The following is excerpted from the question-and-answer section of the transcript.
(Questions from industry analysts are provided in full, but answers are omitted - download the transcript to see the full question-and-answer session)
Question: Gregory Allen Harrison - BofA Securities, Research Division - Analyst
: We're seeing that your -- some of the responses are deepening. We're seeing PRs turn into CRs. How long do you think that it would make sense
to continue the therapy in the real world in hopes of continuing to see those responses deepen?
Question: Arlinda Anna Lee - Canaccord Genuity Corp., Research Division - Analyst
: I guess my questions are more for the clinicians. Dr. Johnson, I think you mentioned that had you not PROPEL as an option you would have pressed
for chemo, curious whether there were particular characteristics with the patients that you know that you thought of PROPEL to kind of help us
predict for which patients might have efficacy, just looking at the responses have been kind of across the board. And I was wondering for both of
you guys, if BEMPEG were available, how might you -- which kind of patient populations would you think to look in to use this first.
Daniel Johnson
Sure. Thank you for the question. Yes. I think it wasn't necessarily something about these patients that made me think that they were going to
respond on the PROPEL trial. It was more the fact that I knew that they had a very little likelihood of responding to standard treatments. And again,
either the patient didn't want chemotherapy where I wanted to be able to offer a chemotherapy-sparing option to them. And I mean, to be honest,
the patients I enrolled, all have very poor prognostic factors. I mean PD-L1 negative liver mets, brain mets, I'm sure in the back of everyone's plans,
like, what are you doing enrolling these patients on the trial. But it was -- it's because I know the biology of BEMPEG can convert PD-L1 negative
to positive. And so I knew that was a good option for these patients that were in a hard spot and did not want chemotherapy.
And then as far as how I would foresee this being used, I think exactly how we're talking about it. Even though this is on clinical trial, every time
you're treating a patient and you have a patient in front of you, you're trying to come up with what you think is the best treatment option for that
patient individually. And having a chemo-sparing option that can convert PD-L1 negative to PD-L1 positive is really enticing for that situation.
Mehmet Alton
I can also comment on this question. So I think there are patient preferences, but also there are clinical contraindications for chemotherapy and
particularly patients previously treated for their locally advanced disease or their bone marrow suppression or cumulative toxicities related with
the treatment sometimes [and miss] our ability to offer them chemotherapy. And we know as currently single agent or combination immune
checkpoint inhibitor therapies, despite how much it changes our therapy landscape is just in every patient population is not as effective as we
would like to see.
So in that case, I think particularly for certain patient populations, there's just really unmet need. That's why, in my opinion, this data about low
PD-L1 or PD-L1 negative patient population or with high disease burden as well as some squamous cell carcinoma brain metastases, these are the
patient populations we always feel a little bit nervous about single-agent immunotherapies in concentration. So it's great to see that signal coming,
and I hope to see it's going to translate into a more statistically significant data in larger scale patient cohorts. But there is definitely an unmet need
in some of those patient populations. And regardless how in high PD-L1 population, immunotherapy works well. Still we lose majority of our
patients within 2 to 3 years. So there is still that part is quite low, and we need to do better on that.
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