Editas Medicine, Inc. (NASDAQ:EDIT) Q1 2024 Earnings Conference Call May 8, 2024 8:00 AM ET
Company Participants
Cristi Barnett – Corporate Communications and IR
Gilmore O’Neill – CEO
Baisong Mei – CMO
Erick Lucera – CFO
Linda Burkly – CSO
Caren Deardorf – Chief Commercial and Strategy Officer
Conference Call Participants
Samantha Semenkow – Citi
Joon Lee – Truist Securities
Mary Kate Davis – Bank of America
Jack Allen – Baird
Gena Wang – Barclays
Brian Cheng – JPMorgan
Eric Schmidt – Cantor Fitzgerald
Jay Olson – Oppenheimer & Company
Yanan Zhu – Wells Fargo
Luca Issi – RBC Capital
Mani Foroohar – Leerink Partners
Operator
Good morning, and welcome to the Editas Medicine’s First Quarter 2024 Conference Call. All participants are now in a listen-only mode. There will be a question-and-answer session at the end of this call. Please be advised that this call is being recorded at the company’s request.
I would now like to turn the call over to Cristi Barnett, Corporate Communications and Investor Relations at Editas Medicine.
Cristi Barnett
Thank you. Good morning, everyone, and welcome to our first quarter 2024 conference call.
Earlier this morning, we issued a press release providing our financial results and recent corporate updates. A replay of today’s call will be available in the Investors section of our website approximately two hours after its completion. After our prepared remarks, we will open the call for Q&A.
As a reminder, various remarks that we make during this call about the company’s future expectations, plans and prospects constitute forward-looking statements for the purposes of the Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the Risk Factors section of our most recent Annual Report on Form 10-K, which is on file with the SEC as updated by our subsequent filings.
In addition, any forward-looking statements represent our views only as of today and should not be relied upon as representing our views as of any subsequent date. Except as required by law, we specifically disclaim any obligation to update or revise any forward-looking statements, even if our views change.
Now, I will turn the call over to our CEO, Gilmore O’Neill.
Gilmore O’Neill
Thanks, Cristi, and good morning, everyone. Thank you for joining us today on Editas’s first quarter 2024 earnings call.
With me today are four members of the Editas executive team, our Chief Medical Officer, Baisong Mei; our Chief Scientific Officer, Linda Burkly; our Chief Financial Officer, Erick Lucera; and our Chief Commercial and Strategy Officer, Caren Deardorf.
We are pleased with Editas’ momentum and progress in the first quarter of 2024. Editas’ goal is to deliver life-changing medicines to patients with previously untreatable or undertreated genetically determined diseases. And our vision and focus strategy is to position Editas as a leader in in vivo programmable gene editing.
Three pillars underpin our strategy. The first of those pillars is to drive reni-cel, an edited cell therapy for hemoglobinopathies, and formerly known as EDIT-301, toward BLA and commercialization. The second is to build an in vivo editing pipeline. And the third is to increase business development activities with a particular focus on monetizing our very strong intellectual property.
At the start of 2024, we announced the following 2024 objectives. For reni-cel, we will provide a clinical update from the RUBY trial for severe sickle cell disease and the EdiTHAL trial for transfusion-dependent beta thalassemia in mid-2024 and by year-end 2024. We will complete adult cohort enrollment and initiate the adolescent cohort in RUBY and continue enrollment in EdiTHAL.
For our in vivo pipeline, we will establish in vivo preclinical proof-of-concept for an undisclosed indication. And for BD, we will leverage our robust IP portfolio and business developed to drive value and complement core gene editing technology capabilities. So how are we executed against this strategy and these objectives in the first quarter? Let us start with reni-cel.
First, on enrollment. We’ve been very pleased with the growing patient and healthcare provider interest in reni-cel. Indeed, we are delighted to share that we have completed enrollment in the adult cohort of the RUBY clinical trial. Additionally, we have enrolled multiple patients and have more in screening in the adolescent cohort of a RUBY study, which was launched at the beginning of this year. And we continue to enroll beta thalassemia patients in our EdiTHAL study. Dosing continues in both the RUBY and EdiTHAL studies.
Second, on clinical data. We remain on track to present a substantive clinical data set of at least 18 sickle cell patients with 2 to 21 months of clinical follow up in the RUBY study in the middle of 2024. And we will share a further update by year-end. We are also on track to present clinical data from the EdiTHAL study of reni-cel in transfusion dependent beta thalassemia in the middle of 2024 and again by year end. Baisong Mei will share more reni-cel detail later on in this call.
On the manufacturing front, I am pleased to share that we have promoted Greg Whitehead to the role of Chief Technology and Quality Officer, leading our technical development, technical operations and quality departments. Greg has more than 25 years of experience in the biotech industry and extensive cell and gene therapy clinical and commercial development expertise.
Now, let’s turn to in vivo and our pipeline development, where we continue to strengthen our in vivo discovery capabilities and continue lead discovery work on in vivo therapeutic targets in hematopoietic stem cells and other tissues. Importantly, we remain on track to establish in vivo preclinical proof-of-concept for an undisclosed indication by the end of the year.
Our internal development efforts are differentiated by leveraging the indel CRISPR technology we already use to upregulate gamma globin expression through direct editing of the HBG12 promoter site in our ex vivo reni-cel program. Our in vivo approach is aimed at functional upregulation of gene expression in genetically defined diseases with a preliminary focus on rare and orphan patient populations.
In the medium to long term, we intend to expand to more common genetically determined diseases. Linda Burkly, our CSO, will share more details on our in vivo strategy and progress towards building an in vivo pipeline later on in the call.
Finally, what is happening in business development? In March, we signed a two year extension to the collaboration with Bristol-Myers Squibb to research, develop and commercialize autologous and allogeneic alpha beta T cell medicines for the treatment of cancer and autoimmune diseases. We also have options to extend that collaboration for an additional two years. To date, Bristol-Myers Squibb has opted into 13 different programs across 11 gene targets to date. Two programs are currently in IND enabling studies and four programs are in late stage discovery.
And in intellectual property, yesterday, oral arguments were held before the U.S. Court of Appeals for the Federal Circuit regarding an appeal of the Patent, Trial and Appeal Boards, or PTABs, previous decision favoring Broad Institute of the US Patent Interference involving specific patents for CRISPR-Cas9 Editing in human cells between the University of California, University of Siena and Emmanuelle Charpentier, or CDC, and the Broad. We expect a decision on the case in the second half of 2024. Eric will share more BD and IP details later on in the call.
We are energized by our progress and execution this quarter. With our sharpened strategic focus, our world-class scientists and employees, our keen drive and execution and strong balance sheets, we continue to build momentum to progress our strategy to deliver differentiated editing medicines to patients with serious genetic disease.
Now, I will turn the call over to Baisong, our Chief Medical Officer.
Baisong Mei
Thank you, Gilmore. Good morning, everyone.
Let’s talk about reni-cel, which is on the clinical development for severe sickle cell disease and transfusion-dependent beta thalassemia. As Gilmore shared, we are pleased that we have completed enrollment in the adult cohort of the Phase 1, 2, 3 RUBY trial and the dosing continues. In the adolescent cohort of the RUBY study, we have enrolled multiple patients and several more patients in screening. The interest and demand are high. I’m very pleased about how quickly we have moved in screening and enrollment of the adolescent cohort.
I’d like to thank colleagues and editors and our clinical trial partners for the collaboration and hard work. And more importantly, I would like to thank patients, their families, investigators, and the study side staff for their trust and support.
In the EdiTHAL trial for transfusion-dependent beta thalassemia, we continue to move forward with enrollment and dosing. We look forward to sharing clinical data in the middle of this year and also at the year-end. As I have shared, I visited and continue to visit our RUBY’s EdiTHAL clinical trial site and speak with the investigators. I appreciate the enthusiasm and support from the investigators and study sites. I’m pleased with the momentum of reni-cel in patient recruitment, apheresis and dosing in both studies.
I’m excited to hear from the investigators that patients those who use reni-cel have already seen positive changes in their lives. As we shared in our February earning call, we aligned with FDA that RUBY clinical trial is now considered a Phase 1, 2, 3 trial for BLA filing. We also have alignment with the FDA on the study design, endpoints, and sample size. We look forward to future discussions with the FDA and continue the collaboration.
Turning to clinical data, as Gilmore mentioned, we are on track to present a substantive clinical data set of sickle cell patients with considerable clinical follow-up in the RUBY study in the middle of 2024 and a further update by year-end 2024. What we will show, the RUBY data set will include clinical data from at least 18 sickle cell patients with a 2 to 21 month of follow-up. And the EdiTHAL data set will include clinical data from seven patients with 4 to 12 month follow-up.
We will present efficacy data including total hemoglobin, fetal hemoglobin, and the vessel occlusive event or VOE for sickle cell patients in RUBY study. And the red blood cell transfusion or transfusion-dependent beta thalassemia patients in EdiTHAL study. And safety data including neutrophil and platelet engraftment for both studies.
As a reminder, in December 2023, we shared safety and efficacy data from 11 RUBY patients and six EdiTHAL patients. Once again, the data confirmed the observation from our prior clinical readouts, including reni-cel drove early robust correction of anemia to a normal physiological range of total hemoglobin in sickle cell patients.
Reni-cel drove robust and sustained increase in fetal hemoglobin level in excess of 40%. All RUBY sickle cell patients remained free of vessel occlusive events following Reni-cel treatment. Reni-cel treated sickle cell patients and transfusion dependent beta thalassemia patients have shown successful engraftment, have stopped red blood cell transfusion. And the safety profile of reni-cel observed today is consistent with myeloablative busulfan conditioning and autologous hemopoietic stem cell transplant.
This data reinforce our belief that we have a competitive product and a product potentially differentiated from other treatments with a rapid correction of anemia. Thanks to the deliberate choice of our discovery group have made early in the program.
The choice of CRISPR enzyme and the target to edit for increased fetal hemoglobin expression matters. Reni-cel uses our proprietary AsCas12a enzyme to upregulate HBG12 promoter. Based on the clinical data thus far, we believe that sustained normal levels of total hemoglobin could be a potential point of differentiation for reni-cel.
Now I’ll turn the call over to Linda, our Chief Scientific Officer.
Linda Burkly
Thanks, Baisong. And good morning, everyone. I’m happy to be talking to you this morning to share more details about our in vivo strategy and our progress towards building an in vivo pipeline. I would like to take a moment to remind you why we believe in vivo medicines will be a disruptive transformative development in medical history with the potential to address genetically determined diseases with durable and curative outcomes for patients.
First, in vivo medicines may reduce the administration burden of delivering editing medicines to patients in need, which will provide for broader access to patients all around the world. Second, off the shelf administration may allow for scalable manufacturing and lower costs to produce. Based on these two principles, we believe that in vivo gene editing will provide accessible cures for genetic diseases and therefore may be the most disruptive development in medical history.
So how will Editas position itself? There are many monogenic diseases that can potentially be cured with gene editing approach. We have said that we will at first target the development of treatments that are clearly differentiated from current standard of care and that will leverage the aspects of CRISPR editing that give it a unique advantage over other therapeutic modalities. Our internal development efforts are differentiated by leveraging the indel CRISPR technology we use to upregulate gamma globin expression through direct editing of the HBG12 promoter site in our ex vivo reni-cel program. Our in vivo approach is aimed at functional upregulation of gene expression in genetic diseases in rare and orphaned patient populations from which we intend to expand to more common diseases.
I’m also pleased to share several progress updates as we advance our in vivo capabilities towards our long-term vision of being a leader in in vivo programmable gene editing. First and most importantly, as Gilmore mentioned, we remain on track to establish in vivo pre-clinical proof-of-concept for an undisclosed indication by the end of the year. Editas is well positioned with established capabilities in the four main components of in vivo gene editing medicine.
One, guide RNA, two, editing enzyme, three, messenger RNA, and four, delivery technology. And we are currently evaluating lipid nanoparticles for delivery of gene editing cargo into multiple tissue types with multiple companies. Additionally, we’re evaluating next generation delivery technology.
Second, our in vivo capabilities with the potential to be used in developing transformative in vivo gene editing medicines are demonstrated by the preclinical data we are presenting at the American Society of Gene and Cell Therapy or ASGCT Annual Meeting in three presentations taking place on Thursday and Friday of this week. On Friday, in an oral presentation, we will share in vivo preclinical data from mouse studies using lipid nanoparticle mediated delivery of an optimized guide RNA and engineered ASCAS12a messenger RNA.
In post-presentations on Thursday and Friday, we will share preclinical data demonstrating ASCAS12a guide RNA modifications that enable high potency gene editing in multiple cell types, including in the liver, and improve gene editing outcomes in vivo, enabling the development of in vivo gene editing medicines. And research on identifying potent large serine recombinases, LSRs, as a foundation to develop novel in vivo gene editing technologies for whole gene knock-in, expanding potential in vivo gene editing targets for developing medicine.
Third, Editas CRISPR-based in vivo gene editing capability has been clinically validated. Notably, in 2020, Editas was the first company ever to treat a human with an in vivo delivered CRISPR-based gene editing medicine, EDIT-101. In fact, earlier this week, the New England Journal of Medicine published a manuscript entitled, Gene Editing for CEP290-Associated Retinal Degeneration, detailing our former lead development candidate, EDIT101, for the treatment of Leber’s congenital amaurosis type 10, or LCA10.
Editas established clear in vivo human proof-of-concept in 2022, and we are pleased that the results from this groundbreaking clinical trial were published by the New England Journal of Medicine. These progress updates demonstrate Editas’ execution on our in vivo strategy and our proven in vivo gene editing capabilities. And I look forward to sharing more details about our in vivo development strategy and our progress towards building an in vivo pipeline later this year.
Now, I will turn the call over to Erick, our Chief Financial Officer.
Erick Lucera
Thank you, Linda, and good morning, everyone.
I’m happy to be speaking to you, and I’m excited to provide updates on our business development achievements, intellectual property, and financial results for the first quarter of 2024. First, in regard to business development, as Gilmore mentioned, in March, we announced a two-year extension to the collaboration with Bristol-Myers Squibb to research, develop, and commercialize autologous and allogeneic alpha beta T cell medicines for the treatment of cancer and autoimmune diseases. We also have options to extend the collaboration for an additional two years.
To date, Bristol-Myers Squibb has opted into 13 different programs across 11 gene targets to-date. Two programs are currently in IND enabling studies, and four programs are in late stage discovery. As a reminder, for each new experimental medicine that Bristol-Myers Squibb develops and commercializes using opted-into genome editing tools, Bristol-Myers Squibb will pay Editas Medicine potential future milestone payments.
Following the approval of any products resulting from the collaboration, Editas Medicine is also eligible to receive tiered royalties on net sales. We are pleased that our Bristol-Myers collaboration has proved to be a productive partnership, and we are committed to future collaborations and partnerships that will allow for the continued access and advancement of gene editing.
And in IP, as Gilmore mentioned, yesterday the oral arguments were held before the U.S. Court of Appeals for the Federal Circuit regarding the CBC’s appeal of the PTAB’s decision involving patents for CRISPR-Cas9 editing in human cells. As you know, the Broad Institute has previously prevailed three times against the CBC, twice with the PTAB, and once at the Federal Circuit. The Federal Circuit’s review will determine whether the PTAB correctly applied the law. It is important to remember the Court will not hear new evidence.
An appellate court decision in the Broad’s favor would reaffirm Editas’ position as the exclusive licensor of the patents covering Cas9 use in human medicines in the U.S. It is also important to remember that only a small fraction of the IP we licensed from the Broad are involved in the ongoing USPTO interference proceedings. We expect a decision on the case in the second half of 2024. We remain confident that the Broad will once again prevail.
Our IP portfolio of foundational U.S. and international patents covering Cas9 and Cas12 use in human medicines are a source of meaningful value as we believe that globally there are more than 100 Cas9, Cas12a programs in development worldwide, with the majority of the programs being developed by 10 companies. We believe these potential deals represent a potential material source of non-dilutive capital, as evidenced by our deal in the fourth quarter of 2023 that extended our cash runway by two quarters. We look forward to future discussions.
And now I’d like to refer you to our press release issued earlier today for a summary of our financial results for the first quarter of 2024. I’ll take this opportunity to briefly review a few items for the quarter. Our cash, cash equivalents, and marketable securities as of March 31, $377 million compared to $427 million as of December 31, 2023. We expect our existing cash, cash equivalents, and marketable securities, together with the near-term annual license fees and contingent upfront payment payable under our license agreement with Vertex, to fund our operating expenses and capital expenditures into 2026.
Revenue for the first quarter of 2024 was $1.1 million compared to $9.9 million for the same period in 2023. The decrease relates to the January 2023 one-time sale of the company’s wholly owned oncology assets and related licenses.
R&D expenses this quarter increased by $11 million to $49 million in the first quarter of 2023. This increase relates to additional clinical and manufacturing costs that support the continued progression of the company’s reni-cel program. The increase is also attributable to one-time payments related to sub-license and license obligations. Editas will continue to incur these types of payments, as we and our collaboration partners advance certain license programs in the gene editing space.
G&A expenses for the first quarter of 2024 were $19 million, which decreased from $23 million in the first quarter of 2023. The decrease in expense is primarily attributable, to one-time professional service expenses related to the 2023 strategic initiatives, and business development activities, as well as reduced legal and patent costs.
With our BD and IP activity and a cash runway into 2026, Editas remains in a strong financial position. We have ample resources to continue the advancement of our reni-cel program, support the progression of our in vivo capabilities to develop our pipeline, and leverage our strong IP position for additional business development and licensing opportunities.
With that, I’ll hand the call back to Gilmore.
Gilmore O’Neill
Thank you, Erick.
We are proud of our progress in the first quarter of 2024, and we look forward to continue to accelerate the momentum in 2024. As we continue to evolve from a development stage technology platform company into a commercial stage gene editing company, we look forward to continuing our transformation and sharing our progress with you.
As a reminder of our 2024 strategic objectives, for reni-cel, we will provide a clinical update from the reni-cel RUBY trial for severe sickle cell disease and the EdiTHAL trial for transfusion-dependent β-thalassemia in mid-2024 and year-end 2024. We have now completed the adult cohort enrollment, and have started enrolling patients in the adolescent cohort in RUBY.
We will also continue enrollment in EdiTHAL and dosing in both trials. For our in vivo pipeline, we will establish in vivo preclinical proof-of-concept for an undisclosed indication, and for BD, we will leverage our robust IP portfolio and business development capabilities to drive value and complement core gene editing technology capabilities.
As we share today, we are making significant progress in all three pillars of our strategy this quarter, including reni-cel, in vivo, and business development, including intellectual property. We enter 2024 with great momentum, and I am proud of the Editas team’s significant progress towards becoming a commercial-stage company, and on developing clinically differentiated transformational medicines for people living with serious previously untreatable diseases.
As always, we could not achieve our objectives without the support of our patients, caregivers, investigators, employees, corporate partners, and you. Thanks very much for your interest in Editas.
And we’re happy to answer questions. Thank you.
Question-and-Answer Session
Operator
Thank you. [Operator Instructions] Our first question comes from Samantha Semenkow from Citi. Please proceed.
Samantha Semenkow
Hi. Good morning, and thanks very much for taking my question. I’m wondering about your in vivo pipeline and the proof-of-concept that you’re expecting, by the end of this year. And what would be the bar for success that you’re looking for in this program? Thank you.
Gilmore O’Neill
Thanks very much, Samantha. I’m going to ask Linda to address that.
Linda Burkly
Thank you, Sam. Thank you for the question. We are looking for proof-of-concept for high efficiency delivery and editing for our target of interest in vivo in this preclinical POC. That will give us confidence in our ability, to target the target of interest. We are going to be sharing more information on this at a future date. Thank you for the question.
Operator
Our next question comes from Joon Lee from Truist Securities. Please proceed.
Joon Lee
Hi. Congrats on the progress, and thanks for taking our question. An interesting update on your disclosure, is the plan to identify large serine recombinases, which implies sort of a newer approach to many of your – that many of your peers are also developing, you know, some call it gene mating, some call it pasting. Does the size of the recombinase-mediated insertion allow for, you know, inserting a coding sequence for dystrophin, for example? And are you able to comment on whether DMD is out of the question regarding your in vivo aspirations? Thank you.
Gilmore O’Neill
Thanks very much, Joon. I’m going to have Linda take that.
Linda Burkly
Yes. Thank you for commenting. We’re excited about the LSR technology that we’re disclosing here. We are identifying many different novel LSRs. We’re not disclosing at the moment the size of the integrations that can be accommodated by these large serum recombinases, but we have quite a few novel LSRs that we’ve identified and we’re further characterizing them. Thank you for the question.
Operator
Our next question comes from Mary Kate Davis from Bank of America. Please proceed.
Mary Kate Davis
Good morning. Thanks for taking my question. Looking at the reni-cel program here, how are you guys looking at the mid-year reni-cel update, compared to the year-end update here? As follow-up time progresses, what should we look for from treated patients in terms of safety and efficacy moving forward? Thank you.
Gilmore O’Neill
Thanks, Mary Kate. Baisong is going to take that one.
Baisong Mei
Yes. Thanks, Mary. In this middle-year release, we expect to have at least 18 patient data for RUBY study. Within the 18 patients, and four of them will have 12 or longer, 12 to 21 months of exposure, and seven will have five months to 12 months exposure, and another seven with two to five months exposure.
With that, we feel this data is very meaningful to see the direction, not only the increase of total hemoglobin normalization of total hemoglobin and increase of fetal hemoglobin, but also the durability of the study and the impact from efficacy perspective, for example, the free of vessel occlusive events.
For the EdiTHAL study, we will have patients from at least seven of those patients with four to 12 months of exposure, which also will be very meaningful. That is compared to the December release. We’ll have 11 RUBY patients and six EdiTHAL patients. That substantial more data will help us to understand RUBY much better. Thank you.
Operator
Our next question comes from Jack Allen from Baird. Please proceed.
Jack Allen
Hi. Congratulations to the team on the progress, and thanks for taking the question. I’m going to stick with the reni-cel program. I was hoping you could provide some color on dosing of the pivotal cohort. I know you’ve commented on the adult cohort being fully enrolled, but have all of those patients received therapy? Any other comments you can provide, as it relates to the size of the cohort that you’ve agreed to, with regulators would be very helpful? Thanks so much.
Gilmore O’Neill
Thanks very much, Jack. I’ll answer the first part and then pass it to Baisong to provide maybe give it a little more color to regulatory interactions. We have obviously completed the adult enrollment, which we’re actually very excited about, not least because that is in the context of two approved therapies.
So it really is a very concrete reflection of the enthusiasm that Baisong has found and described, indeed, increasing enthusiasm about our program with his visits to sites and conversations with investigators, healthcare providers, and indeed with patient efficacy groups. We have scheduled many of those patients already for dosing, and we’ll give you further updates on the progress of dosing at a later date.
And with regard to the regulatory color, I think, Baisong, you might want to maybe just share a little more of that.
Baisong Mei
Yes. For regulatory, as we shared, we have alignment with FDA that the RUBY study is a Phase 1, 2, 3 study for BLA filing. And we also have alignment on the sample size, duration, and study design of that. So we continue to have a collaboration with FDA, on the further discussion about this program.
Jack Allen
Great. Thank you.
Operator
Our next question comes from Gena Wang from Barclays. Please proceed.
Gena Wang
Thank you. If I may, very quick two questions. First, should we read into your ASGCT presentation for in vivo indication, such as glaucoma? And second, I know you mentioned also a little bit, but when we look at the current approved genomic therapy for sickle cell, we still have a 10% patient relapse with VOE events. What do you think is the key factors that we should look into for the potential differential durability with hopefully 100% control rate?
Gilmore O’Neill
Thanks very much, Gena. I’m going to ask Linda to handle the first part of your question around the ASGCT and then Baisong can talk about durability, what we’re seeing today?
Linda Burkly
Yes, thank you very much, Gena. Primary open-angle glaucoma is obviously an area of very high inmate need, and while we conducted those studies, because of that, we are not currently pursuing that indication, but we were able through those studies to really demonstrate impressive preclinical POC and showcase our in vivo capabilities with respect to three components.
Our ability to deliver lipid nanoparticles in vivo, with our gene editing cargo, our proven capability of our proprietary enzyme, AsCas12a, to edit in vivo and our guide modifications, to enhance a gene editing potency. So these capabilities really position us well for delivering in vivo gene editing medicines, and we’re really pleased with the ASGCT disclosures. Thank you.
Baisong Mei
Yes, I can now take up on the question about the VOE relapse for sickle cell patients. First, I would like to say, I want to congratulate the entire field for the effort in treating sickle cell disease, including the recent approval of the two molecules. And so, I think what we see is that with the continued effort of all of us, we will continue to improve and transform the treatment for sickle cell disease patients. Within reni-cel, and we are still continuing to collect the clinical data, as I mentioned, we expect that this is, not only a competitive, but differentiated molecule. And with the normalization of the total hemoglobin correction of anemia. So, we’re looking forward to see our own data on the VOE. As we reported so far, we have seen all those patients, those with reni-cel, is free of VOE event.
Gena Wang
Thank you.
Operator
Our next question comes from Mani Foroohar from Leerink Partners. Please proceed.
Unidentified Analyst
Hi, good morning. This is [CJ] for Mani. Thanks for taking our question. I was just following the agreement with Vertex last year. Just how are you thinking about future IP monetization opportunities?
Gilmore O’Neill
Thanks very much. I’m going to ask Erick to address that question.
Erick Lucera
Yes, thanks for the question. Obviously, as we said in the transcript, we view the future potential royalty monetization and licensing activities as an integral, and very important source of non-dilutive capital. As you know, these are foundational IP patents which are applied to just about everybody’s projects in Cas9, Cas12. And we expect to have conversations with those folks as soon as we can.
Unidentified Analyst
Thank you.
Operator
Our next question comes from Brian Cheng from JPMorgan. Please proceed.
Brian Cheng
Hi, guys. Thanks for taking our question this morning. Can you just remind us, what’s your latest thinking around the timing of holding a discussion with regulators on sickle cell? And just given the data that you’re going to present mid-year, any updates and color on the timing of holding a productive conversation with regulators would be appreciated? Thank you.
Gilmore O’Neill
Thanks very much, Brian. I’m going to ask Baisong to talk about that sort of – I think your two questions, really which is about what the data are in the middle of year and how they integrate with our discussions with regulators?
Baisong Mei
Yes. So, Brian, as I mentioned, we are very pleased with the data we’re going to release in the middle of the year, and which is substantive, and also give us good direction how much we will get and to have, for example, a data set to have equivalent to the CASGEVY BLA filing, for example. So, that’s kind of one part of that. We’re very happy to see the amount of data and the patient outcome from the data.
And then the other thing, is about the regulatory engagement. As I mentioned, we already have a line of this Phase 3 study to support the BLA, and we have continued engagement with FDA. We have not disclosed all those details of the interaction yet, but as a reminder, we have RMAT designation, and which allows us to have frequent interaction with agency.
But also with the high-level interaction with agency. And this, of course, give us opportunity for potential priority review enrolling submission. So, we’re very excited to the direction. We’ll continue to have engagement and collaboration with FDA.
Brian Cheng
Thank you, Baisong.
Operator
Our next question comes from Eric Schmidt from Cantor Fitzgerald. Please proceed.
Eric Schmidt
Thanks for the question and congrats on the progress. Are you able to give the approximate number of patients, who are enrolled in the RUBY trial with sickle cell disease? And then it sounds like you’ve been able to make pretty good progress in enrollment in that study, despite the availability of commercial cell therapies. I was just wondering at centers that have both experimental and commercial cell therapy available, maybe Baisong could talk a little bit about what’s driving the decision to use the Editas product over others? Thanks.
Gilmore O’Neill
Thanks very much, Eric. Baisong would kind of date you on where our clinical trials.gov sets as a target for the cohort in our trial. And then obviously build on his perceptions of why we’re doing so well with enrollment even in the context of commercial therapies being available.
Baisong Mei
Yes. Yes, thanks Eric. We are very pleased with the momentum by the enrollment in both the EdiTHAL cohort and the adolescent cohort. And for the EdiTHAL cohort, we shared that in February with those we enrolled 40 patients. Now we enroll slightly more than 40 patients and therefore we closed the EdiTHAL cohort enrollment. And for adolescent cohort, we started like the beginning of this year.
We already enrolled a multiple patients, and have multiple patient experience. We’re very pleased with that. Then as I mentioned, I’m on the road all the time to visit our investigators and the study sites. And then, they really feel that when is actually there our belief the reni-cel based on the MOA based on the data we have continued to sharing on that.
I also give credit the entire field in working on that with the two gene therapy approved for sickle cell, is also increased the interest in the direction of the gene therapy for sickle cell disease. So that’s how we see over the last year or so we see really great momentum that for reni-cel enrollment, especially after we release our data.
Operator
Our next question comes from Jay Olson from Oppenheimer & Company. Please proceed.
Jay Olson
Oh hi, congrats on all the progress and thank you for taking the question. Can you talk about the timing of the collaboration extension with Bristol? Was there some new data that triggered the new collaboration and is there any color on what new data Bristol may have seen? And then separately, can you talk about any work that you’ve done on developing a milder conditioning agent? Thank you.
Gilmore O’Neill
Well, what I would do is ask Erick to address the question about the BMS. What I do want to say, I can address the conditioning, which is that just at our last earnings, we talked that we are going to continue monitoring the space. We have significant contacts in the academic and non-academic worlds around the field. But we have actually really deployed our efforts, and our resources internally to focusing on our in vivo pipeline, including developing hematopoietic stem cells.
The rationale for that being that, we see that where a milder conditioning therapy is actually approved, it would be used universally and adopted universally in transplant centers across multiple indications, including stem cell transplantation with hemoglobinopathies. And with that, I’m just going to pass to Erick, just to talk about the BMS deal.
Erick Lucera
Yes, thanks for the question. With respect to the timing of the renegotiation – or the extension, obviously, we put out a press release in the very recent past, a week or two ago, something like that. And that would give you an update on the timing. I’d say with respect to the data, Bristol-Myers, as you know, recently completed a portfolio review. And we were pleased to see that all of the projects that were working on them, are continuing to move forward.
I think if – we would leave discussion of specific programs to them to talk about anything that they’re seeing in those programs, I would highlight the fact that at their most recent R&D day last September, which I think was the first one they’ve done in several years, they did mention six products on their pipeline chart, which were using our technology.
So I would refer you to their R&D disclosures from that meeting, to get an update on the work that they’re doing with us. But we are very excited about working with them. This has been a partnership that has survived several mergers and several portfolio reviews. So, we’re very excited about what we’re seeing.
Jay Olson
Thank you.
Operator
Our next question comes from Phil Nadeau from TD Cowen. Please proceed.
Unidentified Analyst
Hi, this is [Alex] on for Phil. Thanks for taking my question. So given the association between total hemoglobin levels and organ function, do you plan to utilize any quantitative endpoints, basically assessing end organ function in the RUBY trial? And if so, what might those look like? And when can we maybe expect initial data? Thanks.
Gilmore O’Neill
Thanks very much, Alex. I’m going to ask Baisong to address that question.
Baisong Mei
Yes, thanks, Alex. We certainly have measurements for the end organ function. We look into the several major organ system, to monitor the function improvement. For example, we monitor the liver function, not only with these different lab values, we look into pulmonary function to check the respiratory system. And we also have cardio echo and other measures talking to – measure the cardiovascular system and that too.
So, we are looking forward to seeing more data on that and give us more understanding of the end organ function, may behave after the treatment. Just a reminder that we also, of course, look into the not only sickle cell, but also other area in terms of the anemia, how that impact function and how that correction of anemia may be able to improve that function after the treatment.
And in sickle cell specifically, over the last couple of years, you already see more publications about end organ function given after the allogenic transplant, to treat sickle cell patients. We are very excited on that. But just to be very honest to ourselves, right, this field is still fairly new and we see some really good publication and direction in this. And we’re looking forward to our own study, as well as the literature on this field.
Unidentified Analyst
Good. Thank you.
Operator
Our next question comes from Yanan Zhu from Wells Fargo. Please proceed.
Yanan Zhu
Thanks for taking our questions. So first on the differentiation of total hemoglobin normalization, I was wondering, have you had feedback from sickle cell treaters on that differentiation and whether there’s any hesitancy or pushback that perhaps the current level of hemoglobin achieved by the marketed product is sufficient? How much of that kind of thinking is out there? And on the in vivo side, I was wondering, are you focused on first in class targets, or perhaps not first in class targets, but hoping to have a differentiation on, specificity and transduction efficiency, et cetera? Thanks.
Gilmore O’Neill
Thanks very much, Yanan. So I’m going to ask Baisong to talk about the differentiation of total hemoglobin. And then I’ll ask Linda just to talk about our approach to first in class, or clear differentiation and where we would see that with our approach to function upregulation?
Baisong Mei
Thanks, Yanan. I mean, certainly we talk about the investigators as well as the KOLs and sickle cell treaters for our differentiation. And how we may be able to see and what is the position of this molecule. And when we’re talking to those hematologists and sickle cell treaters that see our data, and when hematologists mentioned that it is no brainer, it is better if you have a 16-gram per deciliter versus 10-gram per deciliter of total hemoglobin.
And then they also, I mentioned that they introduced as of our study, and there are quite a few knowledgeable hematologists. They see the difference among several molecules. And one investigator said that he was waiting for our trial and did not participate other. So those are the anecdotal examples on that. As I mentioned earlier, we certainly want to look forward to see the clinical data.
Gilmore O’Neill
It’s also worth highlighting, of course, that the FDA has recognized that a 1-gram per deciliter difference is meaningful, or certainly likely to predict a clinically meaningful benefit and that they use that threshold to give an extended approval to Oxbryta in the past.
Baisong Mei
Yes. Talking about that, this is also, when we communicate with FDA, this is also a point we have been discussing with FDA too.
Gilmore O’Neill
So thanks very much, Baisong, Linda, just regarding in vivo and where our focus is.
Linda Burkly
Yes. In vivo, our in vivo approach is aimed at functional up-regulation of gene expression in genetically determined diseases. And this strategy positions us very well to be differentiated from others in terms of our targets and our target editing strategies. And what this means, is that we can go after targets that others can’t go after. And so from an indication perspective, we can go after indications that perhaps others can’t go after. And so we could have a first in class strategy. Also, within a given indication, we could devise a targeting strategy that would be best-in-class, if you will. So we can have first in class strategies as well as best-in-class opportunities. I hope that answers your question.
Yanan Zhu
Yes. Thank you. Very helpful. Thanks for all the answers.
Operator
Our next question comes from Luca Issi from RBC Capital. Please proceed.
Luca Issi
Oh, great. Thanks so much for taking my question and congrats on all the progress. Maybe just a quick one on reni-cel and the filing strategy. What’s the vision here for the BLA? Are you planning to file adults and adolescents concurrently or sequentially? Any color there, much appreciated. And then maybe quickly on the Middle East. Can you just talk about the opportunity for sickle cell disease in the Middle East? Vertex seems really, really excited about that market. So wondering what’s your strategy there to potentially tap that market? Are you still focused on partnership? Can you potentially access that via distributor? Again, any thoughts there, much appreciated. Thanks so much.
Gilmore O’Neill
Happy to do. Thanks very much, Luca. So I’ll ask Baisong just to talk about our regulatory strategy as far as we have shared it. And then Caren can talk about just how we’re looking at and thinking about the Middle East. And frankly, in the context of the rest of the world.
Baisong Mei
Yes, yes. Thanks, Luca. We are very pleased with the interaction with the agency and continued interaction with the agency about the reni-cel and for the RUBY study as a Phase 3 study to support the BLA, and all the front of the Phase 3 study, we have alignment on that. And we have continued conversation with FDA on this route.
We have not shared the specifics about the date of the BLA, or the indication of adult alone or adolescent. But as we shared, we are very pleased with the enrollment for both adult cohort as well as adolescent cohort. So that gives us a great position for this molecule. Thank you.
Caren Deardorf
Great, Luca. Thanks for the question about Middle East and certainly just the populations outside the United States. And there’s absolutely a number of geographies where there is a significant population of sickle cell patients, and really high unmet need beta cell ischemia as well.
What I’d say is our continued drive to execute in the U.S., and to move reni-cel forward with differentiation, just continues to support the opportunity for us to partner at the appropriate time. And that’s certainly something that we’ve said we are open to and will certainly provide more color in the future as appropriate.
Luca Issi
Thanks so much.
Operator
Our next question comes from Steve Seedhouse from Raymond James. Please proceed.
Unidentified Analyst
Hi, thank you. This is [Nick] on for Steve. We actually had a longer term question. To what extent can you leverage the infrastructure that Vertex is already building out for CASGEVY will EdiTHAL won’t be able to plug into the existing authorized treatment centers once launched? Thank you.
Gilmore O’Neill
Thanks very much. And Nick. I’m going to ask Caren to address that.
Caren Deardorf
Yes, thank you, Nick, for the question. First, we’d say – I’d say that I’m really pleased to see some of the initial progress for the other therapies and being able to get patients started. We always anticipated that it would be a dipping, many centers starting to dip their toe. As they build the infrastructure and they gain the confidence. So to answer your question, absolutely.
We’ve always said that in this kind of market of the complexity, of the ex vivo, being a fast follower is absolutely an advantage. We also, on our own, have a really strong base of over 20 clinical sites in the U.S. with very strong enrollment and relationships that we’re leveraging. And those relationships and the guidance they’re giving us will be really pivotal for us as well.
But this is a field that will benefit, from the increase in education with patients, which Baisong mentioned, also helps with our enrollment and just building the infrastructure. But we are engaged on the KOL, the patient advocacy, as well as on the payer front to ensure that we’re prepared. So thanks for the question.
Unidentified Analyst
Thank you. Our next question comes from Jack Allen from Baird. Please proceed.
Jack Allen
Great. Thanks so much for taking the quick follow-up here. I just wanted to touch on reni-cel one more time, and ask when we might hear a little bit more about the differentiation, as it relates to the treatment process. Have you provided any color on the number of apheresis cycles, and how editing efficiency of the Cas12a enzyme may allow you to be more efficient in manufacturing the process?
Gilmore O’Neill
Thanks very much, Jack. So I’m going to ask Baisong to talk about that.
Baisong Mei
Yes. Thank you. We have not shared specifics about the number of cycle and the apheresis. What I mentioned before was since I joined, we actually work together with our internal as well as a apheresis external – apheresis expert. We actually have protocol amendment, to improve the apheresis cycle and also provide assistance to study site for the apheresis cycle, which is significant, because it’s reduced the patient burden.
It’s a smoother manufacturing process. We’re very pleased to see the progress in that front. And just to add on that, we are hoping this clinical experience will be very much helpful for commercial endeavor.
Operator
Our next question comes from Mani Foroohar from Leerink Partners. Please proceed.
Mani Foroohar
Hi. Thank you for taking our follow-up question. Kind of similar to the last question, you previously talked about optimizing the vein-to-vein process. Would you be able to walk us through how reni-cel could provide advantages from either both operational or logistics perspective? Thank you.
Gilmore O’Neill
So Baisong I’m going to ask, I’ll ask Baisong to address that.
Baisong Mei
Yes. Happy to. We are over this process, really working together that with the study sites to optimize this process. And that coming from multiple factors. One of the factors just mentioned is bio- apheresis. The other factor is the logistics. And we provide support on that. The third factor is actually patient condition. As we know that we are treating the severe sickle cell disease. And before the reni-cel treatment, they can have multiple VOE per year. And that also can impact the vein-to-vein time.
Caren Deardorf
Mani, this is Caren. I would just add that, again, in the fast follower position, one of the things that it gives us the opportunity to do is to really understand as the first two therapies are commercialized, what’s working, what’s not working, what they need to see differently, and really making sure that Editas sets ourselves up as the partner of choice. And so, we’re working very hard on that. And we’ll certainly talk about that at a later time.
Mani Foroohar
Great. Thanks so much for taking questions.
Operator
Ladies and gentlemen, this concludes today’s call. Thank you once again for your participation. You may now disconnect.
