Marc Hedrick
Analyst · H.C. Wainwright
Thank you, Alicia, and good afternoon, everyone, and welcome to Cytori's first quarter 2018 earnings call. My name is Marc Hedrick, President and CEO of Cytori; and joining me on today’s call is our Chief Financial Officer, Mr. Tiago Girão. On the call today, I will provide an update on the company’s oncology and cell therapy programs. And Tiago will update on our financial performance, then we’ll have time for Q&A after which I will update on forthcoming milestones. So let me begin by discussing our nanomedicine platform. First of all in terms of our lead oncology drug candidate, ATI-0918, a pegylated liposomal doxorubicin, from a manufacturing regulatory perspective, we’re continuing to make progress building out our manufacturing team and key support functions in our San Antonio manufacturing plant. The total team size in San Antonio is up to 13 people and we anticipate that growing to 20 employees. Since our last call, we are now manufacturing characterization lots loaded with active pharmaceutical ingredient. We’ve completed our self-image contract and that's in place with Brylan from Michigan and in Europe Cytori has received confirmation from the European Medicines Agency that ATI-0918 is eligible for centralized authorization procedure. But basically, what this does is it allows the marketing authorization holders to market the medicine and make it available for patients and healthcare professionals in all the EU member states, including the EEA, the European Economic Area countries. In addition in Q1, Cytori submitted a new envisioned name request to the EMA, which will ultimately as the authorized brand name that will place the ATI-0918 on in the designation. Now, as you may know, liposomal doxorubicin is in a unique niche in the generic space. The drug itself is intended to treat seriously-ill patients with life-threatening diseases. It's a tough drug to make. It's much more like a biosimilar, in terms of it's manufacturing and formulation complexity, than it is to a typical generic. Also manufacturing and quality-related issues have affected the market, resulting in global supply shortages over the last decade. Also, in addition, emerging real-world clinical publications are suggesting that clinical performance is not identical between Lipodox, a generic competitor, in other words, that all liposomal doxorubicins are not created clinically-equal. But I think, in that's an opportunity for Cytori. And we think that an important part of our differentiation in the market will be around quality. In particular for this drug, we want to be positioned as a high-quality, made in the USA, provider of the drug, with the best-possible clinical effectiveness. So digging deeper and looking at the market dynamics in the competitive landscape, I want to give you a little bit more color. We are continuing to monitor the global market landscape and update our models. And if you look at the market estimates and bio surveys, it indicates that there’s a current global market opportunity of approximately $400 million to $750 million a year in revenues, with China really driving the growth forecast for that market. In Europe, the current market opportunity estimates are approximately $120 million to $300 million a year. And in Europe Janssen’s Caelyx is currently the long pegylated liposomal doxorubicin product available there. Cytori believes that significant revenue share can be gained by being either the first or second generic approved by the EMA, and that ATI-0918 has the potential to take one of these two positions. Now, to be complete I want to point out some public information that investors may be aware of, it’s in the EMA meeting archive, providing the potential EU competitors, TLC, has actually submitted a letter on March 9 of this year, requesting an extension of a clock-stop to respond to EMA’s list of questions. This company had previously announced a submitted marketing authorization for the generic pegylated liposomal doxorubicin product candidate in May of 2017, and we’ll continue to monitor that on the competitive side. In the U.S. and Canada, liposomal doxorubicin market revenue estimates are roughly similar to that in Europe. In other words, about third of the market is in the North and South America, about a third is in Asia-Pacific and about third is in Europe in EMA. If you look, specifically again at Europe, that the – in the U.S., that the market share is – the revenue leader is the J&J product and the rest of the market is split between Lipodox and generic competitors. We continue to gauge the evolving market dynamics and evaluate strategic options to position ATI-0918 program for U.S. entry, but currently, that’s not our priority market. Now in China, we feel that there’s significant opportunities for this product. Currently, there are three marketed and approved pegylated liposomal doxorubicin products, none of which, to the best of our knowledge, have completed or submitted any bioequivalency study data. For these three drugs, estimated combined annual revenues greater than $100 million have been seen and it’s growing at about 50% per year. Additionally, this currently includes only three of 31 provincial reimbursement drug list. And also China FDA policies for generic drugs have recently changed, increasing the quality bar there, so we’re exploring strategies to gain rapid market access to China for the 0918 product, by leveraging our completed BE trial. We did plan to partner this drug for a commercial interest, so we’re actively seeking licensing and commercial partners to market, sell and distribute ATI-0918 to North America, Asia and Europe. Now regarding our self-therapy pipeline, the SCLERADEC-II European trial has completed enrollment and we are awaiting this trial and think for the trail read out, which we anticipate in the second half of 2018. As it relates to STAR and HABEO for the U.S., we recently received feedback from an FDA pre-submission reading, indicating that a clinical trial focused on more-severely affected diffuse systemic sclerosis patients could be an appropriate next step, given the results of the STAR clinical trial. We recently finalized meeting minutes and are pursuing additional dialogue with the FDA to clarify the parameters and key aspects of a follow-on clinical trial with HABEO. At this time, we do not have and are not prepared to commit resources required in order to conduct an additional clinical trial for HABEO, and instead we’ll rely on partnering our out- licensing opportunities as the basis for continued development. In terms of our BARDA-supported relief trial for single IV administration of our self-therapy product of deep and – deep partial and full-thickness thermal wounds, we have now initiated two sites and are in the process of planning and initiating other sites to get the first patient enrolled in that trial as soon as possible. And then, finally, in terms of our Japanese urinary incontinence trial, called enrollment’s complete. We’re working with the PI and Nagoya University to complete all follow up and report 12 and 24-month follow-up data. Now regarding our commercial performance. Product revenue was $731,000 versus $591,000 in Q1 2018. The BARDA contract revenue in Q1 was $917,000, versus $1,018,000 Q1 2017. In Japan, specifically, Q1 2018 product revenue was $578,000, which represents an 80% year-over-year growth over Q1 2017. Looking behind the Japan product revenue growth was a clear trend towards consumable utilization increase in that market. Q1 2018 consumables grew 53% year-over-year versus Q1 2017, and the indications around that growth are principally osteoarthritis, leveraging our previous ACT-OA trial data and breast in esthetic surgery. We anticipate currently that, that trend will continue in that market and we are focusing the lion's share of our commercial activity in Japan to grow consumable utilization. Now, I'll hand off to Tiago for the financials.
Tiago Girão: Thank you, Marc, and good afternoon, everyone. Our primary focus remains unchanged: the development of our late-stage clinical pipeline and related commercial preparatory activities that we believe can translate into shareholder value. In parallel, we are carefully managing our resources as tightly as possible while continuing to improve our operating performance. Despite the additional investments in our recently-acquired assets from Azaya, operating cash burn reduced to $4.1 million in Q1 2018 as compared to $4.8 million in Q1 2017. The reduction in cash burn is mostly related to reduction in net losses as adjusted for noncash items of approximately $1.3 million. This is offset by working capital give back of approximately $600,000. Adjusted net totaled $4.4 million in Q1, or $0.07 per share as compared to $7.5 million or $0.33 per share in Q1 2017. Note that, net losses in Q1 2017, include a noncash charge of $1.7 million recorded associated with eProcess, research and development, part of the Azaya asset acquisition. For research and development expenses, in Q1, our R&D expenses excluding share-based compensation were $2.5 million as compared to $3.2 million in Q1 a year ago. The decrease in R&D spending is attributed to the decrease in headcount from the restructuring activity implemented in September 2017, and the completion of our STAR clinical trial activity. These reductions are offset by our investments into ATI-0918, our nanoparticle doxorubicin, for which manufacturing activities are ongoing in our San Antonio facility. As a percentage of overall spend, our R&D expense for Q1 was 48% of total operating expenses, when excluding share-based compensation. This is in line with our plan and indicative of our focus in late-stage program. Now, on our sales and marketing activities. Those decrease this quarter to approximately $650,000 as compared to approximately $900,000 in Q1 2017. The decrease in expenses in Q1 relates to lower salaries and benefits as well as lower professional services related to HABEO pre-commercial activity mostly done in the U.S. G&A expense, excluding share-based compensation, and approximately $600,000 related to a one- time lease termination charge this past February, was $1.6 million this quarter as compared to $2 million in Q1 2017. The continued tightening of our G&A expenses was related principally to reductions in salaries and benefits, resulting from the 2017 restructuring as well as discretionary spend. Now with respect to the revenues. Q1 total revenues were $1.6 million and materially consistent with Q1 a year ago. Product revenues increased by 23% in 2018 versus 2017 and was largely related to our focus on consumable growth in Japan, as outlined by Marc earlier. As per our guidance, we once again achieved double-digit consumable growth for the quarter in Japan. And we continue to expect such trends to continue. Our government contract revenues relates to our activity supported by BARDA. Such activities decreased by approximately $100,000 as we transition from the development activities to a kickoff in lease activities as part of the newly-awarded option of the BARDA contract. As a reminder, the FDA-approved the IDE for the RELIEF trial in 2017 and we negotiated BARDA Option 2 of the contract last year, where we were granted approximately $13.4 million to complete such trial. We have contracted with our CRO and have, so far, initiated a couple sites of the RELIEF trial. Turning to the balance sheet. As of March 31, we have $5.9 million of cash and $13 million of debt principal. We plan to balance on-going capital requirements through several targeted activities that include revenue growth, business development opportunities, operational efficiency measures and working capital management, in addition to accessing the capital markets. Now back to you, Marc.