Ronald Andrews
Analyst · Janney Montgomery Scott. Please go ahead
Thanks, Bob, and welcome, everyone, to our conference call to discuss our second quarter 2019 financial results and operating highlights. Joining me today on the call are Al Parker, our Chief Operating Officer; Mitch Levine, our Chief Financial Officer; Tony Kalajian, our Chief Accounting Officer; and Lyndal Hesterberg, Chief Scientific Officer. We will all be available during the question-and-answer session at the end. I'd like to start off today's call by taking a moment to express how truly excited I am to be here. As many of you may know, I've spent majority of my long career leading molecular diagnostic companies across all stages of development, from R&D to test commercialization for both in vitro diagnostic and lab-developed test products. These experiences over the last 30-plus years have led me to recognize the incredible opportunity of OncoCyte, first, as a board member and now as the CEO. I believe we're poised to make a tremendous impact in the continuum of care for oncology patients with DetermaVu and other complementary high-value tests. DetermaVu is an entirely new approach to cancer detection and diagnosis. The test uses our proprietary immune system interrogation method that provides relevant biological information by detecting gene expression changes in the immune system in response to cancer. We believe DetermaVu will be a powerful clinical decision-making tool, which could help patients avoid risky lung biopsies and their associated complication and costs. The unmet medical need and value proposition are clear. I'm convinced this is a truly unique approach with the potential for enormous commercial success in a very large and growing U.S. and global market. So where do we stand in our development of DetermaVu? In late June, we provided an update that our time line for the DetermaVu CLIA Validation study had shifted from our original estimates. As a reminder, the CLIA Validation study will assay 120 blood samples previously tested as part of our R&D validation study so that we can demonstrate equivalent test performance when conducted in the company's CLIA-validated laboratory with CLIA laboratory staff and include specific protocols to confirm the accuracy, reproducibility and precision of DetermaVu in a real-world clinical CLIA lab setting. So while we had a delay in terms of timing, our belief in our approach hasn't wavered, and what I can tell you today is that the entire OncoCyte team is focused and committed to advancing DetermaVu through to a commercially available liquid biopsy product. Right now it's an all hands-on-deck operation as we work through the final steps needed to transition our workflow that was validated in our R&D setting over to a true clinical environment with all the variables and constraints associated with use in the clinical world. I'd like to share something to put this all in perspective. In my career, I've been very fortunate to transition diagnostic tests from an R&D environment into a clinical setting over 40 different times. What I can tell you is that out of all those tech transfer events, actually only one went through as planned. Most never make it through without some technical nuance, and that's what caused our development team to pause and re-evaluate. This is something I've learned to expect as part of the process. And because we understand the importance of keeping our shareholders informed, I'd like to spend some extra time today updating you on exactly what happened, the current status of DetermaVu and how we're working to get back on track to move the program forward. To provide a little background, the transition from an R&D setting to a clinical one requires ironing out all the details of workflow standardization to ensure sufficient reproducibility is in place for reporting actual patient results. The reality we face is that test components and reagents used in the R&D setting are typically research-use only, or what in our industry we call RUO. In my experience, I've consistently seen that companies need more time than they anticipate to work out the implementation of RUO components in the CLIA setting. An important aspect to note for those new to our space is that manufacturers of RUO reagents are not required to QC these products, and thus, from time to time, we will see variability in changes in the product composition that have to be accounted for in our clinical lab setting. I'd also like to point out this was the right moment during the development of DetermaVu to pause, step back and systematically evaluate all system components to ensure each clinical step is robust and reproducible. Since taking on the CEO role in early July, I've personally witnessed the incredible effort of the R&D team in what they've been doing to get us back on track and can attest that we're all focused on completing our evaluation of the entire testing process. Here are the details for exactly what we've been working on. Our Next Generation Sequencing, or NGS, as we call it, workflow consists of multiple steps, starting with the extraction of RNA from a patient blood sample. There are multiple steps in the extraction process to clean the RNA, separating it from proteins and other nucleic acids found in the blood. Purified RNA is then further prepped with multiple reagents and buffers to be ready for the sequencing system. This is a step we call the library preparation. Once complete, the RNA library is loaded onto a gene chip and the sample is placed into the Thermo Fisher gene studio for sequencing and interpretation. While it may sound like a very complex process, NGS workflows have actually been refined and automated over the past few years to become compatible with clinical use, and we will be benefiting from that automation as we bring our tests into the CLIA setting. So let's start off with the good news. The gene studio platform that we implemented last year is performing well. The system remains incredibly reproducible, and we remain confident that this is the best next-gen sequencing platform for use for the commercial launch of DetermaVu. Importantly, all the reagent components are manufactured under good manufacturing processes, or GMP as we call it in the industry, a requirement for FDA submission, making it ideal for reproducibility demands of our CLIA setting. The key finding from our R&D efforts over the last 4 to 6 weeks is that we were encountering issues with lot-to-lot variability from our RNA extraction reagents. Now that we have isolated the cause, we will establish incoming QC protocols to ensure no further impact on our test reproducibility as well we'll work closely with our vendor to gain early notice of changes to these important reagents. Extracting RNA from blood in a consistent manner is essential to the reproducibility required for CLIA validation, and we are now moving forward to rapidly reproduce the experiments necessary to keep DetermaVu advancing on the development pathway. Also important to note is that while we're working on the extraction reagent issue, we also went back and completed a thorough review of all the workflow components. We evaluated our vendors, automation and quantitative analytical methods and now believe we are in a much better position with our development process to ensure the reproducibility that is essential for patient care. So with all that said, here's where we stand today. Our updated timeline is built in the time to retest the original R&D samples in our updated workflow. We have the samples ready to go and have identified possible solutions to expedite and move the process along as efficiently as possible. Once completed, we will then reinitiate the CLIA validation process. These additional steps mean we're pushing out the original timeline by approximately 6 to 9 months. Because of this change in timing from the original plan, many of you have asked us to be more transparent about the process. So to honor that request, here are some specific milestones we will work towards. Over the next few weeks, we anticipate completing our work with the new lot of extraction reagents, which have been validated by our newly implemented QC process. This effort will allow us to establish the robustness of our full test system on the selected lots. Once that's completed, we'll begin to test the full system on clinical samples from our archived sample set to validate reproducibility. When our R&D team is fully confident we've met the requirements for establishing the robustness and accuracy of our testing methods, we will then begin the full CLIA Validation study, and we will establish our lockdown performance parameters. Based on the work we've done to date, we believe we can complete this process within 6 to 8 weeks, which will move us into Q4. Upon completion of these steps and CLIA validation, we will begin our final clinical validation. As previously communicated in this phase, we will analyze approximately 440 blinded prospectively collected patient blood samples, and this will be the final confirmation prior to making DetermaVu commercially available. Notably, the good news is that we have collected all of the patient blood samples that we need to complete the study and stand ready to expedite this final step. It's probably most important to highlight that while we have encountered a modest delay in our commercial availability time line, this hasn't shifted the time line in working toward our final goal of securing broad reimbursement for DetermaVu. The real target we're aiming for is the Centers for Medicare & Medicaid Services, or CMS, review of our reimbursement dossier. As mentioned in our press release today, we're very fortunate to recruit Padma Sundar, an expert in marketing and market access in molecular diagnostics, and she has been actively working toward this goal in parallel with advancing our CLIA Validation and Clinical Validation studies. As of today, we believe we have an assured approach to what is ultimately our most important milestone. For those of you who are not familiar with the CMS process, there are a number of important steps that must be completed before submitting a dossier for CMS review. First and foremost is a reproducible test, which as we discussed already, we're working diligently to deliver. Another component is a peer review publication. And I can share that we're already making progress towards the manuscript template that details the underlying science and results of our DetermaVu studies. We've also started the planning for the clinical utility study we will need for final CMS acceptance and are poised to start site recruitment immediately after we complete clinical validation. The good news here is that we have a number of key opinion leaders who are enthusiastically ready to participate with us. Moreover, I'd like to remind you that we've already had enthusiastic responses for 10 public and commercial health plans, which represent 77 million covered lives. They can see the potential of DetermaVu to improve patient outcomes and improve their health care economics. These stable opinions, plus our extensive work to prepare for CMS review, are encouraging, and lead us to believe that we can still execute an aggressive time line for reimbursement, which is the most important milestone for revenue generation from our diagnostic test. So thank you for allowing me the time to share the development process in such detail. I hope it was helpful information. Next, I'd like to address our quest for high-impact talent. I have a personal philosophy that great people are the key to achieving great things. And while I'm very impressed with our current team at OncoCyte, there are some critical skill sets and experience we needed to add to complement our team and fully execute our tactical plan. I shared on the last call part of these efforts have been focused on building a world-class commercial team to support the launch of DetermaVu. As mentioned during the June call, we successfully recruited Padma Sundar to serve as Senior Vice President of Marketing and Market Access. Having Padma on the team experience and her experience from Guardant and Affymetrix is a great step forward as we advance our plans to market DetermaVu to the broadest possible patient population. Her experience as a marketing executive preparing and developing markets for molecular diagnostic tests with a focus in the liquid biopsy space will be invaluable to our efforts and is already paying dividends. More recently, we were fortunate to bolster our team with the appointment of Dr. Kim Dickinson as Vice President of Clinical Operations. Kim, as a respected leader in clinical operations and pathology, brings the experience that will be essential to advance our R&D programs and clinical studies. We believe that adding Kim to the team will allow us to fully exploit the potential inherent in our immune system interrogation approach. She will be key to delivering access to patients, to samples and to trial sites as we enter the clinical phase of our development and as we broaden our efforts into other areas of unmet clinical need in lung cancer management. So let's talk a bit about the future. I'm very confident in OncoCyte's ability to provide relevant information to physicians along the patient journey. Today, despite a significant investment in research over the last 10 years, the cure for lung cancer continues to evade the medical community. Importantly, the industry's increasing research and focus has lead us to a better understanding of the disease continuum and uncovered several critical decision points that today remain underserved by current liquid biopsy landscape. The decision point today that has created the most shareholder value has been centered around answering what targeted therapy is best suited for this patient. While this is an important decision point and one best suited for the cell-free DNA and circulating tumor DNA companies like Guardant and Foundation Medicine, there are several other important critical questions earlier in the clinical decision continuum that remain unanswered today, leaving significant room in the market for the OncoCyte approach. The market opportunities for these unmet needs along the patient journey are substantially larger than the ones currently served by the ct and cfDNA players. Our strategy team has identified critical decision points along the lung cancer continuum, where we can bring incredible value to patients, stakeholders and ultimately to our shareholders. We have a line of sight on several potential opportunities to complement DetermaVu and bring forward the time line for potential revenues for OncoCyte. I look forward to the following investor conference season to share more of these strategic insights and to share how OncoCyte aspires to continually improve the management of lung cancer patients while increasing our value to stakeholders and shareholders. While these initiatives are in their early stages, I want our shareholders to understand that we believe DetermaVu is just the beginning. Our vision is bold and compelling and we believe achievable both technically and financially. Right now though, I hope it's clear that our top R&D priority is executing on DetermaVu and completing the work that remains to deliver a commercial product with widespread adoption and reimbursement. It's been incredibly exciting to be a part of the evolution of molecular diagnostics over the past 20 years. I've been very fortunate to have led some amazing teams through transformative shifts in clinical decision-making and in patient care, and I believe there's much more to come. And that's why I'm so pleased to be here at OncoCyte. Our team has done pioneering science that is just on the cusp of being translated into widespread clinical benefit. I am committed to getting DetermaVu across the finish line and I hope after this call you, too, are confident that we're on our way. At this point, I'd like to turn the call over to Mitch Levine for a review of our financials. Mitch?