It is well understood that there are multiple cell populations and multiple signaling pathways involved in the disease progression involving tissue injury, chronic inflammation, and the resulting tissue damage that leads to loss of organ function, as well as the processes involved in the repair and regeneration of damaged tissue.  Therapeutic approaches targeting single signaling pathways in these complex disease and repair processes have not proven effective, and most cell therapy approaches expand a single cell type to attempt to arrest manifestations of the disease.  Aastrom is taking what we believe is a highly differentiated and superior therapeutic approach by developing multicellular therapies that utilize an expanded population of the key cell types that the body naturally uses to repair and regenerate damaged tissue.

Ongoing discovery research by Aastrom scientists and our outside collaborators continues to define the mechanism of action of ixmyelocel-T and differentiate our product from other cell therapies based on the activity of the two key cell populations in ixmyelocel-T:  mesenchymal stromal cells (MSCs) and M2-like anti-inflammatory macrophages.  These key cells have multiple direct activities and beneficial effects on nearby cells that have been shown to promote tissue repair and regeneration by reducing inflammation and promoting angiogenesis and remodeling of damaged tissue.  Based on the activities of these cells and the resulting therapeutic effects, Aastrom’s unique multicellular therapy platform offers the potential for multiple therapeutic applications in treating cardiovascular and other fibrovascular disorders of the lungs, liver, kidney and other organs.

There is enormous therapeutic potential for ixmyelocel-T based on its multicellular composition and the promising results in the treatment of ischemic or damaged tissue demonstrated in preclinical and clinical studies conducted to date.  We look forward to generating results in our current ixCELL-DCM phase 2b study of ixmyelocel-T for the treatment of advanced heart failure due to ischemic dilated cardiomyopathy, and continuing to explore the potential therapeutic effects of ixmyelocel-T to repair and regenerate damaged tissue in other severe diseases.

Regards,

Nick Colangelo

Our previous results in DCM —in both preclinical and clinical studies — suggest that our patient-specific multicellular therapy can produce a range of clinical benefits for patients with severe heart failure whose limited treatment options include heart transplantation. The rationale for developing ixmyelocel-T in this orphan disease indication is compelling, and we are delighted to announce enrollment of the first patients in the ixCELL-DCM clinical trial this week.  We look forward to completing enrollment in this clinical trial early next year and to reporting our results in 2015.

In our continuing research during the past year, we have learned a great deal more about the therapeutic activity of the cells comprising ixmyelocel-T.  These findings will enable us to identify new therapeutic applications for ixmyelocel-T and our cell-production technology for the treatment of other rare diseases.  Importantly, this research positions us to target applications that can be evaluated with relatively smaller clinical studies through a more streamlined regulatory pathway.  We look forward to broadening our research platform to explore these exciting new product opportunities.

Like most other biotech companies developing novel therapies, Aastrom will need to raise additional capital, and we are currently evaluating several financing options.  Our recent restructuring which reduces our operating expenses by half, our progress in launching the DCM Phase 2b clinical program and our efficient manufacturing system help make our company a more attractive investment opportunity today.  We also are supported in this endeavor by a talented team with the expertise to execute our new R&D strategy and the experience to optimize our resources quickly.

The decision to prioritize our clinical development activities was a difficult one, but I am encouraged by the determination of my colleagues to advance our company and create sustainable long-term value for all of our stakeholders.  I look forward to reporting on our progress as we begin a new chapter in Aastrom’s remarkable history.

Regards,

Nick Colangelo

Researchers have made important advances in their ability to manipulate adult cells.  For example, scientists from the University of Cambridge’s Institute for Medical Research reprogrammed skin cells to behave like liver cells so that we can better understand the mechanisms of different liver diseases and more easily identify optimal targets for therapeutic drugs. While these efforts may open up new avenues of research, there have been some challenges in administering these cells in humans. Studies have found that the reprogramming process in adult stem cells may increase the risk of tumors. In some cases, reprogrammed cells appear to retain the memory of their original cell activity, which could make their behavior unpredictable. When researchers at the Children’s Hospital in Boston tried to transform blood cells into tissue cells, they reverted back to blood cells soon after.

By contrast, therapies derived from adult stem cells that have not been reprogrammed appear to have a lower potential to form tumors. Most adult stem cell therapies in clinical development incorporate cells from bone marrow, umbilical cord blood, skin or gut. These cells have been shown in numerous studies to be relatively safe and have now been used to treat different diseases in more than 50,000 people around the world. Aastrom’s lead product candidate, ixmyelocel-T, which is derived from a patient’s own adult bone marrow stem cells, has been tested safely in more than 200 patients.

In addition to evaluating the advantages and disadvantages of therapies derived from embryonic and adult stem cells, researchers are also exploring two different methods of stem cell transplantation. Some stem cell therapies are allogeneic, meaning that cells are taken from a donor, processed, and then used to treat one or more patients. These types of therapies carry the risk of graft-versus-host disease, which occurs when the donor’s transplanted stem cells attack the recipient’s body tissues.  An allogeneic transplant also has the potential to transfer pathogens that cause disease or illness from a donor to a recipient.

With autologous therapies, patients receive cells that come from their own body, which virtually eliminates the risk of graft-versus-host disease or the introduction of new pathogens. This characteristic of ixmyelocel-T helps to eliminate the risk of rejection and the need to treat patients with immunosuppressive therapy before or after administration.  In our proprietary production process for ixmyelocel-T, we work to expand the populations of certain cells found in bone marrow that are known to play a role in repairing tissue, restoring blood flow and reducing inflammation. Findings from our clinical research thus far indicate that ixmyelocel-T has the potential to produce long-term engraftment and tissue repair.

Cell therapies have the potential to substantially improve the lives of patients affected by poorly treated chronic diseases. Well-designed and well-controlled clinical trials will enable us to evaluate the relative risks and benefits of these therapies and realize their therapeutic potential.

Regards,

Daniel Orlando

February is American Heart Month, and it is during this time that we recognize many of the important advances in medical research that may help us prevent and treat cardiovascular disease more effectively. In recent years, breakthroughs in surgery, drug therapy and devices have expanded options for patients, making it possible to lower the risk of a cardiac event and treat the effects of peripheral artery disease (PAD). Despite these advances, cardiovascular disease remains the leading cause of death in the United States. Each year it disrupts the quality of life of millions of people and is the cause of approximately 160,000 amputations and 1.5 million heart attacks in the U.S.

Fortunately, there are reasons to be optimistic. Recent advances in regenerative medicine and cell therapy are encouraging and have shown the potential to improve the lives of patients with the most severe forms of cardiovascular disease. In preclinical and clinical studies, cell therapies have demonstrated the potential to repair damage to the heart muscle and other vascular tissue that can occur with a cardiac event. They also have the potential to help restore blood flow or repair genetic defects. If we continue to make clinical progress in this area, cell therapies may become an effective, less costly treatment option for people with advanced cardiovascular disease. For example, we know that patients living with critical limb ischemia (CLI) or dilated cardiomyopathy (DCM) are severely compromised and have few treatment options available. Currently, the only effective treatment option for DCM patients may be a heart transplant, a procedure which is hard to obtain, highly invasive and puts patients at risk of future complications. For patients with CLI, amputation may be the only treatment option, but it reduces quality of life and functionality and often leads to additional amputations if the disease progresses.

Our cell therapy shows promise in providing significant relief to these patients without the risks associated with either transplantation or amputation. We have advanced our lead product candidate, ixmyelocel-T, into Phase 3 clinical trials as a potential treatment for CLI and into Phase 2 clinical trials as a potential treatment for DCM. By repairing damaged tissue using a therapy derived from a patient’s own bone marrow cells, ixmyelocel-T could represent a major advance in the treatment of these severe and often fatal forms of cardiovascular disease in the years ahead.

We are working aggressively to advance the development of ixmyelocel-T in order to bring this potential new treatment option to patients as quickly as possible. We look forward to continuing our research in this area and identifying new areas in cardiovascular medicine where ixmyelocel-T may improve patient care.

Regards,

Daniel Orlando

As the new interim chief executive officer of Aastrom Biosciences, I am honored to lead the company as we continue to advance the clinical research programs for our lead product candidate, ixmyelocel-T.  I believe we have a unique opportunity to improve the lives of people with severe, chronic cardiovascular diseases with ixmyelocel-T, and am very pleased to have the opportunity to bring my experience building successful pharmaceutical brands to this development program as we begin to formulate plans related to commercialization.  Since I joined Aastrom in August as chief commercial officer, I have seen firsthand the potential of our technology to treat these diseases and the dedication of our team to bring this promising therapy to patients who may benefit from it.

Our work with many of the leading clinicians in vascular medicine will continue to be critical to the success of our drug development programs.  As I take on this new role at Aastrom, I want us to build on these relationships as we continue to enroll patients in the REVIVE CLI Phase 3 trial and position the Phase 2b DCM trial to enroll patients in 2013.  In addition, we will advance our preclinical research efforts to identify additional cardiovascular diseases where ixmyelocel-T may be beneficial.

We will continue to build on our legacy in many other ways in the weeks and months ahead.  Our company has established a reputation for transparency and candor that we must continue to uphold.  We will continue to communicate openly about our business activities and clinical research results, and we will hold ourselves accountable to our stakeholders and make decisions that are in their best interests.  Most of all, we will remain dedicated to our goal of helping people with severe, chronic cardiovascular diseases.

Thanks to strong management and great science, Aastrom is a recognized leader in regenerative medicine with one of the most advanced clinical programs in the industry.  As we work to develop our commercialization strategy for ixmyelocel-T, I offer my full commitment to helping Aastrom achieve this goal and express my sincere thanks to our colleagues and investors for their support in this endeavor.

Regards,

Daniel Orlando

Aastrom’s commitment to transparency was reinforced by the recent announcement from GlaxoSmithKline (GSK).  GSK made headlines when it announced a new policy to disclose all clinical data from the company’s drug development programs.  Previously, the company had followed prevailing industry standards by releasing results from only some of its clinical studies (generally, only the positive ones).  A 2008 study[i] by the University of California, San Francisco found that many drug companies do not routinely report negative clinical data, while some do not make any data available to the public.  We welcome GSK’s initiative – it is good clinical practice and consistent with our commitment to transparency at Aastrom.  This move toward greater transparency is an important trend with profound implications for the future of research.

We believe that the benefits of disclosing all clinical results, not just the positive study results, far outweigh the real or perceived risks.  Full disclosure allows any interested party to review all of the potentially relevant data about experimental therapies.  This allows for a much broader and more accurate assessment of both safety and efficacy – the mechanisms of action – and also enables scientists and physicians to identify potential areas for future research.  When publicly available information is incomplete, it can lead the medical community to flawed conclusions that may limit the chances of future clinical success or, in extreme cases, actually cause patients harm.

Many researchers share our view that more transparency from our industry (pharmaceutical and biotechnology companies), including the creation of a global clinical research database, will help address these issues.  Peer review is a critical element of this transparency.  We encourage our study investigators to publish data from our clinical programs in peer-reviewed journals or present their findings at international peer-reviewed medical meetings.   This includes data from clinical studies, studies related to our manufacturing processes and early preclinical research.  We have also maintained a commitment to sharing the results of all of our clinical research programs, and will continue to do so.

For example, earlier this year Aastrom presented two posters with data showing new potential therapeutic advantages of ixmyelocel-T, our investigational regenerative medicine therapy that is currently in Phase 3 clinical trials for the treatment of critical limb ischemia and in Phase 2 trials for the treatment of dilated cardiomyopathy.   At the Keystone Symposia on the Molecular Basis of Vascular Inflammation and Atherosclerosis held in Big Sky, Montana in March, we presented data showing that ixmyelocel-T may have atheroprotective properties.  In a separate in vitro study, ixmyelocel-T was shown to resolve atherosclerotic lesions, or plaques, that form inside the arteries.  These findings are potentially exciting but need to be shared publicly to help medical experts assess these findings and confirm their validity.

In June 2012, Aastrom also announced the results of a second preclinical study to evaluate the ability of ixmyelocel-T to protect the heart from damage in a murine (mouse) model of heart failure.  In this model of non-acute left anterior descending (LAD) coronary artery occlusion, animals treated with ixmyelocel-T demonstrated reduced mortality compared to the control group (22% vs 44%).  Again, our disclosure of these results was consistent with good disclosure practice and reflected our commitment to maintaining the integrity of our development programs.

For those of you interested in taking a closer look, links to all of the available data from our critical limb ischemia and dilated cardiomyopathy development programs may be found on our scientific publications page. This page includes access to journal articles, presentations and posters.

We look forward to continuing the development of ixmyelocel-T and providing full disclosure of our clinical results.  Transparency is a core value for Aastrom – it will help ensure that we continue earn the trust of patients and medical professionals who may rely on our therapies, gain the support of investors who help finance our business and help researchers in regenerative medicine identify promising new avenues of research in regenerative medicine.

There have been many studies over the years highlighting the fact that drug discovery and development is typically a very long, risky, complex and costly process.  It is not uncommon for drug development programs to last a decade or more, beginning with early-stage discovery and research, and progressing through late-stage clinical development, regulatory review and approval.  Within that timeline, companies must continually monitor progress and determine when and whether to expand their focus to include essential commercialization strategies to prepare to bring promising late-stage product candidates to the patients who need them.

Over the past year, Aastrom has initiated a number of important activities to support the future commercialization of ixmyelocel-T, which is currently in Phase 3 clinical trials for the treatment of patients with severe peripheral arterial disease (PAD) and existing tissue loss, and in Phase 2 trials for the treatment of patients suffering with dilated cardiomyopathy (DCM).

As an important step in this process, earlier this year we expanded our executive leadership team by naming Dan Orlando chief commercialization officer. Dan is the first executive at Aastrom to be devoted exclusively to planning and executing our commercialization and business development strategies.  Dan has more than 25 years of commercialization experience. He was previously with Takeda Pharmaceuticals for over 13 years in executive leadership positions in marketing, sales and business development, most recently as vice president, business development, for North and South America.  During his career, he has helped to establish dozens of pharmaceutical brands including, most significantly, Actos®. Under Dan’s leadership, Actos® became the top brand in diabetes.

Since he joined Aastrom, Dan and our entire commercial team have been busy!  To give us essential information about the market opportunity for ixmyelocel-T, the team engaged an independent market research firm to complete qualitative market research studies with physicians and payers.  This market research is providing us with many new insights regarding the use of our regenerative medicine therapy in the treatment of patients with severe PAD.  For example, our research thus far has found that:

• There is widespread interest in ixmyelocel-T as a treatment option for patients with severe peripheral arterial disease with existing tissue loss.  Physicians feel that they have too-few options for patients in need and also confirm that amputation is a poor treatment option that presents many patients with challenging psychosocial, financial and clinical consequences.
• Physicians also indicate a strong preference for autologous (patient-specific) cellular therapies, indicating that they feel that products such as ixmyelocel-T might be safer compared to other potential therapies.
• Both physicians and payers believe that a therapy able to reduce the number of amputations will be a cost-effective treatment option.
• Many surgeons expressed interest in eventually using ixmyelocel-T in combination with revascularization procedures.
• These findings, and the results from additional research on the commercial opportunity for ixmyelocel-T, will provide Aastrom and potential partners with a clear sense of the commercial opportunity available with ixmyelocel-T and the strongest and clearest path to maximize that opportunity.  This information will help us prepare our marketing strategy and our clinical and patient education materials and programs.  We are very excited that these early market-research results confirm many of our anticipated value propositions for ixmyelocel-T and that we will be well positioned to reinforce these messages in our marketing and outreach activities.

As we move ahead with our commercial plan for ixmyelocel-T, we haven’t lost sight of our near term goals — to finish clinical development and obtain regulatory approval for ixmyelocel-T.  We continue to work closely with our clinical investigators and the independent steering committee to support enrollment in our pivotal Phase 3 REVIVE clinical trial of ixmyelocel-T in patients with severe PAD.  As we maintain our focus on that important objective, we are also building the commercial capabilities we will need to make ixmyelocel-T a successful product.

With regards,

Tim

In July 2012, after several companies had been treating patients with unapproved stem cell therapies, the U.S. District Court in Washington affirmed the right of the FDA to regulate therapies made from a patient’s own stem cells. I believe this is a good decision that will protect patients, strengthen our industry and ensure the safety and therapeutic value of approved products.

The move to introduce appropriate oversight and regulation of cell therapy comes as no real surprise – the number of authorized cell therapy clinical trials has increased steadily in the U.S. over the past 10 years, from 12 trials initiated in 2001 to more than 50 trials initiated in 2011. While certain aspects of the U.S. regulatory process might be considered burdensome, I believe it is imperative that stem cell therapies be tested rigorously and to the highest standards. The fact that cell therapies are derived from cells found in the body does not eliminate this responsibility. Regenerative medicine has transformational potential, but that does not necessarily mean that each cell therapy technology or product will result in a safe and effective therapy.

Clinical trials often identify unexpected and unanticipated safety issues. Rigorous clinical trials also often find that some proposed products are not as efficacious as they need to be to balance their risks. For example, only one in four biologic treatments has ultimately proven to be both safe and effective, according to a BioMedtracker study. Marketing any therapy – for cancer, heart disease or any other disease – that has not been proven to be both safe and effective in rigorous clinical trials puts patients at risk and ultimately hurts all research organizations working to develop new therapies.

Some recent changes in the law include welcome regulatory reforms. For example, the Federal Drug and Safety Innovation Act (FDASIA), which President Obama signed in July 2012 to speed up drug development, helps Aastrom in two important ways. First, FDASIA has granted more therapies “Accelerated Approval” status, which reduces the number of regulatory steps necessary before a therapy is submitted to the FDA. Second, it also created a “Breakthrough Therapies” category to expedite the review of therapies intended for serious medical conditions, such as CLI and ischemic DCM. A streamlined approval process can help to reduce the cost and complexity of clinical trials, and will potentially make it possible for companies such as Aastrom to advance promising new therapies more efficiently in the years ahead.

Clinical investigators must also work with industry regulators to develop better regulation. The insights and recommendations of clinicians are key to the success of many clinical research programs in regenerative medicine, and we should encourage their participation in this process. At Aastrom, we have worked extensively with respected and well-known physicians in the vascular community to develop clinical protocols that will yield the best information in support of product marketing applications.

Currently, our cell therapy ixmyelocel-T is being evaluated in a Phase 3 clinical trial for critical limb ischemia and in a Phase 2 clinical trial for ischemic dilated cardiomyopathy. We are working hard to maintain the highest standards for our clinical trials, engage the most knowledgeable and experienced investigators, and give our cell therapy product the best chance of clinical, regulatory, and commercial success. We are also committed to presenting and publishing our data and other research findings in peer-reviewed settings to researchers, clinicians, patients and others involved in developing and using new treatments for patients with serious cardiovascular diseases.

There is already substantial evidence to indicate that regenerative medicine has the potential to improve medical outcomes, enhance quality of life and reduce overall healthcare costs for many patients. But none of these goals can be achieved without first ensuring that cell therapies are both safe and effective for patients. A rigorous clinical trial system and regulatory oversight are key to protecting patients, improving care and bringing much-needed therapies to patients and the physicians that care for them.

With regards,

Tim

Discovering, developing and launching new medicines is a challenging enterprise, often requiring more than a decade of pre-clinical and clinical research and an investment in the tens  or hundreds of millions of dollars.  And the harsh reality is that only about one in ten drugs that reach clinical stage development eventually win FDA approval.  Despite these long odds, the biotechnology industry has continued to flourish, even though many traditional sources of capital, such as venture firms, are shrinking and new sources of capital are needed.  What does all this mean for the future of cell therapy and companies like Aastrom that are focusing on promising but complex cell therapies?

Many of the risks inherent in drug discovery and development are magnified in cell therapy because the field is relatively young, the science behind it is still emerging and few cell-therapy products have been approved.  However, with each clinical and regulatory success, the therapeutic potential of cell therapy becomes more apparent and investor sentiment improves.  As a result of recent progress, interest in regenerative medicine is now growing steadily, the number of cell-therapy clinical studies is increasing and capital is flowing toward a few companies with the most promising and late-stage development programs.

Aastrom has benefited from these trends and emerged as a leader in cell therapy because we have focused on compelling applications of our proprietary technology in terms of medical need, clinical rationale and commercial opportunity.  This has been supported by extensive research into the underlying causes of chronic cardiovascular diseases, the activities of the cells we administer, rigorous development of clinical protocols to ensure high-quality study results and conservative market analysis to support investment in our programs.  It has also required a commitment to transparency and candor about our business – both in terms of the status of our programs and the results of our research.

As investors get to know our company and industry better, we hope they will evaluate carefully the information we and other companies report, especially related to clinical results.  To paraphrase a famous advertising slogan, “an educated investor is our best customer.”

Here’s my advice on how to be an educated investor in cell therapy:

• Learn the differences among open-label, compassionate-use and fully controlled clinical studies – not all clinical trials are designed to the same standards and goals.
• Follow the data – are preclinical and clinical study results presented in well-regarded, peer-reviewed publications and scientific meetings, or only in companies’ press releases?  When data are not presented in peer-reviewed settings, it can be difficult to assess progress in both preclinical and clinical research.
• Focus on companies with experienced scientists and managers with track records of success in the pharmaceutical and biotechnology industries – is the team solid, with the full range of experience necessary to bring a product to market?
• Study the balance sheet – well-capitalized companies have usually earned the support of smart, diligent investors.

Finally, make sure you understand the company’s strategy for getting its product approved.  Is it built on anecdotal data from small clinical trials or robust evidence of safety and efficacy from large well-controlled studies?  Are there precedents for its clinical and regulatory strategy?  Are qualified independent medical experts advising the company?  As the former CEO of a leading biotechnology company once said, “The longest route to approval is a short cut.”  Educated investors understand that there are no short cuts in developing innovative new therapies and there are no shortcuts to successful investing in cell therapy.

With regards,

Tim

As investors and the media continue to follow the progress of stem cell therapy companies, the need for clarity and transparency about our work is growing. We welcome this trend and the responsibility it places on us to describe clearly, openly and on a regular basis what we do.

Over the past year, we have found that investors, clinicians, patients and advocates are most interested in our answers to three key questions:

1. Why do you believe Aastrom’s stem cell therapy will work more effectively than other methods of treating disease?

2. What makes critical limb ischemia (CLI) an appropriate target for Aastrom’s stem cell therapy?

3. When will a large pharmaceutical company embrace stem cell therapy and partner with Aastrom?

The answer to the first question is that bone marrow cells have been used safely and effectively for over 30 years to fight certain diseases. Our stem cell therapy is produced from each patient’s bone marrow. Certain cell types found in and expanded from bone marrow – especially the CD90+ mesenchymal stromal cells and the CD14+auto+ M2 macrophages that comprise the majority of our stem cell therapy – have been shown to support tissue remodeling, address chronic inflammation and promote angiogenesis. No other stem cell therapy has this unique combination of cells. Based on compelling preclinical and clinical results, we believe that delivering our stem cell therapy directly to damaged tissue has therapeutic effects for CLI patients that are not possible with other treatment methods such as open surgical procedures, endovascular devices or traditional pharmaceuticals. Our clinical results thus far provide strong support for this conclusion. 

The answer to the second question is that many CLI patients have no other treatment options today. Despite the very best efforts of dedicated physicians and other healthcare providers, 25% of CLI patients die within one year of diagnosis and up to 40% suffer a major amputation of their leg. Traditional medicine is, unfortunately, failing these patients and the medical need is very high. However, stem cell therapies, especially those which use multiple cell types like ixmyelocel-T, appear to address the chronic inflammation, tissue remodeling and angiogenesis needs of these very sick patients. These are the key attributes that play a role in the treatment of CLI patients, who suffer from the most serious form of peripheral artery disease (PAD). Our clinical findings to date suggest that treatment with ixmyelocel-T can reduce the risk of tissue damage, major amputation and death in patients with CLI.

The answer to the third question is that a number of pharmaceutical companies are interested in our technology and clinical progress – but we cannot predict whether or when one of them will decide to work with us. Stem cell therapy, or regenerative medicine, is still a relatively new treatment modality that needs to be proven in well-controlled clinical studies. Partly for this reason, we have worked extensively with clinicians and regulators to develop our REVIVE Phase 3 CLI study, secured a special protocol assessment (SPA) from the FDA and established an independent steering committee, led by Dr. William Hiatt at CPC, to help guide this program, which is the largest ever conducted in CLI. Potential partners have been impressed with our rigorous preparations and we know that through our successful execution of the Phase 3 REVIVE-CLI trial, we will obtain a definitive answer regarding the efficacy and safety of ixmyelocel-T in the treatment of this disease.

These are not the only questions we are asked, but they are probably the most important ones we try to address regularly. Obviously, our answers in the future will depend upon our clinical findings and the decisions we make about Aastrom’s clinical and commercial strategies. In the meantime, we are continuing to advance ixmyelocel-T, educate the financial and medical communities about our work and uphold the values of scientific rigor, accountability, integrity and transparency that are the hallmarks of our company.

With regards,

Tim