Good morning, everyone. Thanks for joining us at the HC Wainwright 27th Annual Global Investment Conference. My name is Emily Bodner, and I'm an Equity Research Analyst at HC Wainwright. I'm pleased to be doing a fireside chat with RAPT Therapeutics. We have Brian Wong, President and Chief Executive Officer, and Rodney Young, Chief Financial Officer. Maybe to start, given you've had some changes this year with your pipeline, acquiring new assets and kind of shifted your strategy, maybe walk us through the current pipeline focus and program. Sure. First of all, thanks, Emily, for the invitation. I really appreciate it. Yes, we've gone through some pivots, but the company still remains focused on transformative therapeutics for a range of INI diseases. Late last year, we licensed our new lead asset, which is called RPT-904. This is a next-generation anti-IgE antibody that we think could transform the standard of care for food allergy and spontaneous urticaria. We're very excited about this new asset, which is currently in phase 2 development, and happy to get into those details with you. Great. Maybe walk us through a bit about the anti-IgE landscape and how RPT-904 differs from Omalizumab, which is the commercial player in this space. Yeah, sure. You know, Omalizumab (Xolair) is an over 20-year-old drug, very successful with about $4.5 billion in revenue per year. It's been approved across four different indications, including first asthma, then rhinosinusitis, urticaria, and finally, late last year, food allergy. It's been quite a long journey for the drug. That's really been the gold standard for urticaria, and now food allergy. Yes. What are some of the differences in construct with RPT-904? Yeah, so the reason why we were attracted first to the space is because, you know, we're seeing Omalizumab (Xolair) take considerable market share in food allergy, and we'll get into this later, but now 60,000 patients in the first year after launch in food allergy, which, you know, I think speaks to the scale and the unmet need. I got excited about that. As we were looking at the IgE space, what really is very attractive about RPT-904 is that it preserves the Omalizumab epitope, which is really critical because there have been attempts to find next-generation anti-IgE antibodies off epitope that have not done so well. It was engineered with some very proven technology, including the YTE mutation to improve the half-life, which was borne out in the clinic in the phase 1 study. There were also some affinity improvements through changes in the variable domain, which we think will enhance the ability to dose more patients that have high levels of IgE and body weight. Yeah, maybe to that point, obviously there was Ligalizumab, which didn't show superiority over Omalizumab (Xolair), the main difference being it didn't have the Omalizumab epitope. Maybe just talk a bit more about that and why that is important for differentiation. Yeah, so Novartis and Roche made a huge investment looking for a next-generation IgE through an antibody called Ligalizumab. Ligalizumab uses an epitope which partially overlaps with Omalizumab, but it's not identical. They had almost a hundred-fold higher affinity than Omalizumab, and they actually saw better reduction in free IgE. Despite that, it was inferior to Omalizumab in a head-to-head study in asthma, and also inferior to Omalizumab in a food allergy study, and only equivalent efficacy in chronic spontaneous urticaria. What that taught us, and there are a lot of theories about why that is, what that taught us is that reduction in free IgE only matters if you have the right epitope. That's why 904, we think, is special. It has all the ingredients for efficacy and good safety, with those improvements around it. Maybe in diving into the phase 1 trial that was run by GeminCare, head-to-head study against Omalizumab (Xolair), you showed a half-life of 60 days, or sorry, 26 days compared to, all right. By the way, yeah. Yeah, it's like 60 days compared to Omalizumab's 26 days, and the lower rate of free IgE. Can you put into context what the longer half-life means from a differentiation standpoint? Yeah, that's right. The deeper and more sustained IgE, and this again, head-to-head comparison, that was really built a lot of confidence as we were looking at the molecule. When we modeled what the dose will be for RPT-904, we used a model that Roche and Novartis used to develop their dosing tables. What was really, I think, quite encouraging is that we could basically match Xolair's level of efficacy at Q8 week or Q12 week dosing versus Omalizumab's Q2 week or Q4 week dosing. Most food allergy patients, because they have high levels of IgE at baseline, actually are dosed with Q12 week. That Q2 week versus Q8 week and Q2 week versus potentially Q12 week is a high level of differentiation, which should lead to better compliance. What are the phase 2 trials that are currently being run with RPT-904? Can you walk us through some of the upcoming data readouts that are expected later this year? Yeah, and maybe just to finish out the differentiation before I move to the ongoing trials is that because a lot of food allergy patients have high IgE in weight, they're actually excluded from the Omalizumab label. We estimate that's about a quarter to 30% of patients. So 25% to 30% of food allergy patients have no option. We think 904 can provide that option for them. We're really excited about the GeminCare readouts this year. They're running two phase 2 trials that should complete. One is in CSU. That's a 135-patient study comparing a Q8 week arm of 904, a Q12 week arm of 904, both at 300 milligrams, versus the approved dose of Omalizumab, which is 300 milligrams Q4 week. We think this data is going to be important for two reasons. The first is that it should validate the long half-life and the better affinity, but also, if successful, this could actually allow us to go directly to phase 3 and actually allow us to get to the approval a couple of years sooner. That's really exciting. The reason why we think this data is particularly translatable is that Omalizumab actually translates very well across populations. The labeling in China is very, very similar to the labeling in the U.S. and in Europe. PKPD is very similar, dosing is very similar. We think the read-through from this GeminCare study to our potential trials is very high. For the CSU study, what level of complete response or partial response do you think is necessary versus Omalizumab? Do you need to see superior efficacy, or is having similar efficacy but a better dosing regimen still enough? Yeah, good question. We'll be looking at, in GeminCare, endpoints that are used for approval, so the UAS7 and various components of the UAS7 score, like itch and angioedema. Because this is a head-to-head study, we can actually look at the change of baseline of 904 versus Omalizumab. What we'd like to see is roughly equivalent efficacy to Omalizumab, but now at Q8 week is our base case, with upside being similar efficacy to Oma, but now at Q12 week. All of our market research, and Rodney can talk a little bit more about this, says that that difference, that dosing difference, even with similar efficacy, is a high level of differentiation where patients will prefer 904 and switch to 904. Anything else to add to that? It's really the less frequent dosing, particularly on the food allergy side, is very likely to enhance compliance, which if you keep the patients on drug, that should increase, improve the patient outcomes. The prescribers and the payers all recognize that, and see that as very valuable. The other thing is, as Brian said, for food allergy, if we can access the Omalizumab ineligible population, those patients literally have no alternative. We would be filling an unmet need. For the asthma study, which is also reading out, it's a smaller study. Just to set expectations, it's 60 patients roughly, 15 patients per arm. They have three different dose levels of RPT-904 versus an Omalizumab (Xolair) control in patients with moderate to severe asthma. It's relatively small, so 15 patients per arm, and it's a short study. It's more PKPD oriented. What we'd like to see there is that there's a better sustained reduction in IgE compared to Omalizumab (Xolair), and also some information to help refine the dose for our phase 3 trials. Do you believe that asthma and CSU are kind of good indicators for potential success in food allergy, and how kind of similar are these different diseases? I think they are, mainly because Omalizumab (Xolair) has shown good read-through between these various diseases. Because we share the same epitope, I think the read-through here is a lot stronger than it would be if you were off epitope. What brought about the decision to advance food allergy in the U.S. as the first indication? Can you walk us through the intended phase 2b trial design? Maybe you could talk about food allergy, and then I'll talk about the trial design. Yeah, so when we were looking at, you know, before we had licensed the asset, we looked at all the IgE-driven indications and, you know, which ones had the highest unmet need. Food allergy came out number one by far. CSU was second. That kind of informed us as to what order we wanted to go after. The other thing is we obviously took note of the rapid launch of Xolair in the food allergy space. At the time, they had 30,000 patients. After only two quarters after approval, it's now up to 60,000. Again, demonstrating, you know, very high unmet need and, you know, a big opportunity. Yeah. In terms of the phase 2b trial, how does that trial design kind of relate to the Omalizumab outmatched trial? What are the results that we saw from the Omalizumab study? The outmatch study was a double-blind, placebo-controlled food challenge study. The way these work is that patients are tested for sensitivity to various foods through skin prick lab testing and then ultimately food challenge. If they are sensitive to a certain food during their food challenge to a certain level, for peanuts, 100 milligrams, then they're enrolled. There's a treatment period and then there's an exit food challenge to look at whether their threshold increased. There's a pre-specified level that they need to achieve. In the case of peanuts, it's 600 milligrams. We are matching outmatch. We have basically a double-blind, placebo-controlled food challenge study in patients 12 and above. We're testing adolescents with the hope to go to children when we're in phase 3. It's a 24-week trial to allow us to get two full cycles of Q12 week. There's the exit food challenge and then there's an extension period. We're planning 100 patients total. 75 patients are sufficient to power the study to look at OMA-like levels of activity. Those 75 are actually the OMA eligible, because what we want to see is that in the same OMA population, we're seeing efficacy that's similar to Omalizumab (Xolair). 25 of the 100 are actually OMA ineligible. We're breaking them out, that population, because the bar is lower. Any efficacy in that population will be extremely exciting, I think. Maybe to go over that 30% of patients who aren't currently eligible for Omalizumab (Xolair), what kind of gives you confidence that you could show efficacy in these patients based on the construct of the molecule? Really, because, you know, the reason why Omalizumab was never tested in those populations is because when Roche and Novartis did the modeling, they could never achieve a reduction in free IgE below that threshold level. They were excluded from trials, which means that they were excluded from the label. When we went back and we tested that in the same model, indeed, Omalizumab could not treat those patients effectively at the highest dose, which is 600 milligrams Q2 week. RPT-904 could readily do that. Most patients excluded could be actually treated with Q12 week, which is pretty amazing. There is some population that would require Q8 week dosing, still excellent. We think that Omalizumab actually, if they went to higher doses, like once weekly dosing or 1,200 milligrams, they probably could treat those patients. They just don't have the formatting, and I think they don't have the time to do that at this point. We think we can get to free IgE levels that will benefit those patients. Again, the bar for success is lower than Omalizumab because those patients have really no option. How much of a benefit do you see the less frequent dosing in food allergy? Is there a particular issue with patients having to get treatment every two weeks or every four weeks? What might that look like? Yeah, so all of our primary market research, and we've talked to hundreds of patients and prescribers and tens of payers, all recognize that that less frequent dosing regimen is a huge advantage. It's very likely to increase compliance, which should help the patient outcomes. Food allergy in particular is an indication where compliance is critical because you're trying to reduce the effect of an accidental exposure to an allergen. You can't actually see the drug working unlike AD or chronic spontaneous urticaria (CSU) where you can see it. Compliance is really important, and the payers, prescribers all recognize that. Payers, in fact, have noted that they'd be willing to pay for that from a reimbursement perspective. They would be willing to reimburse at a premium relative to Omalizumab (Xolair). Keeping children out of the hospital is highly motivating, even for payers. Maybe touching on the fact that Omalizumab (Xolair) is supposed to basically become biosimilar in the near term, does that impact your approach or potential strategy at all? Say it quickly. Oh, that's my off-label. Omalizumab biosimilars. What's our strategy? Yeah, so again, the patent expires this year. Roche has said they expect biosimilars to launch next year. We think we have two really important differentiating factors. The first is the less frequent dosing, which, you know, payers, prescribers, everyone recognizes is super important. The other really important aspect is if we are able to show efficacy in that Omalizumab ineligible population. Obviously, Omalizumab and Omalizumab biosimilars wouldn't be, are not able to treat that segment. Those two factors should give us two very clear differentiations and give us some pricing leverage. How do you think about the market opportunity for RPT-904 in food allergy? What has the initial launch of Omalizumab (Xolair) in that setting kind of shown us? Yeah, so the opportunity is huge, right? There's 17 million diagnosed patients in the U.S., and that's on the order of a similar prevalence as atopic dermatitis. Obviously, a much less crowded field in food allergy. We think there's about a quarter of that, or 4 million or so patients, are severe, and that's really the population that we're most focused on. We think about half of that severe population would be willing to take a shot, a biologic, and we think we could probably get 40 to 50% market share of that. We would be differentiated from Omalizumab (Xolair) and Omalizumab biosimilars because of the dosing frequency and the ability to treat the Omalizumab ineligible population. How are you thinking about next steps potentially in CSU or asthma after the phase 2 data? Are these indications that you might consider moving forward in the U.S., or is the focus just on food allergy for now? Yeah, I think when we did our prescriber checks and our payer checks, CSU was pretty high up there in terms of unmet need. Omalizumab (Xolair) is the standard of care, but there's certainly room for innovation. We think that, and all the payers and prescriber research suggests that Q8 week or Q12 week dosing would be a major advance. Not only would it expand the market, it would cause patients to switch. Very likely, RPT-904 would become standard of care in urticaria. I think it's a little bit different in asthma. Omalizumab (Xolair) is not the standard of care. There are drugs that have taken that position, like Dupixent or Tespire. We're a little bit more cautious about asthma, maybe down the road, as we want to look for a broad label, which could sort of lift all boats. That's something we could be doing later. The other indication, which I think there's a very high unmet need, is seasonal allergic rhinitis. Huge prevalence, and a large proportion of those patients don't respond to steroids. We think a non-steroid approach that's really convenient could be pretty exciting to those patients that don't respond to other therapies. Maybe to close out, if you could just briefly discuss your cash position and also kind of give us a summary of upcoming catalysts for the next year or so. Yeah, at the end of Q2, we had $170 million in cash, and our guidance is that that cash runway should take us through the first half of 2027, which is about the time we expect to have the readout from our phase 2b food allergy trial. The other important catalyst that's upcoming, as you all mentioned, are our partners' readouts before the end of this year, both in their CSU trial and their asthma trial. Great. Thank you very much, Brian and Rodney. Thanks, everyone, for listening in. Hope you enjoy the rest of the conference. Thanks, everyone. Thanks, everyone.
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