Gerard Michel
Analyst · BTIG. Please proceed. Marie, your line is live
Thank you everyone for joining us. This past quarter's results continued the strong growth we have seen since the launch of HEPZATO KIT this past January. I am very encouraged by our progress with both center activations and treatment rates. In the third quarter we reported $11.2 million in total revenue, including $10 million in US revenue from HEPZATO and $1.2 million in European revenue from CHEMOSAT. As we have previously reported, the $10 million in quarterly HEPZATO revenue was a critical milestone, triggering an approximately $25 million financing from warrant exercises. The key drivers of our revenue ramp in the US are center activation and the average number of treatments per center. In terms of center activation, we finished the quarter with 11 active centers, with an additional center becoming active in October and as of today we have 12 active centers. In the third quarter we activated Massachusetts General Hospital, Ohio State, Honor Health and University California San Diego. In early October we activated Duke and we have another center scheduled to treat their first patient in the next two weeks. There are a further five centers which recently complete fully completed preceptorships and have started screening for their first patient. We should exit the year with at least 15 treating centers and sometime in the first quarter have 20 treating centers. Our 2025 goal is 30 centers by the end of the year. Importantly, and to reiterate for prior calls, we haven't seen any center in the activation process halt the process. I'm very proud of our progress with center activations and I appreciate our investors patience and understanding regarding the complexity of the process and the inherent variability in the time required to activate a center. Now I'd like to delve into a second important metric. Average treatments per center. Our average treatment rate post per month post activation averaged just under two treatments per month in the third quarter. Given the pattern of many, of many of the new centers having low volumes for the first few months, we expect this average treatment rate to stay flat for the foreseeable future as we continue to add new centers. The one exception may be this coming quarter, the first holiday season since the launch of HEPZATO KIT. Based on conversations with centers, we expect that due to hospital schedules and patient preferences, there will be effectively one and a half to two weeks fewer treatment days in the fourth quarter, leading to a lower treatment average over the entire quarter. We shouldn't lose treatments, but the timeframe between treatments will likely be extended for a subset of the patients. I'd like now to turn to our CHEMOSAT 4sales in Europe. While revenue was roughly flat versus the prior quarter, it did increase over 100% over the same time period last year. Going forward, we expect modest but consistent year-on-year growth. As previously mentioned, given the relatively low price point in Europe, we have chosen demand for the EU market on a roughly break-even basis. Recall that we believe that the near to mid-term value of our efforts in Europe is to identify and utilize sites for clinical trials and as a continuing source of publications both in metastatic uveal melanoma and other tumor types, both of which will support EU and US adoption. CHEMOSAT has a broader pan solid tumor device label and some of our European centers have over a decade's worth of experience with CHEMOSAT. We are early in the process of identifying and opening commercial and trial centers in France, Italy and Spain, expanding beyond our current major treating centers in the UK, Germany and the Netherlands. We believe it is important to have multiple treating sites in all major European markets. In addition to the significant commercial activity, we continue to support both internal and external efforts, to add to a growing body of evidence, the percutaneous hepatic perfusion procedure enabled by our hepatic delivery system, whether utilizing melphalan delivered by Delcath CHEMOSAT or the HEPZATO KIT, is an important treatment option for patients with liver dominant uveal melanoma as well as potentially other liver-dominant cancers. As detailed in today's release, in the third quarter there were numerous presentations and publications based on both the FOCUS study and a number of retrospective studies from a variety of independent investigators. A subgroup analysis from the FOCUS trial presented at ESMO 2024 demonstrated similar outcomes in overall survival, overall response rate and progression free survival between patients with and without extra hepatic lesions or based on prior therapy. In addition, tumor responses were observed throughout the entire treatment period, supporting the strategy to continue treatment until best response is achieved. These are very important factors in both choice of therapy and duration of treatment. A 30-patient study was published in the Annals of Surgical Oncology by researchers at Moffitt Cancer Center in Tampa, Florida. This study reported that HEPZATO used in first- or second-line therapy for Metastatic Uveal Melanoma provided better disease control in the liver and improved progression free survival compared to both immunotherapy and other liver directed therapies. A 167-patient study published in the journal Therapeutic Advances in Medical Oncology by investigators from the University of Tubingen, Germany, reported that first line liver directing therapies including CHEMOSAT significantly improved the melanoma specific survival in patients with liver metastases from Uveal Melanoma compared to first line systemic therapies. We believe that this is an important finding because in cancers where the liver is the life limiting organ, specifically Metastatic Uveal Melanoma liver directed therapy may be a more appropriate option than systemic therapy. Finally, a 33-patient study was published in the ESMO Journal of Gastrointestinal Oncology by researchers from the University Hospital of Leipzig. The study, which included previously treated patients with unresectable intrahepatic metastases from seven different cancer types, reported a hepatic disease control rate of 91% with six patients over 18% achieving complete response in the liver. Median hepatic progression pre survival was 52 weeks across all patients. This is another strong signal that our hepatic delivery system platform, whether CHEMOSAT or HEPZATO, may have a role in treating other cancers. We continue to engage medical oncologists in the US and EU to discuss integration HEPZATO into treatment algorithms in combinations or sequencing with available treatment options of Metastatic Uveal Melanoma. In the third quarter a new investigator-initiated trial, the SCANDIUM 3 trial started screening patients in Sweden. This 40-patient trial is comparing randomized treatment with two cycles of CHEMOSAT, six weeks apart followed by treatments with ipilimumab and nivolumab with the control arm being ipilimumab and nivolumab alone, which is one of the global standards for care for Metastatic Uveal Melanoma. This trial is distinct from the CHOPIN trial being run in Leiden University in the Netherlands which starts with ipilimumab and nivolumab and sequences in two CHEMOSAT treatments. At this time the CHOPIN trial is fully enrolled with 76 patients and we are anticipating analysis of the primary endpoint progression free survival at one year to occur in mid-2025. We expect presentation of the results in the second half of 2025. During the past quarter, Delcath has engaged in discussions with a number of internationally recognized medical oncologists at leading cancer centers with the objective of identifying the next HEPZATO clinical development targets. Liver dominant metastatic colorectal cancer and metastatic breast cancer were identified and endorsed by experts as potential new indications for HEPZATO. Delcath is planning to initiate two phase II randomized clinical trials to compare safety and efficacy of HEPZATO plus standard of care versus standard of care alone in these two indications. The metastatic colorectal clinical trial is designed to enroll approximately 90 patients and will be conducted at more than 20 study sites in the US and Europe. The protocol is complete and the lead investigator for the colorectal cancer clinical trial has been identified. Patient enrollment and treatment is expected to begin the second half of 2025. The Phase II trial in patients with liver dominant metastatic breast cancer will start somewhat later, likely in the fourth quarter of 2025. From a financial perspective, the company is in a strong position. Our third quarter operating cash burn was only $3.6 million and given our revenue ramp, we are on the cusp of being cash flow break even. We have more than adequate resources to fund further expansion of both our commercial and our clinical development activities. The future of the company is extraordinarily promising given our expected revenue growth, strong balance sheet, and the ability to further develop our hepatic delivery system platform across additional diseases. I will now call hand the call over to Sandra to share further details on our financial position.