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Summit Therapeutics Inc. (SMMT)

Q2 2017 Earnings Call· Thu, Aug 31, 2017

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Transcript

Operator

Operator

Good day, ladies and gentleman and welcome to the Summit Therapeutics Plc Financial Conference Call. Today’s conference is being recorded. At this time, I would like to turn the conference over to Mr. Richard Pye. Please go ahead, sir.

Richard Pye

Management

Thank you and welcome to everyone joining us on the call to discuss our financial results for the second quarter and half year ended July 31, 2017 and our operational progress. Earlier today, we issued a press release summarizing these results. If you have not had a chance to review, they are available on our website at www.summitplc.com. Joining me on our call today are our Chief Executive Officer, Glyn Edwards; and our Chief Financial Officer, Erik Ostrowski. Before we begin our discussion, I would like to remind listeners that we will be making forward-looking statements during this call. I refer you to our filings with the Securities and Exchange Commission for description of the risks and uncertainties associated with an investment in Summit Therapeutics. While we may elect to update these forward-looking statements at some points in the future, we specifically disclaim any obligation to do so, even if our views change. These forward-looking statements should not be relied upon as representing our views as of any date subsequent to today. I would now like to turn the call over to Glyn for an overview of our corporate activities.

Glyn Edwards

Management

Great. Thanks, Richard and thank you all for joining us on the call today to discuss our achievements during the second quarter and the first half of our financial year. This year has been marked by strong focus on the advancement of ezutromid for the treatment of Duchenne muscular dystrophy, or DMD; and ridinilazole for the treatment of C. diff infections, or CDI. Both of the drug candidates are at important stages of their clinical development with ezutromid progressing through a Phase 2 proof-of-concept trial and ridinilazole expected to start Phase 3 trials in the first half of 2018. Before I review how we have set the stage for this exciting year 2018 that’s coming up, I would like to take a step back and remind you why we strongly believe that our DMD and CDI programs have the potential to improve the lives of patients, and I will start with Duchenne, DMD. This is a rare genetic disease characterized as a progressive muscle wasting disorder that causes the loss of motor, pulmonary, and cardiac function and ultimately death by late 20s or early 30s. It’s caused by a variety of mutations in a single gene that encodes with the protein called dystrophin. Dystrophin acts as a molecular shock absorber and in mature muscle fibers. Without it, muscle fibers can’t withstand the force of muscle contraction and therefore catastrophically fail. Our bodies also produce a related protein called utrophin and this performs a similar function to dystrophin in developing muscle fibers and during the repair of damaged muscle fibers. Patients with DMD are able to produce utrophin in a normal manner due to the damage that muscle fibers undergo and so they have a high amounts of utrophin present because of this damage. But as the fiber reaches maturity, utrophin…

Erik Ostrowski

Management

Thank you, Glyn. I will now provide an overview of our financial results for the second quarter ended July 31, 2017. We present Summit’s results in accordance with International Financial Reporting Standards in pound sterling, but for convenience purposes, I’ll give U.S. dollar equivalents for certain key numbers. As we described in our earnings release today, at July 31, 2017, we had cash and cash equivalents of £28.3 million or $37.3 million compared to £28.1 million at January 31, 2017. Of note, as Glyn mentioned, during the second quarter we received a $20 million or a £17.2 million development milestone payment pursuant to our license and collaboration agreement with Sarepta Therapeutics. This milestone payment was triggered upon the first dosing of the last patient in our ongoing phase-out DMD trial. We reported a profit for the second quarter ended July 31, 2017 of £10.9 million or $14.4 million driven by the receipt of this milestone payment as compared to a loss of £6.4 million during the second quarter of 2016. Revenue was £18.9 million for the second quarter ended July 31, 2017. This figure is comprised of two components, the first being the £17.2 million milestone payment, which was recognized as revenue in full during the quarter and the second being £1.7 million related to the $40 million or £32.8 million upfront payment that we received when we entered into the license and collaboration agreement with Sarepta in October of 2016, which we are recognizing ratably over time. Research and development expenses increased to £6.6 million or $8.7 million for the second quarter ended July 31, 2017 from £5.4 million for the second quarter of 2016. This increase reflects a greater investment in the DMD program and an increase in research and development related staffing costs offset by a decrease in CDI clinical program related activities. General and administration expenses increased to £2.5 million or $3.3 million for the second quarter ended July 31, 2017 from £1.9 million for the second quarter of 2016. This increase was primarily due to a negative movement in exchange rate variance and an increase in staff-related costs offset by a decrease in legal and professional fees. We believe our cash on hand will allow us to fund our key program initiatives through December 31, 2018 not inclusive of the cost of the Phase 3 clinical trials for the CDI program, which as Glyn mentioned, we aim to commence in the first half of 2018. I will now turn the call back over to Glyn for closing remarks. Glyn?

Glyn Edwards

Management

Thanks, Erik. We are continuing to execute our strategy for both programs and ensuring we have the right team in place as we stand poised to make a difference to the lives of patients with DMD and CDI in the coming years. So, now I would like to open the line for questions.

Operator

Operator

Thank you very much, sir. [Operator Instructions] We will now take our first question from Chad Messer from Needham & Company. Please go ahead.

Chad Messer

Analyst

Great. Thanks for taking my question and for the update. Maybe just on the upcoming Phase 2 -- exploratory Phase 2against fidaxomicin, can you frame for us what we should be looking for in that data, you have talked about it a little bit in your press release, but just could you set expectations for what we would see?

Glyn Edwards

Management

Thanks Chad. Good question. So this was an exploratory study and our real focus in this study is it’s a comparative microbiome study. So what we are really looking to explore here is in real patients what is the state of the microbiome on entry into the study and then how does that change during treatment and after treatment with ridinilazole and looking how it’s changes during treatment and after treatment with fidaxomicin. It’s a small study and so it’s not powered or in any way designed for efficacy endpoints although we will have measured those and those will be published. But the prime focus is on what happens to the microbiome, and in addition to the microbiome measurements and the efficacy measurements, obviously you are always looking at the safety profile of a new treatment, so we will also be gathering and publishing further safety information on ridinilazole.

Chad Messer

Analyst

So when you say effect on the microbiome, is that sort of like the cladograms that we saw from the study versus vanco and if so do we know how fidaxomicin behaves in studies like that?

Glyn Edwards

Management

This – we have -- obviously the group that’s done the most detailed microbiome analysis of the effect of various antibiotics on patients to-date, primarily with CoDIFy study on looking at vancomycin and then ridinilazole, there have been not so much microbiome studies published on fidaxomicin, but microbiology studies looking at different species in different families, and what you see there is that fidaxomicin is more selective than vancomycin as you would expect, but ridinilazole is even more selective than fidaxomicin, so the hypothesis before we get data is that from microbiology sort of test tube experiments or petri dish experiments, you would expect to see that ridinilazole is even more selective than fidaxomicin, but obviously in real patients it may be different. And so, this study is our chance to see how the two drugs compare in their effect on the microbiome in comprehensive state-of-the-art microbiome study.

Chad Messer

Analyst

And then maybe just a quick bigger picture one on ezutromid and if I may now that we are a couple of quarters into the EXONDYS launch, anything sort of anecdotal that you can report in terms of excitement for your own program, any sort of the changes out there now, but now that there is finally treatments available for some of these patients?

Glyn Edwards

Management

I don’t think we have detected any changes relative to us, because we have always had a large number of incoming calls from [indiscernible] wanting their children to get access to ezutromid through the trial program or through compassionate use, yet we don’t have the compassionate use program. So the weight of those calls continues and there continues to be huge interest in ezutromid because even within Europe, the PTC drug in the U.S. with EXONDYS, those only are suitable for a small proportion of patients. And so for the vast majority of patients, ezutromid is the most advanced treatment option. But I mean, I am not qualified to say it, but certainly our interaction with the physicians who are treating DMD patients is they are pretty excited by EXONDYS 51 and there is a treatment option available. So, I think it’s Sarepta and Exondys has been great news for those patients with the relevant mutation, but for the vast majority of patients. The excitement continues to be for ezutromid.

Chad Messer

Analyst

Great. I’m certainly looking forward to the data in first quarter.

Glyn Edwards

Management

Thanks, Chad.

Operator

Operator

We will now take our next question from Hartaj Singh from Oppenheimer. Please go ahead.

Unidentified Analyst

Analyst

Hi, Glyn. Good morning. This is Emma on for Hartaj. So assuming we see a clear positive thing in the biopsies at 24 weeks, is there any potential to initiate Phase 3 discussions without leading to that 48-week data or I guess could you just walk us sort of a best case development pipeline?

Glyn Edwards

Management

Yes. So, thanks a lot, Emma and thanks for explaining the voice change from Hartaj. So, yes, we see this as two bites at the cherry and that if we see good strong data on the 24-week data that would be enough to initiate the registration studies. And obviously, if we saw less strong data than that, we would wait till the 48-week data before kicking off registration study. So, we have plans for both eventualities. And our expectation is that, yes, and a further study would be required for approval, and that that would be a randomized study with a placebo arm and that the primary endpoint would be something – the information that we get from this current study on a surrogate endpoint for instance, utrophin or muscle fiber maturity or MRI or one of those things. And our expectation is that just a single registration study would be required. It’s difficult for us to confirm the size of that study, but our estimates are that it reached somewhere around 150 patients of that order if we are going for surrogate endpoint. Now, obviously all this depends on what data we see and if we see exciting and strong data also on the functional endpoints, then that might change the design of the registration study. But our expectation is from our PhaseOut DMD study, it was really focused on surrogate endpoints that the selection of patients and the study design is not optimal for functional endpoints and so our plans at the moment are that most likely success is to be seen through the biomarkers, through MRI and that the registration study would be focused on those endpoints.

Unidentified Analyst

Analyst

Great. Thank you so much.

Operator

Operator

We will now take our next question from Liisa Bayko from JMP Securities. Please go ahead.

Unidentified Analyst

Analyst

This is John on for Liisa. Thanks for taking the question and the update. Just a couple of short ones, can you remind us the breakdown of the formulations that will be available for the first quarter readout and which partial endpoints do you expect to kind of correlate best if we do see an increase in ezutromid?

Glyn Edwards

Management

Thanks, John. Thanks for your questions. So, we recruited 40 boys into the PhaseOut DMD study, 30 of those received the formulation that we called F3 and 10 of them received the sprayed right formulation that we call F6 and so approximately half of both groups will be reporting biopsy data. So, that’s approximately 15 of the F3 and approximately 5 of the year the F6, but obviously the other surrogate endpoints like MRI, those are in the entire population. So, we will have those 40 boys at 24 weeks. I am sorry with my concentrating announcing the first part of your question I have completely forgotten the second part.

Unidentified Analyst

Analyst

No worries. I am wondering if we see an increase in ezutromid, what functional endpoints that you are evaluating expect do you show a clear effect?

Glyn Edwards

Management

Yes. I think we are looking at a whole number of things. And I think the ones where if there is an effect, we expect to see are going to be those that are most closely related to those where we have seen effects in the prior animal studies. And so in prior animal studies, we have seen changes to the utrophin levels, both the quantity and more particularly the distribution. So, those are the areas that we have the highest confidence in. Second highest confidence is in muscle fiber maturity. So again, in the mouse models, the measure of muscle fiber maturity is different. So, in mouse models, you see changes in what I called centrally nucleated fibers and the most equivalent human endpoint in our phase-out study is going to be looking at the developmental myosin. And so we have a measure of muscle fiber maturity it’s not exactly the same, but again we have got pretty high confidence that if the drug is having an effect, we will see a change in muscle fiber maturity and that’s the measure. And then when we get to MRI, we have not – it’s not been widely used that will let us huge excitement about it. And so MRI can be used to measure fraction, which is the primary endpoint, but also the level of inflammation and there have been several studies in DMD with other therapies or natural history studies looking at the effect of steroids that have seen effects there, but I think that has – that’s less of an experimental sort of line of sights to this study. So, I think – so the priorities in terms of my confidence if the drug works, first utrophin and second, muscle fiber maturity and then third, the MRI measures, but the great thing about doing experimental biology and translational medicine is the data will be what the data will be and we are hugely excited to be getting this data early next year. And we have talked just about a few of the measures, but there is a lot of other measures going on here. And I guess the thing that would give us the most confidence is if we saw not just changes in one measure, but we saw a level of consistency across various measures.

Unidentified Analyst

Analyst

And one last one from me, are there any milestone from Sarepta tied to either the interim or the final data and if so are those included in kind of your expectations for cash burn?

Glyn Edwards

Management

No, we are super cautious on something about Erik’s cultural indoctrination of us. So, we don’t include any of these additional milestones in our cash projections. I will get Erik to come in a minute to say how that’s looking. And there is no milestone related directly to the interim look, but obviously success in the interim look accelerates the program brings the development program forward with higher chance of success. And so it will bring close those future development and regulatory milestones. So, there is nothing directly tied to PhaseOut DMD, but obviously success in that brings the next stages of the program there and with more certainty and that obviously has an impact on our chances of receiving those payments. Erik, you want to say a bit about the cash flow?

Erik Ostrowski

Management

Yes. I guess reiterating what Glyn said in terms of any other milestone payments be including in that cash guidance. What’s been disclosed publicly around ezutromid related development milestones is that a total $42 million and the only specificity that we provided publicly on that $42 million is that there is $22 million related to the milestone that we achieved over the most recent quarter.

Unidentified Analyst

Analyst

Great. Thanks again.

Operator

Operator

We will now take our next question from Joseph Hedden from Rx Securities. Please go ahead.

Joseph Hedden

Analyst

Hi there. Thank you for taking my question. Just one on finance piece and then another on ridinilazole if I may. As far as OpEx is concerned, I am appreciating that costs are ramping as ezutromid program goes on, but they are still slightly ahead of where we are thinking, can you possibly give us a guide as to what your second half spend might be. And then on ridinilazole thinking about the trial versus fidaxomicin and the exploratory end point data there and got microbiome exploratory data, is there anyway, are you thinking of can you build that meaningfully into clinical endpoint into the Phase 3 trials, registration trials planned for the first half of 2018 or have you had any discussion with regulators as to whether any of that data might be useful in a discussion to support registration? Thanks.

Glyn Edwards

Management

So I will answer the second part of that question and Erik will shortly answer the cash guidance and cost guidance question. So the answer is yes, we will be doing microbiome measurements in the Phase 3 study, but not on every patient. The Phase 2 study against vancomycin we looked at 100 patients, we have looked at 30 patients in the trial against fidaxomicin. The two Phase 3 trials are over 700 patients each. And we have already conducted the biggest microbiome study that would be overkill. But I think the key to approval is quite brutal in Phase 3 studies, it’s actually the clinical data for antibiotics. So approval will be driven by how we do in sustained clinical response. We are looking for superiority and we powered the study for superiority. But the reason why we have included microbiome measures in the Phase 3 is really for marketing and more sort of science based to encourage take up of the drug if we do meet the primary endpoints. And that the more coherent story that you have about the mechanism of action of the drug, the potency of the drug, the reasons for its success in changing the – and improving the outcomes from a recurrence point of view the better we think we will be able to build take up over a new antibiotic. And if you look at one of the main drawbacks or the main hindrance is to rapid take-up of new antibiotics in the past is being that from an antimicrobial resistance point of view the best thing from society’s point of view is to keep new antibiotics and only use it resistant cases. That actually gets turned on its head once you have highly selective antibiotics in that with a highly selective antibody you do not want to be using vancomycin, which is broad spectrum and use systemically in some really nasty systemic infection, you don’t want to be using in the gut infection. And so actually that the experts agree that if you have got something very narrow spectrum then that should be moving to first line and these valuable broad spectrum drugs like vancomycin and metronidazole should be kept back for those serious infections. And so it’s really important to build on the data supporting your selectivity if you want to drive a change in the treatment. So – and our objective and our belief is that we can very quickly get ridinilazole to become the standard of care in the first and second line treatment of CDI. So has long-winded way of starting off with a positive, yes we are measuring it, but actually it’s not going to help so much the regulatory approval, but it will help drive sales and market penetration.

Erik Ostrowski

Management

Yes. And I guess to the second component of your questions on financials, the trend you have seen over the past couple of quarters has been DMD program expense increasing particularly as we conduct the PhaseOut DMD study. We had the microbiome related study Glyn discussed earlier ongoing, now if that trial winding down those CDI costs obviously go down, offset somewhat by some of the Phase 3 prep work that we are doing on the C. diff site though mainly CMC related activities. So you are not talking significant dollars there. And then turning back to my runway guidance through December ‘18, recall that we are not including in that guidance any of the Phase 3 clinical study expenses, hopefully that will help.

Joseph Hedden

Analyst

Okay, that’s great. Thank you.

Operator

Operator

We will now take the next question from Sheena Berry from N+1. Please go ahead.

Sheena Berry

Analyst

Hello, I am just wondering obviously you crossed earlier stage, if you are able to provide an updated color on the future generation utrophin modulation pipeline and progress there and if you – if they aren’t in a position to update now, when we might expect [indiscernible]?

Glyn Edwards

Management

Hi Sheena. Thanks for that. We continued to invest pretty heavily in the next generation of utrophin modulators in our collaboration with Oxford and there has been quite a lot of progress that we are hugely excited by and that. But we are not updating any – with any new data today on that and we plan to make announcements at scientific conferences both ourselves and through the team at Oxford. So apart from some warm words that progress continues I have got nothing new to add to it today. The scientific conference season tends to be the next part of the year coming up and into the spring. So if there are going to be any presentations, it’s going to be in the next six months. I think from a value driving point of view the key components we have really are the ezutromid program and the ridinilazole program.

Sheena Berry

Analyst

Yes of course and obviously a lot to explore to.

Operator

Operator

[Operator Instructions] We will now take the next question from [indiscernible]. Please go ahead.

Unidentified Analyst

Analyst

Hi, thanks. So my question is on the C. diff program, can you tell us the expected cost of the Phase 3 trials?

Glyn Edwards

Management

Yes, thanks for [indiscernible] of this. Yes, so one of the elephants in the room has been that the Phase 3 trials for ridinilazole going to be substantially more than would be for an orphan indication like the Duchenne. And so the guidance we have given is that to do both Phase 3 studies is going to be something of the order of $100 million and that’s why we have been indicating for some time that announcing how that’s going to be financed is going to be a key announcement before we actually start the Phase 3 trials. But we have been working on a number of strands for this for some time. And as we said in the prepared statement earlier that could involve a partnership. But there is also quite a lot of less dilutive funding available from governments and from the philanthropic world for novel antibiotics. And so we want to find out if we can get this non-dilutive funding and exactly how much before we make our decisions on partnership income. But you can tell from the very positive comments we have made that we expect to start Phase 3 trials on-time at the beginning of 2018 that we remain confident to be making announcements about the funding of the Phase 3 program in the not too distant future.

Unidentified Analyst

Analyst

Alright. I look forward to that. Thank you very much.

Operator

Operator

As there were no further questions in the telephone queue, I will now turn the call back to our speakers for any additional remarks.

Glyn Edwards

Management

Yes, thanks very much for the questions guys. That’s really helpful and thank you all for joining us today. We look forward to providing with updates on the program, including updates on the funding of the C. diff. And then as we look into 2018, there is going to be a ramp of really exciting clinical data. So, I think if you look back over the last 12 months, Summit has made huge progress and we are poised for a hugely exciting 12 months coming up. So, I look forward to more of these goals. Thanks a lot.

Operator

Operator

Ladies and gentlemen, this concludes the Summit Therapeutics Plc financial conference call. Thank you all for your participation today. You may now disconnect.