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Dicerna Pharmaceuticals, inc (NASDAQ:DRNA)
Q2 2021 Earnings Call
Aug 9, 2021, 8:00 a.m. ET

Contents:

  • Prepared Remarks
  • Questions and Answers
  • Call Participants

Prepared Remarks:

Operator

Good morning, ladies and gentlemen, and welcome to the Dicerna Pharmaceuticals' Second Quarter 2021 Earnings Conference Call. [Operator Instructions]. I will now turn the call over to your host, Tierney Sovic of Stern IR. Please go ahead.

Tierney Sovic -- Senior Analyst-Biotech Investor Relations

Thank you, Operator. Good morning everyone, and thank you for joining us to review Dicerna's second quarter 2021 financial results and operational highlights.

For anyone who hasn't yet had a chance to review our results, we issued a press release earlier this morning, which is available under the investors and media tab on our website at dicerna.com. You may also listen to this conference call via webcast on our website, which will be archived beginning approximately two hours after this call is completed.

Speaking on today's call will be Dicerna's President and Chief Executive Officer, Doug Fambrough, who will review our program portfolio and strategy; and our Chief Financial Officer, Doug Pagan, who will review our second quarter financials. We also have Sheeram Aradhye, our Chief Medical Officer, Jim Weissman, Chief Operating Officer; Rob Ciappenelli, our Chief Commercial Officer; and Bob Brown, our Chief Scientific Officer, available today to address questions during the Q&A session.

Following our remarks, we will open the line for your questions. I'd like to remind listeners that management may make forward-looking statements on today's call pertaining to the Company's finances, business and operations, including the discovery, development and commercialization of our product candidates and technology platform and the therapeutic potential thereof, the success of our collaborations and any potential future collaborations.

Such forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially from those expressed or implied in such statements. Applicable risks and uncertainties include those relating to our preclinical research, and clinical progress and other risks identified under the heading Risk Factors included in our most recent Form 10-Q and Form 10-K. While we may elect to update these forward-looking statements at some point in the future, we specifically disclaim any obligation to do so if our views change.

Now I'd like to turn the call over to Doug Fambrough, Dicerna's President and CEO. Doug?

Douglas M. Fambrough -- President and Chief Executive Officer

Thanks, Tierney. Good morning, everyone. Since we just did our PHYOX 2 data call on Thursday, I'd like to start today at a high strategic level before discussing particular programs. RNAi is a powerful modality. The 24-year since its academic discovery encompass the long period of technology maturation leading to the breakthrough of GalNAc-mediated delivery of highly modified RNAi duplexes which has led to multiple approved products with more product candidates at NDA stage.

Last Thursday afternoon, Dicerna added our first to this list as our lead product candidate, Nedosiran demonstrated a strong safety profile and impressive activity profile in the primary hyperoxaluria type one or PH1 population. These data, we believe sets up a high likelihood of PH1 approval in the US, Europe, Japan and other markets, and we intend to submit an NDA to the FDA in Q4.

The PHYOX 2 pivotal data directly demonstrate the strength of our GalXC RNAi technology platform. I know everyone on the line today is highly sophisticated, and can recognize that relative to other approved biotech modalities such as monoclonal antibodies and AAV gene therapy, the ability to practice RNAi at a cutting-edge, critical mass level is remarkably concentrated in a small number of companies, and we're proud to be one of them.

It was less than four years ago that Dicerna was a micro-cap company trading at a little over $3 per share, no collaborations, no GalXC clinical data, and less than $100 million on the balance sheet. Today, we end Q2 with almost $710 million, the large majority coming from technology monetization with six collaboration, six different companies engaged in moving Dicerna GalXC molecules forward, six clinical stage programs including Nedosiran, nine more that have entered preclinical development, and our platform now extends RNAi delivery to tissues beyond the liver opening a deep well of opportunities to exploit for years to come. That's a pretty good four years.

What really excites me though is what we can accomplish over the next four years. In that time, we expect Nedosiran to be approved and available for patients in major markets around the globe. We expect to move Belcesiran for alpha 1-antitrypsin deficiency associated liver disease or AATLD where we hold 100% of U.S. rights and which is now early in Phase II. We expect to move this deep into pivotal development. We anticipate the RG6346 program for chronic HBV which is in a Phase 2 combination trial being conducted by Roche will have further progressed in clinical development and completed its five Phase 2 cohorts and with success will have opted into co-fund pivotal development bringing a U.S. co-promotion option.

We expect our DCR-AUD program for alcohol use disorder to achieve human proof of concept that have moved to advanced trials, potentially breaking open a vast under-served market. We expect multiple programs from our Novo collaboration to have entered development, and we expect to have opted in to two of those, but only after having seen positive human clinical evidence, which is to say, we get to choose the likely winners after seeing some clinical data. We expect current development programs from Lilly, AZ/Alexion and Boehringer Ingelheim to be moving through the clinic.

We expect new programs to be entering the clinic on average, one per quarter over the next two years and potentially beyond that at a similar rate. Amongst those, we expect to have taken multiple new GalXC and/or GalXC-Plus proprietary programs well into clinical development. Indeed, we initiated early development of two GalXC-Plus, non-liver wholly owned programs which will debut when they are closer to clinical entry.

It will be quite a ride over these next four years and we have the capital to execute on this, because our current cash runway with expected revenue from existing collaborations runs into 2025. That's longer than we've previously disclosed. I'll return to that in a moment in the context of Nedosiran and PHYOX 2 pivotal trial results. But first, let's come down from the high level to the actual corporate updates for the second quarter as well as subsequent events.

Starting with Belcesiran, that we are developing for the treatment of AATLD. Last month, we announced interim results from our Phase 1 study, which met our objective, demonstrating strong dose-dependent reductions in serum alpha-one antitrypsin in healthy volunteers with administration of a single dose of Belcesiran. In this analysis of the four completed active treatment dose cohorts at 0.1, 1.0, 3.0 and 6.0 milligrams per kilogram Belcesiran was found to have an acceptable safety profile and was generally well tolerated.

One more dose cohort, 12 milligrams per kilogram is ongoing. And our objective is to present the results from all dose cohorts at an upcoming medical conference. We also began patient dosing in our randomized, multi-dose, double blind placebo-controlled Phase 2 ESTRELLA trial of Belcesiran in June. The ESTRELLA Phase 2 study includes a 24-week cohort and a 48-week cohort to be conducted in parallel, each with up to 27 participants who have a diagnosis of PiZZ type AAT deficiency and AATLD. As this study progresses, we are looking forward to having a better understanding of Belcesiran's potential to treat the underlying cause of AATLD.

Also last month, we announced the FDA acceptance of our IND for DCR-AUD, our investigational GalXC RNAi therapeutic candidate for the treatment of Alcohol Use Disorder. We had filed that IND in late June, and we are now clear to begin Phase 1. We plan to initiate a 24-week randomized, double-blind, placebo-controlled Phase 1 trial this quarter to evaluate the safety and tolerability, pharmacokinetics and pharmacodynamics of single-ascending doses of DCR-AUD in healthy volunteers. The trial will also assess the interaction between DCR-AUD treatment and alcohol consumption using standardized Ethanol Interaction Assessments, which will provide critical pharmacodynamic data to inform the development strategy for that high potential program.

From a collaboration standpoint, we announced in May, the FDA's acceptance of Eli Lilly's IND for LY3819496 targeting LPA for cardiovascular disorders or Lp[a] sometimes referred to. This is the second clinical stage investigational GalXC RNAi candidate from our collaboration with them. It triggered a $10 million milestone payment to us and paved the way for Lilly to begin Phase 1 dosing of the compound, which began in June.

There are also two Lilly partnered programs and IND enabling studies in addition to the two clinical stage programs. Also in May, Boehringer Ingelheim accepted DCR-LIV2, an investigational GalXC RNAi candidate for the treatment of NASH to advance to the development stage. This candidate's acceptance triggered a single digit multimillion dollar preclinical milestone to Dicerna and preclinical work is underway.

And earlier this year, we added to the development pipeline a second candidate under the Novo collaboration. Finally, we have two programs in our AZ/Alexion collaboration that are progressing through IND enabling studies. Now let's turn attention back to Nedosiran. As you all know, we presented topline data from our PHYOX 2 pivotal clinical trial last week and Nedosiran successfully and decisively hit both the primary and key secondary endpoints while showing a strong safety profile.

The results were driven by strong oxalate reduction activity in patients with PH1, while patients with PH2 showed inconsistent results. Consequently, we see a path to approval in the U.S. and elsewhere for the PH1 indication, but not the PH2 indication. In PH1, we believe that Nedosiran is highly competitive with the currently approved product for PH1. We are reiterating our guidance of a Q4 NDA submission for Nedosiran and will continue our development program, including the PHYOX 7 and PHYOX 8 clinical trials for patients with PH, who have compromised renal function or our pediatric respectively with the goal of subsequent supplemental NDA submissions to add those populations to the Nedosiran label.

With respect to PH2, we are reviewing all of our data, preclinical and clinical and confirming with experts in the PH field to understand this result. We will continue to monitor the patients with PH2 from the PHYOX 2 trial, who have all rolled over into our PHYOX 3 open label extension study. Extended observations may or may not provide additional insight. In any event, we do not see a near-term path to including PH2 and a proposed new Nedosiran drug label.

In the meantime, we look forward to reading out our PHYOX 4 single dose study in patients with PH type 3. Upon review of that data, we will decide how to proceed in PH3. Up to now, we have articulated the strategy of fully integrating our Company using Nedosiran as the vector and rationale for building out a commercial function in the United States. That strategy was based on achieving a label with at least PH1 and PH2. With both of those indications and data in PH1 comparable to what was achieved in PHYOX 2, we were projecting the ability to ramp sales to where our commercialization efforts would be cash flow positive in a reasonably short period of time.

Without PH2 on the label, however, ramping our commercial efforts to cash flow positive is more uncertain, with substantially more capital investment required along the way. I do not believe that is the right choice for Dicerna and Dicerna shareholders. Consequently, we have decided to seek a commercial collaboration partner or partners to make Nedosiran available across all major markets including the U.S. subject to approvals.

Accordingly, we plan to forego investment in commercial infrastructure at this time. This approach will reduce our planned spend and is the basis for extending our runway guidance from the prior into 2024 to into 2025. Importantly, this does not signal any reduction in investment in our pipeline. On the contrary, we may choose to increase investment in our pipeline as we fully process the PHYOX 2 data and refine our plans.

Normally at this point, I'd be turning over the call to Shreeram Aradhye, our Chief Medical Officer for additional color on our programs. However, having just had our PHYOX 2 topline data call last Thursday and recently having spoken to many of you about our Belcesiran Phase 1 data, we are instead going to proceed to the financial discussion. Shree is here with me and is available for questions after the prepared remarks.

So, I will now turn the call over to Doug Pagan, our Chief Financial Officer, Doug?

Douglas Pagan -- Chief Financial Officer

Thank you, Doug. I'd like to briefly walk through the key financial results for the second quarter 2021 and direct you to our press release outlining these results into our quarterly report on Form 10-Q which was filed with the SEC this morning. Net loss for the second quarter 2021 was $40.8 million or $0.53 per share compared to $31.8 million or $0.43 per share for the same period last year.

Revenue for the second quarter totaled $41.3 million compared to $40.4 million in the same period last year. As of June 30, 2021, we had approximately $160.2 million of current deferred revenue, and approximately $268.6 million of non-current deferred revenue. Additionally, we have recorded deferred income related to our sale of royalty rights to Royalty Pharma, $1.1 million of which is current and $178.7 million, non-current.

R&D expenses for the second quarter totaled $56.1 million compared to $53.4 million for the same period last year. The year-over-year change was primarily driven by increases in facilities and employee-related expenses resulting from the higher R&D head count necessary to support our expanding pipeline and collaboration agreements. These increases were largely offset by a decrease in external direct R&D expenses.

G&A expenses for the second quarter of 2021 totaled $25.5 million compared to $20.6 million for the same period last year. The year-over-year change was driven primarily by increased professional services. We expect G&A expenses to remain comparable with the current period as we cease our plans to build in-house commercial operations for Nedosiran. Year-to-date we have received $74.5 million in milestone fee and reimbursement payments from our collaboration partners, primarily Novo and Roche and continue to guide to receiving $83 million for the full year 2021. These payments represent an important source of proceeds and demonstrate the value we expect these collaboration programs to continue to generate as they mature.

As of June 30, 2021, we had $709.6 million in cash, cash equivalents and held to maturity investments compared to $544.9 million as of March 31st, 2021. This cash balance with our revised operating plans and projected proceeds from existing collaborations should provide us runway into 2025. As Doug mentioned, we will be seeking one or more partners for global commercialization of Nedosiran. Economics from any potential arrangements have not been factored into our stated runway projections. Our strong balance sheet will allow Dicerna to continue to invest in advancing our clinical pipeline, supporting our collaboration partners and expansion of our platform technologies.

That concludes my review of the financials. I would now like to open the call for questions. Operator?

Questions and Answers:

Operator

[Operator Instructions]. Your first question comes from Jonathan Miller with Evercore ISI. Your line is open.

Jonathan Miller -- Evercore ISI -- Analyst

Thanks so much, guys. I guess I will start by asking what sort of a commercialization partner or partners you're looking for, for PH1? Is this more of a major pharma co-promoter, co-commercialization sort of a deal, or are you looking for contract sales? Can you give us a little bit more color about what you're looking for on that global commercialization?

And then secondly, also on PH, I guess, now that you've had the weekend to think it over, do you have any hypothesis on PH2 failure at this point? And obviously, you're still following those patients, but do you have any clarity for us on when we might expect to hear an update from you on what happened biologically there?

And then thirdly, I know you mentioned you're waiting for PHYOX4 to make a final call on this, but assuming PHYOX4 and PH3 look good, would your plan, at this point be to include PH3 in the same NDA as PH1, or would that be a separate submission?

Rob Ciappenelli -- Chief Commercial Officer

Hey, Jonathan, it's Rob Ciappenelli, I appreciate the questions. I'll tackle the first one. Related to partnerships for Nedosiran, I think the best way to look at it is, we're looking at this as an out-licensing opportunity, not as a contract sales strategy.

So we will be looking at, and have continued to speak with both global biopharmaceutical companies, as well as significant regional players, all that have great acumen in the rare disease space. We'll continue those conversations and provide our updates as soon as we get into the conclusion of those discussions.

Douglas M. Fambrough -- President and Chief Executive Officer

Thanks, Rob. So, John, you asked for a clarity on PH2. The PH2 result was kind of a shock to the whole PH field. Certainly I have interacted with some KOLs, and there was a, I think, a fairly broad expectation that there would be activity in PH2 and there isn't at the current time, a leading hypothesis for why we didn't see consistent results with a monthly dosing regimen of Nedosiran, particularly after the apparent signal from a single-dose in patients.

That means it's really not possible for me to give guidance on when some clarity may be provided, but I don't see a path in the near-term for there to be any clarity. And this is going to take some time to understand, and I think it's going to trigger some biochemical level work in academia, we're not going to be doing that here.

With respect to PH3, I think the base operating assumption should be our NDA will be for PH1 only. We will see what the results are from a single dose of PH3 and assess them. But I think anyone planning or projecting should assume the NDA filing is just PH1. Thanks Jon.

Jonathan Miller -- Evercore ISI -- Analyst

Thanks so much guys.

Operator

And your next question comes from Mani Foroohar with SVB Leerink. Your line's open.

Rick -- Leerink Partners -- Analyst

Hey, good morning. This is Rick on the line for Mani. Thanks for taking our questions. So first, what are some of your expected timelines for getting visibility into establishing commercial partnerships for PH1? Is there any guidance you can provide us here?

And I guess also, do you anticipate that timelines would be different based on whether you choose to have a single partner for commercialization or multiple partners here?

Rob Ciappenelli -- Chief Commercial Officer

Hey Rick, it's Rob. In terms of our partnership discussions, those are ongoing both -- as I've mentioned, both globally and with regional players. I don't see it as a rate-limiting step in terms of making Nedosiran available. We're continuing, first and foremost with filing the NDA. The NDA is a key resource document for filings beyond the U.S. So think about it this way, we're on track, as guided to Q4 filing of the NDA.

Concurrent to that, we're continuing the discussions with both global and regional players. I would expect us to, in the next couple of quarters be able to come back with clear conclusions in terms of what we're going to be doing with Nedosiran outside the United States, and as well with a partner in the U.S.

Rick -- Leerink Partners -- Analyst

Got it. Thanks. That's helpful. And I guess also taking a step back, what does this change in strategy mean for commercialization plans for the rest of the wholly owned pipeline?

I guess, I'm just trying to think, is there any read-through here to the rest of the pipeline? Is there a certain threshold you'd like to meet to start building commercial infrastructure, or is it more likely that we're going to see commercialization partners here for the rest of the pipeline?

Douglas M. Fambrough -- President and Chief Executive Officer

So Rick, I don't think there's any read-through for the subsequent programs, the next one likely to come down to that stage would be the A1AT program, which has a focus call point. Similarly, DCR-AUD, which will be further out has a focus call point in addiction medicine, both of which would be appropriate for us to build out, especially sales force when that comes to pass.

The key thing we're looking at, in deciding to fully -- forward integrate and become a commercial company, is that we are confident that, that investment is going to generate a return, and that we're going to be cash-flow positive. And as I -- I think we said a reasonably short period of time, and then that will be a source of cash for the Company.

If we don't have confidence in that, then it doesn't make sense to make that investment. That will be made on a case-by-case basis, but the next opportunities could support building out that infrastructure.

Rick -- Leerink Partners -- Analyst

All right, perfect. Appreciate the detail here, and thanks for taking our questions again.

Operator

Your next question comes from Madhu Kumar with Goldman Sachs. Your line is open.

Madhu Kumar -- Goldman Sachs -- Analyst

Hey everyone, thanks for taking our questions. So I want to start with Alpha-1 Antitrypsin. So can you kind of walk through the -- the plan for choosing Belcesiran over the Alnylam AAT RNAi drug.

Is there something [Indecipherable] that's not publicly available about the Alnylam AAT drug that kind of makes you favor Belcesiran, or how should we think about the election for Belcesiran over that other drug?

Douglas M. Fambrough -- President and Chief Executive Officer

So Madhu, that took into account -- the decision between Alnylam and Dicerna took into account all of the pre-clinical, clinical data to date, as well as the logistics of working with our own compound versus working with Alnylam's compound. There are quite a few things that are not publicly available about the Alnylam compound, and our own frankly that weigh on that decision. And it's not a decision we're going to revisit.

Madhu Kumar -- Goldman Sachs -- Analyst

Okay. And then thinking about the extrahepatic space, can you give more visibility about kind of where you're thinking about pursuing? I mean, we've previously discussed the CNS space, how are you thinking about that now and how are you thinking about more granular timelines for putting extrahepatic compound into the clinic [Phonetic]?

Douglas M. Fambrough -- President and Chief Executive Officer

So I am really pleased at the breadth of delivery to other tissues that we're seeing. So in CNS, we are partnered with Lilly. And so I think much of the CNS work will be under that collaboration. But we've talked about adipose tissue and muscle and tumor-associated immune cells and there are other issues we haven't mentioned that we're achieving delivery.

I do notice that certain other tissues are a focus for other companies. Notably, muscle would fall into that category. And I think overall, there are probably a relatively fewer number of opportunities in muscle. I would like to see Dicerna in more of a whitespace, open field running room. So you -- when we reveal the programs, I think we'll see that we are probably attacking in a slightly different direction than some of other early [Indecipherable] companies going outside the liver, drawing on the strength of GalXC-Plus to get to other tissue types.

The pre-clinical timelines are now -- we have planned the best we can, but COVID has really disrupted pre-clinical timelines, with respect to things like non-human primate availability. And we're not going to guide right now on the clinical entry timing, and we do want to be fairly close to clinical entry before we talk about what we're doing because we do expect people to jump into the programs we're doing.

So what I can say is that, we have two programs that we have initiated development on. We've locked the clinical candidates, gone into manufacturing. All of that planning to pre-clinical entry is underway and we'll give more detail in a couple of quarters probably.

Madhu Kumar -- Goldman Sachs -- Analyst

Excellent. Thanks very much.

Operator

And your next question comes from Stephen Willey with Stifel. Your line is open.

Stephen Willey -- Stifel -- Analyst

Yeah, good morning. Thanks for taking the questions. Maybe just a couple of quick clinical ones. In Estrella, can you talk about the extent of fibrosis that you're allowing in patient who will be eligible to enroll into that study.

Is -- are these going to be F3s, F4s? Are you allowing cirrhotic patients into that study? And then with respect to AUD, in terms of patient eligibility, I mean, obviously, this is a healthy volunteer population; healthy volunteers, I guess, do consume alcohol. Is there any kind of restriction, or do you have some kind of guardrails around consumption in that study, or at least attempts to, just for the first Phase 1 experience?

Shreeram Aradhye -- Executive Vice President and Chief Medical Officer

Yeah. Hi, it's Shreeram. In ESTRELLA, our goal is to enroll the population that gives us a good read on the benefits of knocking down the mutant protein and potential consequent benefits on liver histology.

So we are enrolling a broad population with representative fibrosis. So that's ongoing. Our goal there is to make sure that we've designed the study in a manner that gives us a good read on seeing the difference in the size of the study that we have designed. I think the worst case patients, so the decompensated cirrhotics are not like -- are not a part of this trial. But other than that, it will be on a broad range. And Stephen, could you repeat your question on AUD for me, please?

Stephen Willey -- Stifel -- Analyst

Yeah. I'm just kind of curious, so in the healthy volunteer experience for AUD, is there some kind of eligibility criteria around alcohol consumption in those patients who are going to enroll? I'm just kind of curious if there is going to be any kind of early efficacy signal that could emerge out of that study just based on the fact that you're going to see healthy volunteers consume alcohol during a 24-week period post-dose.

Shreeram Aradhye -- Executive Vice President and Chief Medical Officer

Yeah. So we -- I think we expect to do this in a step-wise manner, and that the first goal of the Phase 1 single ascending dose is to establish safety and tolerability. And as Doug said, do a very controlled exposure to ethanol as a way of gathering the pharmacodynamic data that confirms for us whether or not we have established the biological state in a human of achieving the necessary knockdown in the liver and what effect that has. Going in our guidance will, of course, be for people to avoid alcohol intake. My expectation is that, over time, the Phase 1 study will give us a read on what people's reactions to drinking alcohol outside of the trial might be.

But coming in, in the initial safety, the single ascending dose, our goal is on making sure that the exposure of ethanol is in a controlled setting to make sure that we have a clear read on what the TD of the drug is. But over time, I make sure that in the multiple ascending dose we should be able to gather more reads on efficacy.

Douglas M. Fambrough -- President and Chief Executive Officer

So in essence, Steve, we do expect to learn a lot about the physiological response of someone who has taken DCR-AUD to the intake of alcohol. That's not the approvable endpoint. The approvable endpoint will be likely the harm reduction in patients who have AUD, that sort of loss control and harm reduction being an assessment of their ability to regain more control over their consumption of alcohol. So on that direct sort of approvable endpoint, we're not going to get anything.

But there is believed to be a very clear linkage between the physiological response and that behavior as seen by the rates of AUD, and people with naturally occurring ALDH2 mutations. Not exactly the same thing we're doing, but closely related. So we should get the important physiological feedback. And that's something we'll discuss and look forward to talking about it when we see it.

Stephen Willey -- Stifel -- Analyst

All right. Thanks for taking my questions.

Operator

And your next question comes from Yaron Werber with Cowen. Your line is open.

Brendan Smith -- Cowen and Company, LLC -- Analyst

Hi guys, this is Brendan on for Yaron. Thanks for taking the questions. Just a quick one from us, I guess, really looking at the A1ATD program. So I guess looking at the landscape here, what can you tell us maybe about Belcesiran specifically, and maybe more so your kind of goals and expectations for the Phase 2 that you think are going to really be necessary to differentiate the drug? I guess my point is really, kind of given that there are other competitors a bit ahead of you in development in that space as well, where you really see the bar for Belcesiran there to stand out? And maybe what kind of gives you confidence you can meet that? Thanks.

Douglas M. Fambrough -- President and Chief Executive Officer

Hi, Brendan. So there is one other company in Phase 2 to 3 AATLD, so not exactly a crowded field. And I'm sure you're aware almost every pharmaceutical market is multiple entrants. But one does think about how the various products are differentiated. In this case, because the mechanism of action is the same, there isn't a mechanistic differentiation.

In the PH1 indication, we have a -- what I think is a very positive differentiation based on the mode of administration with our pre-filled syringes that are for administration by patients with PH1 at home on their own, compared to the competitor product which has a healthcare professional involved, and is weight-based, and so variable volume, and so not in prefilled syringes.

We shall see in A1AT, as we head into pivotal trials and our competitors heads into pivotal trials, what those regimens are. And so that will assess how we want to present the product, relative to a competitor. But I think the most important dynamic has to do with the fact that most of the diagnosed patients with AAT liver disease are in fact patients of AAT lung disease as well, because that has a clearer diagnostic path currently, and with approved products has had a fair amount of patient finding that's gone over for a long period of time. And I think there is a natural pairing between augmentation as a therapy for the lung and RNAi as a therapy for the liver.

And you'd in fact see that the competitor product has sort of collaboration with an augmentation provider. It is, as it happens a minor interest in the augmentation market. And so, I think that presents a fairly obvious counter strategy for us with respect to pairing our RNAi compound with augmentation that we intend to pursue.

There isn't any particular time pressure to do that. But there I think that solution providing, associated with lung and liver is going to be very interesting and it will be to one's advantage to be with the market leader, as opposed to with a more minor player.

Brendan Smith -- Cowen and Company, LLC -- Analyst

All right, great. Thanks very much.

Operator

Your next question comes from Luca Issi with RBC Capital. Your line is open.

Luca Issi -- RBC Capital -- Analyst

Yeah, terrific. Yeah, Luca Issi from RBC Capital Markets. Just a few questions here. Maybe the first on Nedosiran. If I recall you correctly, you previously guided that you estimated peak revenues, to your peak sales, I should say, between $500 million and $1 billion.

Wondering if you can comment on how you're thinking about peak market opportunities here now that you've seen Phase 3. And then maybe on business development? Wondering if there's any appetite to broaden the scope of your extrahepatic delivery via BD.

We've seen recent deals between Ionis and Bicycle and Alnylam and PeptiDream. So wondering if this is something that you're also considering? And then finally, maybe on A1AT, wondering if you can comment on the timelines here for seeing the actual data in patients here? Thanks so much.

Douglas M. Fambrough -- President and Chief Executive Officer

Hi. You know, I'll -- trying to write, keep track of the questions there. I think Nedosiran sales potential was the first one. So I'm not going to get into detailed numbers here, but we had PH2 in our forecast as being a significant minority of the total sales. Less than half, but a significant amount. For PH3, relatively small fraction.

But PH2 was a -- has a significant minority thus taking it off the label or not getting it included in the label, it's a significant effect. I'm not going to get more specific than that on our prior forecasts, which obviously is no longer applicable given PH2 is no longer included. Shifting to business development around delivery. That is something that we are considering, and we've had conversations with players in the field. Having said that, we are very pleased with the delivery we're getting with our in-house technology, which as I mentioned is getting us to a pretty broad array of tissues.

So we're not feeling a particular need at this point to form a collaboration with someone who can help us get to other tissues. We are already in a situation where the number of opportunities we're considering far outstrips the number of programs that we can plausibly prosecute.

So it's definitely in the mix and there are some really interesting approaches out there. But the strategy that we have taken in our research labs has been paying off, and we're really pleased with our in-house work.

Luca Issi -- RBC Capital -- Analyst

And maybe the timing of the A1AT data from ESTRELLA. Is there any kind of guidance that we should think about it?

Rob Ciappenelli -- Chief Commercial Officer

I forgot about that one. Shree, you want to just quickly...[Speech Overlap]

Shreeram Aradhye -- Executive Vice President and Chief Medical Officer

Luca, it's Shree. You know, you can do the math. I mean, we're enrolling a study that has two cohorts with paired biopsies that happen at 24 weeks and 48 weeks with up to 27 subjects. We haven't yet fully decided on the timing of a potential interim analysis. The study started enrolling earlier this year. We are getting some sites on board in Europe.

So I think it will be some time. We will need to have a decent number of subjects. Having had the right number of -- with paired biopsies to be able to meaningfully present information that is interpretable and from which we can draw reasoned conclusions. So I'll -- that's above the guidance I can give you right now.

Luca Issi -- RBC Capital -- Analyst

Got it. Super helpful guys. Thanks so much.

Operator

Your next question comes from Yigal Nochomovitz with Citigroup. Your line is open.

Yigal Nochomovitz -- Citigroup -- Analyst

Hi Doug. Thank you very much for taking the questions. I just had a high-level question. At this point, do you believe you have an optimal number of pharma partnerships, or are you willing to entertain additional partnerships to further extend the footprint for the GalXC technology platform? And if the latter is the case, are there certain disease areas that you believe would be better suited for partnering versus developing on your own?

Douglas M. Fambrough -- President and Chief Executive Officer

Sure, Yigal. Happy to take this one. We've had a really nice set of collaborations, and they're good partners to work with. There is a logistical challenge in adding more names to that list. Our ability to make clinical candidates definitely outstrips our development capabilities.

And I think that's true for the foreseeable future. And with an excess of opportunities in candidates, to me, and I think to the whole team here, it makes sense to have someone else take things forward that we're not going to take forward. So there is still, I think, rationale in our strategy to enter into collaborations on opportunities that we don't intend to pursue on our own. Our capabilities to pursue opportunities are a lot broader than they were in 2018 when we did our Alexion and Lilly deals.

And our pressure to bring in cash, which was fairly strong at that period of time, now is -- we have a lot of luxury of choosing our spots. And so our posture is a little different with respect to collaborations now. It is to really spend our time figuring out what we're going to do, and then later, we'll take the things that we're not going to do, and we would like to find a path forward for those. Some of the spaces that we're working in, we've mentioned delivery to adipose tissue, there are clear metabolic and sort of obesity indications associated with that, that probably are not right for Dicerna.

I would note, we are already collaborating with the two largest players in the metabolic space. It would be nice to perhaps extend those collaborations into GalXC-Plus. It wouldn't burden the logistics anymore, but it would satisfy the goal of bringing in capital and making sure those programs move forward.

So I see a role for the collaborations. But whereas in 2018, 2019, it was a primary part of strategy. It's really a secondary part of strategy now. And the primary is building out our own pipeline. And then the collaborations will fit in a secondary role, but it's still an important piece, I think.

One of the things that all of us would like to do per our -- what we have as our vision statement here at Dicerna is maximize the impact of RNAi on medicine, that means getting a lot of drugs. We can make candidates, we can make a lot of candidates. It's very modular. So we want a lot of candidates to move forward. I'm really pleased there are 15. We want that number to keep growing and growing. So I hope that gives you some perspective, that's the -- well short of any sort of guidance. But I think does -- it is informative to what our mindset is, about how we're going to think about collaborations.

Yigal Nochomovitz -- Citigroup -- Analyst

Thank you. That's very helpful. Thanks, Doug.

Operator

And your next question comes from Mayank Mamtani with B. Riley Securities. Your line is open.

William Wood -- B. Riley Securities -- Analyst

Yes. This is William Wood on for Mayank Mamtani. Thank you again for taking our questions. Glad to see you being proactive with your corporate strategy and follow-up from PHYOX2 last week. So I was curious about what learnings might be applied from your ex-U.S. licensing process, now that you've made the choice to make global rights available?

Rob Ciappenelli -- Chief Commercial Officer

Hey William, it's Rob. In terms of kind of some insights, I'll provide a couple. A high degree of interest. And William that interest not only was in Nedosiran beyond the U.S., but a number of the parties kept coming back to us and saying we'd vote the U.S. So I think that puts us in a really good spot to continue these conversations both through global and regional players.

The bottom line is that Dicerna is going to do whatever we can to most appropriately put this into the market so that patients have an option, not only in the U.S. but globally. And frankly, these conversations, I feel put us in a good place to work toward that.

So the key insight is that a number of the players that we've been talking to have some -- or some have had some interest in the U.S. as well, but we'll be continuing to look specifically across all the different stakeholders and proceed accordingly. Back to Doug.

William Wood -- B. Riley Securities -- Analyst

Awesome. Doug?

Douglas M. Fambrough -- President and Chief Executive Officer

I didn't have anything more to add. And I think we're going to wrap up at this point. Operator is there any additional questions?

Operator

Alright, that concludes our question-and-answer session. I would now like to return the call over to Doug Fambrough for closing remarks.

Douglas M. Fambrough -- President and Chief Executive Officer

I want to thank everyone for participating this morning. I want to reiterate that PHYOX2 is an important milestone, and I am really pleased with our platform. It bodes very well for the future. And I look forward to updating the additional GalXC programs as they mature in subsequent calls. Thanks, everybody. Bye-bye.

Operator

[Operator Closing Remarks].

Duration: 47 minutes

Call participants:

Tierney Sovic -- Senior Analyst-Biotech Investor Relations

Douglas M. Fambrough -- President and Chief Executive Officer

Douglas Pagan -- Chief Financial Officer

Rob Ciappenelli -- Chief Commercial Officer

Shreeram Aradhye -- Executive Vice President and Chief Medical Officer

Jonathan Miller -- Evercore ISI -- Analyst

Rick -- Leerink Partners -- Analyst

Madhu Kumar -- Goldman Sachs -- Analyst

Stephen Willey -- Stifel -- Analyst

Brendan Smith -- Cowen and Company, LLC -- Analyst

Luca Issi -- RBC Capital -- Analyst

Yigal Nochomovitz -- Citigroup -- Analyst

William Wood -- B. Riley Securities -- Analyst

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