Autolus Therapeutics plc (AUTL)
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Goldman Sachs 45th Annual Global Healthcare Conference

Jun 12, 2024

Speaker 2

Christian, thank you, thank you for joining us. Maybe just to kind of kick off and get the start, could you just give us kind of an overview of Autolus, and in the journey?

Christian Itin
CEO, Autolus Therapeutics

Yeah, I'm happy to do that. Thanks a lot for inviting us, and thanks for those of you who managed to actually battle the rain and get in there and stay dry, which I think is an accomplishment today. Autolus is a CAR T company, so we're doing autologous cell therapy. Our lead program is obe-cel, a program that we have now under review with the FDA for a BLA with a target PDUFA date for November 16. We also filed with the European agency at the end of March, so that's also in process, and we expect to file with the UK agency, the MHRA, in the H2 of this year. So in the middle of that process, we built our own capabilities.

So we built our own commercial manufacturing facility, which is designed to support our lead indication, for the product, which is acute lymphoblastic leukemia, relapsed patients. And we have, behind the program, an ability to go into a range of malignancies, but also autoimmune diseases, which are both active development at the company, and, a range of product opportunities behind that in, with using dual targeting, where we use two structures on the cell surface we go after, but also much more sophisticated programs that we're starting to work in, in solid tumor fields, with the lead program being in neuroblastoma, which is a pediatric solid tumor, kidney-associated, where we have actually five programming modules involved in that program. That's, right now actually starting up at the University College London.

Speaker 2

Perfect. Maybe we'll start on obe-cel, 'cause as you mentioned, kind of the most advanced asset in ALL there. ASCO last week, you had some updated data there. Obviously, it's not kind of the pivotal, but could you maybe just kind of talk us through what was presented there and the extent to which the agency has access to that data, given that the filing is and the review is ongoing?

Christian Itin
CEO, Autolus Therapeutics

Right. So first of all, the update we provided is actually from our pivotal study, the FELIX study. And we have now a follow-up of about 22 months as a median follow-up, and that actually allows us to get a very good understanding of what the long-term benefit is for the product. And what was very encouraging to see was that we're seeing event-free survival stabilize at around 40%, literally going horizontal, if you look at these curves, indicating that we have a substantial proportion of the patients that have an opportunity to get into a long-term benefit and long-term remission, and hopefully cure, with the product, in an indication where up to now, that was actually not feasible. So that's a very significant step forward.

The fact that we have now this longer follow-up gives a lot of confidence that this is a real tail we're seeing in the curves. And we see it also translated in the same way into the overall survival curve, where we also see a stabilization at 40%, and in fact, the overall survival curve going horizontal as well. This has been very exciting. I've been developing this field for a long period of time, developed the standard of care in the setting with my old team. That product has been... was a major step forward, now marketed through Amgen Blincyto, but we never were able to actually show long-term outcomes in these patients, nor were any other program.

So when the data were presented, there was a discussion after that by Lori Muffly, who's a very well-known physician in the leukemia and lymphoma field out of Stanford University, and she basically called the data revolutionary because it is a different quality in terms of outcome for these patients. What we also were able to show, which was also very encouraging and quite unusual, is that normally what you have to do in patients with acute leukemia is you induce a very profound response, typically an MRD negative complete remission, and then once you achieve that, you actually transplant the patient with a stem cell transplant. And only that second step, the stem cell transplant, with any other therapy, gives actually a longer-term outcome.

A small proportion of the patients also received a stem cell transplant, and in fact, what we're seeing is that these patients actually did worse. Their outcome actually was worse. Part of it was due to the fact that some of these patients actually passed away with treatment-related adverse events that were linked to the transplant. And the other portion is that most of the patients, before transplant, had active obe-cel in their system, so they had measurable CAR T-cells. And obviously, the conditioning of these patients and then the transplant itself would actually kill all circulating immune cells, including the CAR T-cells, and so you were basically taking away the active agent. And so the combination of those two actually led to a worse outcome.

So when we look at our longer-term outcomes in event-free survival and overall survival, if we take away the patient, patients that were transplanted, the curve actually lifts up, which is the contrary of what you see with any other, therapeutic modality, indicative, again, of the fact that we have a very different type of outcome with the product. And the final part that we were observing was that patients that actually had long-term outcome also had long-term persisting CAR T-cells.

The persistence of the CAR T-cells actually becomes a predictor for long-term outcome as well, which will be very helpful in terms of decision-making, because you can not only then monitor tumor burden and the recurrence of the tumor, but you can record much earlier than that, actually, if the CAR T-cells were actually still around and if they're actually being lost, then obviously that's indicative of a reason or a need for potential additional therapy with a patient. It gives you early warning, and it gives you an ability as a physician to plan and to actually sort of prepare for the next steps for the patient, should they be necessary.

Speaker 2

Okay. Excuse me. So in terms of the filing,

Christian Itin
CEO, Autolus Therapeutics

You're good.

Speaker 2

Another go? In terms of the filing that's underway, where are you in terms of FDA review process?

Christian Itin
CEO, Autolus Therapeutics

Right. So the FDA filing was done in November last year. We got the filing accepted in the middle of January. We did announce at that point in time what was helpful to have in terms of feedback from the agency, and we referenced that also in the press release at the time, is that the agency did not expect to require an advisory committee. So that's obviously a very good statement. And we're now at the point we're sort of in the H2 of the review process. Just in general terms, the H1 tends to be focused on the data itself, the clinical data, but also looking at the ability to actually manufacture and supply commercially. So those are key activities that are gonna be reviewed in the H1 of the cycle.

The H2 of the cycle, it's, it's more about the specification of the product, it is more about the label and the, and the REMS, the risk mitigation program for the... Which is sort of the key areas of focus in the H2. So now in the H2 of that review.

Speaker 2

And then, sorry, I think I'm there, I think I'm there now. In terms of the manufacturing piece, where are you on the review process there?

Christian Itin
CEO, Autolus Therapeutics

Yeah, so the manufacturing obviously is very critical in this space. The products are very much defined by the manufacturing process. In order to actually be able to manufacture, on the one hand, reliably, at scale, but also economically, it was very important to actually establish our own infrastructure that was really tailored to this particular manufacturing process. One of the challenges that you have in this field is that your manufacturing process has to work every time, and it is not one of those situations like we have with typical biologics, where we can fail every fifth run or every tenth run, and that's still okay because, obviously, the patients do not get impacted. It's a monetary issue, it's a financial issue, but it is not an issue from a patient access perspective.

In our case, that's not true. Every patient, actually, that we manufacture for actually has to rely on our ability to deliver product. So reliability in your manufacturing is incredibly important. And that is really where we focused on to a large extent. It's around the development, the stability of the process, the robustness of the process. And we're able to actually, with these very difficult population and during the height of the pandemic, with all the issues that I think we all rather not, prefer not to remember, we had an out-of-spec rate of about 5%, which is very low. And we managed to get 84% of all patients actually dosed. That is higher than what actually has been able and what was demonstrated, certainly for these patients, prior to the pandemic.

And also gives us a lot of confidence that our systems we put in place are very robust. So in terms of the facility itself, we built a facility that allows us to serve at least 2/3 of all adult ALL patients in the U.S. and in Europe. That is about 2,000 patients. The total capacity of the facility is about 3,000 patients worth, per year. And we have actually set this facility up in record time. We had groundbreaking in November 2021. We filed the BLA with all the data in it, including the validation, of the facility in November 2023. So within 23-24 months, we went literally from groundbreaking to fully validated facility, and the entire data package worked up to go into BLA. That is certainly way, way shorter than anyone actually had done it.

We had to do it because frankly, we had no choice. We had to actually meet the timeline for the product, and it was absolutely necessary to be actually in a position where we can also supply at a cost level that is economical. For us, we're actually able, with this facility, to operate somewhere in the range of about 15% cost of goods. That actually allows us to have a good level of profitability for these types of products, and gives us a very unique opportunity to drive this indication and actually launch in a setting where we should have no limitations on access to capacity, which is very different from pretty much any other launch that was done in this space.

Speaker 2

Okay. And then talked about the manufacturing there, just in terms of launch preparedness from a commercial perspective, because being a CAR T therapy, there's more to it than just kind of launching the product and going to market. Could you just kind of walk us through where you are there? And then I guess confidence that if and when the approval comes through on the PDUFA, you can go directly to market.

Christian Itin
CEO, Autolus Therapeutics

So, on the manufacturing side, there's two key licenses that we need. The first license we need is actually one from the U.K. authorities, from the MHRA, which is a license to do manufacture both for clinical as well as for commercial supply, and particularly for export. Most of our patient, or all of our patients with the initial label, obviously, will be in the U.S. So that license was very important. We had the inspection from the MHRA in the very early part of the year, and we received the license in March this year. So the facility already is licensed to do that. Subsequent, obviously, we have reviews by the FDA, which is the second step and requirement to sort of get to an ability to launch.

Now, in addition, what you obviously have to do is you have to actually set up the systems that actually ensure a chain of custody. And chain of custody is really important because this is truly personal. The products we manufacture can only be given that one patient where we extracted the cells from. So you have to actually ensure that entire journey from collecting the cells all the way through manufacturing, product release, back to the patient, can be tracked and traced without any gaps. So there's a set of systems you have to set up in order to do that, but it also means that you have a very involved engagement with the centers themselves.

So when we engage with the centers, you know, it starts out with actually identifying the patient, and there's a ping coming from the center through a platform that we developed that basically is a query for access to the product. The patient gets assigned a patient number, and we then actually start working through the actual timing for the apheresis, get the kids there, get the cells extracted, shipped to our facility in the U.K. In the U.K., we then actually manufacture the product. We'll run through the release process.

While the release process is happening, the product already gets shipped into the U.S. to a logistics center that is close to the site, that is actually run by Cardinal Health, a company with whom we have a collaboration to do that. And what that allows us to do is actually cut time out of that cycle and get a quicker return. As soon as the product is formally released, at that point in time, the product actually gets shipped out, and that's basically the last whatever 100 miles or so, 50miles-100 miles from that depot to the actual treating hospital. The patient gets prepared for infusion, the product gets infused, and then the patient gets followed. So it's a very involved process. It also requires you to accredit the centers.

So the centers actually need to be accredited in order to deliver these types of therapies, which means that there is an adequate level of training. There has to be sort of run through with the treating physicians, the nurses, the pharmacy at the hospital, the apheresis team that initially collects the cells. But there is also additional support: support on reimbursement, as well as support on the patient, whether it be logistics and otherwise. And then all of these products have a long-term obligation to follow from a safety perspective, a REMS program. And so when you think about that, this is a very involved process. And what you have to make sure, and you want to make sure, is that the workload for the center is minimized, the access is minimized.

It is as simple as possible from a center perspective, and that's really where we spent an enormous amount of time developing that with a fantastic team that, frankly, we recruited from kind of the best places within the industry, with a lot of experience in CAR T launches and understanding, a very good hands-on understanding of what worked, what didn't work, and where there were issues at the centers that we actually can overcome by changing a process or, providing technology to do that. So it's a very involved process. So the centers are now being prepared for the activation. The activation can only occur when the label is actually granted by the FDA. We're going to have, at that point, between 30 and 36 centers ready.

We're going to go from there to 60 centers, and 60 centers in the U.S. will give you more than 90% of all patients treated with relapsed refractory ALL in the country. So we're going to go very quickly to a relatively large number, and even the starting number of centers is substantially bigger than most launches that actually have been done in our space. And the only reason why we think we can do that is that we actually have the ability to supply from a manufacturing perspective.

Speaker 2

Okay. And then just in terms of that process, how different is it relative to the process with Kymriah, for example? Just 'cause obviously you've gone to the effort of trying to simplify it, but then the risk is that centers and physicians are kind of used to another process and there's some resistance there.

Christian Itin
CEO, Autolus Therapeutics

I think you want to, you want to keep the process identical or similar where you can.

Speaker 2

Yeah

Christian Itin
CEO, Autolus Therapeutics

And only deviate from that where the product requires you to do simplify. So that's really kind of what you want to do, because in the end, you know, when you think about the centers, they have, you know, multiple products they're going to be managing. They're in different IT platforms, there's different interfaces, the different policies. And the more bespoke you actually create your process, the more difference you have and the more of a hurdle you actually create for the center to actually run with that. Now, imagine on top a, an indication like an acute leukemia, where you might have a situation that per month, a center may have between 0 and maybe 10 patients.

And so what that does, when you think about the normal proceedings in the center, means that pretty much every time that you have a patient, it's probably a different person, it's a different shift, and that person needs to actually have a very easy way to engage and actually get that order in. So one of the key things that we've done is we made sure there's literally a single access point for each one of the centers that, for any query, can be called up. And it's that access point, that coordinator, that actually then actually provides the necessary services that are required to address whatever the issue is at that particular site. So those are very practical, very simple things, but they're very important because they do actually reduce the hurdle for adoption.

that obviously is one of the key things that we need to make sure we address.

Speaker 2

Okay. And then in terms of kind of the competitor set in ALL, obviously, kind of you're not the first CAR T to market. There's more to come. What is the key differentiation in your view on obe-cel?

Christian Itin
CEO, Autolus Therapeutics

Well, there are two areas that are fundamentally differentiated. The first one is this is the only product that on its own gives a long-term outcome. That's a huge differentiator 'cause these patients are all dying.

Speaker 2

Yeah.

Christian Itin
CEO, Autolus Therapeutics

And to have an ability to get that converted is important. We also were able to show, and this is data we showed at ASH, that if we manage to actually get the patient's tumor burden down to less than 5% before dosing, we have an event-free survival that's between 70% and 80%. So it tells you actually how to manage the patient. It also tells you that you want to go early in the relapse and really get as many of these patients in that state, so you actually can translate that into long-term outcomes for the most of those patients. So that's the first thing. That's a fundamental difference. The second thing is, we actually get there with a safety profile that actually, from a immunological toxicity perspective, is better than BLINCYTO and a different league from everyone else.

And that is important because we're looking at, you know, high-grade CRS in about 2% of the patients. We're looking at high-grade neurological toxicity in 7% of the patients, the time to resolution being shorter than with competing products. So you look at, you know, competitor data is anywhere from high-grade CRS rate in the range of 25%, high-grade ICANS between 25% and 38%. So this is a totally different ballpark in terms of intensity of patient management. And also we can predict pretty much based on the tumor burden at lymphodepletion before we dose, actually whether what the level of risk is that a patient will develop any neuro, any form of immunological toxicity. So predictability, plannability, much less resource use.

With that inability, an onset of adverse events, which is delayed, which actually allows you to, from a reimbursement perspective, to actually have the vast majority of these patients in the quote-unquote, hospital outpatient segment from a reimbursement perspective, and for patients with low disease burden, actually in a hospital outpatient setting. That has a huge benefit in terms of the actual way that these patients can get, the hospitals can get reimbursed for the work they're doing. They get reimbursed at a higher level and a higher rate. There's also an opportunity for a new technology access payment, which is something we're certainly gonna be applying for, which will be unique for the product. There's none of the other products have that at this point.

That actually is a very substantial added amount of revenue per patient for the treatment center, which also actually drives obviously the interest there. So it's less resources, it's a higher level of reimbursement, it's a higher number of patients you can manage, it's a better patient experience, and it's a chance for long-term outcome. So it is a very differentiated product.

Speaker 2

Okay. In terms of guidelines, what are the expectations there in terms of a guideline update once obe-cel is approved?

Christian Itin
CEO, Autolus Therapeutics

We would expect that there's gonna be a fairly quick update or a pick-up into the NCCN guidelines. That's the expectation. And certainly would be consistent with conversations that we had.

Speaker 2

Okay. We've talked a lot about the US process. Just I guess we also want to talk about kind of autoimmune and some of the other things in the time. So quickly on the European side of things, where are you in terms of regulatory process?

Christian Itin
CEO, Autolus Therapeutics

Right. So we did file the MAA with EMA at the end of March. At that point, well, it filed early, but at that point, it was accepted. So the product actually is now in formal review. We're getting up to the review cycle. In Europe, a bit different from the FDA. The FDA has pretty much a rolling process of, you know, generating, you know, information requests, and basically works with the data on a continuous basis, and you get actually on an ongoing basis, you engage with the agency on whatever question that the agency may have. In Europe, it's a bit different. Basically, the questions get accumulated.

First time that you basically get a sharing of questions is 80 days after your filing's been accepted, and then that gives you pretty much a good lead on where the key questions are, the key areas of focus are, and then the formal questions actually are gonna come back at 120 days. And then you have to take a certain amount of time to answer that. This is basically one bolus of question, so that takes a little bit of time to go through. Once you've done that, you go back, that's actually when you then get into sort of whatever cycle that you might actually get into and eventually towards the CHMP opinion.

Speaker 2

Okay. And then just on pricing, how should we think about that, both in the US and in Europe when we get there?

Christian Itin
CEO, Autolus Therapeutics

Right. From a US perspective, I think we have two very good benchmarks to look at. We have, on the one side, the pediatric patients. Our age group, by the way, is, in the trial, has been from 18 years to no limit on the upside, on the upper end of the range. The age range for Kymriah is up to 25 years. In fact, patients up to 40 can actually receive in real life, Kymriah. With Tecartus, the program from Kite Gilead, actually, it's 26 years and older. So we're actually crossing both of those products. Now, the pediatric side, the current price is $582 per patient. And on the adult side with Tecartus, is $462.

So that's the bracket, and we're gonna be somewhere in between those two, in terms of the price that we're gonna pick. In Europe, that's more variable. The list prices originally were very close, between the U.S. and Europe. What you then usually have in Europe is an element of a discount, depending on the healthcare system and the way they value therapeutics. And it's gonna be very interesting to see what the development is. There is a lot of movements in Europe. In an odd way, Europe has become a consumer of healthcare, with the majority of pharmaceutical activities being outside of the E.U., being in the U.K. and in Switzerland, which is a really odd thing. And you see some change in behavior with that.

And the other aspect, I think, from a U.S perspective is, what's very different in Europe, is that there are different buckets of capital and budgets that are being used to actually pay for healthcare. One of the big ones in the U.S, obviously, would actually cover in your... if you get your bill, would be actually related to infrastructure. Now, most of the infrastructure piece in Europe actually is carried by taxes. So infrastructure, this includes also people, base salaries, all of those good things. That's actually covered through taxes, and because it's covered through taxes, it doesn't actually get properly allocated or considered in the overall cost of healthcare.

On the other hand, you have then a much more a focus on actual specific treatment and drugs and therapeutics, and that's also where there is quite a different view in thinking about where value is, what the benefit to a particular system is, and a different way of measuring that. In an interesting way, in the U.K, where there's a nationalized system, there's actually full transparency on the cost because of that. And there's actually a very good way of understanding the value to the healthcare system overall. That is very beneficial, actually, and actually for therapies like ours, which have such a profound impact on patients, actually gives you a better way of actually articulating the value and, and frankly, have a reasonable conversation around that. So it'll be very interesting.

It'll be interesting to see what the developments in Europe are, and typically, the launch process in Europe would be on a country-by-country basis, 'cause, you know, the regulatory approval is central, but then the reimbursements are really on a national level and tailored to the respective differences in the national healthcare systems.

Speaker 2

Okay. That's clear. On the safety side of things, and obviously, it'd be good to get your perspective, there's been a lot of kind of noise around the broader CAR T space. How do you think kind of obe-cel may or may not be impacted by any kind of broader safety warnings that the FDA put in place?

Christian Itin
CEO, Autolus Therapeutics

Well, I think the first observation is that I think whenever you have... whenever there is a sense that there might be a broader potential risk with a drug or therapeutics category, that tends to get reflected in the labels across. And we've seen that happen in lots of different types of therapeutic approaches, and we certainly see that happen also in the CAR T space. One of the things that you have with most of these agents is a risk for secondary malignancy. Now, we need to understand, though, that secondary malignancies are primarily driven by the genotoxic nature of the high-dose chemotherapies that these patients get exposed to. That's where actually the mutations get triggered.

There is a particular risk that was articulated by the agency but is not substantiated by data today, is that you could actually have a pre-exposed or predisposed T cells in those patients that could also then be transduced with a chimeric antigen receptor, and that cell could actually have gained a benefit or an improved ability to survive. That is a certain theoretical risk. We haven't really seen it play out. In the numbers, we don't see it. There were 22 cases overall reported. There is one case that I'm aware of that had shown presence of CAR T in a T cell that was actually removed. However, the actual lesions that drove the malignancy and the transformation preexisted in the apheresis.

In other words, it is actually a consequence of the prior lines of therapy, get an accumulation, and then you might actually also have a transduction of that cell. Overall, we don't see a change in the actual benefit risk profile, and we haven't seen any evidence of an elevated level of those events.

Speaker 2

Okay.

Christian Itin
CEO, Autolus Therapeutics

I think that's, I think, important to remember, and when we think about the autoimmune side, it's worthwhile remembering that when you look at all the biologics in the autoimmune space, you get a, in each one of the labels, a reference of a risk of malignancy. The risk of malignancy there is not primarily driven by exposure to genotoxic agents, but the risk of malignancy is driven by the fact that you have long-term immune suppression, and it is the actual reduction in immune surveillance which increases the risk for malignancy. So those are kind of the areas that we're looking at, and, and I think, you know, from where we're sitting today and what we know about the products, in particular about our own products, we don't see any change in the benefit risk profiles that we're projecting or we have demonstrated.

Speaker 2

Okay, makes sense. You mentioned autoimmune there, so maybe we'll spend some time there for a moment. The advantages of obe-cel that you see in the ALL population, for example, do you think that those hold true in the autoimmune indication? And, I mean, conscious that in ALL, you're probably competing with the first generation of CAR T products, whereas in autoimmune, there's kind of the next advancements from various companies across the sector. So how confident are you in that kind of profile and those characteristics holding true?

Christian Itin
CEO, Autolus Therapeutics

It's a really good question. So the fundamental difference is that we actually have data. Okay? We don't need to project. We actually have data we can compare. And the interesting thing about the data is that, when we started out, we developed obe-cel initially for the treatment of children with acute leukemia, and obviously, that allows us to compare to Kymriah, which is frankly, where we have most of the data from in the autoimmune field, a derivative from Kymriah. What we're able to show is that Kymriah, like any of the other first-generation programs, has a tendency of actually, after delivering the kill to a target cell, to linger on that target cell and actually staying bound to it.

The problem with that is, biologically, that you get an overactivation of the T cells or the CAR T cells, and that drives a lot of the adverse events we're seeing.

Speaker 2

Okay.

Christian Itin
CEO, Autolus Therapeutics

Obe-cel was designed to actually not to do that, and in fact, has a property that allows the cells to disengage rapidly with about a 100-fold faster disengagement rate. And that actually allows us to deliver the kill without having overactivation in the product and the T cell. That's fundamental to the design of the product. And what we were able to show is, in a direct comparison with the same way of managing the patients between Kymriah and with obe-cel in pediatric patients, that while you had 47% of the kids with Kymriah experience high-grade CRS, none of the children had experienced that with obe-cel. The only difference was the way the cells would engage and actually be able to sort of deliver the kill without getting overactivated. That fundamental principle is unique to obe-cel.

Any of the other programs that actually be taken forward by Novartis, as well as by BMS, share the same receptor that Kymriah had, identical receptor. So that change doesn't change their properties. Their fundamental properties is still differentiated, and we see that actually in the data from the team in Erlangen, that originally actually worked in pediatric ALL with their product. That's where it comes from. That has allowed us to compare our data, and what we were showing is... what we're seeing is the exact same thing that we've seen with Kymriah prior, which is that we had very, very similar high grades and high levels of activity, long-term persistence in kids, very long-term outcomes in about 35%-40% of the children... but no high-grade CRS, whereas they are still seeing it with their product.

We see that actually preserved that feature and differentiation in the features. That's obviously something that we can build on because we can actually build on data in very, very challenging patients with very significant amount of tumor burdens or target cell burdens.

Speaker 2

Okay. You have the CARLISLE trial ongoing in SLE. First, could you just kind of remind us timelines there, and then what you'd be looking for from that data set to justify progression, both in SLE and in other-

Christian Itin
CEO, Autolus Therapeutics

Right

Speaker 2

autoimmune disorders?

Christian Itin
CEO, Autolus Therapeutics

So the nice thing, obviously, is that today we have probably the strongest data set that shows we can create a complete reset of the B cell compartment in patients. The only way you get to long-term outcomes in ALL, this is beyond MRD testing. So this is the only program that has ever shown that. So that's point number one. The second is, the dosing that was used in the original work that was done in Germany was based on the pediatric ALL dosing. It was 1 million cells per kg. We used the exact same dosing in pediatric patients as well with obe-cel. So what this allows us to do is actually pick that dose, but rather than actually do weight-based dosing in adult patients, which doesn't make much sense, to go to a fixed dose.

And so we're basically converted that weight-based dosing into a fixed dose of 50 million cells. We know we could have gone lower than that, but 50 million is a good volume to work with practically in the clinic. It's a volume you can actually manage. And are now confirming that dose in literally 6 patients, and from there, we're gonna go into a phase II directly. So that's sort of the plan and gives us.... And it's really only possible because we do have a large data set that we can build on, and that allows us directly to extrapolate without having to do a dose escalation type of series.

Speaker 2

Okay. I'm guessing kind of, you know, relatively small numbers in the initial trial, so that doesn't impact your capacity from a ALL perspective and ability to serve the market there?

Christian Itin
CEO, Autolus Therapeutics

Not at all. In fact, the clinical supply, we're still actually supplying from a second facility, so it doesn't impinge at all into the commercial capacity.

Speaker 2

Okay. Just ahead of the launch, just thinking about profitability of obe-cel in the initial indication, how should we think about that? Obviously, you kind of have a huge amount of manufacturing capacity, but you're not going to necessarily need that from, from-

Christian Itin
CEO, Autolus Therapeutics

Look at the program is that, first of all, the program on its own, with the basic infrastructure, et cetera, allows us to get profitable. Dependent on the level of additional investment we're gonna do in additional indications, obviously, that may the timing of profitability varies quite a bit. And so that is actually the key determinant there. But the product itself is definitely a profitable product, with a very nice margin, and we expect that as we're going through the launch period, that we should be able to reach that within the ramp of the launch.

Speaker 2

Okay. And then briefly, just to finish on capital and financing, where are you in terms of liquidity and where does that take you?

Christian Itin
CEO, Autolus Therapeutics

Yeah. So we did add $600 million at the beginning of February this year, part through a collaboration with BioNTech, which brought in $250 million, and then we raised $350 million on top of that. So it gives us a cash position at the end of Q1 of about just shy of $760 million. And that allows us to actually drive the launch, drive the product forward into at least one additional indication all the way through developed, and gives us a very appropriate runway of 3+ years. So we're in a very good spot to really drive the launch and really get to the next stage of the company.

Speaker 2

Okay, perfect. We're right on time. I think we got through 10% of my questions, so let's try and do a longer session next time. Thank you, Christian.

Christian Itin
CEO, Autolus Therapeutics

Thank you very much. Appreciate it. Thanks, everybody.

Speaker 2

Thank you for that.

Christian Itin
CEO, Autolus Therapeutics

Appreciate it.

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