Marc Hedrick
Analyst · Maxim
Thank you, Kristen and good afternoon everyone. Thank you for attending the call. Welcome, my name is Marc Hedrick, I’m President and CEO of Cytori. Joining me on the call today is a big group, our Chief Financial Officer, Tiago Girão; our VP and General Manager of Cell Therapy, John Harris who is joining us from Japan; our Chief Medical Officer, Dr. Steven Kesten and also our Senior Vice President Clinical Affairs, Dr. Mark Marino is joining us today. Little bit about Mark, he joined us earlier this year and has brought a substantial background in the pharmaceutical industry and therapeutic development to Cytori. Mark’s a graduate of the United States Military Academy at West Point. He’s an internist, a clinical pharmacologist and after serving as Chief of Department of Pharmacology at Walter Reed and on the faculty at The Uniformed Services University of the Health Sciences and Walter Reed, he’s held a number of corporate executive leadership positions including the Global Head of Clinical Pharmacology for Eisai and Roche, Head of Research and Early Development in Mankind Corporation and VP of Clinical Development at Daiichi Sankyo. Welcome Mark. And want to let our listeners know that I’ve asked Dr. Marino to now take on our clinical affairs lead role as Dr. Kesten has notified that it’s time for him to retire after a very long career, as a well respected academic physician and highly productive executive in the biotech and pharmaceutical industry. Steven has graciously agreed to stay involved with Cytori as needed on a consulting basis as he transitions and we’re thankful to Steven for his service. We have recently issued our Q2 earnings release which is now posted on our website and a copy of this transcript will be available there soon as well. So the agenda for today’s call is similar in past quarters. First, I’ll discuss our pipeline progress including key updates in clinical programs; Tiago will then update on financials; John will discuss our commercial progress and then I’ll get back on and update on forthcoming milestones, and then we’ll have time for Q&A. So first on the clinical pipeline, in terms of scleroderma, in Q2 was a big quarter for us. We completed enrollment in U.S. Phase 3 approval trial called STAR or hence scleroderma. First I’ve got to say that we are really thankful to our patients here in the U.S., the advocacy groups that supported this trial and the investigators and the support teams for their enthusiastic support for the trial which really exceeded all our expectations. The enrollment was accomplished ahead of schedule and for the record, the last patient handled was on June 6, 2016. We ultimately enrolled 88 patients, eight more than originally planned. Thus far, to our knowledge, there are no safety concerns that have been noted in the trial thus far. And in fact last weekend, we were invited to present a poster at the Scleroderma Foundation National Meeting in New Orleans where we presented the poster outlining the trial protocol and the treatment approach to the patients and physicians that were in attendance. The data readout for STAR is expected to be mid-2017. Related to scleroderma and as a heads up, in Q2, we filed for U.S. orphan approval for scleroderma from the FDA. We anticipate hearing back from them in the second half of 2016 and the idea behind this which may not be immediately apparent is the downstream, potential retreatment strategies for scleroderma patients may need to incorporate the cryopreserved version of the ECCS-50 therapeutic which is to be studied in the current EU trial. We feel that this may qualify as an orphan drug in the U.S. as it is in Europe, and we have filed that paperwork with FDA and should hear back relatively soon, and we’ll keep you apprised to that. In Europe, in terms of scleroderma, as planned, we filed for scientific advice from the EMA in Q2 regarding conditional market authorization and we expect feedback in Q3 on that. The EU investigator initiated trial called SCLERADEC-2 is enrolling albeit slowly than we would like and slower than originally forecast. There is some 2016 risk on that milestone completion. As previously discussed last quarter however, the U.S. STAR trial enrolled ahead of schedule and will actually be the dataset that the company intends to use to seek EU approval as well as approval here in the U.S. which effectively mitigates any potential time risk to the SCLERADEC-2 trial. Now to osteoarthritis, I would like to begin by sharing the preliminary top-line findings from our 94 patient, Phase 2 randomized control trials, single administration of the autologous cellular therapeutic ECCS-50 for patients with knee osteoarthritis of moderate severity. In Q1 after the 24 week time point, we reported interim findings from a limited data unblind focused on safety, feasibility, primary endpoint readout and early trend to mean values between active and placebo in patient reported outcomes. The complete trial readout is scheduled for 48 weeks follow-up. And as a reminder, the primary purpose of the trial is to establish safety and feasibility but also we assess the effects of two therapeutic doses, export a number of pre-specified secondary endpoints potentially useful in subsequent trials as potential primaries, and we tested for significance for the pain on walking single question on the KOOS scale at 12 weeks which is already press released back in Q1 earlier this year did not reach statistical significance. So now regarding safety and feasibility; we can say that inter-articular application of a single dose of ECCO-50 is feasible and safe in an outpatient base setting. So the feasibility issue, the trial enrolled ahead of schedule and a greater number of patients than originally planned were enrolled. And in fact, up to three patients were treated in a single day without problems. To the safety issue, there were no SAEs related the fat harvest or ECCO-50 administration. There were some minor imbalances in non-serious AUs[ph]. As to the patient reported outcomes, specifically on dosing now, we found which was consistent with our overall preclinical and clinical experience thus far and frankly consistent with the threshold dosing paradigm that we hold in cell therapy, there was no clear benefit in using 40 million cells versus 20 million cells. That being the case for the purpose of reporting preliminary findings, we focused our evaluation on pooled active and pooled placebo groups as a comparative assessment. In terms of the pre-specified exploratory endpoints, relative to potential follow-on trials, we found that in each of the following time points 12, 24 and 48 weeks, there were consistent trends suggesting symptomatic improvement and the target need of the treated group relative to placebo control after single administration of ECCO-50. Positive trends were seen in the following endpoints of the three time points in terms of total KOOS, all individual KOOS sub-scores, KOOS subscale question pain on walking which as mentioned was selected as a primary, pain on walking 50 feet, OA activity osteoarthritis activity, osteoarthritis disease severity, OARSI-responders and then the need for rescue medications. Only pain on standing and SF-36 did not consistently favor the active arm. As of note, these trends were observed despite lower need for analogies with rescue medication in the actively treated group. In general, the magnitude of the mean changes observed in the trial from baseline to the various time points were substantial, consistent with placebo effect or saline effect as reported in recent med analysis. In comparison, the difference between active and placebo at various time points were all consistent was relatively small. Some comparisons between active and placebo for patient reported outcomes approached and in some cases reached statistical significance. While the ECCO-50 showed signals as to improvements in patient reported outcomes, as a potential regenerative therapy for these patients that uses living cells, MRI valuation of joint pathologic changes were an important aspect of safety and exploratory analysis of this trial. To that effect, we use blinded expert MRI readers to evaluate the MRI Osteoarthritis Knee Score in this case MOAKS to evaluate a possible effect of the overall disease severity of the knee. The MOAKS analysis system device in the 15 anatomic subunits and measures various parameters that correlate with both early and late joint dysfunction. And longitudinal studies to detect changes MOAKS is generally used to follow patients out well beyond two years to establish trends and it can also be used as a prognostic tool for the need for total knee arthroplasty. This trial showed consistent trends in all six pre-specified MOAKS classification score and it’s important to note and in particular emphasize that while preliminary and further analysis is warranted, this suggests that the therapy may result in an effect on the target knee joint pathologic features at 48 weeks from treatment, for the treated group relative to placebo control group after single administration of the therapeutic. Specific anatomic subunit analysis is important here and correlation with symptom improvement data is ongoing to further characterize the nature of any cell effect. For the record, specifically the six features we assessed and trended positively were inpatients were the number of bone marrow lesions, the percent of bone marrow size, the size of bone marrow lesions as a percent of the sub-region, the percent full thickness cartilage loss, the cartilage loss as a percent of surface area and the size of the largest osteophyte. The safety profile coupled with observed trends in patient reported outcomes and joint imaging favoring cell therapy in its first trial in patients with this indication are encouraging and particularly intriguing in the context of the potential imaging benefits in the joint itself, the correlation is -- though. So what are the next steps? Our advisors have recommended further and deeper examination of the data in particular correlations of the patient reported outcome and MRI data and looking at specifically at anatomic sub-regions which requires of actually raw data set and those analyses are being considered. We have an awful lot of data here. So, from a strategic perspective, what is the preliminary data meaning for the company in terms of our overall plans? Well as mentioned previously, our corporate focus remains on targeting niche orphan indications that can be brought to market quickly and cost effectively, scleroderma is the prime example there. However, knee OA -- a dispute is a compelling opportunity and building on this trial with further development, we feel it’s warranted but will require partner support. Our intention is to reach out to those with whom we’ve been in contact, that have had interest or may be interested in this data and we’ll share the full dataset with them. But also, and I think this is an important point, we will work with our current commercial partners in Japan that have obtained approval to treat OA patients under provisions, under the new regenerative medicine law and are interested in the clinical use of this product and moderately severe osteoarthritis patients. This safety and feasibility data will use to help support that effort. Finally, we intend to detail the study results via academic presentation and publish that in a peer review journal, if and when accepted. So let me move on to brief update on our urinary continence trial, the ADRESU trial continues to enroll, that’s a funded trial by MHLW, which is enrolling at four sites in Japan. It’s a 45 patient open label approval trial to assess the safety of the ECCI-50 combination cell tissue therapeutic for male urinary incontinence after prosthetic intervention. The timeline of present enrollment rates suggest that we still look for data to be available some time in 2018. In terms of our thermal and radiation injury program, supported impart by Health and Human Services and BARDA, we can report that we believe that we now have alignment with the FDA regarding our application for IDE approval on intravenous administration in acute burns. So therefore [indiscernible] ways, we anticipate approval toward the end of 2016 and enrollment beginning in mid-2017, and that timeline is looking increasingly clear to us. Approval of this trial is linked to further milestones and expanded development efforts under our existing contract with BARDA. Furthermore, this is also important as a new trial for us because this is the first use in the U.S. of our intravenous formulation of ADRCs administered intravenous with inpatients which represents a significant new clinical R&D opportunity for us in patients that have an ongoing active systemic inflammatory process. So with that, I’ll turn the call over to our CFO, Tiago Girão. Tiago?
Tiago Girão: Thank you, Mark and good afternoon everyone. During Q2, we continued to fully invest in our key R&D programs, while working to reduce our losses and operating cash burn and improving our operating performance. Our operating cash burn in Q2 was $5.7 million which is slightly higher than planned, mostly due to our accelerating enrollment of the STAR Phase 3 trial. Our net loss continues to trend in the right direction. When adjusted for non-cash charges related to changes in fair value of warrant liabilities and a beneficial conversion feature charge on preferred stock, net loss was $6.4 million in Q2, a 26% decrease when compared to $8.7 million loss in Q2 of 2015. For the six months ended June 30, our net loss when adjusted for non-cash charges related to changes in fair value of warrant liabilities and a beneficial conversion feature charge on preferred stock was $11.7 million as compared to $15.2 million for the same period in 2015, representing a 30% decrease. As outlined by Marc, our primary corporate focus is to bring an approved therapy to market in the U.S. and to that extent, in Q2, our research and development expenses, excluding share-based compensation was $5.1 million, or a decrease of 13% over the $5.9 million spent in Q2 of 2015. The decrease in spend from 2015 to 2016 is primarily related to the higher number of patients enrolled by the OA trial in Q2 as compared to the STAR trial in Q2 2016. We continue to optimize our sales and marketing activity and related expenses, which excluding share-based compensation was approximately $800,000 this quarter, as compared to $600,000 in Q2 2015. The increase is mainly attributable to the ongoing investments in the Managed Access Program and our sales operations in Japan. G&A spend during this quarter, when excluding share-based compensation, was down to $2.2 million compared to $2.3 million in Q2 2015. Although we will continue to focus on reductions in discretionary spend, we expect G&A expenses to stay relatively consistent at current levels. With respect to our revenues, in Q2, we recognized total revenues of $2.8 million compared to total revenues of $3.5 million in Q2 2015. Note that in Q2 2015 included approximately $700,000 related to the initial order from Lorem Vascular which did not recur this quarter. Product revenues were $1.1 million during this quarter compared to $1.6 million in Q2 2015 or $900,000 when excluding the initial order from Lorem Vascular, so there was $200,000 increase quarter-over-quarter. Japan revenues almost doubled during the quarter, growing from $352,000 in Q2 as compared to $690,000 in 2016. John Harris will provide a bit more color on this later on the call. Contract revenues were $1.7 million during the quarter as compared to $1.8 million a quarter last year. Turning to the balance sheet, at June 30, we had $20 million in cash and $17.7 million in debt. In addition, during this quarter, we paid off the remaining outstanding obligations related to the acquisition of the Cytori Olympus joint venture. Based on our current projections, we believe such cash balance provide liquidity for at least 12 month of operations and through scleroderma data. Operationally, we are later focused on the execution of our key clinical objectives and will continue to emphasize on our Phase 3 scleroderma program. With respect to the 2016 financial guidance, for the balance for the year, we believe we can realize further additional improvements in operating efficiencies and expect to continue to narrow our losses and operating cash burn. With that, we are reiterating our operating cash burn guidance of approximately $18 million to $20 million and we’ll continue to expect total revenues to range from $12 million to $14 million, with growth coming primarily from product revenues from Japan and our Managed Access Program. Looking beyond 2016, based on our current projections, including recent Japan achievements, operating cash burn trends were significantly improved on a year-over-year basis, narrowing our losses into breakeven territory by the end of 2018. And with that, I’ll turn over to John Harris, our VP and General Manager for Cell Therapy. John?