Good morning, ladies and gentlemen. Welcome to the Bio-Path Holdings Q2 2023 Earnings Conference Call. At this time, all participants are in a listen-only mode. Following the formal remarks, we will open the call up for your questions. I would now like to turn the call over to Will O'Connor of Stern Investor Relations. Please proceed.
Thank you, operator. Welcome to the Bio-Path Holdings conference call and webcast, the company's Q2 2023 financial results, and to provide an update on recent pipeline and corporate developments. Earlier, we issued a press release, which outlines the topics that we plan to discuss on today's call. The release is available at biopathholdings.com. With me today from Bio-Path are President and CEO, Peter Nielsen, and Senior Vice President of Finance, Accounting, and Administration, Anthony Price. Before we begin, I'd like to remind you that today's discussion will contain forward-looking statements that involve risks and uncertainties. These risks and uncertainties are outlined in today's press release and in the company's recent filings with the Securities and Exchange Commission, which we urge you to read. Our actual results may differ materially from what's discussed on today's call. With that, I'll now turn the call over to Bio-Path's CEO, Peter Nielsen.
Thanks, Will. Good morning, everyone, and thank you for joining us. We continued to make tremendous progress throughout the H1 of 2023, and in recent weeks, as highlighted by the compelling interim results from stage 2 of our phase 2 study of prexigebersen as a treatment for acute myeloid leukemia, a blood cancer for which there are limited treatment options and for which the prognosis is grave. The data showed prexigebersen demonstrating meaningful clinical improvement with a tolerable safety profile in these high-risk patients. On the strength of these data, we now plan to file for regulatory designations that may accelerate the pathway for bringing this potentially life-expanding therapy to patients battling this deadly hematologic cancer.
Beyond prexigebersen, we continue to advance our robust clinical development program across a number of important programs that leverage our innovative DNAbilize platform technology to deliver RNAi nanoparticle therapeutics directly to cancer cells. We are forging a new path in DNA-powered medicine that we believe will give patients a fighting chance to beat these difficult-to-treat cancers. I'll begin with the progress we have made with our lead product candidate, prexigebersen. As I mentioned, we recently announced positive interim results from stage 2 of our phase 2 clinical trial of prexigebersen for treatment of acute myeloid leukemia, or AML, in combination with frontline therapy, decitabine and venetoclax. The amended stage 2 of the phase 2 trial in AML is an open-label, 2-stage, multicenter study of prexigebersen in combination with decitabine and venetoclax in 2 cohorts of patients with previously untreated AML and relapse-resistant AML.
A 2-drug combination of prexigebersen and decitabine. The primary endpoint for this study will be the number of patients who achieve complete remission, which includes complete remission with incomplete hematologic recovery and complete remission with partial hematologic recovery. 14 newly diagnosed patients were evaluable in cohort 1 and treated with at least 1 cycle of prexigebersen, decitabine, and venetoclax combination therapy. All patients in this cohort were at adverse risk by 2017 European LeukemiaNet, or ELN, guidelines for secondary AML. Prexigebersen was well tolerated, and adverse events were generally consistent with decitabine and venetoclax treatment and/or AML. 12 of the 14 evaluable patients, or 86%, achieved complete remission, and 2, or 14%, achieved partial remission or PR.
In total, 100% of the evaluable patients had a response to treatment. The complete remission rate of 86% for the evaluable patients in cohort 1 is significantly higher than complete remission rates of 62% for newly diagnosed patients treated with frontline combination treatment of decitabine and venetoclax. This result is further highlighted by the high-risk rating of our cohort 1 evaluable patients and the inclusion of secondary AML patients, both of which are classes of patients which are difficult to treat. 14 refractory relapsed evaluable AML patients in cohort 2 were treated with at least one cycle of prexigebersen, decitabine, and venetoclax combination therapy. All patients in this cohort were adverse risk by 2017 ELN guidelines or secondary AML. Prexigebersen was well-tolerated, AEs were generally consistent with decitabine and venetoclax treatment and or for AML.
8 of the 14 evaluable patients, or 57%, achieved complete remission. 2 patients, or 14%, achieved partial remission, and 3 patients, or 22%, achieved stable disease. In total, 93% of the evaluable patients had a response to treatment. The complete remission rate of 57% for the evaluable refractory and relapsed patients in cohort 2, is significantly higher than complete remission rate of 21% for refractory relapsed patients treated with the combination treatment of decitabine and venetoclax. As with newly diagnosed patients in cohort 1, this result is further highlighted by the high-risk rating of Bio-Path's cohort 2 evaluable patients and the inclusion of secondary AML patients.
Efficacy data for the initial interim analysis of cohort 1 and 2 are compelling and show that prexigebersen-based combination therapy was not only safety administered in cohort 1 and cohort 2 to high-risk, newly diagnosed and refractory relapsed AML patients, considered suitable for standard chemotherapy, but also demonstrated efficacy, efficacy signals significantly better than current therapies. This is particularly encouraging as refractory relapse patients are a challenging population in which current treatment options are suboptimal. As a result of the interim review, we have demonstrated the superiority of prexigebersen combination therapy in treating AML patients and currently plan to pursue U.S. Food and Drug Administration, or FDA, expedited programs for Fast Track and Breakthrough Therapy designations. Fast Track designation is designed to expedite the development and review of drugs, to treat serious conditions and to fulfill an unmet medical need.
Breakthrough Therapy designation is a process designed to expedite the development and review of drugs that may demonstrate substantial improvement over available therapies. We look forward to keeping you apprised on our progress on the regulatory front. Turning now to our BP1002 program, which targets BCL-2. As you know, BCL-2 is responsible for driving cell survival in up to 60% of all cancers. High expression of BCL-2 has been correlated with poor prognosis for patients diagnosed with AML. venetoclax has shown activity against the anti-apoptotic protein BCL-2 and works by neutralizing the protein's BH3 domain. It is an approved treatment for chronic lymphocytic leukemia, or CLL patients, and untreated AML patients. However, with the exception of some patients treated with stem cell transplantation, disease relapse invariably occurs, oftentimes due to BH3 domain mutation over time. BP1002 also treats BCL-2 proteins.
However, BP1002 activity is based on blocking the BCL-2 messenger RNA and not the BH3 domain. As a result, we believe BP1002 could provide an alternative for venetoclax patients who have relapsed, including AML patients who previously received venetoclax treatment. A total of six evaluable patients will be treated with BP1002 monotherapy in a standard 3+3 design, with starting dose of 20 milligram per square meter. The approved treatment cycle is two doses per week over four weeks, resulting in eight doses administered over 28 days. The phase 1b portion of the study will commence after completion of BP1002 monotherapy cohorts and will assess the safety and efficacy of BP1002 in combination with decitabine in refractory relapsed AML patients. We expect completion of the cohorts, initial cohorts in the next few months.
Next, let's turn to our phase 1b clinical trial of BP1001-A in patients with solid tumors, including ovarian, endometrial, pancreatic, and triple-negative breast cancer, some of the most challenging cancers to treat with today's therapeutic toolkit. BP1001-A is a modified product from prexigebersen, sharing the same drug substance with enhanced nanoparticle properties. This trial is being conducted at several leading cancer centers and will initially evaluate the safety of solid tumor patients. Patients diagnosed with recurrent ovarian and endometrial cancer often have poor outcomes, and it is our hope that we may provide clinical benefit for such patients. We have completed cohort 1 and have advanced to cohort 2 of the study. Finally, let's review the progress we've made with BP1003, which targets the STAT-3 protein. STAT-3 is a transcription factor that regulates various tumorigenic processes such as tumor proliferation, metastasis, and drug resistance.
Its overexpression and aberrant activation characterize many cancers, including breast, lung, ovarian, liver, and colon cancer. Activation of the STAT-3 pathway in breast and ovarian cancers promotes tumor initiation, migration, and Taxol resistance. STAT-3 also promotes 5-FU resistance in colorectal cancer cells. Its role in numerous malignancies make STAT-3 a potential cancer therapeutic target. BP1003 is a novel liposome-incorporated STAT-3 antisense oligonucleotide that effectively reduces STAT-3 expression and enhances the sensitivity of breast and ovarian cancer cells to Taxol and 5-FU. This results are in line with previous work in which BP1003 plus gemcitabine displayed enhanced antitumor activity in pancreatic ductal adenocarcinoma. Together, these results strongly suggest that BP1003 combination therapy is a novel strategy for patients with advanced solid tumors.
We are particularly excited to launch our first in-human validation of this cutting-edge therapy and in an especially challenging cancer indication that has limited treatment options. With that, I'll now turn the program over to Anthony Price for a brief review of our financials, along with balance sheet highlights. Anthony?
Thanks, Peter. The company reported a net loss of $4.2 million, or $0.53 per share, for the three months ended June 30, 2023, compared to a net loss of $3.0 million, or $0.42 per share, for the three months ended June 30, 2022. Research and development expense for the three months ended June 30, 2023, increased to $3.1 million compared to $1.9 million for the three months ended June 30, 2022, primarily due to manufacturing expenses related to drug product releases during the Q2 of 2023 and increased patient enrollment related to our phase 2 clinical trial for prexigebersen in AML. General and administrative expense for both the three months ended June 30, 2023 and June 30, 2022, was $1.2 million.
As of June 30, 2023, the company had cash of $3.4 million, compared to $10.4 million as of December 31, 2022. Net cash used in operating activities for the six months ended June 30, 2023, was $6.9 million, compared to $6.7 million for the comparable period in 2022. With that, I'll now turn the call back over to Peter.
Thanks, Anthony. As you can see, we have made meaningful progress, and the encouraging interim data from our prexigebersen study compel us to advance this study as quickly as possible and to file for regulatory designations that could accelerate our path to approval. While these are challenging financial markets, we strengthened our balance sheet in order to have the funds needed to bring these important programs to fruition, because there is no greater challenge than the battle against these deadly cancers. This is what drives us every day. These positive interim results give us further confidence that our DNAbilize platform is ushering in a new path in DNA-powered medicine that can make a difference in the lives of these patients. With that, operator, we're ready to open the call for questions.
We will now begin the question-and-answer session. To ask a question, you may press star, then one on your touch tone phone. If you're using a speakerphone, please pick up your handset before pressing the keys, and to withdraw a question, press star, then two. At this time, we will pause momentarily to assemble our roster. Again, to join the queue, it is star, then one. Our first question here will come from Jonathan Aschoff with Roth MKM . Please go ahead.
Thank you. Good morning. Hi, Peter. I was curious about the cash runway. You can give us a little guidance on that. It looks like-
Well-
you have, you know, five, $5.1 million.
Yeah, we had $3.17 reported. end of June. We did a small raise at the beginning of August. We've got cash on hand that can take us out through the Q4. There'll be a slowdown in things because we have to, on our phase 2, for example, where we've had a lot of activity, we're at the point now where we have to pause to communicate with the FDA. We also wanna get our expedited filings in place. Clearly, we'll need to raise more cash, and as we step up after we come out of what, what hopefully, regulatory pathways we have moving forward to speed us up. We've got cash to operate.
These are tough times and, you know, but we're a pretty darn good story, and we're ready for co-development at this point. We're gonna go to ASH, where we've got a molecular biomarker program that'll go with our program, makes it more efficient. We have a very good story to tell, and we'll get the funds that we need to ramp up.
Would you expect a further contraction in the H2 of the year for R&D spend, or pretty much a flattening of both operating expenses?
That's a good insight on the R&D. It was a big number, but it's because, as we talked about, we were, we needed to build up supply of drug vials, and we have a tremendous amount. Again, to refresh for everyone, you know, our drug is not approved, so therefore, once it's completed, it, it resides in prepaid expense. Then once it's released to us, it's not an approved product, so therefore it has no value, it drops to the expense line. We've had such big numbers because we have really built up a supply of, of drug, drug vials to support principally our phase 2. The answer to your question-
would it make sense that the R&D-.
Yeah
-would drop, you know, closer to $2 million than it's, you know, currently it's, you know, very close to $3 million. You think that would come, you know, materially closer to $2 million a quarter for the next couple quarters than the current $3 million?
Yeah.
Is that accurate?
Yes. It's, it's gonna drop. We don't have any major drug delivery programs that we have to support here in the near term, so we're pretty much set with that now.
Okay. I think I'd ask you about the drugs, but you did a very good job in early August, I think, going through the current state of everything that you had. That seemed pretty complete.
Well.
Yes?
You'll be pleased to know that, I think we mentioned the last quarter, that we had two new sites coming in on our lymphoma, BP1002. They're ready now, and in fact, I think we enrolled a patient that would be our third patient in that cohort, which would get us off of that first dose cohort. Those programs are starting to kick in. The AML part of, BP1002, is also. We've had three times the third patient. Those are very sick people, as you recall. They're coming off venetoclax, and they have a very short survival, but we have one now that's been dosed, and hopefully that'll make the, the last one for that first, dose cohort.
Right. That gets them out of 20 and puts them into, what was the next dose? What was it?
Yep.
402.
20, 40, 60, 90.
40. Right. Okay. Okay. Thank you very much, Peter.
You're very welcome, Jonathan.
With that, we will conclude our question and answer session. I'd like to turn the conference back over to Peter Nielsen for any closing remarks.
Thank you, operator. Well, thank you again, everyone, for joining us and for your continued support of Bio-Path. Have a great day. Thank you.
The conference has now concluded. Thank you very much for attending today's presentation. You may now disconnect your lines.