|
BioLineRx Ltd.
|
|
|
|
|
|
|
By:
|
/s/ Philip Serlin
|
|
|
|
|
Philip Serlin
|
|
|
|
Chief Executive Officer
|
|
|
|
|
|
• |
Announced positive topline results from GENESIS Phase 3 trial of Motixafortide in stem-cell mobilization (SCM). The data demonstrate that the study successfully met all primary and secondary endpoints with an exceptionally high level of
statistical significance (p<0.0001).
|
• |
88.3% of patients receiving Motixafortide + G-CSF underwent transplantation after only ONE administration of Motixafortide and in only ONE apheresis session, compared to 10.8% for G-CSF alone; potentially supports Motixafortide on top of
G-CSF as new standard-of-care mobilization agent in autologous bone-marrow transplantation.
|
• |
The Company is proceeding with activities in support of an NDA submission in this indication anticipated in the first half of 2022, including a pre-NDA meeting with the FDA planned for the second half of this year.
|
• |
Presented data at the 2021 American Association for Cancer Research (AACR) Annual Meeting analyzing results by liver metastasis status from the Company’s Phase 2a COMBAT/KEYNOTE-202 triple combination study testing Motixafortide in
metastatic pancreatic cancer. The analysis further strengthened the results reported from the study in December 2020, since not only were substantially all patients initially diagnosed with stage 4 disease, but the vast majority (~80%) of
the patients had liver metastases, emphasizing the extremely difficult patient population in this study.
|
• |
Strengthened balance sheet with underwritten public offering resulting in gross proceeds of $34.5 million.
|
• |
Initial results from Part 2 of the Phase 1/2a trial of AGI-134 in solid tumors in the second half of 2021;
|
• |
Pre-NDA meeting with the FDA for SCM in the second half of 2021;
|
• |
NDA submission for SCM in the first half of 2022.
|
December 31,
|
March 31,
|
|||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
Assets
|
||||||||
CURRENT ASSETS
|
||||||||
Cash and cash equivalents
|
16,831
|
16,047
|
||||||
Short-term bank deposits
|
5,756
|
42,036
|
||||||
Prepaid expenses
|
152
|
1,079
|
||||||
Other receivables
|
141
|
190
|
||||||
Total current assets
|
22,880
|
59,352
|
||||||
NON-CURRENT ASSETS
|
||||||||
Property and equipment, net
|
1,341
|
1,243
|
||||||
Right-of-use assets, net
|
1,355
|
1,297
|
||||||
Intangible assets, net
|
21,714
|
21,707
|
||||||
Total non-current assets
|
24,410
|
24,247
|
||||||
Total assets
|
47,290
|
83,599
|
||||||
Liabilities and equity
|
||||||||
CURRENT LIABILITIES
|
||||||||
Current maturities of long-term loans
|
3,092
|
3,220
|
||||||
Accounts payable and accruals:
|
||||||||
Trade
|
5,918
|
5,756
|
||||||
Other
|
1,440
|
1,100
|
||||||
Lease liabilities
|
191
|
140
|
||||||
Total current liabilities
|
10,641
|
10,216
|
||||||
NON-CURRENT LIABILITIES
|
||||||||
Warrants
|
10,218
|
5,247
|
||||||
Long-term loans, net of current maturities
|
2,740
|
1,891
|
||||||
Lease liabilities
|
1,661
|
1,598
|
||||||
Total non-current liabilities
|
14,619
|
8,736
|
||||||
COMMITMENTS AND CONTINGENT LIABILITIES
|
||||||||
Total liabilities
|
25,260
|
18,952
|
||||||
EQUITY
|
||||||||
Ordinary shares
|
9,870
|
18,731
|
||||||
Share premium
|
279,241
|
321,920
|
||||||
Warrants
|
-
|
975
|
||||||
Capital reserve
|
12,322
|
12,616
|
||||||
Other comprehensive loss
|
(1,416
|
)
|
(1,416
|
)
|
||||
Accumulated deficit
|
(277,987
|
)
|
(288,179
|
)
|
||||
Total equity
|
22,030
|
64,647
|
||||||
Total liabilities and equity
|
47,290
|
83,599
|
Three months ended March 31,
|
||||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
RESEARCH AND DEVELOPMENT EXPENSES
|
(5,422
|
)
|
(4,278
|
)
|
||||
SALES AND MARKETING EXPENSES
|
(175
|
)
|
(154
|
)
|
||||
GENERAL AND ADMINISTRATIVE EXPENSES
|
(1,243
|
)
|
(1,017
|
)
|
||||
OPERATING LOSS
|
(6,840
|
)
|
(5,449
|
)
|
||||
NON-OPERATING INCOME (EXPENSES), NET
|
469
|
(4,561
|
)
|
|||||
FINANCIAL INCOME
|
140
|
117
|
||||||
FINANCIAL EXPENSES
|
(414
|
)
|
(299
|
)
|
||||
NET LOSS AND COMPREHENSIVE LOSS
|
(6,645
|
)
|
(10,192
|
)
|
||||
LOSS PER ORDINARY SHARE - BASIC AND DILUTED
|
(0.04
|
)
|
(0.02
|
)
|
||||
WEIGHTED AVERAGE NUMBER OF SHARES USED IN
CALCULATION OF LOSS PER ORDINARY SHARE
|
176,454,423
|
559,537,952
|
Ordinary shares
|
Share premium
|
Warrants
|
Capital Reserve
|
Other comprehensive loss
|
Accumulated deficit
|
Total
|
||||||||||||||||||||||
in USD thousands
|
||||||||||||||||||||||||||||
BALANCE AT JANUARY 1, 2020
|
4,692
|
265,938
|
-
|
12,132
|
(1,416
|
)
|
(247,966
|
)
|
33,380
|
|||||||||||||||||||
CHANGES FOR THREE MONTHS ENDED MARCH 31, 2020:
|
||||||||||||||||||||||||||||
Issuance of share capital, net
|
208
|
895
|
-
|
-
|
-
|
-
|
1,103
|
|||||||||||||||||||||
Employee stock options exercised
|
7
|
204
|
-
|
(204
|
)
|
-
|
-
|
7
|
||||||||||||||||||||
Employee stock options forfeited and expired
|
-
|
103
|
-
|
(103
|
)
|
-
|
-
|
-
|
||||||||||||||||||||
Share-based compensation
|
-
|
-
|
-
|
663
|
-
|
-
|
663
|
|||||||||||||||||||||
Comprehensive loss for the period
|
-
|
-
|
-
|
-
|
-
|
(6,645
|
)
|
(6,645
|
)
|
|||||||||||||||||||
BALANCE AT MARCH 31, 2020
|
4,907
|
267,140
|
-
|
12,488
|
(1,416
|
)
|
(254,611
|
)
|
28,508
|
Ordinary shares
|
Share premium
|
Warrants
|
Capital Reserve
|
Other comprehensive loss
|
Accumulated deficit
|
Total
|
||||||||||||||||||||||
in USD thousands
|
||||||||||||||||||||||||||||
BALANCE AT JANUARY 1, 2021
|
9,870
|
279,241
|
-
|
12,322
|
(1,416
|
)
|
(277,987
|
)
|
22,030
|
|||||||||||||||||||
CHANGES FOR THREE MONTHS ENDED MARCH 31, 2021:
|
||||||||||||||||||||||||||||
Issuance of share capital and warrants, net
|
6,805
|
24,979
|
975
|
-
|
-
|
-
|
32,759
|
|||||||||||||||||||||
Warrants exercised
|
2,051
|
17,523
|
-
|
-
|
-
|
-
|
19,574
|
|||||||||||||||||||||
Employee stock options exercised
|
5
|
38
|
-
|
(38
|
)
|
-
|
-
|
5
|
||||||||||||||||||||
Employee stock options forfeited and expired
|
-
|
139
|
-
|
(139
|
)
|
-
|
-
|
-
|
||||||||||||||||||||
Share-based compensation
|
-
|
-
|
-
|
471
|
-
|
-
|
471
|
|||||||||||||||||||||
Comprehensive loss for the period
|
-
|
-
|
-
|
-
|
-
|
(10,192
|
)
|
(10,192
|
)
|
|||||||||||||||||||
BALANCE AT MARCH 31, 2021
|
18,731
|
321,920
|
975
|
12,616
|
(1,416
|
)
|
(288,179
|
)
|
64,647
|
Three months ended
March 31,
|
||||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
CASH FLOWS - OPERATING ACTIVITIES
|
||||||||
Comprehensive loss for the period
|
(6,645
|
)
|
(10,192
|
)
|
||||
Adjustments required to reflect net cash used in operating activities
(see appendix below)
|
(93
|
)
|
3,963
|
|||||
Net cash used in operating activities
|
(6,738
|
)
|
(6,229
|
)
|
||||
CASH FLOWS - INVESTING ACTIVITIES
|
||||||||
Investments in short-term deposits
|
(6,000
|
)
|
(42,000
|
)
|
||||
Maturities of short-term deposits
|
12,191
|
5,758
|
||||||
Purchase of property and equipment
|
-
|
(19
|
)
|
|||||
Net cash provided by (used in) investing activities
|
6,191
|
(36,261
|
)
|
|||||
CASH FLOWS - FINANCING ACTIVITIES
|
||||||||
Issuance of share capital and warrants, net of issuance costs
|
1,103
|
42,765
|
||||||
Employee stock options exercised
|
7
|
5
|
||||||
Repayments of loans
|
(682
|
)
|
(814
|
)
|
||||
Repayments of lease liabilities
|
(41
|
)
|
(49
|
)
|
||||
Net cash provided by financing activities
|
387
|
41,907
|
||||||
DECREASE IN CASH AND CASH EQUIVALENTS
|
(160
|
)
|
(583
|
)
|
||||
CASH AND CASH EQUIVALENTS – BEGINNING OF PERIOD
|
5,297
|
16,831
|
||||||
EXCHANGE DIFFERENCES ON CASH AND CASH EQUIVALENTS
|
(65
|
)
|
(201
|
)
|
||||
CASH AND CASH EQUIVALENTS - END OF PERIOD
|
5,072
|
16,047
|
Three months ended
March 31,
|
||||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
Adjustments required to reflect net cash used in operating activities:
|
||||||||
Income and expenses not involving cash flows:
|
||||||||
Depreciation and amortization
|
321
|
182
|
||||||
Exchange differences on cash and cash equivalents
|
65
|
201
|
||||||
Fair value adjustments of warrants
|
(476
|
)
|
4,597
|
|||||
Share-based compensation
|
663
|
471
|
||||||
Interest and exchange differences on short-term deposits
|
(108
|
)
|
(38
|
)
|
||||
Interest on loans
|
44
|
93
|
||||||
Exchange differences on lease liability
|
(82
|
)
|
(65
|
)
|
||||
427
|
5,441
|
|||||||
Changes in operating asset and liability items:
|
||||||||
Increase in prepaid expenses and other receivables
|
(238
|
)
|
(976
|
)
|
||||
Decrease in accounts payable and accruals
|
(282
|
)
|
(502
|
)
|
||||
(520
|
)
|
(1,478
|
)
|
|||||
(93
|
)
|
3,963
|
||||||
Supplemental information on interest received in cash
|
184
|
22
|
||||||
Supplemental information on interest paid in cash
|
275
|
200
|
||||||
Supplemental information on non-cash portion of transaction related to exercised warrants
|
-
|
9,568
|
Page
|
||
F - 1
|
||
F - 2
|
||
F - 3
|
||
F - 4 - F - 5
|
||
F - 6 - F - 9
|
December 31,
|
March 31,
|
|||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
Assets
|
||||||||
CURRENT ASSETS
|
||||||||
Cash and cash equivalents
|
16,831
|
16,047
|
||||||
Short-term bank deposits
|
5,756
|
42,036
|
||||||
Prepaid expenses
|
152
|
1,079
|
||||||
Other receivables
|
141
|
190
|
||||||
Total current assets
|
22,880
|
59,352
|
||||||
NON-CURRENT ASSETS
|
||||||||
Property and equipment, net
|
1,341
|
1,243
|
||||||
Right-of-use assets, net
|
1,355
|
1,297
|
||||||
Intangible assets, net
|
21,714
|
21,707
|
||||||
Total non-current assets
|
24,410
|
24,247
|
||||||
Total assets
|
47,290
|
83,599
|
||||||
Liabilities and equity
|
||||||||
CURRENT LIABILITIES
|
||||||||
Current maturities of long-term loans
|
3,092
|
3,220
|
||||||
Accounts payable and accruals:
|
||||||||
Trade
|
5,918
|
5,756
|
||||||
Other
|
1,440
|
1,100
|
||||||
Lease liabilities
|
191
|
140
|
||||||
Total current liabilities
|
10,641
|
10,216
|
||||||
NON-CURRENT LIABILITIES
|
||||||||
Warrants
|
10,218
|
5,247
|
||||||
Long-term loans, net of current maturities
|
2,740
|
1,891
|
||||||
Lease liabilities
|
1,661
|
1,598
|
||||||
Total non-current liabilities
|
14,619
|
8,736
|
||||||
COMMITMENTS AND CONTINGENT LIABILITIES
|
||||||||
Total liabilities
|
25,260
|
18,952
|
||||||
EQUITY
|
||||||||
Ordinary shares
|
9,870
|
18,731
|
||||||
Share premium
|
279,241
|
321,920
|
||||||
Warrants
|
-
|
975
|
||||||
Capital reserve
|
12,322
|
12,616
|
||||||
Other comprehensive loss
|
(1,416
|
)
|
(1,416
|
)
|
||||
Accumulated deficit
|
(277,987
|
)
|
(288,179
|
)
|
||||
Total equity
|
22,030
|
64,647
|
||||||
Total liabilities and equity
|
47,290
|
83,599
|
Three months ended March 31,
|
||||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
RESEARCH AND DEVELOPMENT EXPENSES
|
(5,422
|
)
|
(4,278
|
)
|
||||
SALES AND MARKETING EXPENSES
|
(175
|
)
|
(154
|
)
|
||||
GENERAL AND ADMINISTRATIVE EXPENSES
|
(1,243
|
)
|
(1,017
|
)
|
||||
OPERATING LOSS
|
(6,840
|
)
|
(5,449
|
)
|
||||
NON-OPERATING INCOME (EXPENSES), NET
|
469
|
(4,561
|
)
|
|||||
FINANCIAL INCOME
|
140
|
117
|
||||||
FINANCIAL EXPENSES
|
(414
|
)
|
(299
|
)
|
||||
NET LOSS AND COMPREHENSIVE LOSS
|
(6,645
|
)
|
(10,192
|
)
|
||||
LOSS PER ORDINARY SHARE - BASIC AND DILUTED
|
(0.04
|
)
|
(0.02
|
)
|
||||
WEIGHTED AVERAGE NUMBER OF SHARES USED IN
CALCULATION OF LOSS PER ORDINARY SHARE
|
176,454,423
|
559,537,952
|
Ordinary shares
|
Share premium
|
Warrants
|
Capital Reserve
|
Other comprehensive loss
|
Accumulated deficit
|
Total
|
||||||||||||||||||||||
in USD thousands
|
||||||||||||||||||||||||||||
BALANCE AT JANUARY 1, 2020
|
4,692
|
265,938
|
-
|
12,132
|
(1,416
|
)
|
(247,966
|
)
|
33,380
|
|||||||||||||||||||
CHANGES FOR THREE MONTHS ENDED MARCH 31, 2020:
|
||||||||||||||||||||||||||||
Issuance of share capital, net
|
208
|
895
|
-
|
-
|
-
|
-
|
1,103
|
|||||||||||||||||||||
Employee stock options exercised
|
7
|
204
|
-
|
(204
|
)
|
-
|
-
|
7
|
||||||||||||||||||||
Employee stock options forfeited and expired
|
-
|
103
|
-
|
(103
|
)
|
-
|
-
|
-
|
||||||||||||||||||||
Share-based compensation
|
-
|
-
|
-
|
663
|
-
|
-
|
663
|
|||||||||||||||||||||
Comprehensive loss for the period
|
-
|
-
|
-
|
-
|
-
|
(6,645
|
)
|
(6,645
|
)
|
|||||||||||||||||||
BALANCE AT MARCH 31, 2020
|
4,907
|
267,140
|
-
|
12,488
|
(1,416
|
)
|
(254,611
|
)
|
28,508
|
Ordinary shares
|
Share premium
|
Warrants
|
Capital Reserve
|
Other comprehensive loss
|
Accumulated deficit
|
Total
|
||||||||||||||||||||||
in USD thousands
|
||||||||||||||||||||||||||||
BALANCE AT JANUARY 1, 2021
|
9,870
|
279,241
|
-
|
12,322
|
(1,416
|
)
|
(277,987
|
)
|
22,030
|
|||||||||||||||||||
CHANGES FOR THREE MONTHS ENDED MARCH 31, 2021:
|
||||||||||||||||||||||||||||
Issuance of share capital and warrants, net
|
6,805
|
24,979
|
975
|
-
|
-
|
-
|
32,759
|
|||||||||||||||||||||
Warrants exercised
|
2,051
|
17,523
|
-
|
-
|
-
|
-
|
19,574
|
|||||||||||||||||||||
Employee stock options exercised
|
5
|
38
|
-
|
(38
|
)
|
-
|
-
|
5
|
||||||||||||||||||||
Employee stock options forfeited and expired
|
-
|
139
|
-
|
(139
|
)
|
-
|
-
|
-
|
||||||||||||||||||||
Share-based compensation
|
-
|
-
|
-
|
471
|
-
|
-
|
471
|
|||||||||||||||||||||
Comprehensive loss for the period
|
-
|
-
|
-
|
-
|
-
|
(10,192
|
)
|
(10,192
|
)
|
|||||||||||||||||||
BALANCE AT MARCH 31, 2021
|
18,731
|
321,920
|
975
|
12,616
|
(1,416
|
)
|
(288,179
|
)
|
64,647
|
Three months ended
March 31,
|
||||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
CASH FLOWS - OPERATING ACTIVITIES
|
||||||||
Comprehensive loss for the period
|
(6,645
|
)
|
(10,192
|
)
|
||||
Adjustments required to reflect net cash used in operating activities
(see appendix below)
|
(93
|
)
|
3,963
|
|||||
Net cash used in operating activities
|
(6,738
|
)
|
(6,229
|
)
|
||||
CASH FLOWS - INVESTING ACTIVITIES
|
||||||||
Investments in short-term deposits
|
(6,000
|
)
|
(42,000
|
)
|
||||
Maturities of short-term deposits
|
12,191
|
5,758
|
||||||
Purchase of property and equipment
|
-
|
(19
|
)
|
|||||
Net cash provided by (used in) investing activities
|
6,191
|
(36,261
|
)
|
|||||
CASH FLOWS - FINANCING ACTIVITIES
|
||||||||
Issuance of share capital and warrants, net of issuance costs
|
1,103
|
42,765
|
||||||
Employee stock options exercised
|
7
|
5
|
||||||
Repayments of loans
|
(682
|
)
|
(814
|
)
|
||||
Repayments of lease liabilities
|
(41
|
)
|
(49
|
)
|
||||
Net cash provided by financing activities
|
387
|
41,907
|
||||||
DECREASE IN CASH AND CASH EQUIVALENTS
|
(160
|
)
|
(583
|
)
|
||||
CASH AND CASH EQUIVALENTS – BEGINNING OF PERIOD
|
5,297
|
16,831
|
||||||
EXCHANGE DIFFERENCES ON CASH AND CASH EQUIVALENTS
|
(65
|
)
|
(201
|
)
|
||||
CASH AND CASH EQUIVALENTS - END OF PERIOD
|
5,072
|
16,047
|
Three months ended
March 31,
|
||||||||
2020
|
2021
|
|||||||
in USD thousands
|
||||||||
Adjustments required to reflect net cash used in operating activities:
|
||||||||
Income and expenses not involving cash flows:
|
||||||||
Depreciation and amortization
|
321
|
182
|
||||||
Exchange differences on cash and cash equivalents
|
65
|
201
|
||||||
Fair value adjustments of warrants
|
(476
|
)
|
4,597
|
|||||
Share-based compensation
|
663
|
471
|
||||||
Interest and exchange differences on short-term deposits
|
(108
|
)
|
(38
|
)
|
||||
Interest on loans
|
44
|
93
|
||||||
Exchange differences on lease liability
|
(82
|
)
|
(65
|
)
|
||||
427
|
5,441
|
|||||||
Changes in operating asset and liability items:
|
||||||||
Increase in prepaid expenses and other receivables
|
(238
|
)
|
(976
|
)
|
||||
Decrease in accounts payable and accruals
|
(282
|
)
|
(502
|
)
|
||||
(520
|
)
|
(1,478
|
)
|
|||||
(93
|
)
|
3,963
|
||||||
Supplemental information on interest received in cash
|
184
|
22
|
||||||
Supplemental information on interest paid in cash
|
275
|
200
|
||||||
Supplemental information on non-cash portion of transaction related to exercised warrants
|
-
|
9,568
|
a. |
General
|
b. |
Approval of financial statements
|
Number of ordinary shares
|
||||||||
December 31,
|
March 31,
|
|||||||
2020
|
2021
|
|||||||
Authorized share capital
|
1,500,000,000
|
1,500,000,000
|
||||||
Issued and paid-up share capital
|
349,169,545
|
639,164,912
|
In USD and NIS
|
||||||||
December 31,
|
March 31,
|
|||||||
2020
|
2021
|
|||||||
Authorized share capital (in NIS)
|
150,000,000
|
150,000,000
|
||||||
Issued and paid-up share capital (in NIS)
|
34,916,955
|
63,916,491
|
||||||
Issued and paid-up share capital (in USD)
|
9,869,795
|
18,731,177
|
• |
the initiation, timing, progress and results of our preclinical studies, clinical trials and other therapeutic candidate development efforts;
|
• |
the impact of the COVID-19 pandemic on our operations;
|
• |
our ability to advance our therapeutic candidates into clinical trials or to successfully complete our preclinical studies or clinical trials;
|
• |
our receipt of regulatory approvals for our therapeutic candidates, and the timing of other regulatory filings and approvals;
|
• |
the clinical development, commercialization and market acceptance of our therapeutic candidates;
|
• |
our ability to establish and maintain corporate collaborations;
|
• |
our ability to integrate new therapeutic candidates and new personnel;
|
• |
the interpretation of the properties and characteristics of our therapeutic candidates and of the results obtained with our therapeutic candidates in preclinical studies or clinical trials;
|
• |
the implementation of our business model and strategic plans for our business and therapeutic candidates;
|
• |
the scope of protection we are able to establish and maintain for intellectual property rights covering our therapeutic candidates and our ability to operate our business without infringing the intellectual property rights of others;
|
• |
estimates of our expenses, future revenues, capital requirements and our needs for and ability to access sufficient additional financing;
|
• |
risks related to changes in healthcare laws, rules and regulations in the United States or elsewhere;
|
• |
competitive companies, technologies and our industry; and
|
• |
statements as to the impact of the political and security situation in Israel on our business.
|
• |
Motixafortide is a novel, short peptide that functions as a high-affinity antagonist for CXCR4, which we are developing for the treatment of stem-cell mobilization, solid tumors and acute myeloid leukemia, or AML.
|
➢ |
In March 2015, we reported successful top-line results from a Phase 1 safety and efficacy trial for the use of motixafortide as a novel stem cell mobilization treatment for allogeneic bone marrow transplantation at Hadassah Medical
Center in Jerusalem
|
➢ |
In March 2016, we initiated a Phase 2 trial for motixafortide in allogeneic stem cell transplantation, conducted in collaboration with the Washington University School of Medicine, Division of Oncology and Hematology. In May 2018, we
announced positive top-line results of this study showing, among other things, that a single injection of motixafortide mobilized sufficient amounts of CD34+ cells required for transplantation at a level of efficacy similar to that achieved
by using 4-6 injections of G-CSF, the current standard of care.
|
➢ |
In December 2017, we commenced a randomized, placebo-controlled Phase 3 registrational trial for motixafortide, known as the GENESIS trial, for the mobilization of HSCs for autologous transplantation in patients with multiple myeloma.
The trial began with a lead-in period for dose confirmation, which was to include 10-30 patients and then progress to the placebo-controlled main part, which was designed to include 177 patients in more than 25 centers. Following review of
the positive results from treatment of the first 11 patients, the Data Monitoring Committee, or DMC, recommended that the lead-in part of the study be stopped and that we should move immediately to the second part. Additional positive
results from the lead-in period were reported at the annual meeting of the European Society for Blood and Marrow Transplantation held in March 2019, where it was announced that HSCs mobilized by motixafortide in combination with G-CSF were
successfully engrafted in all 11 patients.
|
➢ |
In August 2020, we announced a decision to perform an interim analysis on approximately 65% of the original study sample size, primarily based on a significantly lower-than-anticipated patient-dropout rate in the study. In October 2020,
we announced positive results from the interim analysis. Based on the statistically significant evidence favoring treatment with motixafortide, the study’s independent DMC issued a recommendation to us that patient enrollment may be ceased
immediately, without the need to recruit all 177 patients originally planned for the study. In accordance with the DMC’s recommendation, study enrollment was complete at 122
patients. In May 2021, we announced positive top-line results from the Phase 3 trial. Based on an analysis of data on all 122 enrolled patients (the intent to treat population) we found highly statistically significant evidence across
all primary and secondary endpoints favoring motixafortide in addition to G-CSF, as compared to placebo plus G-CSF (p<0.0001). The addition of motixafortide to G-CSF also allowed 88.3% of patients to undergo transplantation after only
one apheresis session, compared to 10.8% in the G-CSF arm – an 8.2-fold increase. The combination was also found to be safe and well tolerated. In parallel, we are proceeding with all activities in support of a New Drug Application, or
NDA, submission in this indication anticipated in the first half of 2022, including a pre-NDA meeting with the FDA planned for the second half of 2021.
|
➢ |
In January 2016, we entered into a clinical collaboration with MSD (a tradename of Merck & Co., Inc., Kenilworth, New Jersey) in the field of cancer immunotherapy. Based on this collaboration, in September 2016 we initiated a Phase
2a study, known as the COMBAT/KEYNOTE-202 study, focusing on evaluating the safety and efficacy of motixafortide in combination with KEYTRUDA® (pembrolizumab), MSD’s anti-PD-1 therapy, in
37 patients with metastatic pancreatic adenocarcinoma, or PDAC. The study was an open-label, multicenter, single-arm trial designed to evaluate the clinical response, safety and tolerability of the combination of these therapies as well as
multiple pharmacodynamic parameters, including the ability to improve infiltration of T-cells into the tumor and their reactivity. Top-line results showed that the dual combination demonstrated encouraging disease control and overall
survival in patients with metastatic pancreatic cancer. In addition, assessment of patient biopsies supported motixafortide’s ability to induce infiltration of tumor-reactive T-cells into the tumor, while reducing the number of immune
regulatory cells.
|
➢ |
In July 2018, we announced the expansion of the COMBAT/KEYNOTE-202 study under the collaboration to include a triple combination arm investigating the safety, tolerability and efficacy of motixafortide, KEYTRUDA® and chemotherapy. We initiated this arm of the trial in December 2018. In December 2019, we announced that preliminary data from the study indicated that the triple combination therapy showed a high level of
disease control, including seven partial responders and 10 patients with stable disease out of 22 evaluable patients. In February 2020, we completed recruiting a total of 43 patients for the study and in December 2020, we announced the
final results of the study. The results of the study showed substantial improvement as compared to comparable historical results of other pancreatic cancer studies across all study endpoints. Of the 38 evaluable patients, median overall
survival was 6.5 months, median progression free survival was 4.0 months, confirmed overall response rate was 13.2%, overall response rate was 21.2% and disease control rate was 63.2%. The combination was generally well tolerated, with a
safety profile consistent with the individual safety profile of each component alone; adverse event and severe adverse event profiles were as expected with chemotherapy-based treatment regimens. We are currently planning next development
steps for this program, including discussions with potential collaboration partners and development of a protocol for a randomized controlled study.
|
➢ |
In August 2016, in the framework of an agreement with MD Anderson Cancer Center, or MD Anderson, we entered into an additional collaboration for the investigation of motixafortide in combination with KEYTRUDA® in pancreatic cancer. The focus of this study, in addition to assessing clinical response, was the mechanism of action by which both drugs might synergize, as well as multiple assessments to evaluate the
biological anti-tumor effects induced by the combination. We supplied motixafortide for this Phase 2b study, which commenced in January 2017. Final results from this study (based on a cut-off in July 2019 from 20 enrolled patients out of
which 15 were evaluable) showed that the dual combination demonstrated clinical activity and encouraging overall survival in patients with metastatic pancreatic cancer. In addition, assessment of patient biopsies supported motixafortide’s
ability to induce infiltration of tumor-reactive T-cells into the tumor.
|
➢ |
In October 2020, we announced that motixafortide will be tested in combination with the anti-PD-1 cemiplimab (LIBTAYO®) and standard-of-care chemotherapy (gemcitabine and nab-paclitaxel) in first-line PDAC. This investigator-initiated
Phase 2 study, led by Columbia University, will initially enroll 10-12 PDAC patients, and will be expanded to a total of 40 patients following an evaluation of the initial 10-12 patients based on pre-defined criteria. The primary endpoint
of the study is the overall response rate. Secondary endpoints include safety and tolerability, progression free survival, duration of clinical benefit and overall survival. Data from the study is anticipated in mid-2022 (although timelines
are ultimately controlled by the independent investigator and are therefore subject to change).
|
➢ |
During 2016, we completed and reported on a Phase 2a proof-of-concept trial for the treatment of relapsed or refractory acute myeloid leukemia, or r/r AML, which was conducted on 42 patients at six world-leading cancer research centers
in the United States and at five premier sites in Israel. The study included both a dose-escalation and a dose-expansion phase. Results from the trial showed positive safety and response rate data for subjects treated with a combination of
motixafortide and high-dose cytarabine (Ara-C), or HiDAC. At the annual meeting of the European Hematology Association, or EHA, in June 2018, we presented positive overall survival data from the long-term follow-up part of this study. In
March 2021, we completed the monitoring of long-term survival data for patients in the study and are evaluating our next clinical development steps in this indication.
|
➢ |
In August 2015, we initiated a double-blind, placebo-controlled, randomized, multi-center, Phase 2b trial in Germany, in collaboration with the German Study Alliance Leukemia Group, to assess the efficacy of motixafortide in addition to
standard consolidation therapy (cytarabine) in AML patients who have responded to standard induction treatment and are in complete remission. During 2020, we finalized plans with our collaboration partners to conduct an interim analysis on
2/3 (N=128) of the 194 patients originally planned in the study, all of which had already completed treatment. Based on the interim analysis, the investigational arm of motixafortide combined with cytarabine did not demonstrate a
statistically significant effect in the study’s primary endpoint, and therefore, the DMC recommended not to continue the study. We continue to believe in the relevance of CXCR4 as a viable target in other AML treatment lines, such as rr/AML
and induction treatment, and we intend to decide on next steps in AML once we have had an opportunity to review and analyze the unblinded data, including detailed biomarker and subpopulation data, from the study.
|
➢ |
During the first half of 2020, we initiated the evaluation of motixafortide as a potential therapy for COVID-19-induced inflammatory lung disorders, including acute respiratory distress syndrome, or ARDS. In this regard, substantial data
is emerging regarding the involvement of neutrophils, neutrophil extracellular traps (NETs), monocytes and macrophages in the development of ARDS secondary to COVID-19 and other viral infections; as well as the key involvement of CXCR4 as a
mediator of those cells in the inflamed pulmonary tissue. Based on the scientific data indicating the importance of blocking the CXCR4/CXCL12 axis during ARDS, we believe that motixafortide may be of potential benefit for patients with
ARDS. Following our initial evaluation, in November 2020, we announced initiation of a Phase 1b study in patients with ARDS secondary to COVID-19 and other respiratory viral infections. The study is an investigator-initiated study, led by
Wolfson Medical Center, in Israel, to evaluate motixafortide in patients hospitalized with ARDS. The primary endpoint of the study is to assess the safety of motixafortide in these patients; respiratory parameters and inflammatory
biomarkers will be assessed as exploratory endpoints. Up to 25 patients will be enrolled in the study, with a preliminary analysis planned after ten patients have completed the initial treatment period. As the incidence of COVID-19 in
Israel has declined dramatically since the beginning of 2021 as a result of a highly successful vaccination campaign, results of the preliminary analysis, which were expected in the second half of 2021, are now expected in 2022 (although
timelines are ultimately controlled by the independent investigator and are therefore subject to change).
|
➢ |
In addition to the above, we are currently conducting, or planning to conduct, a number of investigator-initiated, open-label studies in a variety of indications to support the interest of the scientific and medical communities in
exploring additional uses for motixafortide. These studies serve to further elucidate the mechanism of action for motixafortide. The results of studies such as these are presented from time to time at relevant professional conferences.
|
➢ |
Motixafortide has been granted three Orphan Drug Designations by the FDA: for use to mobilize HSCs from the bone marrow to peripheral blood for collection in autologous or allogeneic transplantation (granted in July 2012); for the
treatment of AML (granted in September 2013); and for the treatment of pancreatic cancer (granted in February 2019). In January 2020, the European Medicines Agency, or EMA, granted Orphan Drug Designation to motixafortide for the treatment
of pancreatic cancer.
|
• |
AGI-134, a clinical therapeutic candidate in-licensed by our subsidiary, Agalimmune Ltd., is a synthetic alpha-Gal glycolipid immunotherapy in development for solid tumors. AGI-134 harnesses the body’s pre-existing, highly abundant,
anti-alpha-Gal antibodies to induce a hyper-acute, systemic, specific anti-tumor response to the patient’s own tumor neo-antigens. This response not only kills the tumor cells at the site of injection, but also brings about a durable,
follow-on, anti-metastatic immune response. In August 2018, we initiated a Phase 1/2a clinical study for AGI-134 that is primarily designed to evaluate the safety and tolerability of AGI-134, given both as monotherapy and in combination
with an immune checkpoint inhibitor, in unresectable metastatic solid tumors. The multi-center, open-label study is currently being carried out in the UK, Israel, Spain and the United States. Initial safety results from the first part of
the study were announced at the beginning of September 2019; at the end of the same month, the second part of the study was commenced. Due to clinical operating issues associated with the COVID-19 pandemic, in April 2020, enrollment to the
clinical trial was temporarily suspended. In August 2020, we renewed study enrollment. Initial proof-of-mechanism of action efficacy results from the second part of the study are expected in the second half of 2021.
|
• |
Our commercialized, legacy therapeutic product, BL-5010, is a customized, proprietary pen-like applicator containing a novel, acidic, aqueous solution for the non-surgical removal of skin lesions. In December 2014, we entered into an
exclusive out-licensing arrangement with Perrigo Company plc, or Perrigo, for the rights to BL-5010 for over-the-counter, or OTC, indications in Europe, Australia and additional selected countries. In March 2016, Perrigo received CE Mark
approval for BL-5010 as a novel OTC treatment for the non-surgical removal of warts. The commercial launch of products for treatment of this first OTC indication (warts/verrucas) commenced in Europe in the second quarter of 2016. Since
then, Perrigo has invested in improving the product and during 2019 launched an improved version of the product in several European countries. In March 2020, we agreed that Perrigo could relinquish its license rights for certain countries
that had been included in its territory according to the original license agreement and was also no longer obligated to develop, obtain regulatory approval for and commercialize products for a second OTC indication. In turn, in March 2020,
we agreed with our licensor of the rights to BL-5010, Innovative Pharmaceutical Concepts (IPC) Inc., or IPC, to return to IPC those license rights no longer out-licensed to Perrigo as a result of the agreement described in the preceding
sentence, in consideration of the payment to us of royalties or fees on sublicense receipts.
|
Project
|
Status
|
Expected Near Term Milestones
|
motixafortide
|
1. Phase 3 registration study in autologous stem cell mobilization (GENESIS) completed; top-line results announced May
2021 showed highly statistically significant evidence across all primary and secondary endpoints favoring motixafortide in addition to G-CSF (p<0.0001). In addition, the combination was found to be safe and well tolerated.
2. Phase 2a study in pancreatic cancer (COMBAT/KEYNOTE-202) completed; full results showing improvement in all
endpoints announced December 2020.
|
1. a. Pre-NDA meeting with FDA in second half of 2021.
b. NDA submission in first half of 2022.
2. Evaluation and planning of next clinical development steps, including discussions towards potential collaborations.
|
3. Phase 2a study for relapsed or refractory AML completed.
4. Phase 2 investigator-initiated study in first-line PDAC
patients.
5. Phase 1b study in patients with ARDS secondary to COVID-19 and other respiratory viral infections.
|
3. Evaluation and decision regarding next clinical development steps.
4. Data from the study is anticipated in mid-2022*
5. Results of the preliminary analysis are expected in 2022*
|
|
AGI-134
|
Phase 1/2a study, ongoing
|
Initial proof-of-mechanism efficacy results of part 2 of study expected in second half of 2021
|
• |
the number of sites included in the clinical trials;
|
• |
the length of time required to enroll suitable patients;
|
• |
the number of patients that participate in the clinical trials;
|
• |
the duration of patient follow-up;
|
• |
whether the patients require hospitalization or can be treated on an out-patient basis;
|
• |
the development stage of the therapeutic candidate; and
|
• |
the efficacy and safety profile of the therapeutic candidate.
|
Three months ended March 31,
|
||||||||||||
2020
|
2021
|
Increase (decrease)
|
||||||||||
(in thousands of U.S. dollars)
|
||||||||||||
Research and development expenses
|
5,422
|
4,278
|
(1,144
|
)
|
Three months ended March 31,
|
||||||||||||
2020
|
2021
|
Increase (decrease)
|
||||||||||
(in thousands of U.S. dollars)
|
||||||||||||
Sales and marketing expenses
|
175
|
154
|
(21
|
)
|
Three months ended March 31,
|
||||||||||||
2020
|
2021
|
Increase (decrease)
|
||||||||||
(in thousands of U.S. dollars)
|
||||||||||||
General and administrative expenses
|
1,243
|
1,017
|
(226
|
)
|
Three months ended March 31,
|
||||||||||||
2020
|
2021
|
Increase (decrease)
|
||||||||||
(in thousands of U.S. dollars)
|
||||||||||||
Non-operating income (expenses), net
|
469
|
(4,561
|
)
|
(5,030
|
)
|
Three months ended March 31,
|
||||||||||||
2020
|
2021
|
Increase (decrease)
|
||||||||||
(in thousands of U.S. dollars)
|
||||||||||||
Financial income
|
140
|
117
|
(23
|
)
|
||||||||
Financial expenses
|
(414
|
)
|
(299
|
)
|
115
|
|||||||
Net financial income (expenses)
|
(274
|
)
|
(182
|
)
|
92
|
• |
the progress and costs of our preclinical studies, clinical trials and other research and development activities;
|
• | the impact of the COVID-19 pandemic on our operations; |
• |
the scope, prioritization and number of our clinical trials and other research and development programs;
|
• |
the amount of revenues we receive under our collaboration or licensing arrangements;
|
• |
the costs of the development and expansion of our operational infrastructure;
|
• |
the costs and timing of obtaining regulatory approval of our therapeutic candidates;
|
• |
the ability of our collaborators to achieve development milestones, marketing approval and other events or developments under our collaboration agreements;
|
• |
the costs of filing, prosecuting, enforcing and defending patent claims and other intellectual property rights;
|
• |
the costs and timing of securing manufacturing arrangements for clinical or commercial production;
|
• |
the costs of establishing sales and marketing capabilities or contracting with third parties to provide these capabilities for us;
|
• |
the costs of acquiring or undertaking development and commercialization efforts for any future product candidates;
|
• | the magnitude of our general and administrative expenses; |
• | interest and principal payments on the loan from Kreos Capital; |
• |
any cost that we may incur under current and future licensing arrangements relating to our therapeutic candidates;
|
• | market conditions; and |
• | payments to the IIA. |
Three months ended
March 31,
|
||||||||
2020
|
2021
|
|||||||
(in U.S. dollars)
|
||||||||
Loss per ADS – basic and diluted
|
0.56
|
0.27
|
December 31,
2020
|
March 31,
2021
|
|||||||
(in number of ADSs)
|
||||||||
Authorized share capital
|
100,000,000
|
100,000,000
|
||||||
Issued and paid-up capital
|
23,277,970
|
42,610,995
|