Trillium Therapeutics Inc (TRIL)

[NY1972]

Analysis by Biomaven:

As Yogi Berra said, it's hard to make predictions, especially about the future. But here are some possible drivers and miscellaneous thoughts:

1. A partnership with a PD1-owning pharma: In theory, cd47/PD1 looks to me to be a good combo, although no actual published preclinical data I am aware of. I'm sure such preclinical data exists by now, and the lack of any noise is notable - either very good news on the combo or bad. A decent partnership would certainly drive the stock nicely and could be a near-term event. But why no partnership yet? I'm sure TRIL could have come up with some partnership by now if they had wanted, so perhaps this hints they are confident and are waiting for more data and better terms.

2. We know CD47 is expressed on pretty much every tumor, so if there is safety and even modest efficacy to be had in monotherapy, the potential is simply enormous. This stock could be 50x or even 100x.

3. But no hints of efficacy yet from their competitors and too early to tell from the company itself.

4. On safety, there was the recent change in their slides, now talking about "no anemia." Hard to know how much to read into that change, although clearly if they had seen significant anemia to date they would not have made the change.

5. Seems likely to me they will have a dosing and safety advantage over the CD47 mabs. But will they lose efficacy compared to them? Or will they gain in efficacy because of their likely safety and dosing advantage? Is not hitting thrombospondin good or bad?

6. The recent PNAS paper suggests that AEs could be quite dependent on whether inflammation is present. Inflammation plus CD47 blockade might well lead to possibly severe autoimmune reactions.

7. Opening up the new trial does at least suggest no severe safety signals to date. But why intratumoral?

So bottom line for me is that this is a stock with considerable upside, but currently zero evidence of any actual human efficacy using CD47 as a target. Doesn't seem like there is huge near-term downside risk though, while a potential near-term upside from a partner is plausible. So a reasonable posture I think is to take say a 50% or even larger position now, but with the expectation of taking profits on any near-term upside move to keep it at around that level.

Comments and contrary opinions welcome.

Peter