Trillium (TRIL) has been a legacy name for PropThink as we’ve been covering it since 2014. With data being presented at ASH conference on December 11th, TRIL has doubled in the last month. We’ll be analyzing this data for any members that are long TRIL or have it on their watch list.
Hundreds of Millions Back A Hot, But Early CD47 Space
Tumor cells frequently express high levels of CD47, an immune checkpoint that tells immune cells to not “eat” these tumor cells. Trillium’s TTI-621 is an immune checkpoint inhibitor that blocks the CD47 “do not eat” signal and enhances antitumor activity.
The players in the CD47 space are listed below. Although CD47 drug candidates are still in early stages of development, investors have poured in hundreds of millions.
Trillium is in a Phase 1b targeting refractory, advanced diffuse large B-cell lymphoma (DLBCL) as its first indication. Even though TRIL’s timeline is similar to its above competitors, it’s difficult to make apples to apples comparison because these companies have yet to release any clinical data. We'll be analyzing Trillium's clinical data below.
ASH Abstract Showing Good Safety after Last Year’s Concerns and Early Signs of Anti-Tumor Activity
In ASH 2016, Trillium’s TTI-621 showed serious adverse events at the 0.3mg/kg dose in patients with Relapsed or Refractory Hematologic Malignancies. 2 out of 5 patients reported Grade 3/4 events. One with Grade3 elevated ALT/AST and Grade4 platelet count and a second patient with G4 platelet count. This safety profile forced Trillium to explore lower dosing (0.2mg/kg), which was established as MTD.
Recently released ASH 2017 abstracts showed that this 0.2mg/kg dose is being well tolerated as a monotherapy and in combination with rituximab. ASH poster could be a de-risking event for TRIL safety, but we want to see the data before jumping to any conclusions. Keep an eye out for full safety profile at ASH.
On the efficacy end, TTI-621 showed promising early anti-tumor activity in patients with refractory, advanced diffuse large B-cell lymphoma (DLBCL).
- Objective responses were observed for 5/14 patients (36%).
- 1/6 pts treated with TTI-621 monotherapy
- 4/8 pts treated with TTI-621 plus rituximab combination
2 out of these 5 responses were complete responses. One CR occurred in a monotherapy who remains in continued CR at 20+ weeks. The second CR was in combination who remains in continued CR at 12+ weeks. This early data is promising because historically, patients with refractory DLBCL have seen objective response rates of 26% with complete response at lower than 10%.
ASH 2017 abstract indicates that Trillium’s question mark surrounding safety could be a thing of the past. The data has also shown some promising anti-tumor activity. Although early, TRIL is the only publicly traded pure play in CD47 realm, a space that has the eye of investors and big pharma.
The company has a pro-forma Sep 30 cash balance of about $65M and fully diluted market cap of ~$220M. With early combination data out, Trillium could be positioned for a near term licensing deal.
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