Michael Tardugno
Analyst · Dawson James
Thank you, Kim, and good morning, everyone. Joining me today is Jeffrey Church, Celsion’s Executive Vice President and Chief Financial Officer, who will provide a review of Celsion’s recent financial results in a few minutes. Also on the call for the Q&A portion are Dr. Nicholas Borys, our Chief Medical Officer. And I hope Dr. Khursheed Anwer, who is attending by cell phone. Dr. Anwer is on his way to an investigator site, to initiate it, for the OVATION Study and is dialing in by cell phone. So, Khursheed, we hope you stay connected.I’m going to apologize a little bit. I have a cold, if you can hear it. So I’ll do my best here.As always, it’s a pleasure to be speaking with you, particularly now as we approach the conclusive milestones, that have been made possible by the methodical and rigorous execution of our clinical development programs for ThermoDox and GEN-1.Today’s call will be mostly reassuring, as most of our prepared remarks are in the public domain already. I’m going to start with a comment that I’ve been making regularly over the past year: possible but not probable; you’ve heard me say that.This has been our guidance for the past year or so regarding the first interim analysis for our Phase III OPTIMA Study. We’ve also said that there is a higher probability of success at the second interim analysis, now anticipated by June of next year, just 7 or 8 short months from now. We stand by that guidance. There is a higher probability and I’ll point that out to you in my remarks.I will once again remind you that our fundamentals are sound. And overall, you should expect no surprises from this management team.Our meetings with various regulatory agencies have resulted in no significant issues. Our manufacturing strategy is solid. Our product cost is enviable. Our clinical trial strategy is unquestioned by the experts.Our spending and cash management has been tight and focused. And our 2 investigational products both have blockbuster market potential by any standard of measure. Recent positive recommendations from the independent Data Monitoring Committee, or DMC, and the independent Data Safety Monitoring Board, or DSMB, for both our OPTIMA and OVATION 2 Studies respectively are underpinned by our solid cash position, a position that’s been sufficient, that is sufficient to support an operating runway into the first quarter of 2021.I’ll also note that additional developments are expected during this time-period that could be transformative for the company. Jeff will cover our current cash position, our financing strategy, and our ability to access funds in more detail during his report on this call.So I want to acknowledge upfront that our stock has been under some undue pressure, I suggest that defies reason. There’s a great deal of misinformation out there. As some of you probably know, some purposely posted, I suspect, some misunderstanding and speculation mostly.I’d offer you this that your best source of information on Celsion and our trials comes from the company, in our filings with the Securities and Exchange Commission, our quarterly conference calls and our press releases.And I’ll remind you that 2020 has the potential to be the pivotal year for Celsion.On my formal remarks, I’d like to cover 4 important themes. The most important of which is number 4, we’ll elaborate it, and that is our commitment to shareholder value. So, let me start with the first one. I’d like to say again, we are well positioned to achieve our objectives.We have the resources, relationships, personnel, technology, manufacturing capability and the capital to continue to deliver, as we have been doing over the past few years.Our lead product candidates are directed to large and underserved markets. I repeat that, our lead drug candidates have excellent commercial potential.Second, our clinical studies are showing promise. As we announced on November 4, the first interim review by the Data Monitoring Committee of the un-blinded safety and survival data from the OPTIMA Study resulted in a unanimous recommendation that the Study continue according to protocol.As I said earlier, this is a recommendation that we had expected. We believe also that the accompanying blinded pool data are predictive of a successful study. My view is that you have to purposely ignore the signals, the science and the published evidence to conclude otherwise.The data show that pool progression-free survival, for example, appears to be tracking identically, if not better than PFS of the 285-patient HEAT Study subgroup, a group that we followed prospectively for 3 years. Let me explain that.This is not a retrospective subgroup coming from a prior study. This is a prospective group. It’s a group that we identified following our research into the key driver of success of treating patients with radiofrequency ablation plus ThermoDox.We now understand that to be a minimum of 45 minutes of RFA treatment in combination with ThermoDox.Once we established that pre-clinically, we then identified a group of patients who were treated with a minimum of 45 minutes, a group of patients comprised of a control arm and an active arm. Virtually half of the patients were in the control arm, half of the patients are in the active arm.Then we followed these patients for 3 years, every quarter for 3 years. And we talked about it regularly, I mean, we had quarterly press releases. And I think if you followed our progress with this group, you’d know that this large well-balanced subgroup, followed prospectively for 3 years, well-balanced, demonstrated a median time to death of more than 7.5 years. That’s curative by any standard of measure in oncology and more than 2 years of overall survival benefit over the RFA arm alone.I want to remind you that sorafenib and other kinase inhibitors, that are approved for advanced disease, advanced HCC, they’ve been approved with as little as 11 weeks survival. So, the magnitude of effect here by any standard of measure is remarkable.These findings have been confirmed by the NIH, an independent review of the intent-to-treat population, focusing on all single lesion patients, that’s 432 single lesion patients. And they concluded, and this is a manuscript, it’s available to you, that, as you increase the heating time and add ThermoDox to the procedure survival improvements are of significance.It’s also been confirmed by various prospective pre-clinically and computational studies, and reinforced with data from the liver cancer studies being conducted by the researchers at Oxford University in England. And that’s also supported with our own 2 Phase II studies in breast cancer. It’s in fluorescence imaging that we recently issued a press release on, among other public research.Now to read it all and it’s available on our website, the science, the medical results and the preclinical evidence are all compelling. Yes, and I would venture even, if you’ll allow me, even to the skeptic members of The Flat Earth Society.We also recently reported that our Phase I/II OVATION Study with GEN-1 in newly diagnosed patients with advanced disease, that’s Stage III and IV ovarian cancer, is gaining momentum. After a very difficult startup, and you know, you’ve been with us, it has been a challenge to get started up for a variety of reasons.The most of which is a requirement, the new requirement initiated or established by the NIH that every investigator site have an independent review committee, a biological review committee, which took a great deal of time to establish in many of our sites.So after that very difficult startup, we are now seeing enrollment rates that could very well be in line with, if not, better than our plan. Importantly, the independent Data Safety Monitoring Board recommended completing the Phase I dose escalation portion of the study at the current dose, which is 100 mg/m², after their review of the first 8 patients randomized in the study.I am happy to report that we now have a backlog of prospective patients in screening for the DSMB after the DSMB’s green light to continue.So obviously, and we meet with them regularly, our investigators are excited about the potential of GEN-1, about the potential for the trial and as are we, and I hope you are too.The third is our supply chain. Now, we’ve taken the necessary steps to ensure a robust and cost-efficient supply chain for both GEN-1 and ThermoDox with multiple suppliers and redundant capacity. Gross margins, not only as a function of price but as a function of very competitive costs, gross margins for ThermoDox will be impressive, no matter the market or the local economy.Remember, now, ThermoDox is being evaluated in HCC. HCC or hepatocellular carcinoma, is primarily a disease of Southeast Asia and China, countries where disposable income is quite modest, so keeping our costs down, extremely important to successful commercial launch.So I expect our gross margins on average, and we’ve been saying this, should be very close to the 90s, if not, in the 90s, when you look at our weighted average gross margin for the [group] [ph]. GEN-1, our interleukin 12 gene mediated immunotherapy, after an intense 2-year tech-transfer, will be manufactured at a fraction of the cost of other plasma-based drugs.This is important. Patients treated with GEN-1 will receive as much plasma as all of the other patients combined in the world. Believe it or not, 17 doses at 100 mg/m² is an enormous amount of plasma. So getting the cost down in order to have an effective commercial strategy, along with gross margin is important.Your company is focused on that from the beginning. And we are now completing our tech transfer. And I’ll remind you, a redundant high-quality low-cost supply chain is critical for big pharma to evaluate and consider us as a license opportunity.Now, number 4, our commitment to shareholder value. And I would say, if you’ve been following us, it’s uncompromising. Hand in glove with conducting successful trials is our focus on non-dilutive and uncomplicated sources of financing.We worked hard to establish a clean cap structure. No warrants, no convertible instruments and the like that can be used to leverage a short position. We owe a great deal to Jeff Church, sitting on my right here, for his excellent negotiation to retire our warrants through a very creative stock exchange. And we know that that stock was used to cover a short position.Last I looked, the short interest in the company is less than 0.5%, less than 1%. That’s remarkable. And I challenge you to look for other micro-cap biotech companies with that kind of reported short position.On the positive side, we renewed our common stock equity facility with Aspire Capital in late October. There is some misunderstanding about this line, let me try to clear it up. This new line is for $10 million. That compares with a $15 million line that we canceled. Important, it replaces the $15 million line.It’s important to know that Celsion alone, at our sole discretion, controls the timing and the amount of stock that will be issued under this agreement. And our intention is to use this facility judiciously. I know it’s a major mean to fund the company. We will use it judiciously and evaluate the market conditions. If they’re not right, then we do not intend to use it.This deal is both defensive and offensive, and is constructive as one of many tools, Jeff will talk about these, that we have employed to avoid the toxic death-spiral financings that are all too common and all too typical in the micro-cap biotech space. We don’t want to and you don’t want us to enter into heavily discounted financings with heavy warrant coverage as we have seen recently be the norm for the micro-cap biotech sector, if you look at deals over the last 18 months as we have, heavily discounted heavy warrants.Last but not least, I want to clear up something on our debt, our use of debt. I believe we use our debt very smartly to leverage your equity investment, uncomplicated venture debt, interest-only for the first number of years. The repayment of this debt is fully accounted for in our spending plans.Now, we ended the quarter with $19 million in cash on the balance sheet. Then we look forward to adding another $4 million through the sale of our New Jersey net operating losses, including $2 million in the current quarter. It will give us more than enough cash to see us through the important value drivers well into 2021.I got to say, we are delighted to be a part of the New Jersey biotechnology pharmaceutical environment. You know that New Jersey is the cradle of civilization for the pharmaceutical industry. Their willingness to provide this kind of incentive for companies like ours to sell their net operating losses ahead of their commercial capability has been very good for the company and certainly good for our shareholders.The last point I’d like to make is that the support from the international thought leaders should be reassuring to you. We continue to receive support from key opinion leaders and global leaders in their fields of medicine, largely focused in liver cancer, ovarian cancer.Requests for support for their trials of ThermoDox and GEN-1 are numerous. We sort through them regularly. We have a number of activities going on with a variety of researchers. Their interest in ThermoDox is driven by our results, and the mechanism of action, the capability that it has to deal effectively with solid tumors is very heartening.Another example of their interest is in then presenting ThermoDox to their medical colleagues. As an example, we recently cosponsored a symposium focused on HCC at the conference of the International Liver Cancer Association in September. This symposium included 2 preeminent researchers in HCC, including Ghassan Abou-Alfa, of Memorial Sloan Kettering and Professor Riccardo Lencioni from the University of Pisa.Professor Lencioni is the preeminent expert in radiofrequency ablation for HCC. The program, I was there, it was well attended; a lot of great questions, many of them focusing on the future treatment options for HCC. You know this is a very underserved indication; very, very difficult to deal with. The promise of Thermodox was explored quite thoroughly.We also note that these kinds of medical education programs that can provide us with a template for introducing ThermoDox, once the data is available to us, but prior to formal market authorization. So we learned quite a bit from this and intend to use it once we have positive data from the trial.I’ll now turn to the positive news regarding the recommendation from the DMC from the OPTIMA Study following a review of the unblinded data at the first pre-specified interim efficacy analysis. The committee unanimously recommended that we continue the study as planned. For this analysis, the DMC reviewed data following 128 patient deaths which occurred early in August 2019. The committee found no evidence of futility or any safety issues of concern in this 556 patient study.As I mentioned, what is particularly encouraging is that PFS events are tracking virtually identically through the 285 patient prospective subgroup seen in our earlier HEAT Study.While, although that the HEAT Study trial did not succeed, the subgroup, who received 45 minutes more of RFA with ThermoDox, I’ll say it again, demonstrated a 2-year overall survival advantage, a median time to death of more than 80 months. I want to emphasize that the bar for success for OPTIMA Study, at the final analysis, is only 70% of this survival benefit.So we have a great deal of margin here to conclude that our study would be successful. So far lower bar for success when compared to the prospective subgroup. I’ll talk about the hazard ratios in a minute.Although, we did not meet the required hazard ratio at the first interim analysis, the company data did provide the following information. Number one, the OPTIMA Study patient demographics and risk factors are consistent with what the company observed in the prospective subgroup with data quality metrics meeting expectations, so it’s very important.Controlling the study, a high-quality study globally has been a life’s commitment here for our clinical operations team and Dr. Borys. And we’re delighted with the quality of the metrics, quality metrics.Number two, that the median PFS for overall, for the OPTIMA Study reached 17.3 months. These blinded pool data compared favorably to the pool data from the prospective subgroup, which showed a 16.8-month median time to progression.Number three, the rate of patient deaths for the OPTIMA Study appears to be tracking well with the HEAT Study prospective subgroup. As we suspected, however, overall survival from the OPTIMA Study was not sufficiently mature to draw any conclusions.The study had a median follow-up, the OPTIMA Study events had a median follow-up of 25 months, whereas the comparative prospective subgroup had a median follow-up of 67 months.So I’d just give you a little suggestion here. If you’d like, the capital marker for the prospective subgroup of 285 patients is published in the HEAT Manuscript. It’s on our website. I encourage you to take a look, judge for yourself, where a meaningful separation occurs.And number 4, the OPTIMA study has lost only 4 patients to follow, so about less than 2% of a patient per year. This kind of follow-up suggests, and by the way the study was designed with an allowance for 3% loss per year, and this suggests to us that patients and investigators believe in the study’s potential. And their commitment is what’s important to us, in order to be able to properly evaluate the results for the trial.So our next preplanned efficacy analysis will occur following a minimum of 158 patient events. The hazard ratio for success of 158 is 0.7. This compares favorably again to the observed, the hazard ratio that was observed for the prospective subgroup. If you look at the Kaplan-Meier analysis, it’s on our website in our corporate presentation, that hazard ratio is 0.65.So for success at the next interim, hazard ratio is 0.7. And I’ll also point out that the p-values are consistent with what we believe what gives an odds-on chance for the second interim to be successful.Now the p-value for the prospective subgroup was 0.02. The p-value allowed for it to be successful at the second interim is 0.0244. So we have some margin here, both with the hazard ratio and the p-value. To conclude, that there is a potential here for success at the next interim.Now, recall that the largest incidence of HCC occurs in China, with more than 400,000 new cases diagnosed there each year. As I mentioned on the last call, the Chinese authorities have expressed an interest, and I have indicated it in patients. It’s my view. In turn, it means to accelerate the data from the ThermoDox trial.This was stated during a meeting with Dr. Borys in 2016. We followed up. They asked us if there was a means to be able to evaluate the data sooner. We followed up this past October. I think it was October 23. The company met with the Director for the Center for Drug Evaluation at the National Medical Products Administration or the NMPA, formerly known as the CFDA. So we met with the Director of the CDE and her team.With respect to the possibility of un-blinding the OPTIMA trial, after the first interim efficacy analysis, they indicated that data maturity was not sufficient to support accelerated or conditional approval at that time. But they did indicate a preference to consider the data from the second interim analysis, which we think is encouraging.Even more encouraging was the suggestion that they made, that the company should consider a compassionate use program in China. We see this as a positive, we certainly do; and are making plans under Dr. Borys’ direction to launch a program in high volume, high quality clinical sites to participate in the OPTIMA Study.It goes without saying the compassionate use program, given what we know, there’s a potential to provide patients with a very unique opportunity to extend their lives.Meanwhile, as I mentioned last quarter, we are continuing our work on the NDA for the ThermoDox and HCC. The goal is to position us to be able to file quickly once we have positive data. I can report to you and for those of you who are NDA wonkies, modules 2 and 3 are nearly completed.In summary, we’re very excited about the potential of ThermoDox and believe this could be an exceptionally valuable asset as more data are generated, and not only for HCC, but for other solid tumors.While ThermoDox and OPTIMA are of immediate interest for some and probably most investors at this point, we believe that GEN-1 holds an equally compelling promise.Earlier in development, GEN-1 is being evaluated in the Phase I/II OVATION II Study of newly diagnosed treatment naïve late-stage ovarian cancer patients. Patients are stage 3 and 4, typically with a malignancy that is heavy tumor burden that fills their belly.They’re typically treated with neoadjuvant chemotherapy prior to surgery. In our study, OVATION II, following OVATION I, which is similar in nature, in this study we treat patients with GEN-1 in combination with chemotherapy prior to surgery. And after surgery, we’ll continue to treat them with GEN-1. The goal of which is to delay progression.OVATION II is a randomized Phase I/II study designed to evaluate safety of up to, this one portion, Phase I portion, up to 100 mg/m². We should have the answer to that before the end of the year. That’s followed by continuation of the selected dose we now believe that will be 100 mg/m².The Phase II is an open-label 1:1 randomized trial. And only as open-label were allowed, as the investigators become confident, to report data from the trial and we’re happy to do that.GEN-1 is designed using our proprietary TheraPlas platform technology. That’s comprised of an interleukin-12 plasma, DNA plasma. And we associated with our lipopolymeric nanoparticle delivery system, TheraPlas. This nanoparticle enables the cell to be transfected with the DNA plasma, resulting in persistent local regional secretion of the cytokine or the inflammatory protein IL-12.And we know that IL-12 protein to be a potent anticancer recruiter of the entire immune system to fight malignancies. We have every reason to believe it can be effective in ovarian cancer.Last week, we reported to the independent Data Safety Monitoring Board, DSMB as I was calling it; completed its safety review from data from the first 8 patients enrolled in the Phase I portion of what will be 138 patients total.Based on the unanimous recommendation the study continues as planned. And we proceed with completing enrollment in the Phase I portion of the trial. The remaining patients in this portion of the trial will continue to receive the current 100 mg/m² of GEN-1.In all, we should have 6 patients, a minimum of 6 patients in the control arm and 6 patients in the GEN-1 arm by yearend. That’s our target. Following that, we will be reporting data, surgical outcomes and objective response rates; followed by translational data, once the tissue samples from these patients have been interrogated by researchers at Roswell Park cancer institute.At this point, we have 16 active sites, expect up to 25 sites up and running in January in the United States. And we will add 2 more in Canada for a total of 28 sites to recruit patients. Our goal is to complete enrollment by the end of next year. And we are very hopeful that we can do that, particularly given the backlog that we’ve seen immediately once reopening the trial in the Phase I portion.The study is powered to show a 33% improvement in PFS, which is the primary endpoint, when comparing a GEN-1 with the standard of care to the standard of care alone. The PFS analysis will be conducted after at least 80 events have been observed or after all patients have been followed for at least 16 months, whichever is later.Also, patients in the GEN-1 arm, as I mentioned earlier, will receive GEN-1 plus chemotherapy after their interval debulking surgery. Again, the goal here is to delay progression, because we know when a patient progresses, the prognosis is not that great. The first 2 portions is expected to begin in the first half of 2020.I conclude by saying we’re very optimistic that GEN-1 will ultimately find its place in the treatment arsenal for ovarian cancer, and will be both competitive in the marketplace and a high-margin product force. With margins and supply in mind, we also announced last week that we are finalizing our tech transfer. In fact, we produced a lot, one first lot for clinical use from or actually 2 lots from our global manufacturers: HISUN Pharma and Poly Pharm, Hainan Poly Pharm in China.As I mentioned, our goal is to ensure an affordable treatment regardless of the market or the region. Once approved, the cost structure for GEN-1 is expected to support rapid market adoption and significant gross margins.Now, before I turn the call over to Jeff to – for his review of our third quarter financials. I want to emphasize that Celsion, again, it is well positioned to deliver significant developments in the coming year. Underpinning our fundamentals is a strong balance sheet, access to capital and a committed management team.We continue to expect to create significant value for our shareholders and patients in the medical community. Now with that, I’ll turn it over to Jeff. Jeffrey?