Operator: Thank you. Our next question comes from the line of Doug Loe with Leede Jones Gable. Your line is now open.
Doug Loe: Thanks operator and good morning gentlemen.
Andrew Hall: Hey Doug.
Doug Loe: You have sort of addressed this €“ yes, good morning Andrew. You have addressed this and some of your other commentary, but then just to ask this question more directly. I mean you can garner as much insight into the effectiveness of the therapy by patients for whom it doesn’t work as you can for patients for whom it does. So, just maybe just kind of answer directly any insights you have from SPiReL or DeCidE as to what patient characteristics are sort of predictive of responsiveness. And it could be any number of things like prior chemotherapy history, stage of disease, you are combining DPX-Survivac with pembrolizumab. So, are you actively screening for PD-L1 or PD-1 receptor expression levels or any other thousand other things you could be screening forward? Just some understanding of what patient characteristics are sort of corresponding to buyback responsiveness would be helpful insight? Thanks.
Andrew Hall: Yes. So, I love the question and expect nothing less. Thanks for the intriguing scientific question. I would happily speculate, but I am clearly not well educated enough to do that. Jeremy Graff is a much better source for that information. But I will preempt the question by saying that in these refractory patients, it’s often nice to see them have some response to previous therapies and that may be acute for the way that they respond to maveropepimut, but I will let the educated scientists in the room, give you a bit of a flavor of his perspective, Jeremy?
Jeremy Graff: Sure. Thank you, Andrew. And Doug, thank you for the question. I think it’s a very interesting but complex question. And we have an entire translational research team, focused on trying to ferret this out. Some of what you mentioned in your question, we know it will be true. From the SPiReL data in the relapsed/refractory diffuse large B-cell lymphoma setting, the Phase 2a study that we had run a couple of years ago, it was very obvious that the benefit that we had seen with maveropepimut and pembro was mostly ring-fenced by the pembro biomarker, PD-L1 status. And so the PD-L1 positive patients are where we saw the complete responses, where we saw the additional partial responses and where we saw the greatest durability of response.
That’s certainly precedented for therapies that involve pembrolizumab. What we also know is the patients that do the best, whether it’s on that SPiReL DLBCL trial or our ovarian trials historically or our bladder trials that we have mentioned. Our patients that show the eruption of survivin-specific T-cells, surviving as a cancer protein, as you know, that’s over-expressed across most cancers, especially very advanced cancers. And surviving is the target against which we are educating the immune response with maveropepimut-S. Our best responses, our complete responders show us the greatest percent of survivin-specific T-cells, and those T-cells persist where we have been able to look with longitudinal sampling. They can persist more than 2 years.
That’s remarkable in the cancer vaccine space. So, we are always interrogating what are the metrics, if you will, what are the characteristics of a patient and the patient’s tumor that may dictate success. We know as well at the molecular level. That if a patient’s tumor has a lot of cancer-associated fibroblast, we published this last year in a couple of different conferences that, that patient tends not to do as well on any immunotherapeutic as well as maveropepimut. So, we are always trying to refine this so that we can ensure that we put maveropepimut in the right place. In our ongoing trial in diffuse large B-cell lymphoma, the VITALIZE trial, we are, in fact, scoring every one of these patients for PD-L1 status, given the relationship we had seen in SPiReL.
