President, Chief Executive Officer & Director, ITEOS THERAPEUTICS INC
BIO-Europe® 2017: iTeos CEO on making noise in busy IO field
Michel Detheux, CEO of iTeos Therapeutics, chats with Mike Ward, global director of content for Informa Pharma Insights, about ...
About Michel Detheux
Michel Detheux, CEO of iTeos Therapeutics, has described the company as one of the few able to work on both antibodies and small molecules, developing original combinations in the immuno-oncology field. He stated that the company started with the program IOA-244, which he described as the first small molecule manipulator of a chemical resistance mechanism used by tumors to escape the immune system. Detheux noted that IOA-244 was partnered with Pfizer at the lead optimization stage, a deal he called transformative, enabling the company to start five new programs and grow from seven to forty people in less than three years. He also said the company developed a best-in-class small molecule A2a antagonist tailored for immuno-oncology, and that most competitors use compounds initially developed for Parkinson's disease that do not work effectively in tumors. Detheux has stated that iTeos has a comfortable cash position, supported by historical investors and non-dilutive funding from the Belgium state and the Walloon region. He said the company has the capacity and expertise to go up to clinical proof of concept, and would be interested in a partner to help accelerate and expand clinical validation. Detheux has positioned the future of immuno-oncology as going beyond PD-1 and PD-L1, targeting patient subpopulations that are refractory or relapse from current therapies.
Transcript (24 segments)
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Michel Detheux0:00
We are one of the few companies being able to work on both antibodies and small molecules, and we are developing new combinations that could be original in the field.
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Mike Ward0:17
Hello, my name is Mike Ward. I'm the head of content at Scrip and the Pink Sheet. We're here in Berlin at the Bio Europe meeting, where pharmaceutical companies, biotech companies, and investors all get together to sort of get a sense of what's new, what's happening, what kind of deals they can construct. One of the hottest areas in recent years has been the emergence of immuno-oncology. Big pharmaceutical companies are sort of building arsenals of immuno-oncology products. We've seen lots and lots of biotech companies being created in this space. For example, in Europe just in the last two years, we've seen just under 50 immuno-oncology startups being created. Of course, the interesting thing is how do they differentiate themselves? I'm joined today by Michel Detheux, who is the CEO of a Belgian biotech company, a startup that was created in 2012, that's in the immuno-oncology space. So, welcome Michel, good morning.
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Michel Detheux1:30
Thank you.
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Mike Ward1:32
So, immuno-oncology looks like a very crowded space. How does ITEOS Therapeutics get any kind of share of voice?
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Michel Detheux1:42
Well, I guess it's a chance to be a spin-off of the Ludwig Cancer Research, which is one of the top three research institutes in the world. And we started with one program, IDO1, which was the first small molecule manipulator described by Van den Eynde in 2003 as being a chemical resistance from the immune system to allow the tumor to escape and grow. Then we started to provide IDO1 with the chance to be one of the three companies being at the clinical development stage for the IDO1 program. And on top of that, we have developed a full pipeline of both small molecules and antibodies targeting the tumor microenvironment to identify the mechanism that could allow the immune system to attack the tumor.
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Mike Ward2:25
And how close are you to actually determining what that mechanism is?
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Michel Detheux2:31
Well, we have started with IDO1, which is now partnered with Pfizer and in Phase 1. But we have a second program which is even more amazing, an A2A antagonist, where we have been able to develop in less than two years a best-in-class approach with a compound tailored for oncology. And this one we will reach the clinics in the near future.
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Mike Ward2:50
Right. And what sort of proof of principle have you achieved so far with that second program?
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Michel Detheux2:56
With the second program, we have a series of different models showing that it's very important to develop a specific compound for oncology because most of the competitors proposed compounds that were initially developed for Parkinson's disease, then they took this blank, old compound and applied them to oncology. We have shown that it doesn't work; these compounds are not acting in the tumor like they act in the brain. On top of that, this receptor is a receptor for caffeine, which is an excitant. When you use these compounds at concentrations that would be efficient in oncology, the mice become totally hyperexcited. That would never be applicable in humans. Then we have tailored a compound which is non-competitive of adenosine for oncology application, which is not going to the brain, to be able to compete with the adenosine immunosuppression found in the tumors. So this is a program we've been working on for about two years now.
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Mike Ward3:55
And you're using what kind of approach? Is it a small molecule approach?
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Michel Detheux4:00
It's a small molecule. You were asking me how we can differentiate from the competitor. We have decided to apply a strategy where we are modality agnostic. We've been able to develop an IDO1 inhibitor in less than two years, an A2A antagonist, and it's also small molecules. We have also antibody programs in development. So we are one of the few companies being able to work both on antibodies and small molecules, and we are developing new combinations that could be original in the field. Today, the standard treatments are the PD-1/PD-L1, and you have more than 3000 possible combinations with this PD-1/PD-L1, but you have only a few combinations that could apply with small molecules. And we believe that ITEOS has been able to select very relevant mechanisms to be targeted with small molecules, but also original approaches with antibodies.
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Mike Ward4:55
Okay, so you've got some sort of proof of principle. What are your worries for the next stage for this? IMPD filing next year?
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Michel Detheux5:06
We are going to start the GLP toxicology studies after completing the non-rodent tox, which was very clean. All the animal models have been completed. We are finalizing the validation of biomarkers for patient selection and pharmacodynamic measurements, and we will be ready to go into clinics in 2018.
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Mike Ward5:25
And these days, most of the same immunology products are being developed in combination with others. So are you already looking at some potential combinations, or will you initially go locally as a monotherapy just to show what it does?
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Michel Detheux5:42
It's a bit different compared to IDO1, for example, because there were some clinical data showing that an A2A antagonist can give some monotherapy effect. This is one option, but clearly the trend is going to better define subpopulations of patients, smaller ones, with combinations. I believe that we will see a switch from a kind of plateau where you know that there is a percentage of patients responding, but there are still a lot of patients which are refractory or relapse from PD-1/PD-L1. And this is what the future is in the field: to position a pipeline to go beyond PD-1/PD-L1.
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Mike Ward6:20
So that's how you select the sort of patient populations you're going for?
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Michel Detheux6:25
Exactly. I mean, obviously we must go for PD-1/PD-L1 combination, but beyond this combination, other indications with original combinations could be identified that could not be the best fit for big pharma, but for small biotech could be an indication that makes the difference.
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Mike Ward6:44
Right. And your business model, because you say with the original program you're already partnered with big pharma companies. At what point would you be thinking about going for a partner with this program?
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Michel Detheux6:57
Indeed, we partnered IDO1 quite early at the lead optimization stage. At the time, we were a company of seven people. The deal has been transformative for us. We have started five new programs and increased from seven to forty people in less than three years. Today, we have the capacity and the expertise to go up to clinical proof of concept. If we find a partner that helps us to accelerate and expand the clinical trial and clinical validation, I will be very interested. But today, we are supported and we have the expertise to go up to clinical proof of concept.
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Mike Ward7:30
Right. Okay. And do you have the sort of finance in place to be able to fund that?
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Michel Detheux7:37
Today, we have a very comfortable cash position. We have been strongly supported by our historical investors, but also by the Belgian state and the Walloon region, which have supported us with non-dilutive funding. And we are still working on capital increase, but it's not a top priority for the moment because we have the big support and the resources to move forward our programs in the near future.
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Mike Ward8:04
Right. And the Pfizer program, when do you expect to have some sort of milestones achieved?
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Michel Detheux8:12
There are milestones which are in the contract for entrance into Phase 2, but we will do an update at the end of the year and show the data allowing to move forward with this interesting program. We have the only IDO1 in the brain that could be a mechanism to control the immune suppression triggered by brain metastasis, one of the causes of death of the patient.
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Mike Ward8:36
Right. Okay. Well, Michel, thanks very much for a nice chat.