Agenus Inc Q4 FY2021 Earnings Call

Thank you for joining us for the Agenus Fourth Quarter 2021 Financial Results. All participants are currently in listen-only mode. After the presentations, we will have a question-and-answer session. I will now turn the conference over to our speaker today, Ms. Divya Vasudevan. Please proceed.

Thank you, and thank you all for joining us today. Today's call is being webcast and will be available on our website for replay. I'd like to remind you that this call will include forward-looking statements, including statements regarding our clinical development, regulatory and commercial plans and timelines, including timelines for data release and partnership opportunities. These statements are subject to risks and uncertainties, and we refer you to our SEC filings for more details on these risks. As another reminder, this call is being recorded for audio broadcast. Joining me today are Dr. Garo Armen, Chairman and Chief Executive Officer; Dr. Steven O'Day, Chief Medical Officer; Dr. Jennifer Buell, Chief Executive Officer of MiNK Therapeutics; Chandresh Harjivan, Chief Operating Officer of SaponiQx; and Christine Klaskin, Vice President of Finance. With that, I'll turn the call over to Garo to highlight the progress that we have made to date this year. Garo?

Thank you, Divya. Thank you all for your participation and your interest in Agenus. As I go through our call today, I'll be referencing slide numbers from time to time on the presentation that appears on your screen. You can also find slides on the Events and Presentations page of our website. To start with, at last year's shareholder meeting, we sought to streamline our business model. Based on that, our business model is comprised of four pillars. This approach allows us to strategically develop our pipeline independently, as well as with partners to build value while de-risking development and accelerating our path to market. The first pillar consists of our value creators, our fully or majority-owned programs, such as botensilimab, our next-generation CTLA-4, previously known as 1181. We intend to develop and commercialize these programs that fall into this category in certain geographies ourselves and partner in other geographies in order to create upfront value for the company and de-risk development. The second pillar consists of potential cash generators through strategic partnerships, such as our partnership with BMS for AGEN1777, our TIGIT bispecific. We have received over $800 million in cash through upfront and achieved milestone payments from these actual transactions over the past five to six years and are eligible for an additional $2.8 billion in milestones and royalties, as well as the option to participate in development and commercialization of these products. The third pillar consists of enablers, such as our PD-1 antibody, balstilimab. These backbone therapies are being evaluated in combination with our pipeline through clinical collaboration with other partners. They provide additional opportunities for commercialization and revenue generation while de-risking development through one centralized entity. The fourth pillar is represented by our subsidiaries, MiNK Therapeutics and SaponiQx. While Agenus retains majority ownership in these entities, they are structured for independent financing, allowing for focus and accelerated development of their respective products. I would like to begin the call by addressing the first pillar, which is driven by our flagship program botensilimab. As you know, we have treated well over 100 patients in Phase I trials evaluating botensilimab as monotherapy and in combination with balstilimab. We presented data at the SITC meeting last year, which demonstrated that botensilimab has an improved efficacy and safety profile compared to what has been reported with previous CTLA-4 antibodies, both first-generation and next-generation. As shown on Slide 3, botensilimab is Fc-enhanced to improve the efficacy and safety of CTLA-4 blockade through three primary mechanisms. First, botensilimab is designed to extend the curative benefits of immuno-oncology to cold tumors that do not typically respond to approved immunotherapies. This is achieved by increasing potency through improved T-cell activation, priming, memory formation, and counteracting the immune suppressive activity of regulatory T-cells, all in one antibody. As presented at SITC, botensilimab is the first CTLA-4 inhibitor to demonstrate clinical responses across nine cold and treatment-resistant cancers. Second, botensilimab is designed to expand clinical benefit in hot tumors such as melanoma, where CTLA-4 is already approved but results in clinical benefit in only a third of patients and long-term survival in less than a quarter of the patients. So there is a lot of room to improve here. We have observed responses across both hot and cold cancers in patients who express their biomarkers associated with poor outcomes to first-generation CTLA-4. Finally, botensilimab is designed to improve safety by reducing or eliminating side effects that cause treatment discontinuation. Notably, no pneumonitis, carditis, or neurological toxicities have been observed so far. Now with that, I would like to turn the call over to our Chief Medical Officer, Dr. Steven O'Day, who is one of the global experts in this field to review our upcoming plans for botensilimab. Steven?

Thank you, Garo. Building upon the data observed in our Phase I trial, we are continuing to expand disease-specific cohorts in the Phase Ib component of the trial, and we will be initiating Phase II studies in melanoma, colorectal cancer, and pancreatic cancer. We have carefully chosen these indications to—first demonstrate superiority to ipilimumab in melanoma where ipilimumab is approved and has been studied the most as a single agent; second, build upon the signals observed in our Phase I study by pursuing botensilimab in combination with our PD-1 antibody in microsatellite stable colorectal cancer; and third, establish botensilimab as a superior combination agent for chemotherapy in cold tumors by evaluating botensilimab in combination with standard of care chemotherapy in pancreatic cancer. First, I will elaborate our approach in melanoma. As a melanoma physician, I am particularly interested in leveraging my background and my network to rapidly enroll and execute this study. The majority of melanoma patients treated with single-agent PD-1 progressed within a year and are in need of more effective treatment options. Response rates with ipilimumab monotherapy are approximately 15%, and most patients progress within months. At SITC, we reported a confirmed partial response in a PD-1 relapsed refractory melanoma patient. Since SITC, we have observed a second melanoma patient responding to single-agent botensilimab with more than a 40% tumor reduction at their first six-week scan. This patient had previously progressed after ipilimumab in the adjuvant setting and subsequently ipilimumab and nivolumab in metastatic study. We have designed a Phase II trial in melanoma evaluating botensilimab monotherapy in both PD-1 resistant refractory setting as well as a PD-1 and CTLA-4 resistant refractory setting. The first cohort in PD-1 refractory resistant patients will allow us to quantify the superiority of botensilimab compared to historical ipilimumab. We are targeting a response rate of 25% or greater. The second cohort in PD-1 and CTLA-4 relapsed/resistant patients will explore whether botensilimab can rescue ipi/nivo failures—a patient population with very limited treatment options. In addition to our botensilimab monotherapy study, we have expanded our AGEN2373 Phase 1b trial and are now recruiting a cohort of PD-1 resistant/refractory melanoma patients to receive AGEN2373 in combination with our botensilimab. AGEN2373 is a CD137 agonist antibody designed to be conditionally active in the tumor microenvironment. To date, AGEN2373 has demonstrated early single-agent clinical activity without evidence of liver toxicity that has stalled other clinical stage CD137 therapy programs. I'm particularly excited about the combination of a checkpoint agonist CD137 and antagonist botensilimab in melanoma and in immunogenic tumors, as this represents a potential novel scientific advancement. Next, we are planning a study in microsatellite stable (MSS) colorectal cancer, where our Phase 1 data with botensilimab and our PD-1 balstilimab combination has shown best-in-class potential compared to standard-of-care and other drugs in development. Colorectal cancer claims over 50,000 lives annually in the U.S. Approximately 95% of Stage 4 colorectal cancers are classified as microsatellite stable or MSS, which correlates with poor responses to immunotherapy. In the second and third line setting, standard-of-care options are poor, and response rates are in single digits—approximately 2% with a median progression-free survival of only two months. In 20 patients treated to date in our MSS colorectal cohort, we observed a 20% response rate and 70% disease control rate for botensilimab and our balstilimab combination with the majority of responses ongoing at six months. This favorably compares to the competitive landscape where first-generation CTLA-4/PD-1 combinations have reported only rare responses and limited disease control. Our study will be designed to evaluate the contribution of components of botensilimab and balstilimab in this combination. We anticipate that the outcome of the study will strengthen the efficacy and safety signals demonstrated to date and could support further Phase 3 development. Finally, I'll provide an overview of our approach in pancreatic cancer. The five-year survival rate for Stage 4 pancreatic cancer is about 3%. This disease claims 50,000 lives annually in the U.S. alone, and there's been no new drug approved with a broad label in seven years. Multiple trials evaluating first-generation CTLA-4 or PD-1 agents as monotherapy have demonstrated no objective responses when evaluating the broad all-comer pancreatic population. At SITC, we reported a confirmed partial response ongoing at six months in a pancreatic ampullary cancer patient that also expressed a low-affinity CD16 allele, which has been reported to result in inferior benefit with first-generation CTLA-4 therapies. We plan on evaluating botensilimab in combination with standard-of-care chemotherapy in metastatic pancreatic cancer. This trial will enable the expansion of our CTLA-4 franchise into cold tumors, which represent a significant addressable population and where immunotherapies have been largely ineffective. Our combination strategy with approved chemotherapy could accelerate the path forward while tapping into the synergistic potential of next-generation CTLA-4 with chemotherapy combinations across multiple solid tumors. We are actively working with the agency to finalize these Phase 2 trial designs. Together, these trials in different settings with different combinations set up botensilimab across both IO and non-IO combinations and de-risk Phase 3 trials. As shown on Slide 5, positive data in these studies can unlock the franchise potential of botensilimab, supporting further development in indications where ipilimumab has been approved as a single agent or in combination or demonstrated benefit, as well as expansion into indications where botensilimab has shown clinical benefit, but other CTLA-4 agents have not.

Thank you very much, Steven. As Dr. O'Day articulated, if you look at each one of our development programs that are being contemplated, we're either working with in-house global experts or outside global experts to attend to these trials, to design the trials, and to determine potential high-probability successful outcomes. In parallel to our clinical efforts, we're building the infrastructure to support planned development and potential launch of botensilimab, including for example, our internal manufacturing capacity to support what will be potentially over $10 billion in annual sales at our Emeryville site, with an additional 80 acres of land that we have allocated for future manufacturing expansion. And our Vacaville site, which is not constructed yet, will be approximately 50 miles north of our Emeryville facility. Let me also talk about AGEN1571. This is a new clinical program that is about to start, and it is AGEN1581. It will happen this year, and it's a novel program targeting tumor-associated macrophages, which promote resistance to PD-1 and CTLA-therapy. There is a very strong rationale as to why we have gone this route to address needs that are not currently being addressed with I-O therapy. The importance of this target class has been validated by Merck's ILT4 antagonists discovered by Agenus and licensed to Merck. That program has shown durable responses in PD-1 resistant cancers. With AGEN1571, we continue to advance additional discoveries targeting myeloid cells. If you turn to Slide 6, I will now move to our second pillar, strategic partnerships. Strategic partnerships, while we retain ownership in the majority of our programs so far, we have accelerated the development of select programs through partnerships with industry leaders. Our partners are advancing six of our discoveries in clinical trials today, reflecting our innovation and pipeline productivity. Our most recent partnership was executed with BMS last year, when we exclusively licensed to BMS our TIGIT bispecific AGEN1777. Similar to botensilimab, AGEN1777 is Fc-enhanced to promote single-agent antitumor immunity, an area where clinical-stage TIGIT therapies have yet to show promise as single agents. It also addresses a secondary inhibitory receptor on T and NK cells to promote improved antitumor immunity. AGEN1777 is currently in Phase 1 dose escalation trials, and BMS intends to advance development in high-priority tumor indications, including a very large indication in the form of non-small cell lung cancer. We have already received $220 million from BMS in the past 12 months across upfront and achieved milestones and retained the option for co-development, co-funding for increased royalties and with a U.S. co-promotion. Another molecule, which we refer to just a little while ago, is MK-4830. As I mentioned earlier, Merck is advancing a myeloid targeting antibody MK-4830 discovered by Agenus. This ILT4 antagonist is in clinical development across a range of cancers, including pancreatic, lung, renal, breast, ovarian, gastric, and glioblastoma. Then we have our Incyte program that was one of our first partnerships. Incyte is advancing our clinical stage programs, and recently initiated a unique combination trial evaluating agent discovered TIM-3 and Agenus discovered LAG-3 antagonists with PD-1 in PD-1 relapsed/refractory melanoma. Across our partnered programs, we are, as I said earlier, eligible for $2.8 billion in milestone plus royalty. These partnerships accelerate the development of our drug candidates, generate capital to further support our pipeline development, and may offer optionality for future participation in development and commercialization. Let me also now make a few comments about botensilimab. This is one of the third pillars of our business model. Enablers, such as PD-1 antibody, botensilimab has exhibited strong clinical activity and excellent safety profile in over 400 patients evaluated to date. In a Phase 2 trial in second line cervical cancer, botensilimab demonstrated a response rate of 20% in PD-L1 positive patients, which represents a 40% improvement over the response rate reported for pembrolizumab, the only approved PD-1 agent for these patients. Now, in combination with zalifrelimab, our first generation CTLA-4 antibody, the response rate with zalifrelimab plus PD-1 or balstilimab has increased to 33% in PD-L1 positive patients. We believe these are major improvements for metastatic cervical cancer patients who have very limited or no options. While a BLA submission based on single-arm trials has been challenging in the U.S., given the changing regulatory environment, these data suggest a meaningful improvement over currently available therapy. Next, I will briefly summarize the fourth pillar of our business model, our subsidiaries MiNK Therapeutics and SaponiQx. MiNK Therapeutics launched an IPO last year to support clinical development of allogeneic iNKT cell therapies in cancer and immune-related diseases. Establishing MiNK with independent financing and leadership has provided greater resources for a complementary yet distinct technology while retaining, very importantly, our flexibility and advantage of cell therapy and antibody combinations. This will be a very exciting program. Clinical programs are underway in solid tumors as well as multiple myeloma. And lastly, before I turn it over to Chan to address SaponiQx, I will refer to Chan, who is the Chief Operating Officer of SaponiQx. Chan, if you can make some comments about the progress we’re making at SaponiQx.

Yes. Thank you, Garo, and I’m really excited to be part of the team. I joined SaponiQx last year after serving as an advisor to the U.S. government on the COVID response broadly and working as a partner at the Boston Consulting Group. I was really drawn to this opportunity to build an integrated vaccine platform to discover novel adjuvant and build more effective vaccines—something close to my heart to address pandemic threats and other diseases. The need for vaccines offering long-acting efficacy and efficient production has become grossly amplified in the current pandemic. We can’t boost the world every six months. The durability offered by our QS-21 STIMULON has been validated over the years by SHINGRIX, with protection exceeding nine years. Clinical and preclinical data support the broad applicability of QS-21 across more than 20 disease settings. However, QS-21 supply is constrained due to its reliance on a complicated and extensive extraction process from a Chilean soap tree bark. So at SaponiQx, we have developed a plant cell culture method of manufacturing QS-21 and next-generation adjuvants. Plant cell culture offers a more sustainable, scalable, and cost-effective method of manufacturing QS-21 versus bark extract. We expect to have GMP material from this manufacturing process this year to enable partner clinical trials. Very excitingly, we are also developing a new novel adjuvant with the potential to increase mucosal immunity through intranasal delivery, which is particularly critical for addressing respiratory pandemic threats such as COVID-19, but also vaccination efforts throughout the world in other disease categories. We’ve built a strong leadership and advisory team to achieve these objectives with rich experience in vaccines, platform design, innovation, and pandemic response from inception to commercial launch. Thank you. With that, Garo, I’m going to turn the call over to Christine Klaskin to discuss our financials.

Thank you, Chan. We ended the year 2021 with a cash and short-term investment balance of $307 million. This compares to $100 million at December 31, 2020. We recognized revenue of $296 million and $88 million for the years ended December 31, 2021, and 2020 respectively, which includes revenues related to our upfront license fees received, non-cash royalties earned, and revenue recognized under our collaboration agreements. Our cash provided by operations for the year ended December 31, 2021, was $10 million with a reported net loss of $29 million or $0.11 per share, compared to cash used in operations of $139 million and a net loss for the year ended 2020 of $183 million or $1.05 per share. Non-cash operating expenses for the year ended December 31, 2021, were $49 million compared to $37 million for 2020. The net loss for the fourth quarter ended 2021 was $68 million or $0.26 per share compared to a net loss for the same period in 2020 of $38 million or $0.20 per share. For the fourth quarter ended December 31, 2021, our cash used in operations was $23 million compared to $36 million for the same period in 2020. I’ll now turn the call back over to Garo.

Thank you, Christine. As we head into 2022 and beyond, we are focused on several near-term and medium-term value drivers. As outlined on Slide 7 in the near-term, I’ll give you a sampling of what we plan to accomplish. One, to launch Phase 2 trials as Dr. O’Day mentioned evaluating botensilimab in melanoma, microsatellite stable colorectal cancer, and pancreatic cancer. Two, complete enrollment of a proof of concept study evaluating botensilimab in combination with our conditionally active CD137 agonist in melanoma. Three, initiate a Phase 1 study for AGEN1571, a novel program targeting tumor-associated macrophages. Four, generate GMP grade QS-21 STIMULON through SaponiQx’s plant cell culture manufacturing method to enable partnership trials. And five, pursue additional strategic collaborations, which we have done consistently over the last five years. In the medium-term, one, we will pursue multiple paths to market for botensilimab. Two, we will continue to advance our VISION platform for more efficient and effective clinical trial designs. Three, we will advance several first-in-class programs targeting stromal and myeloid biology. Four, we expect to complete construction of our commercial GMP facility in Emeryville under the leadership of our Chief Manufacturing Officer, Dr. Al Dadson. And five, we will continue to progress existing collaborations and pursue new partnerships. Thank you very much for your attention. And we will now open up for questions.

And your first question comes from the line of Kelly Shi from Jefferies. Your line is open.

Hi, good morning. This is Jason Bouvier on for Kelly Shi. Thank you for taking our question, and I apologize if I missed this. But on the Bal/Zal combo and cervical, just wondering if you’ve had any conversations with the FDA on a possible path forward, or if you are still considering a development path forward for that combination. Thank you.

Very good question, actually. Unfortunately, because of the changes in the agency’s guidance over the last two years, we believe the path for single-arm trials, even randomized trials that don’t meet their criteria is closed. It’s unfortunate because patients will not benefit from the clear benefit that has been shown in, for example, our trial that has been published in the Journal of Clinical Oncology and presented at major conferences. But in the U.S., we believe that window is closed. Just like, for example, some of our competitors indicated recently by pulling their own BLA from randomized trials, some of the new trial requirements are so onerous that it makes no sense to spend the money to bring them to conclusion. So to answer your question, very directly, we will not pursue the approval of botensilimab as a single-agent therapy or botensilimab plus our zalifrelimab as combination therapy in cervical cancer in the USA.

Got it. Thank you very much.

Your next question comes from the line of Mayank Mamtani at B. Riley. Your line is open.

Good morning. Congrats on the progress, and thanks for taking our questions. So maybe just starting with incremental updates on botensilimab, if I said the name right? Could we just get a bit more color on some of these initial indications in terms of path to accelerate approval as I understand, to engage with regulators? Is it PD-1 refractory melanoma where it seems like you have already identified single-agent target ORRs? Or—could you clarify the pancreatic metastatic setting you’re going into the first line with chemo or is it later lines? And then I have a follow-up.

Sure. I think these are excellent questions for Dr. Steven O’Day. So if I can ask Steven to address them.

Yes. Thank you for the question. So in melanoma, as I indicated, we think that this is an optimal opportunity for testing single-agent botensilimab activity in two settings. One is the PD-1 resistant refractory, but CTLA-4 naive setting where single-agent ipilimumab has approximately a 15% response rate, and we’re targeting a 25% or better response rate in this cohort of patients with an improved safety profile. Even more exciting, or equally exciting, is a cohort of actual CTLA-4 refractory patients. So patients who have received either ipi/nivo frontline, or have had sequential nivo or KEYTRUDA, and then had single-agent ipilimumab in the second line setting, where response rates would be expected essentially to be zero. We look forward to seeing if botensilimab can perform in this setting where the bar is very low, and the unmet need is even higher. As I indicated in the call, we already have in our Phase 1 trial a patient who had received ipilimumab in the adjuvant setting and then progressed and then received ipi/nivo in the metastatic setting. So we’re very excited to explore those areas. Obviously, I have a world-class group of melanoma KOLs that I have been part of for over 30 years that are getting energized by our Phase 1 data and look forward to testing the next-gen CTLA-4 in both of these important melanoma cohorts. In terms of pancreas, we see this as a cold tumor with the opportunity to really prime with our next-gen CTLA-4 in combination with chemotherapy. This will be looked at initially in the second-line metastatic setting, but obviously we have interest in moving to first-line metastatic once we establish safety of combination and initial responses in this setting.

Thank you for that level of detail. And maybe just a follow-up on 1181. Could you—as you think high level going beyond the initial three tumor types like lung, like prostate, what then your view is that complimentary therapy that is not an established I/O or non-I/O that could make sense to synergistically from a mechanistic standpoint?

Yes. Thanks. That’s another great question. CTLA-4, we think with a next-gen molecule that has better priming and memory and T-cell regulatory depletion, and a better safety profile can be a foundational combinational partner, not only with PD-1 where obviously in MSS colorectal, we’re seeing some very exciting signals. But we think it can be a foundational partner with chemotherapy or a standalone agent in a hot tumor like melanoma or many other potential combinations. So we see these three areas that we’ve outlined as sort of representative of a single-agent demonstration in a hot tumor like melanoma combining with a more typical PD-1 combination in a very difficult-to-treat MSS. Whether it can be a foundational and better partner than PD-1 in combination with chemotherapy in pancreas, where PD-1 and chemo combinations have not worked well in the very cold tumors. We’re very strategic about outlining three different experiments with three different tumor types that set up next-gen CTLA-4 as a single agent and a combination of both within I/O and ex-I/O. Our collaborative partners that are in discussions find this very interesting, as it will move the asset forward with much deeper resources across other tumors like lung and prostate and other big unmet needs.

Great. And if I could also ask a quick 1571 question. Have you disclosed the specific target for that? And more broadly, how might data mid-year inform how you plan to develop it this year in clinic? I would appreciate the color there.

So we’re currently contemplating the path forward, including potential partnerships with this compound, Mayank, and we’re not disclosing any details just yet.

Okay, great. And as my final question was just quickly on SaponiQx. How far are you from the clinic, particularly for the intranasal vaccine?

So if your question is about the potential of an intranasal vaccine using the saponin family of adjuvants, we do have, as you may know, a very, very promising adjuvant in the name of QS-7. What we have done with QS-7 is really because it's so active as a mucosal adjuvant. We have now developed plant-based cell lines to improve the yields from QS-7, because for many, many years we have known that QS-7 is a very effective vaccine adjuvant, but the yields achievable from the natural source have been very poor to make this a viable candidate. With our new plant cell culture methodology, we have selected cell lines that actually express QS-7 in high enough quantities for this to be promising. We are pursuing this, but I think it will take until perhaps the end of this year to have GMP quantities of QS-7, so that we can run some experiments and have partnership discussions.

Thanks so much for taking the questions.

Your next question comes from the line of Mike King. Your line is open.

Good morning, guys. Thanks for taking the question. I just wanted to—I don't want to draw conclusions, but wanted to ask if your thought—given the experience that you had with balstilimab, is botensilimab single-arm study in some of these cold tumors a possibility? Or are you considering going from Phase II into Phase III?

Let me answer this question with a very definitive guidance. Given the changing regulatory environment, Mike, I think it would be unwise for us to take chances with single-arm trials. We don't believe that the new guidance is necessarily in the best interest of the patients; however, that is not within our control. So going forward, right in the U.S., I think it would be fair to conclude that we will engage in randomized trials for approval.

Okay. Even in populations with unmet need?

Yes, this is Steve O'Day. In addition to that, I think obviously we've set these trials up to follow the data. If we see data that’s clearly very exciting in a significant unmet need, we will engage in intensive discussions with the agency around the best path forward. Obviously we want to be mindful that confirmatory and large randomized trials are almost certainly going to be necessary, but the data will be set up to follow as it develops.

Okay. Terrific. And then just shifting gears real quick, can you say what the mechanism of 1571 is? Is it ILT4? Or is it another target in the tumor-associated macrophage space?

It's in the same family, Mike, but I think it's best for us not to yet release the specific target.

Fair enough. And then finally, is there any—you mentioned all of your wonderful partnerships, Gilead, Insight, Merck, but anything that you can tell us about— and Bristol, about when we might start seeing some data coming out of those programs to further validate your discovery platform? Thanks.

I think, I mean, we can't speak, of course, on their behalf, but given the progress and the speed of patient enrollment in the trials with all of our collaborators, Merck certainly with their ILT4, Gilead, Insight with various programs, Gilead with our conditionally active compound, the CD137, and Bristol with AGEN1777. Enrollment in all of these trials is at a pace that you may see some clinical activity this year. However, because these are their programs, I think it would be presumptuous for us to make comments on them, and we'll defer to them.

Your next question comes from the line of Matt Phipps. Your line is open.

Hi, good morning. This is Hunter on for Matt. Maybe just first, it seems like you've switched up your strategy for 1181 a bit from your original plan of starting a couple of trials in gynecological cancer. So could you sort of speak to what went into that decision?

Sure. I'll refer this to Dr. O'Day because these programs are his brainchild with input from his colleagues that have expertise in respective areas. I want to ensure that our audience understands that we have seen activity in nine different cancers with our small trial, which is quite unusual. Small trial meaning a little over 100 patients with nine different tumor types showing activity is almost a remarkable outcome. Given that, we will pursue 1181 across many tumor types, but because of regulatory, practical, and bandwidth considerations, and due to the promising data that we've seen in those three indications, the risk-reward was such that we should pursue those and prioritize them as the first targets. But Steven, would you like to elaborate more on this?

Yes. It’s a great question. The answer is, as Garo said, we have broad activity across nine different tumor types. It’s strategic in the sense that GYN malignancies— we have good activity in both ovarian and endometrial with limited numbers obviously to date. But it really comes down to our bandwidth, what experiments we’re trying to do that will move the asset forward, and a regulatory environment that's rapidly changing. We've consulted KOLs across diseases. We’ve thought this through carefully; we think that single-agent activity in melanoma is a great avenue. Combination with PD-1, our data with MSS colorectal is really the farthest along and exciting. A cold tumor like pancreas is in dire need of a better priming agent. We believe that these three important tumor types and experiments will answer some fundamental questions about our assets.

Okay, great. Thanks for that. And then maybe it's good to hear that you've seen that additional response in melanoma. Could you maybe say how many melanoma patients have been treated to date, now that you've got those two responses? And then maybe just one more for these three Phase 2 trials, I know you said you're still working on the design, but are you thinking that those will be randomized trials or are you assuming that you'll have to move to randomized Phase 3s in those indications?

So without getting into too much specifics, the Phase 1 trial was really limited to non-melanoma patients until very recently. So we've already seen these two responses in two separate disease settings—one, PD-1 refractory, and then, PD-1/CTLA-4 refractory setting— with just a handful of patients. We are actively expanding the melanoma cohort and will accumulate more data in the coming months that we hope to update you on as we launch the Phase 2 melanoma trial. I'm sorry, what's the second part of the question?

Yes, I was just asking about the design of the Phase 2s coming up whether or not you're thinking those trials will be randomized trials.

Right now, we talked about conducting single-arm studies in these two cohorts, and I will release more details on the design after further discussion with the FDA in the other diseases.

We have a follow-up question from Mayank Mamtani. Your line is open.

Yes. Thank you for taking my follow-up. I just have a quick financial question that just came in. So in terms of recognizing what seemed like a 2.8 billion in milestones and Royal accumulative. Can you just clarify if there is anything near-term, say this year? And maybe also just if you could provide any color on what might be added next to this list. Anything you have visibility on that could bring that sort of next bonus of cash, potentially an upfront payment.

Mayank, if I understand this question correctly, are you asking whether there will be additional partnerships we anticipate or if we will get more payments from existing partnerships during the course of…

Yes, kind of both. On Slide 6, that cumulative number is 2.8 billion, but curious if there is anything going to be near-term on those milestones. And then yes, things that are not on this slide that we should keep in mind as we think about 2022 financials.

Right. So as Christine said, we closed the year with a little over $300 million in cash, and it's possible that we will get additional milestone payments this year or option exercise payments during the course of this year. It’s also possible that we will enter collaborations for possibly different geographies for different compounds in 2022. Our strategy is to ensure that our financings or sources of financing are not dependent on any specific thing. This is one of the reasons, for example, in our filing today, we expanded our options or potentially funding the company through equity financing. There are no immediate plans for anything right now. One of the hallmarks of our strategy over the years has been our consistency in generating collaboration income—over $800 million in the last five-plus years—and we have been consistent in not coming into the markets with marketed offerings. We will continue to exercise prudence in how we fund the company until a watershed event occurs. For us, a watershed event is an accelerated path for product approval or a mega collaboration.

Thank you for taking my follow-up. That’s helpful.

Excuse me, presenters, there are no more phone questions. You may continue.

Thank you very much for your time and interest in our company. Please feel free to connect with us. In the future, we may change the format of quarterly communication, so stay tuned for that. But we're always happy to entertain questions from our investors and other constituencies. Thank you very much.

This concludes today's conference call. You may now disconnect.