Evaxion A/S (EVAX)
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Earnings Call: Q4 2022

Apr 27, 2023

Operator

Greetings, and welcome to the Evaxion corporate call. At this time, all participants are in listen-only mode. A brief question- and- answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star then zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Corey Davis. Please go ahead, sir.

Corey Davis
Managing Director, LifeSci Advisors

Thank you, operator. Good morning in the U.S. and good afternoon in Europe. Thank you for joining us to all. With me on the line today are Per Norlén, Chief Executive Officer, Bo Karmark, Chief Financial Officer, and Birgitte Rønø, Chief Scientific Officer, who will join us for Q&A. Today's call will be available for replay, as indicated in our press release. Let me quickly remind you that the following discussion contains certain statements that are considered forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995. Forward-looking statements involve risks and uncertainties that are not guarantees of future performance, and actual results may differ materially from those expressed or implied by these forward-looking statements due to a variety of factors, including those risk factors discussed in the company's annual report on Form 20-F and other documents filed with the SEC.

At this time, I'd like to turn the conference over to Per Norlén, the company's President and CEO. Go ahead, Per.

Per Norlén
CEO, Evaxion

Thank you, Corey. Good morning and good afternoon to everyone. I'm pleased to welcome you to today's conference call. During the call, I will provide you with a brief overview of the excellent progress we made across our pipeline and our core AI technologies over the last 15 months. I will share our outlook for 2023. I'll turn the call over to Bo, who will review our 2022 financial report. We will open up the line for questions. Before going into our programs, I'd like to spend a few moments on our strategy. I joined Evaxion in October 2022 based on my belief that the company's proprietary artificial intelligence or AI technology is world-leading and has the potential to generate superior immunotherapies for cancer and infectious disease.

This aligns perfectly with our strategic focus on our leading AI platforms for vaccine target discovery, on our excellence in target validation, and on building a pipeline through partnerships. With increased focus and associated organizational changes we made, we've been able to extend our cash runway into December of this year. I want to start by recognizing the performance, dedication, and commitment of entire Evaxion team in setting up the company for success. Now, I would like to take you through the recent progress in our product development portfolio. Starting with oncology. Our program is focused on developing personalized cancer immunotherapies, aiming to substantially improve disease outcomes for patients with advanced cancers. The foundation of our oncology program is PIONEER, the PIONEER AI platform. PIONEER has enabled us to successfully identify patient-specific, tumor-specific mutations called neoantigens.

These neoantigens can be incorporated into a personalized drug and be delivered to produce an enhanced antitumor response. Clinical data from our clinical programs in EVX-01 and EVX-02 have provided important validation for our approach to developing personalized cancer vaccines. Building on those learnings, important technology advances and new discoveries have allowed us to advance a third-generation vaccine candidate, EVX-03, and towards the clinic. I'd like to start by highlighting the initial proof of concept clinical trials in melanoma for EVX-01 and EVX-02, and then provide a high-level overview of our newest oncology programs and technology collaborations. EVX-01 is our first-generation peptide-based vaccine. It's provided us with proof of concept that our PIONEER technology can identify the right neoantigens and generate a potent antitumor immune response. We've been evaluating this vaccine in two early stage studies in combination with checkpoint inhibitors in adults with metastatic melanoma.

Results of the first trial, a phase I/II-A study in 12 patients, will be presented at the American Society of Clinical Oncology or ASCO in June in Chicago. Patients in this study are heavily pretreated, and many are non-responsive to immune checkpoint inhibitors. As a result, a low treatment response would be expected with current standard treatments, such as checkpoint inhibitors. Interim data reported last fall showed that we see a high response rates. Six out of the nine first patients had an objective response, with two patients actually demonstrated a complete response. These data compare very favorably to results from historical controls, and we are now eagerly looking forward to presenting the full study readout at ASCO in June. EVX-01 progressed to clinical phase II-B with dosing of the first patient in September last year.

With accelerated progress of our new generation DNA-based cancer immunotherapy, EVX-03, we recently made a decision to enroll a smaller number of patients in the phase II-B study of EVX-01, now intended to enroll up to 20 patients. The study is conducted in collaboration with Merck, which provides Keytruda, the objective is still to confirm the results of the phase I/II-A study. We expect to present the interim re-results of this study in the fourth quarter of this year. Moving to EVX-02. We designed this vaccine as a DNA-based personalized cancer immunotherapy, building on our ability to select the right neoantigens, as demonstrated with EVX-01. Shifting from a peptide backbone to a DNA backbone, we believe will allow us to shorten production timelines and manufacturing costs for this product.

We were extremely happy to share the positive clinical data from our phase I/II-A first-in-human study of EVX-02 during the late-breaking research session at AACR on April 18 this year. We evaluated EVX-02 in combination with a checkpoint inhibitor Opdivo or nivolumab in patients who had undergone complete surgical resection of late-stage melanoma and were at high risk for recurrence. The primary objective of the 12-month study were to assess the safety, tolerability, and immunogenicity of the combination, as well as to evaluate relapse-free survival. All 10 patients who received the full dose and schedule of eight immunizations with EVX-02 were relapse-free at their last assessment. Of those patients, nine completed the full study and were relapse-free at 12 months end of study visit.

One patient discontinued the trial prior to the completion due to a non-EVX-02 related adverse event and was also relapse-free at the last visit, which was at nine months. From a study perspective, we showed that the combination of EVX-02 and nivolumab was well tolerated and only mild EVX-02 associated adverse events were observed. From an immunological perspective, robust and long-lasting neoantigen-specific T-cell immune responses were confirmed in all patients. All patients who completed the full course of EVX-02 treatment. In conclusion, we were pleased to report that we met both primary endpoints on safety, tolerability and immunogenicity and our secondary endpoint on clinical efficacy. With all 10 patients who completed the EVX-02 treatment being relapse-free during the trial and with robust and treatment-specific immune responses, we see clear signs of a treatment effect.

The EVX-02 data further affirm our ability to select the right neoantigens matched to the cancer of each patient and demonstrates the value of our PIONEER platform. I'd like to highlight our newest oncology program, the third generation cancer vaccine, EVX-03. We believe EVX-03 could be a game changer in personalized cancer immunotherapy. This vaccine is also a DNA-based vaccine and contains several exciting improvements. It was designed to incorporate novel targets based on our new AI platform, ObsERV, that identifies patient-specific endogenous retroviruses. It may sound surprising, about 80% of our genes are in fact composed of DNA leftovers from viral infections that happened over the course of human history. Such viral fragments, or ERVs, are often expressed in cancer cells, which holds a lot of promise.

We have in fact recently demonstrated in preclinical models that ERVs can be used as highly effective targets for cancer immunotherapy. We have shown that ERVs are often expressed in patients with few tumor mutations. Based on this discovery, adding personalized ERVs to the neoantigen therapy that may help us to treat cancer patients who are today considered unresponsive to immunotherapy. This is, we believe, the first time that a personalized ERV therapy will be assessed in a clinical trial. In addition to adding ERVs to the program, we have also boosted EVX-03 with a genetic immune stimulant that attracts antigen-presenting cells to the vaccination site and improves the immune activation. Collectively, we believe these technological improvements will enhance the efficacy of EVX-03 and supported by data from preclinical models showing superior potency compared to products based on standard DNA technologies.

Subject to additional funding, we expect to file a clinical trial application or a CTA in the 3rd quarter to evaluate the combination of EVX-03 and an immune checkpoint inhibitor in patients with metastatic cancer. Patient recruitment is expected to begin in the 4th quarter this year. Before we switch gears to infectious disease, I'd like to make a note regarding our collaboration with Pantherna. As mentioned before, Evaxion continues to explore technologies that will enhance and support the development and delivery of our product candidates. In February this year, we announced data from a preclinical study showing that the combination of tumor neoantigens identified by our PIONEER platform and Pantherna's mRNA vaccine delivery technology drove a strong immune response and led to the complete tumor growth inhibition.

This data validated the combination of our vaccine candidates with mRNA platforms. They paved the way for collaborations with other mRNA partners. Turning to our infectious disease portfolio, we have two proprietary AI-driven technologies called EDEN and RAVEN to identify novel, unique targets or antigens for the development of superior vaccines to prevent bacterial and viral infections. I'm very enthusiastic about our three infectious disease programs. Let's start with S. aureus. Our Staphylococcus aureus program, EVX-B1, is a four-component vaccine for prevention of skin and soft tissue infections and has shown significant protection in validated preclinical models of sepsis and of skin infections. The next step for this partnering-ready program is IND-enabling toxicology studies.

For our gonorrhea program, EVX-B2, we announced in the fall of 2022 that we, in collaboration with the University of Massachusetts Chan Medical School, has received an NIH grant for development of a lead vaccine candidate. We are currently developing a multi-component vaccine candidate with broad efficacy in a panel of 50 gonorrhea strains and which has shown strong protection in preclinical models. Finally, for our vaccine to cytomegalovirus, or CMV. In December of 2022, we announced an exciting joint research collaboration with the company ExpreS2ion to develop a next-generation CMV vaccine candidate that elicits both cellular and humoral antibody responses. The initial phase of this collaboration will be jointly funded until 2025. After that, the parties could expand the research collaboration into a development and commercialization agreement.

Each of these infectious diseases represent a significant global health issue, affecting millions of people around the world and currently lacking effective vaccinations. For Staphylococcus and gonorrhea, antibiotic resistance is increasing fast, making this an extremely hot area. Our strong data, unique technology platform, and market need form the basis of a very attractive preclinical partnering opportunity. Now, I'd like to turn the call over to Bo. Bo Karmark.

Bo Karmark
CFO, Evaxion

Thanks, Per. I will focus my comments on our financial results for 2022 compared to 2021. All the numbers will be approximate for easy sharing during the call. For additional information regarding our fourth quarter results and prior period comparisons, please refer to today's press release and our 20-F form which we will file today. Starting with our expenses, research and development expenses for 2022 amounted to $17.1 million. General and administrative expenses amounted to $8.2 million. Research and development expenses decreased by $2.5 million or about 30% compared to last year. The decrease was primarily driven by a decrease in external development costs related to EVX-01 and EVX-02. The decrease was partly offset by increase in personal costs.

General and administrative expenses increased by $1.9 million or 31% compared to last year. This increase was primarily due to $1.8 million increase in professional fees and expansion of our corporate functions. The net loss for 2022 amount to a loss of $23.9 million compared to a loss of $24.7 million for 2021. As of December 31st, 2022, we had $13.2 million in cash and cash equivalents. With the recent cost savings, we expect our cash balance to be sufficient to fund our operations into December 2023. Now I would like to turn the call back to Per for a few closing remarks before the Q&A.

Per Norlén
CEO, Evaxion

Thank you, Bo. Looking out to the rest of 2023 and beyond, I'd like to highlight a few things. We will present the full readout of the EVX-01 phase I/II-A study during the ASCO conference in June. We'll report interim results from the EVX-01 phase II trial in patients with melanoma in Q4. Also in Q4, we will initiate patient recruitment in a phase I study for EVX-03 in patients with solid tumors and then moving into non-small cell lung cancer. In conclusion, I'm optimistic about the next year for Evaxion. I believe that Evaxion has the potential to develop immunotherapies to substantially improve the treatment of cancer and vaccines to prevent infections that impact the world. Over the last seven months, as we've refined our strategy and focus, we are invigorated by the data and the promise that our programs can make a difference.

On behalf of everyone at Evaxion, I invite you to continue to keep in touch with the company and follow our progress in 2023 and beyond. Before I turn the call over to the operator for the Q&A, note that Birgitte Rønø, Chief Scientific Officer, will join us for the Q&A segment of today's call. Operator, over to you for Q&A.

Operator

Thank you, sir. Ladies and gentlemen, we will now be conducting a question- and- answer session. If you would like to ask a question, please press star and then one now. A confirmation tone will indicate your line is in the question queue. You may press star and then two if you would like to remove your question from the queue. Again, if you would like to ask a question, please press star and then one now. The first question we have is from Jeff Jones from Oppenheimer. Please go ahead.

Jeff Jones
Managing Director and Senior Analyst, Oppenheimer

Good afternoon, guys, thank you for taking the question. I guess two quick questions. With the reduced size of the EVX-01 study. The phase II data, one true data that you'll report out at ASCO. What are the next steps here? Would you proceed with another phase II, or could you move on to pivotal studies, and what are your plans? With respect to EVX-03, and you mentioned needing additional financing to kick those studies off, how much money would you be looking to raise to support that next clinical trial? How much money would you need to run the clinical trial? Thank you.

Per Norlén
CEO, Evaxion

Yes. Thank you so much, Jeff. This is Per Norlén speaking. Basically, if we start with EVX-01, as you say, we will report the phase I data in at ASCO in June, and present the first interim data of the phase II trial in Q4. If I understand it correctly, you asked the question for the clinical development plan beyond that trial. Is that correct?

Jeff Jones
Managing Director and Senior Analyst, Oppenheimer

Yes.

Per Norlén
CEO, Evaxion

Yes. Today, we have, the focus of the strategy is actually to move more towards, our most unique technology, which is in our EVX-03 program, where we have both a genetic immune adjuvant and DNA technology, and including the ERVs. We will, use this EVX-01 trial. It's, basically to, confirm, the very promising data we had in the phase I trial. That was a relatively small trial run at 1 clinical site. Now the phase II trial is run at multiple sites in both Australia and Europe. Confirming the data in a larger population, even if it's not very large, that's a major objective here, since we do have, strikingly good data in the phase I trial. Just in confirming it seems it's a major importance.

to your question, it's more likely. It of course, it's depending on emerging data, but EVX-03 is a primary focus, and that's most likely where we'll focus our resources after that phase II trial. On EVX-03 then, I think your question was on the cost of that trial. If you say the total trial, it's a relatively small size trial. we are in the range of, maybe you can help me. Is it $5 million-$8 million? that will be distributed over, say, two years of time. In fact, it's more. We of course, need to raise additional capital to start the trial, but we don't need to have the full cover for that trial upfront at the end of the year.

In that range, up to $8 million.

Jeff Jones
Managing Director and Senior Analyst, Oppenheimer

Okay, great. Thank you very much.

Operator

Thank you. Ladies and gentlemen, just a reminder, if you would like to ask a question, please press star and then one now. The next question we have is Richard Ramanius from Redeye. Please go ahead.

Richard Ramanius
Equity Analyst, Redeye

Hello. Good afternoon. My first question is, do you expect to reach any non-dilutive funding during this year? For example, through an upfront payment?

Per Norlén
CEO, Evaxion

Yes. I mean, in terms of non-dilutive funding, if we talk on the one hand on grants, we are applying for grants, and that is possible, but of course, not something we calculate on. We also have a very active business development discussions. Actually, there's a lot of interest in our early programs. We have high hopes of getting additional funds into the company. Again, it's, that's something we can't control, but it will be really positive upside, of course.

Richard Ramanius
Equity Analyst, Redeye

Okay. Just Second last question, what kind of interests have you seen for the new EVX-03 ERV platform?

Per Norlén
CEO, Evaxion

Yes. Thank you, Richard. That's, we get a lot of interest from that. As probably most of you know, we had a release recently, we are first mover here with a personalized ERV technology for personalized cancer immunotherapy. We do get a lot of interest, both from companies looking at neoantigen themselves and from other potential partners. It's a very promising opportunity here. Of course, as you know, what we can do is expand the potential target population for cancer immunotherapy from patients with only hot tumors like melanoma, renal cell carcinoma, and so on, to actually completely other patient populations with much fewer cancer mutations that can potentially respond equally well to immunotherapy.

It's opening up the field tremendously if it works, and that's what we aim to show.

Richard Ramanius
Equity Analyst, Redeye

Okay. That's all for me. Thank you.

Per Norlén
CEO, Evaxion

Thank you.

Operator

Thank you, sir. Ladies and gentlemen, at this stage, there are no further questions. I would like to turn the floor back over to Per Norlén for closing comments. Please go ahead, sir.

Per Norlén
CEO, Evaxion

Yes. Thank you so much for joining this call, and hope to meet you again in the future. Thank you.

Operator

Thank you, sir. Ladies and gentlemen, that then concludes today's conference. Thank you for joining us. You may now disconnect your lines.

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