mRNA expression with fimaNAc and with different applications. Here, the first bar with intramuscular delivery with fimaNAc. Close to 10 times fold increase.
With intradermal application, close to 30 times fold increase, and with intratumoral, meaning direct into the tumor, close to 50 times fold increase with this application. That's why we see a strong potential for the technology here going forward, and also the established collaborations show that the external world also show interest for the technology. A short summary of fimaNAc with naked mRNA delivery. We have a local delivery technology, which is an asset, to put it that way. We can co-inject our molecule with mRNAs. We can avoid systemic side effects by that. The illumination can be done in the same procedure, and by the illumination, we target and restrict the mRNA effects to the illuminated areas. Since PCI is a platform technology, the clinical proven programs, meaning fimaChem and fimaVACC, support the application of the NAc platform as well.
We have ample safety data in humans, both from systemic and by local administration. This is important for the next step by taking fimaNAc into the clinic. I think that's the details I'm able to provide on this slide. Some words about the collaboration recently established with OliX Pharmaceuticals. It's an extensive preclinical research collaboration, with a leading developer of RNA therapeutics. We will combine our knowhows and technology platforms to explore synergies and the potential for further partnership. The partnership is governed by a research collaboration agreement. There are no monetary terms in this collaboration, and there are no major financial commitments for PCI Biotech in this collaboration matter. It's important step, and it's our first step into Asia, so that's also good for the interest of the technology in general terms.
The existing collaborations we have are listed here, and we continue to pursue new and value-adding collaboration opportunities. It is my usual slide, the finance slide. In Q1, there are no major changes from previous quarters. We have a net change in cash during the period around NOK 20 million minus, which is kind of the average we have had over the last year. More specifically also in the figures, we had the very special situation in Q1 last year with actual net profit, but that was due to exchange rate effects on the bank deposits placed in EUR. We still have a solid cash position here of NOK 164 million by end of March. We have an overview of the recent key achievements and near-term milestones. In second half of 2020, we enrolled the first Asian patient in October last year.
We also worked hard with optimizing the study by optimizing the protocol and procedures and implement them at all sites. The increased screening and enrollment we see in Q1 2021 is a direct result of this work. As I said, we also hope and expect to see further improvements as the COVID-19 impact on the study further improves. For fimaVACC, early January this year, phase I results were published in a scientific journal, and these data are now being used for partnering efforts. Also for fimaNAc, we presented the results from previous collaborations at a scientific conference, U.K.-based virtual conference. Our presentation was focusing on the mRNA delivery. Now in April this year for fimaChem, we had the first patient enrolled in the RELEASE study, and we continue with our trial management procedures.
We now expect to see the IDMC review of safety for two fimaChem treatments within second half of 2021. I think I have completed the presentation, and we can open up for questions through the telephone conference. Please, moderator, if there are any questions out there.
Thank you, sir. Ladies and gentlemen, if you would like to ask a question, please signal by pressing star one on your phone keypad. If you're using a speakerphone, please make sure your mute function is turned off. Once again, if you would like to ask a question, please press star one. Speakers, we have our first questions from Adam Karlsson at ABG Sundal Collier. Please go ahead, sir. Your line is open.
Hi, Ronny. Thanks for taking my questions and send my regards to Per. I hope it's nothing serious, and he makes a speedy recovery. You've communicated that there would be a reshuffling of trial sites for the RELEASE study closure of ineffective sites and so on. I was wondering whether you could give any more details on approximate numbers or roughly how many sites have been replaced because of a lack of recruitment. Separately, whether you can give an indication of the approximate proportion of currently open sites that have enrolled their first patients.
I can answer the first question at least, that there are a couple of sites that have been closed. Regarding the proportion of sites, I can answer that as well because I don't know. That's the easy answer for me. I don't know. I'm sorry.
Sure. Out of interest, I don't know if you're able to say, but in what geographies or kind of regions, countries or larger, are you seeing the most enrollment? Is that a changing picture or has it been kind of static over time, independent of the COVID impact and so on?
No, what we have said is that the opening of sites in Asia has had a good effect. We see a good activity in Asia and with only one patient enrolled in the U.S., the other activities are in Europe, and we see increased activities across several countries in Europe.
Sure. Thank you. In regards to the OliX collaboration you announced earlier this week, I was wondering whether you could comment on how that came about. Obviously, it's a South Korean company, far away geographically speaking anyway. Was it that they approached you or who initiated that contact? Was it driven by any kind of particular data? Thinking about the presentation at the RNA Therapeutics conference, was there any kind of trigger that brought that about or any details around that?
Yeah, I think all the things you mentioned with both the publishing of the data and our internal efforts has generated this interest. This is not our first collaboration, but it's the first in Asia, and I can give credit to our DD CBO for managing to not placing the technology in Asia yet, but at least open a door in Asia.
Sure. Just finally, perhaps, I was wondering whether there's any comments that you can make on the status or the stage of the now five fimaNAc collaborations that you have in place. Are you at liberty to say whether there's any one of them potentially getting close to maybe translating into a more formal product development partnership or going to the next stage, so to speak?
We are not willing to give any details on that. What I can say is that the different collaborations are at different activity levels, and it varies over time. They are all active, and we had a review of all the collaborations last year where we closed down some of the collaborations due to not a clear interest from the counterparty. We do regular reviews of the collaborations in that sense as well. There are good progress within some of these collaborations without going into any further details.
Okay, perfect. Thank you very much.
Thank you, sir. We have our next question from Tron Johansen, private investor. Please go ahead.
Yes, thank you. Hello, Ronny. Last time I asked about the fimaNAc collaboration, and Per Walday said that you had interest from big pharma companies. Do you still have this interest from them?
We still see interest for the fimaNAc technology, yes. I'm not going into specifics of the size of the companies that shows interest, but we see interest, and recently proven by this South Korean collaboration. I'm not commenting on details on sizes of companies for potential other discussions.
Okay. One more question. You're telling regarding both fimaVACC and fimaNAc that you are actively now exploring the potentials of this. Also, as you said on fimaNAc, you are looking for value-added collaboration opportunities. For an investor, value-adding means payment, if you can say so, for the technology. Do you believe that you can achieve this during this year?
I will not guide on that.
Okay. Thank you.
Thank you. We have no further questions at this time from the audio.
Okay. I suggest that we take a short break, I'll have the opportunity to review potential questions from the webcast console, any posted questions, written questions. We will have a one-minute break. Thank you for your patience. I will be assisted here in the cancer cluster with reading some of the questions from the web.
Yep. We have a couple of questions from the web here. The first one, you are expecting an IDMC safety review in the second half of 2021. Does that mean that you have close to eight patients that has got two fimaChem treatments?
The review is done after eight patients have gone through the second fimaChem treatment, and there is a safety window after that. Yes, we expect to see eight patients to have gone through the second fimaChem treatment. We are able to then report on this during second half of 2021. I'm not saying that we have eight patients today, but we expect to have the review done in second half of 2021.
Yes. Okay. Thank you. Another question here. Did you mean that OliX is bearing the majority of the cost for this new collaboration?
What I try to communicate is that this is a preclinical collaboration. There are no major costs in this preclinical setting, and some of the experiments will be done here. Usually, some of the experiments are done here in these collaborations, and some of the experiments are done by the counterpart, and we cover the costs as they occur in this. There are no major cost commitments for either parties in this collaboration due to being a preclinical stage.
Okay. Thank you very much.
Okay. Thank you. Thank you for the attention, and I also take the liberty to send warm thoughts to my boss, and I hope that Per will be back on the podium at the next event. For those of you that understand North Norwegian, I'm sure that Per will storm up. Thank you.