8-21: $IOVA deep dive

hey everyone um thanks for watching I am Martin scy this is a deep dive into a company called iance so we're going to look at iance uh in the best most thorough way we can time permitting and then try to um I think my mic's on the wrong mic can you guys hear me okay it's actually pretty good never mind mind um yeah so time permitting we'll we'll look at it as closely as we can and then we'll um if we have time for other things we'll do other things but somebody on godell requested this so I thought I'd oblige and provide my thoughts on that just setting up here and I'm going to advertise on [Applause] Twitter all right cool well this is going to be a little different if you watch the Bristol Meers um Deep dive it's going to be a little different from that because um when you look at a company like Bristol Myers you're kind of doing this like portfolio valuation of quite a number of different Assets in one kind of like bucket and that's a very different investment proposition from looking at a single asset company or a company with one or two or three assets when you look at a company like that you really have to dig deep um really really deep it can't be superficial it has to be this really insane you know deep dive and um you can't leave details for um for just anything um so in anyway uh in any event Let's uh sort of look up uh the model so anyway this company has uh am tagv which is lethel for melanoma and it's Cell Therapy I've always hated Cell Therapy um I uh the reason is change is scary to humans in general you know we always get scared of new things um but change is often a really good thing we have to think about changing our mental models and our Frameworks for the way we look at things one of the things that is scary about cell therapy is it's very different from the way we're used to looking at medicine we're used to looking at medicine as this is a molecular structure that I can rest easy on right I mean one of my favorite drugs of all time is called PX um it's also known as citral um show you the molecular structure real quick here it is Plavix was a bestselling drug sold many uh billions of dollars saved many lives so one of the first great blood thinners and uh very easy synthesis very simple molecule not very many atoms in fact um you have this heterocycle Benzene uh one chlorine hanging off there uh hydrogen coming out of space here and a simple functional group there and you have pretty you have a great drug and then when we went to antibodies um you know the molecules were a lot bigger but they were still sort of familiar in the sense that amino acids make up these gigantic proteins so that's okay um they're they're very different but they're large and you know it took a little getting used to it but that was fine cell therapy is totally different cell therapy is this idea that you can take actual full cells and uh put them into people as medicine now Cell Therapy wasn't new interestingly uh we've been doing autologus um Stell cell transplant St stem cell transplant and allergen egg stem cell transplant for a long time but why are cells so strange well one you it's hard to characterize them you know they're kind of a black box we really don't understand what's going on in the cell in perfect detail we understand the broad Strokes for sure sure but that's one big question so what the heck is this cell doing the other is um just from Simply the uh uh Source perspective and Manufacturing where are these cells coming from and we know that if we give somebody else's cells into your bloodstream your immune system is going to have a really potent reaction to that and that's why with stem cell transplant we eradicate the immune system uh and try to get a graph and you still could get graph first host so that's the sort of uh question that's very important where are these cells coming from maybe they're coming from the patient maybe they're coming from somebody else how do we um sort of deal with that and the last thing that really bothers any traditional drug person about cell therapy is pharmacokinetics in drugs we can measure how long the drug stays in the bloodstream and we can do that in animals and we can use something called allometric scaling to predict how it'll work in humans and when a drug has good pharmacokinetics or PK for short we can advance it into further into human clinical trials if it doesn't we can't there's no way to tell with cell therapy kind of where is the drug quote unquote because there're cells not a drug where are these cells in the body can we Trace them can we track them not really we just sort of hope that they kind of engraft or stay or or something and uh that's why a lot of these cell therapies are very akin to Stem Cell transplants um they're not exactly uh the ones that aren't sort of transplantable don't do very well so let's look a deep dive into mtag V we have a lot to learn about this drug um I'm going to start with their website so pretty clearly here it says your melanoma your cells your treatment okay well that seems uh reasonable um uh let's see so there's authorized treatment centers I don't know where just checking where I live if there's an authorized stream center near here it's kind of not great but I don't know let me just try New York okay memorial stone ketering we know that one and uh New York Presbyterian two great hospitals here in New York um so if you want this drug there's there's how you get it um which is odd right every usually in medicine every oh there's a third there's a well it's two locations to New York Presbyterian um typically you know when you when you get prescribed to Medicine you don't uh have to figure out where to get it from any pharmacy something like that would work fine but here you really have to go to special treatment center which is again very very odd um that's because the drug is going to be manufactured just for you which is is really wild um again crazy idea so one of the big questions I have here is what kind of conditioning if the patient um gets any conditioning what kind of conditioning will the patient get um and we're going to look into that I think I looked it into it last last time I I forgot uh lympo depletion with is 2 so this is a very light conditioning regimen usually when you do a a conditioning regimen we're looking at iovance iova uh please don't spam my chat if you spam my chat I get angry yes I speak fluent Albanian but that's not the concern right now we're looking at a company called iovance trades on NASDAQ it's a $111 stock um 300 million shares outstanding so a 3.2 billion market cap 400 million in cash so 2.8 billion Enterprise Value they have an FDA pro drug called M tagv um so it looks like you take uh and and kind of the best way to like really do a deep dive and research um this stuff sorry is uh going here so we're going to type in liel hope I spelled that right great and you can see there's a um a p 16 papers one in jco uh which is a well-known Journal see if there's another well-known Journal usually it would be at the top all right well at first glance there's that's one uh one paper of interest but um typically you would want to read every single paper that gets published about this drug so let's start with this one jco is pretty good pretty good Journal oh yeah the the farm of Burke I was uh talking about was uh mer is it was a mer chemist um uh what was called see if I can find it thanks for reminding me of that I'm looking for the for the book it was not um yeah I think this is it okay I'm almost certain this is it maybe not sorry guys this this is going to be worth the wait it was like really uh my friend was mentioned many of my friends were mentioned in the book actually um and it really was a it it was a Merk guy so I want to make sure that I find it Well I might have to look it up later unfortunately because I really can't find it it's surprising um I think that they I remember some of the drugs they went through oh well I don't want to get side so sidetracked but it was a wonderful little book um so I feel bad that I can't remember it cuz I I probably want to read it again yeah I think in fact I think I remember Laten was one of the drugs mentioned but there are several others so again and I'm uh zokor you guys remember simat [Applause] right this was such a tiny book it was so out of print um like nobody read this book but it was so good and I'm trying to remember my friend Jim McDonald who was a top guy uh that Merc was also mentioned in the book so I'm still looking for Roy vilos I think was mentioned in the book too all right well I think I have to give up because I'm getting too sidetracked so let's talk back about it iance here uh the deli coffee is great thank you all right say they call this a tumor infiltrating lymy therapy to me those words don't mean anything um that's really not that specific and to me I just I don't glean anything from that I just call that cell therapy so I want to see the details before I'm willing to uh think about that further um who are the authors is one of the things I look at first um I recognized some of these names off the bat but let me just see who the first author is okay this Ahmad sarak it looks like he's uh he looks like he's see it doesn't really say what his affiliation is which is not great oh there we go okay he's at Moffet which is a well-known Cancer Center um so most of these people are clinical investigators that have worked at uh that work at different cancer centers in fact it looks like maybe all of them are um yeah I recognized uh chzn who's a well-known physician oh there's one or two guys at from the company iovance I see their names there let's recognize some of them as well all right so typical clinical paper here effective treatment options are limited for patients with Advanced melanoma who progress after checkpoint Inhibitors like Kuda and targeted therapies adoptive self therapy what is adoptive cell therapy probably also meaningless but adoptive well whatever that term means we're going to assume it uh doesn't mean much Cell Therapy using Tils or tumor tumor infiltrating lymphocytes not really again a meaningful term so I would just say Cell Therapy has demonstrated efficacy in advanced melanoma lless cell is an autolus aha now we know what that means it comes from the patient centrally manufactured so it's not manufactured locally or whatever tumor infiltrating lymphocyte you know that's a broad class of white blood cells it's not really um clear what that is is it te- cells for example um so we'll just write here autologus thank you guys so much I've I'm so lucky I've been able to change and influence even a tiny bit some people's lives um but yeah let's see if we can hang with this company and really understand it and I'm trying to explain the science as simply as I can again autologus means it comes from you Auto uh means coming from itself um in I guess Latin or something um so so everything here so far is understandable right and a lot of these words don't mean anything um they're words that are used to I mean I hate to say it but like a lot of scientific writing is the goal of communication is to be exact and to convey the the precise um context you wish to convey in scientific writing a lot of times there's just a you know a lot of nonsense I only stream I try to only stream from home because I don't want to distract my colleagues so I'll probably go into the office a little later but I I just don't want to uh when I'm streaming I'm I'm cognizant that I don't my colleagues probably don't want to hear it because they're programming or something like that um and I get to be more uh full here okay so so far we're we're and again I'm going to take the approach that you don't know anything about medicine at all but again scientific writing can be a little confusing but so far we know what the drugs called LIF lucel filel liil youell maybe and its goal is to treat melanoma and it's a Cell Therapy um so it says here we conducted a phase 2 open label what does that mean single arm meaning everyone got the same thing multi- Center meaning more than one Hospital study in patients with Advanced melanoma so open label basically just means there's no um uh there's no blinding everyone knows exactly what the protocol is going to be um so no no no blinding no uh no Mysteries whatsoever and so these were patients that had previously been treated with checkpoint Inhibitors and BFF Mech Inhibitors so these are really bad patients they are very very sick they are likely to be dead in 6 months um how do you know that well you can do some research on that yourself but you know people who have metastatic melanoma and they've no longer responding to a checkpoint inhibitor and they're no longer responding to these drugs which don't work very well anyway you you have a very very limited lifespan there now there is one things you have to ask every time you look at a medicine is has anything else happened in medicine for this disease and the answer is yes and in fact Bristol Meers which we looked at last time uh has a drug for metast stolic melanoma and it's it's a it's a brand new antibody um let's see if we can pull it up and that's why like I said it's handy to specialize in a sector because you end up kind of getting insights from one thing to the next and it doesn't look like we made a um page for it but up dual lag is the drug I'm talking about it's a lag three antibody and they combine it with the checkpoint inhibitor so from a competitive perspective but also from a scientific Integrity perspective it's interesting that this drug was studied in before the upd AAG era and that is important because it sucks to study a medicine while another medicine is changing the game for that disease then it kind of your medicine is is maybe a little less relevant now you know because people are going in that other direction so it's it's a very um you know very interesting way to look at it anyway so these are very very sick people mety melanoma doesn't sound bad it's like oh melanoma how bad can it be it's skin cancer the most skin cancers are not bad like squa cell carcinoma and some of the other basil cell carcinoma but metastatic melanoma means the melanoma has spread from your skin to a vital organ and it's a very aggressive disease typically okay so it says here leilia cell was produced from harvested tumor specimens so they harvest your tumor melanoma uh in central cgmp or Central GMP facilities using a streamlined 22-day process okay so it takes 22 days they cut the tumor out of you or part of it um they cut all of it out of you but it's on a vital organ so they can't cut it out of you um so they cut what they can out of you send it to the facility takes 22 days and then they send it back so this is very interesting so typically when you send cells back imagine sending somebody million cells well how many cells are in the body know trillions right so how do you I mean how many blood cells are there in the entire uh blood blood system you know number of lymphocytes in blood well okay uh we do know this from complete blood count right um if anybody went to medical school you know there's 1,000 to 5,000 lymphocytes in a microl ler of blood in fact I have a CBC here some where and if you have more lymphocytes if you have an infection then less if you don't so um if you have those lymphocytes for microl ler we know there's five liters of blood right so let's see there's five liters of blood so there's 5 million microliters right and if there's a th to On The Low End to 4,800 on the high end there's going to be 5 billion lymphocytes or on the high end 24 billion lymphocytes so if I give you a million cells is this really going to make a difference no they could be super cells and they still won't do anything right it's just not a lot it's one 5,000th of the amount of cells you have well if I give you another zero say 10 million cells and still not very many um how about 100 million cells well maybe that's starting to get there that's 2% of your lymphocytes maybe um so you know we're going to try to replace the lymphocytes but the problem is we can't replace the existing cells or can we well it says here that patients received a non-mo of lymo depletion regimen so typically with these cell therapies especially for transplant you want to wipe out all of the cells you want to wipe out the whole bone marrow the whole blood cell kind of um system uh excluding the red blood cells and you can do that with chemotherapy and in fact if you ever get a stem cell transplant the reason it's so tough is you're going to be in the hospital with no immune system and you're put into almost like a clean room so you don't get an infection and um that uh is very you know very very tough process proc in fact it can be lethal the treatment can be lethal um which is uh really frustrating for Physicians I'm trying to save your life but the therapy is is has a good chance of killing you and that's why stem cell transplant is the last ditch effort often for very very severe diseases it's not done um lightly so myo oblation ablation means to destroy right ablative ablation we even are now starting to use this word in AI believe it or not um but it just means to destroy or remove or something like that and so Milo is the bone um well Milo is really um is really the bone marrow uh but Milo blaive is what it sounds like so typically you get this Milo ablative regimen of chemo and so that's not what they're doing here interestingly they're doing something called uh lympo depletion which again is not really a word that means anything uh what does that mean they're going to try to lower your lymphocytes well that sounds like myo oblation euphemism to me but um you know regardless um they're going to lower something with I2 uh I2 is an old drug in fact if you know the history of Biotech it was maybe the first I want to say it was the first cyto kind ever cloned and made under re combinant DNA technology it was made by a company called Chiron CH i o n which is was legendary biopharma company that did a lot of Firsts I want to say it was in 19 oh boy maybe 82 but I don't remember exactly I wasn't born yet um so it says here that they got the the the regimen which we know is I 2 but they don't say that here yet and they got a single infusion of of the drug so you get a single infusion um let's see administer single infusion after lymphodepletion and then you get six doses of high dose I2 is that for more lympo depletion I don't get it with or after six doses of high dose I2 okay so we'll get the Deep dive on the regiment exactly sorry I don't do deep Dives unless you're a godell customer I appreciate all the godell customers and even there I don't have the time to do deep Dives for everyone godell is a um a terminal software me and my colleagues make uh that we think is going to compete with Bloomberg and many other um great uh terminal software companies we have a lot of fresh ideas I think a lot of the people out there that are trying to make Financial software aren't doing it in a intelligent way they don't really understand what Traders really want um uh I think we do um because we are Traders we we traded our whole lives and so in any event um iovance is an interesting company um there's uh some people that are very large stockholders that are well respected um so you know it'll be interesting to see what happens um with this company um but they did get FDA approval so let's keep going there so the primary end point and this is really important um in every clinical trial there's a primary end point and I was telling a friend the other day about bone for bone Ferrari bone ferreri oh I should get his name right bone feron I believe yeah I got it bone Fon correction and this idea that multiple comparisons are invalid in statistics and inference and it makes sense if you played a basketball game and we know what the primary endpoint of a basketball game is Right a primary endp point of the basketball game is points whoever scores the most points at the end of the game wins it's not at halftime it's not how many assists there are it's not how many slam dunks there are or three-pointers it's just um godell is the this website uh Luke uh our terminal does kind of everything in finance uh or it will uh it's still being built of course but you're welcome to try it for free um in in basketball we know what the primary endpoint is ahead of time and we don't change it it' be weird if halfway through the game we said you know what for this game in this game only we're going to uh yeah foreign stocks are actually coming this week so thank you McNugget starting with Canada and then we'll add all of the other uh markets soon and then maybe the price will go up too you know I like to raise prices you know if but if you subscribe now you keep the same price forever so that's the deal I'll make after the drug pricing increase I thought I had to be nicer to the people so if you subscribe now you lock that price in Forever uh but we are going to raise the price probably double it um in the next uh month or two um so sign up now if you want um or wait wait till then uh I'd rather you wait till then so you pay more but anyway um the um yeah I I know stock compensation is Christos um I um SBC is is hard to Value um you know traditionally use black shws model and black Shaws is not a reliable sort of way to measure stock option cost uh if all the stock options expire worthless then they didn't cost anything um it doesn't mean it didn't hurt the company at all to issue stock options but it's not really diluted and that's what we worry about anyway forget Zoom for a second let's go back to iance so the primary end point in this clinical trial um is something called o or objective response rate and there is a little handbook on how to measure this and it basically means tumor shrinkage so a response is a is a certain amount of tumor shrinkage and you typically need 50% tumor shrinkage and they talk about what exactly you know uh how exactly you measure by the axis the long or the wide and sometimes these tumors are pretty hard to measure uh so you know you typically need a a 50% reduction from the size and for complete response you know which is obviously pretty awesome you want a a complete um uh disappearance of the tumor getting a complete response is awesome in cancer it's very rare but a complete complete response means the tumor's gone a partial response means 50% or more of the tumor's gone so um that's kind of uh how that works so the primary end point here is objective response rate and again that I can't stress how important this is and I want you to wrap your mind around what statistics is like if in the middle of the the basketball game we said you know oh the winner is going to be determined by how many three points there are and it just so happens that your team is leading in three pointers but is down in total points points well you say well that's not fair you can't change it in the middle and then say oh well we did so well with three points but we we we missed the game because we lost uh by points but we won by three points and it sounds silly when you do it in basketball when you do it in me in uh when you do it in medicine people do it all the time and nobody says it's silly but it is and smart people who know medicine know how invalid it is to do something like that now we note what happened but we can't take it as seriously as the pre-specified primary endpoint meaning before the trial started we said this is what we're going to measure this drugs by this successive drug uh this drug we're not going to look at anything other than that from a statistical perspective we might note what happens but the main goal has to be set for before it's called AR priori sometimes or just pre-specified primary Point okay so it says here 66 patients received drug um there's a bunch of different numbers here um from different cuts of this data but let's just type Nal 66 with 3.3 prior therapies that's a mean so that means that the average patient had three a little more than three prior drugs which is a lot for melanoma um so they probably got some chemo they probably definitely got Kuda first uh then they got or another pd1 inhibitor then they may have gotten a targeted therapy and then maybe some chemo and none of that worked and they're dying and these are people who are very very sick um 100% of them got a pd1 um a number of them got ctla4 um and a number of them got a a bft drug um and so what they found was 66 uh 36% of patients had uh overall response which is kind of good so a third roughly 36% of patients had their tumor shrink by 50% and imagine yourself as one of these patients you've tried you have metastatic melanoma maybe it's spread to your liver and your doctor says you have six months to live you take Kuda and that keeps you alive for six months then you try ctla4 it doesn't really work then you try a Mech inhibitor it doesn't really work and you may have a few months to live at this point um and then you try this drug and uh all of a sudden um your tumor shrinks but you only have a onethird chance of your tumor shrinking but it doesn't um Disappear Completely it uh may only shrink by 50% or more but it also is important for the other 64% of people whose tumors didn't shrink by 50% or more what happened to their tumor because if it just stayed in check well that's better than the tumor growing or you dying um and certainly of these 36% of people who are lucky and had their tumor strength by 50% or more is is a pretty good uh thing so uh 36% with two complete responses so two patients had complete disappearance of their tumor and um 22% had partial responses that's the two people is quite good but that's only two out of 66 which is about 3% right so you have a 3% chance of a cure um but the you know you have a 36% chance or 34% chance 33% chance of a 50% or better tumor reduction and you're not going to die if your tumors are shrinking um which is great Disease Control rate is sometimes what we call people who don't progress but their tumors don't quite meet the objective response they don't shrink by 50% they might shrink by 20% or something like that so 80% Disease Control rate means well the T tumors may not be shrinking by 50% or more but but they're not progressing the other 20% unfortunately did progress and most likely passed away um the median duration of response so if we just take these 36% that do respond how long do they respond for because it's no good to me if my tumor shrink for two weeks and then they come roaring back and that does happen sometimes um the um in this case it looks like the median duration of response was at least uh 18.7 months on it well that's the median but it does look like some of those patients had a response you can see this one for 02 months well what is 02 months that's really not very much that's six days before the tumor came roaring back but on average if you do respond to this drug in that 36% you will um have a decent resp response okay in the primary refractory to pd1 subset the Orr and Disease Control rate was 41 81 now I thought all of these people were refractory it's at 100% here so I'm a little confused but it says 100% previously received Kuda or ABDO or any other pd1 maybe it meant that they were completely refractory to pd1 I think that's what it means not that they took it it worked okay and then they progressed but from the start pd1 never worked for them I'm not sure this is even worth noting but I'll write it down anyway refractory Cort 41% or 81% uh Disease Control rate safety profile is consistent with lympo depletion and is 2 okay so um it doesn't sound like there are any side effects from the therapy but these are very sick people so there is a tolerance for side effects let's keep reading now the that's the summary of the article we're going to start reading the actual detailed article and we do need to do this I know there are a lot of people uh that have ADHD that don't want to do all this work but I hope to show you that you do have to do the work all right so indication of course is metastatic melanoma okay the treatment of metastatic me melanoma uh with immune checkpoint Inhibitors that's key true to an optivo and targeted uh inhibition with BFF and Mech has improved patient outcomes 40 to 65% of patients with Advanced melanoma have primary resistance okay so that's what they're sort of saying here 40 to 65% of patients have primary resistance to pd1 uh of those with initial Disease Control 30 to 40% develop an acquired resistance usually that means some kind of mutation in the uh um in the tumor um and so 15 to 20% of B's v600 V is the amino acid called veine and 600 is literally the 60000 amino acid so B is the Gene and the 600 amino acid in this Gene is veiling and it moves to some other amino acid which is called a mutation so not that hard to read these things if you know what you're reading 15 to 20% fail to respond to targeted therapy and only 22% remain progression free at 3 years so very very tough disease uh although primary resistance is lower in patients treated with pd1 antibody plus ctla4 antibody those are two drugs together and they're fairly toxic you know these targeted therapies that promise to eliminate the side effects of chemo well we don't quite get there yet um 36% of and I understand pd1 is not exactly a targeted therapy but it was supposed to be this post-chemo era and it's just a different kind of chemo in a lot of ways anyway um 36% of patients discontinue therapy because of Adverse Events that's what I'm talking about 88% because develop immune uh immune related Adverse Events these drugs work by revving up your immune system the the pd1 Inhibitors um so anyway patients progressing after pd1 after pd1 and ctla4 and after targeted agents have very limited options 4 to 10% have responses to chemo and uh The Limited uh median overall sural 7even months I said 6 months earlier so not too bad it's gotten a little better I guess but it always used to be six months so now you have seven months if you failed all those drugs so really dire prognosis there are no treatment options with approval based on data from patients with melanoma who have progressed after uh checkpoints for BFF wild type wild type just means um the normal mutation or not the normal mutation the normal Gene uh that everyone has in other words the gene that's in the wild hence wild type uh for one line of uh so so these are these would be second line patients who have failed kruder opdivo or to line for people who failed kup Divo and also a BFF specific drug that specifically targets that mutation in addition patients recurring with melanoma after Adent so this is before surgery pd1 therapy um for highrisk disease represent an emerging unmet need great so this is just a background of basic PD basic melanoma background and that's what's nice about these papers is usually the first page will give you a nice soft introduction to the topic uh sometimes these papers just dive right into the deep science and you know if you're new to the space some when I read papers in other disciplines I I get lost you know within the first sentence and I don't like that so that's that's the unfortunately that's how it works all right adoptive cell therapy with til which again I think is their term which I don't like uh everyone wants to make a euphemism to to stand out but it's basically this whole thing is just a Cell Therapy to Me Cell Therapy offers a potential therapeutic option for melanoma but it has not been studied extensively in the checkpoint era or the pd1 era cool the cell their cell therapy which they call T are enriched with polyclonal tea cells with diverse antigen specificity again I kind of want to understand how they get there um that you know they get confident to sort of say to sort of say that okay extraction of a fragment of tumor followed by X Vivo expansion so expansion means letting the cell divide and growing the cell so you have to feed the cells and you have to put them in a in a place where they they're able to grow so autus let's see reection Aus well let's see tumor reection followed by expansion so so X Vivo expansion means outside of the body Vivo means life or in Vivo means in life X Vivo means well we're going to take the tumor out of you and then we're going to put it in some kind of equipment and expand it there so extraction of a fragment of tumor Fall by X Vivo expansion removes til from the Hostile tumor micro environment okay and reduces the immunosuppressive effects of intratumoral regulatory te- cells let's break that down a little bit more and I firmly believe you can understand anything if you slow down enough if you get frustrated and angry that you don't understand anything well you're never going to make it with that perspective but if you slow down a little bit and look at it it's not that hard so we got this part extraction of a fragment of tumor that's pretty simple snip snip uh or it's actually like a punch key punch hole punch sometimes but I think this is actually more of a like a surgical knife reection so it's a very serious one all right followed by ex by xvivo expansion we got that part too we take the tumor put it in some kind of expansion type equipment okay they're saying that this process removes the T which they call tumor infiltrating lymphocytes lymphocytes you mostly think of te- cells um removes tiil from the Hostile tumor micro environment so there's a tumor micro environment sort of around the tumor and in the tumor that's a little different from outside of the tumor and people have studied the acidity of this micro environment it's predeliction for glycolysis and other things but personally and there's also other structures around the tumor like stroma uh extracellular Matrix structures uh but in any event they say extraction of a fragment tumor and expansion removes the til from the tumor micro environment that makes sense because you're not taking the whole tumor with you right you're just taking a piece and those Tils no longer have to deal with the the Hostile tumor micro environment that's fighting them right the tumors evolve mechanisms to fight the the your body's immune system so instead once you take um those uh cell uh that tumor fragment away it can't rely on the rest of its Buddies the rest of the micro environment to stop the te- cells well that's important okay so it by doing that it reduces the IM immunosuppressive effects of intratumoral regulatory te- cells so immunosuppression means less immune system suppress the immune system but that's what's fighting the tumor so you don't want that but your body does that um part of that is because the tumor uh is putting out these regulatory te- cells to stop uh stop you from fighting the tumor and they're saying that when you take the tumor out and put it in this expansion device you'll have a lot less of that that's great so it says here expansion of these outside of the body X Vio rejuvenates the cells yielding billions of such cells to be infused back into the patient well again I mentioned that there are 5 billion to 24 billion lymphocytes period so it's exciting that they're saying they're going to yield billions of cells because that's kind of the amount we need to make a difference we can't just give the guy a million cells it's going to have to be a very large amount okay so far so good right that wasn't that hard melanoma is characterized by High mutational burden so in melanoma there's a lot of mutations in different genes uh that's not always the case in cancer by the way and highly individualized neoantigens what does that mean well Neo means new and an antigen is something that uh your immune system is supposed to Target um antigenicity is what you want in a vaccine for example you're introducing an antigen and you're hoping the body makes an immune response to the antigen and in this case in fact we all have antigens and neoantigens from mutations but because we're under a certain age our immune system is still vibrant and still stopping these tumors from growing as we get older our immune system weakens and these neoantigens start to become cancer so when it says highly individualized that means that there are diseases like non-s small cell lung cancer where there's very specific Gene and very specific mutation down to the amino acid that you can individually treat that's not the case in melanoma where you have aoras a cornicopia of tumors uh of tumor uh mutations and it's hard to sort of decide well what drug do I give for that so a cellular therapy product that can address the broad nature of neoantigens and the unique array from each patient would lead to the possibility of a tailored response okay so they called this thing leil youell and its old brand name used to be the name used to be Ln 144 which and we want to search for that too we only search for liilia cell we may not get anything but we we need to search for this term too and the search engines have gotten a little bit better about that um so liilia cell is an autologous tilil therapy it uses tumor tissue te- cells capable of recognizing tumor antigens that's the ideal and being expanded xva while maintaining the heterogeneous repertoire of te- cells there's lots of different kind of t- cells using a centralized manufacturing process I guess what they're saying is that you don't want the manufacturing process to give you this one type of t- cell this homogeneous t- cell all right we report the safety and efficacy of leilia cell a onetime cellular therapy in patients with Advanced melanoma who have progressed on checkpoints and B if there were be positive trial was conducted with the Declaration of Helsinki doesn't that sound auspicious the Declaration of Helsinki and the g gcp where is Helsinki again Finland right uh and the gcp guidelines of the I that's another you know hty idea the International Conference of har on harmonization the IC was the idea that they would harmonize all of the rules for one to make one set of rules there's probably some Swiss guy with a long beard deciding this uh all patients were provided uh written form consent that is part of the Del Declaration of Helsinki I think and the trial was designed and sponsored by iance Biotherapeutics Inc which is iova on NASDAQ and that's what we're studying and yes we're just trying to make a quick Buck here but there are brave people who work at this company built this company and investors as well that stake their money to on this company and they build something amazing uh how amazing and do we want to buy the stock or not is another question uh but it is something to keep in mind that these are real people it's not just four letters um four letters on NASDAQ it's it's a bunch of people that decided I want to start this company I want to make this company and we're see see it through okay all authors discussed analyzed interpreted the results and vouch for the accuracy and completeness of the data analysis and adherence to the protocol you can actually get the study protocol which is really cool maybe we'll look that up in a minute all authors contribute to the study professional medical writing was paid for by the sponsor okay so this is the NCT entry and this is very important n236 0579 why what is this well you can go to clinical trials.gov and actually I hope this doesn't take me somewhere else good it'll show you the clinical trial entry so this is an entry that the public can see and they'll look at it and say maybe I want to be in this trial and you can see when the study started which is very interesting that was a long time ago study start 9 2015 now whether the first patient got dose then or not another question but it's something interesting and it also said that they treated 178 people and you can see I had this 66 then I had 111 up here and 178 up here so it sounds like they kept going um and they called it a phase two I called it a phase one two but you know what let's get EV F out and call it a phase two it doesn't really matter what you call it and so they had 57 study locations and what's a secret about these open label studies and I'll tell you guys a little bit of Wall Street secret that you may be obvious to you maybe you already knew it or maybe it's brand new to you if you know where these studies are like for example the Sarah Canon Research Institute in London and you ask the doctors who work there maybe you're friends with somebody who worked there or you went to high school with the doctor there or something like that and you say do Dr Smith are you in the iovance trial yes I am how many patients have you dosed well I dosed five of them how are they doing well four of them got cured you may want to go buy the stock you may not want to go buy the stock depending on what your lawyer tells you I don't suggest it either way but it is something that uh you know could be uh due diligence on one hand but some people may call that insider trading as well got to be a little bit careful um it's uh it it's it's complicated what if one of the patients posts on social media um there's a lot of ways to look at and think about it now if somebody tells you the entire study results of the whole study I'd say that's inside your training but if just one doctor says the patients are doing well or something like that well it's only five patients there's going to be 100 patients in the trial does that really mean anything could be nothing um so in any of us something to think about that maybe certain Wall Street players do that I would never ever encourage that but you know they have the list of doctors right here I mean it's right there you tell me this guy in Hungary isn't going to tell you what happened um so in any event all the details s are here what's interesting is you can see that they they actually changed from one manufacturing process to another and they call that gen one for gen two and then they had this where maybe they were going to retreat so they had four Cod fors gen one gen two retreatment and I'm not even sure what Cort 4 is it's still open maybe shouldn't still be open okay so we have the official NCT number this is the paper we're reading sarac at all that describes the results so we have everything we kind of need to really understand this medicine this is the cohort 2 Data I guess and it says here the patients were enrolled from April 2017 to January 19 that doesn't really connect with the Clin trials thing but maybe it's the cohort 2 at 26 sites okay so they had stage 3 C or four metastatic melanoma with radiologic progression um they must have uh progressed on the drugs we've talked about many times basically everyone was eligible to get the drug one lesion measuring 1.5 cm in diameter had to be reected so what's 1.5 CM I don't know maybe the size of one knuckle your pointer finger it's about two 1.5 cmers maybe half half of one knuckle depending on how big your finger is half of a knuckle to one knuckle so about a I don't know a little nugget maybe not quite a grape sized rection but around a grape but that's the minimum so maybe maybe grape think of a size of a grape so they have to take that out of you um and they shipped that away and processed it 22-day process that results in a cryopreserved product or frozen product shipped back to the to the patient now it's not giving us a lot of details about how it works or why it works or how it's made but this is a clinical Journal so they really just talk about clinical trial results p patients received a non-m lympo depleting regimen aha so it's actually not I 2 they got something different they got cyclos cyclophosphamide which is a serious chemo and fludarabine which is another serious chemo these wipe out your immune system not as bad as some other drugs that could wipe out your immune system like mlin I guess but these are serious um serious uh lymphodepletion or immunosuppression or myo blaive I would call them therapies uh so single infusion of 10 to the 9th power which is a billion cells uh ofil cell after cyclophosphamide ferine six doses of high dose I2 after so I2 I think would stimulate the immune system so it does it get those cells to divide or not I'm not sure but it's kind of a another it's it's an entire regimen it's ablate the bone marrow add new cells and then stimulate the immune system with I2 this it's kind of a a bunch of things to do here it's between 1 and 150 billion so uh cells so 150 billion cells that's more than the cells you have I think a bunch of the cells do die or get washed out or don't make it but that's kind of a lot um so you have to thought and administer it 24 hours after the last dose of fludarabine again a VI chemo that will eliminate some of your blood cells so the patients are not that old average of 55 median of 55 years some of them younger than that I mean half precisely half of them younger than that but one is as young as 20 medic melanoma is not just an old person's disease um most of the patients were stage four some in late stage three stage 3C um well it says here that the mean number of Prior therapies is 1.69 but previously they said it was 3.3 I think that was the median so some of these guys got like 10 therapies or something but that's a little bit odd right here it said the 66 patients received a mean of 3.3 prior therapies well why does it say right here 3. okay 3.3 I was looking at this thing 1.69 standard deviation got it so it's consistent 3.3 here I was thinking maybe my eyes are deceiving me most of these guys got ctla4 that's yoy um that's another Bristol Meers drug some of them got the combination some of them got BFF and Mech in fact looks like most of the BFF and Mech positive patients got those which makes sense some of them got il2 them itself some of them got surgery and radiotherapy but most of these people did that did not work for obviously that's why they're in this trial here's the the metastases so 35% have a liver growth 11% brain liver and or brain about half the patients so if you have melanoma and spreads your liver or your brain you're in big trouble um some of the about half the patients their tumor was more than 70 uh millimeters so that's seven uh centimeters which is I don't know maybe this big the size of an apple it's a pretty big tumor uh how many uh tumors at Baseline uh more than three on average pretty pretty scary um in fact almost all of them had more than three so um on average six six different tumors yeah can be very vicious and uh most of them stopped Kuda or something like that five months ago so again I would say most of these patients don't have very long to live okay and then there's a short course of Isle 2 every 8 to 12 hours up to six doses after liilia cell parin point is as we discussed um pretty simple statistical analysis rapid enrollment that's very telling um historical response rate of similar patients is 10% so pretty unlikely to see a response just by accident or with chemo or something like that again uh two people had partial response some people had what's called stable disease so that's part of what we discussed earlier is the Disease Control rate so 14% per ressed and 6% were nonv valuable which for me just means they probably progressed or even died this is a really usually great chart to look at this is sometimes called a waterfall chart and uh I like this a lot I'm going to include it in our model so I'm going to just take a snapshot of it and um uh paste it so imagine you see see this chart I would love to be in this trial if I had this disease right because it looks like on average I'm going to be around here my tumor is going to shink a little right but I might end up in this area here with huge tumor shrinkage would be great doesn't look like I have a high chance of jumping in here so this is a really nice drve and this is a big Disease by the way there are a lot of people with metastatic melanoma and at the price that they're charging I I think is insane um some insanely high price uh they can definitely sell a lot of drug and last quarter they sold 13 million let's see if we can see the price it's again it's a one shot theill cell it's one therapy so you get one time shot I want to say it was 150 no 515,000 holy [ __ ] W that is expensive 55 hell of a price man so metad melanoma is is more rare than lung cancer or some of these other diseases but let's let's do a little modeling here let's let's try this of course I'd raise it of course I'd raise it JD Blart knows longtime follower he knows I'd raise that why not a mill [ __ ] it why not all right is your life see this is the way I would pitch it I would say is your life not worth a million and the patient's sitting there thinking he's right my life is worth many millions yes it is worth more than a million your life is worth billions it's infinite so a million is nothing that's how scr gets it done anyway let's go back to reality metastatic melanoma no the patient patient's obviously not paying a dime um no nobody could afford that they might pay a co-pay but even then for cancer typically they're not paying a dime um so what's the prevalence or incidence of this incidents 0.9 for 100,000 people what one in 100,000 so we that's pretty simple there 350 million Americans right so if we divide by 100,000 we get 3500 people get metastatic melanoma every year that seems lower than I thought but we can look for some other data too it is fairly rare I I must admit that but I thought it was a little bit higher than that and again it's very different for malignant melanoma metastatic melanoma and regular old melanoma very very different things most of the time melanoma is caught it's cut out it doesn't spread but the metastatic melanoma or Advanced melanoma it's a bit different we may come across the number we may not iovance probably has a number whatever number they're saying you could probably cut in half not always some some companies tell the truth well it does say no that's not right well we don't necessarily have okay well this is actually a good number it says 8,000 people in the US die from melanoma each year and given this is a fairly bad prognosis something between 3500 and 10,000 sounds about right but let's just pretend you could treat all these people with this drug you're talking about half a million times say 4,000 5,000 patients that's two2 and5 billion dollars of Revenue and you don't need to be a financial analyst know a 3 billion market cap is very cheap um so you could be seeing a 10x in this drug um if that's what happens now I don't think they'll get every single patient um but think about it if Kuda doesn't cure you and they said that even if you got a good response to Kuda you eventually will relapse and we'll look at that data in a second so I want to look at that data I might want to look at that right now let's take a look so Kuda was the main thing before Kuda it was six months your dead that's it goodbye no chance talism ab and OBO nalab they changed the game so let's take a look this is stage three adant early stage adant it's a lot of Trials seven-year followup of keynote o06 this is what we're looking for phase three keynote one o6 H liab versus IAB that's your boy from bris L Myers versus pemro which is hruda from Merc and your voy from brl Myers This is not an iance study um so this is a longterm study me overall survival or penro was 32.7 months so again imagine going from six months to live to almost three years amazing huge breakthrough that's why Bristol Myers did a an amazing job there uh it elium ad not as good 15.9 months but still better than the old standard of six but it looks like on average you know medium PFS 9.4 months for penro so it looks like for pism ab you get nine months before your tumor grows and it was a 56% o r no no hold on maybe we should just open the open the file so what I'm trying to do here if you can't put it together is I'm basically trying to figure out how many people will be El eligible for the ioan strug here's What's called the Kaplan Meyer curve and this is crucial this is really crucial and all this will be available on my GitHub which I update regularly and that's free of charge for all of you wonderful people all right so what does this mean do you want to be in the blue group or the red group blue group did better and it looks like about half these people are going to have this really long response but half of them are not and so so I'm going to use this data to try to construct a model of people that are available for this disease to to be treated so go back in time a little bit they basically say 3500 people get diagnosed with medic melanoma every year how many don't get cured and then therefore how many are available to treat now normally you have to like aggregate this over time but in reality if you don't respond to this you're basically in big trouble so I could actually say that maybe as many as like 30% are available for treatment 30 to 50% and remember we're only looking at the US here the rest of the world is basically a third world country so just one big third world country so $900 million of sales if they got every one of those patients they're not going to get every one of those patients but maybe we try something like this 70% well you know what it'll start with uh 20% and then maybe it goes up and it caps out at 70 [Applause] [Applause] so revenue of 600 million pretty good um does that mean it should be A3 billion doll company or more H I don't know and is are my numbers exactly right uh not quite yet we still have some more thinking to do here and you know what just just for your benefit I'm going to save this I'm going to save this in in the folder I probably want to review some of these um references especially the ones about Lilia cell and and how how it works but this is really really valuable let's see if there's some [Music] other pieces of this and then we're going to move on to some other data but the melanoma opportunity alone seems to substantiate the market cap and that's just melanoma in the US that's pretty good all right let's see if we can um look at something else I'm G to let's look at the press press releases from the company what are they talking about what are they excited about well here is their last quarterly result I wonder if they did a conference call probably right okay they gave guidance so they're saying next quarter they're going to do 53 to 55 that's a lot can't imagine their percan revenue is going to go up very much right so it all has to be coming from and tag V that's only 80 patients if you think about it if you look at the price tag you can actually tell how many people exactly took the drug you can back into it by just dividing so if they had 13 million in Revenue well 24 people took the drug 25 people 78 people here still very large Market they can address there's probably a few thousand people that they could um get this drug to so I don't know let's say they add another 50 patients and you could also think about how many centers they have lined up so if they have 50 or 100 centers where you can even get this drug then you know it sort of makes sense that each one would would would have a couple of patients or something like that right [Applause] okay cost of goods for this is going to be a little bit higher than [Applause] normal and you can see the core business would basically be profitable um pretty quickly and the nice thing about cell therapy is it never goes generic those pesky generics really hurt pharmaceutical companies they make our Revenue go down a lot I don't like that um and you can't really make a generic Cell Therapy um so that's great news for iance this drug will be around a long time so I thought they could get 20% of the market Market which would be 180 million and looks like it was not too far 120 is maybe more realistic but then the rest of this just adds up um I don't know what's going on with the prucan sales I have to see what their relationship there sort of looks like that's a noard strug if I was not mistaken novaris bought Chiron a long time ago [Applause] [Applause] looks about right costs about $125 million to run an operation like this that you know between your sales force and your general expenses that's basically correct [Applause] might get a little leverage if you sold the company to somebody [Applause] else that already has a bunch of that infrastructure but in general that's kind of what you're going to get now this is just a US company interestingly so would actually be beholden to whatever tax rate politicians decide and foreign companies you don't or at least in companies that don't necessarily have um complete us operations which this one does you could um have some tech shielding okay so let's say it matures very quickly right there what's interesting is I don't think this would shrink and the discount rate is going to be fairly low it's not going to be as low as big Pharma but this drug is FDA approved it's just basically a license to make money okay so what is this worth $3 billion that's exactly what the market cap is funny right it's maybe a little higher so instead of 3.2 maybe 3.6 and that's just melanoma that's just the US um so it's probably fairly valued yeah every time I do one of these the Market's so efficient but hold on I'm assuming they're doing something else they're not just doing this oh wow they're saying well they have guidance for the next two years isn't that funky I didn't notice that do you see that they're saying they're going to do 450 to 475 in 2025 I have them doing that kind of in 2026 so what are they smoking well maybe maybe oh I'm looking oh I you know what I this should be in 2024 anyway yeah yeah yeah so in fact maybe they're not smoking maybe that's right had this a little little bit messed up okay well I don't know if I really have it messed up but regardless all right so they're [Applause] saying they're going to do 450 to 475 next year that's juicy it's really juicy it's a big number it's kind of ballsy to predict your growth curve like that and so the question is like this must work for some other cancers too right it's not going to just just work for melan NOA they're basically saying that they've already they had 25 in the second quarter which makes sense I'm glad that that checks out because because that's literally how much it cost 515 * 25 is 13 million Revenue so that's kind of cool that that works out exactly right um but he also said or the company also said they have 30 patients since the start of Q2 and this was in August so that means that they're kind of on track for my number which is 78 you think about it they might even beat it could be could be 70 or 80 but it could be higher too it could be 90 it's about right that number is about right 70% gross margins what I guessed more or less they also think prucan will increase significantly which is kind of interesting I want to know what their prucan deal is approved 21624 so couple months ago six months ago or so well they only have 50 well 70 atcs so you can only get this in certain places which is a little tricky um you have to be at a top hospital to get this so I think the the most they can penetrate into the market is going to be even less than 70% so there must be more patience than I think we'll have to see 75% covered by private payers 20,000 patients annually with the US and a few Global markets okay well 20,000 patients would be 101 billion dollar they're not going to get that I have a more reasonable number of 2,000 patients which is only us maybe that doubles for the rest of the world not Europe's going to pay for this but UK Canada Australia those countries are cheap too Switz are one less so but small country cohort 1A this is Frontline study yep okay so there's some opportunity here if you do it with the with checkpoint Inhibitors in fact they want to do it with the new Bristol drug relatab or Abdul lag huh well so it's a smart company man they're they're trying to get all the patience I don't know if that price is going to stick for first line but here's the completely different subject they're doing lung cancer H now we're cooking right this could be a completely new market for them could be a 5x 10x market for them let's see if there's anything real we can hang on to there I don't assume anything until I see the data it's tantalizing but you know we don't know until we look at it right so they have a post anti pd1 non- small cell small cell is pretty big Market many many billions even in refractory second L they're like market so they're trying to go for approval here complete enrollment with data in 2025 bla in 2026 okay they also have endometrial cancer and then they have um something called iov 401 which is uh pd1 inactivated til that's pretty smart I'm guessing they would do melanoma yeah oh and they this is actually in clinical trials already I like this so far I have a new I2 as well uh a lot of people try to make new is twos I don't know if it's all right now now there's Isle 12 oops looks like they can't even treat that many patients they can treat enough looks like they can treat maybe a billion and a half of Revenue or something like that for all right pretty pretty useful pretty interesting let's keep going I wonder they I guess they didn't do a conference go or did they you can check that out too yeah they did a conference call okay let's listen to that real quick I theraputics call to discuss second quarter 2024 results and updates my name is Daniel Daniel's got a hell of a lisp up question please this confence is thank youno [Music] andcome discar and first2 Dr our president and chief executive officer will provide an introduction and summarize key update for our us [Music] I don't think they change the price for non- small cell I think they would Frontline melanoma or second line melanoma or first line melanoma with Kuda which is already expensive I mean you're talking about really expensive therapy uh they might have to discount it highlight additional details of the US La of in ADV M drinski Chief Operating Officer will com on experience and the expansion plan John CFO will review our financial results including revenue and financial and Dr frerick finstein chief medical officer will review key clinical pipeline up Dr Brian Gman Ed medical Affairs and Dr Mar Cur Ed Regulatory Affairs [Music] also afternoon weed found.com before we start I to remind everyone that statements made during this confer call will include forward looking statements regarding I's goals business focus business PL and transaction Revenue that Revenue commercial activities loal trial and results regulatory approval and interactions plans and strategies research andclinical activities potential future applications of our technology manufacturing inability regulatory feedback and guidance payer interaction licenses and collaboration cash position and expense guidance Andy foring statements are to numerous RIS and unties many control including the RIS and unties descri from time to [Music] time I will thank you pleased to discuss our 24 second quarter and first half results [Music] [Music] mon [Music] [Music] access [Music] it says here that the lung cancer data is 26% objective response rate it's not that high it's not bad though I think it's about I'm trying to think of a therapy that would fit in looking at this it's probably not that different from Kimo to be honest [Applause] [Applause] I I closed it by accident for can you give a vaston I guess they give oh this is [Music] old okay so first la you have anywhere from 30 to 45% I have a new analyst joining me here she might make some commentary what do you want hm okay there's a reri m which is a ly [Applause] drog and then you have Nintendo m which I always joke it's a pretty funny Nintendo Nintendo droke well here's a 36% response rate another 132% so this is tricky because second line is a big opportunity but you have you are getting that range of results anyway so getting H getting getting a 30% response rate 26% in this case it's not that good for monotherapy without side effect is pretty good somebody says dust taxle taxer is standard second line but uh don't you give a veg F2 give triplet do tax all carbo plattin and either of ason or sza interesting so it's not it's not a slam dunk I'll say that but it's look I mean the more options you have the better it's a small cohort 30 23 patients it's not really gigantic uh amount of people there and it's in Wild type so these These are outside of the addicted tumors 1cr 5 PRS I don't think you can read too much into that yeah I mean it's it's certainly something I just don't know if it's see it's sort of tricky you get the melanoma business if you believe them and they seem to be good management my numbers are too conservative and I acknowledge they're conservative and even though they're conservative they give me a slightly higher stock price than even now which is kind of the margin of error it's not really noteworthy but they also have prucan which I haven't been probably valuing correctly I'm actually curious how they got prucan so I'm going to look that up back to my godell terminal going to just do iance and I press uh so I press back tick which is the key next to one the back tick button on your keyboard um it's kind of hard to see sometimes but uh some people call it different names but this is the back tick button right next to the one to the left of the one so when you press back tick on goodel it takes you to the terminal if I'm out here somewhere and I I need to go to the terminal I press back tick then uh I type in the ticker iance I can hit tab or like if you're Bloomberg user you could hit f8 which is the way Bloomberg works for equity and then um I could do CF for company filings and here I see all the company filings I want to read the 10K so I want to see how they got um prucan where did it come from from let's do a quick search ah there it is oh they bought it from clinten 2023 very cool I wonder what that deal look like [Applause] 212 million sounds like a pretty damn good deal wish I did that deal [Applause] [ __ ] basically bought it for four time sales smart and if it goes up because it's used with this drug it's even smarter let's see I said it will go up significantly so now get to 4 billion and again that's pretty conservative and I'm not giving them credit for any of the other cancers wish you could buy it a little cheaper [Applause] there also going to be other drugs in the mix here I me it's not going to be permanently same opportunity I could easily see a double though I mean yeah I like it I would be long it's not like u i mean if lung works out it's and it's working out obviously to some extent I just wonder I guess you don't want to give this a chemo they have to do a registration trial that I mean for some patients they prefer this to chemo perhaps but they have to go through a my blade of regimen anyway I mean you're going to get some market share in l maybe not even if it's not that high it actually funny enough the second line lung cancer Market is so much bigger than melanoma that even a small market share in second line lung would give you a pretty substantial Revenue boost so I think this is double roughly I'm just kind of spitballing here but it's early days those uh that lung cancer data is on 20 30 patients that's not uh perfect 23 patience but it is a big unmet need I mean eventually you fail first line what's up Emmy Demitri how are you guys doing so I think I think it's a I would definitely own some it's looks like very smart management very attractive kind of stuff all right with all that said anything I uh can do for you you guys while I'm got about a half an hour or so to do other things other than ioans thank you for your patience in this very deep dive let me add it to my list here just going to keep it on my screen like that someone wants Sango someone wants rust the rust Life is tomorrow I think shorting biotech is still a great sector uh or space you can make a lot of money shorting biotech abio I can look at [ __ ] as I mentioned I thought about buying the whole company um AMD Bitcoin Nvidia reports next week some of us have bought Zoom let's see what abio is up to I haven't looked at [ __ ] in Forever was it still called abon abiona [Applause] these guys always had a terrible balance sheet always running out of money looks like they raised some enough to operate but let's let's see if they have any debt tiny bit of debt pretty small price value one of the problems these guys always had is they always had a ton of like mediocre looking projects they never had like one amazing drug they like 50 Soo drugs in the clinic but it looks like they they still have that same lead drug which is for epidermis B Bosa which is a very fascinating fascinating disease it's a weird blistering skin disease there's another drug that's kind of beaten them to the punch and it's weird because you have to graft the skin uh the new skin on it yeah I guess iance could get bought out that's a good point but I don't really think about that when I invest I just think about is this a valuable company or not all right so this is also autologous cell gene therapy so that's funny it's not I mean iance isn't gene therapy but still kind of interesting a lot of cool things you can do in biotech right I got a complete response letter it's not what you want when you're working with the FDA complete response letter means no sometimes called a crl crl in April about chemistry I mean the big question here is can they be competitive with the crystal drug right the drug has a funky name Progene Progene Zam Carousel zamy Carousel they'll eventually have a real a real name Medicare reimbursement decisions bizarre it's not even approved yet used to be called EB 101 gu this is their phase three trial [Applause] oh okay pretty good data so they they double blinded based on the wounds of the patient these patients have these open blistering wounds I won't show you pictures because they're very not great looking um and so they randomized them to Placebo so some patients got the gene cell therapy and some patients did not and 81% healed versus just 16% with the other one it's pretty good these are really bad think about the worst blister you know wound you can imagine now there is this company Crystal and Crystal Crystal biotech and they have a similar drug but it's FDA approved I believe and I think it sells it's very very good you can see this person with uh some big scar over there oh man view wounds before and after by juc treatment I just want to warn everybody that if you don't want to see um some fairly serious medical um pictures that can be disturbing to some viewers just don't you don't want to see these um so you might want to turn away um okay it's not for everyone so here's a pretty serious wound and you can see some clearance this data doesn't look that different from Fabion h I thought it was like a much much better data but 68 vers 23 it's about the same as abiona data if anything that abona at is a little better how are they selling let's see big big sales wow all right well that's interesting it it it could be attractive um they're gonna have to compete with [Music] um Crystal but crystal is a six billion market cap they have some other drugs and aviona has got 100 million market cap so you know they could sell pretty well there this this is a company that could never get anything right they kept they just kept shooting themselves in the foot over and over and over again so it's just like I think that's why the Stock's been such a dog nobody trusts these guys nobody believes them so they finally going to get it right or will continue to disappoint and there's been some companies in the past where it's just like dog after dog after dog so we have to look at abiona in more detail but that's my my quick um take is it's it's definitely [Applause] interesting could could be some serious upside there all right guys well that was fun um is Keith Gill bankrupt from gme I don't know hope [Applause] not um yeah anything else yeah just let me know on godell I'm happy to do whatever um homework you guys want on any stock I enjoy it um and uh yeah we're shipping some new things on uh Goodell very soon including new countries uh with real time data uh in very a bunch of different countries and a bunch of other uh new features thanks again guys see you later