Mitchell Steiner
Analyst · Cantor Fitzgerald. Please go ahead
Thank you, Sam and good morning. With me in this morning’s call are Michele Greco, the CFO and CAO; Phil Greenberg, Executive Vice President, Legal; and Sam Fisch, Director of Investor Relations. Thank you for joining our call. Veru is an oncology and urology biopharmaceutical company with a focus on developing novel medicines for the management of prostate cancer. Today, we will update you on the clinical development of our drug pipeline and the commercialization of our products as well as provide financial highlights for the first quarter fiscal year 2020. It is estimated by the American Cancer Society that in 2020 there will be about 191,930 men with newly diagnosed prostate cancer which is a 10% increase from 2019. There will be an estimated 33,330 deaths from prostate cancer in 2020, a 13% increase from 2018. After following for two decades, this is the second year in a row that we have seen an increase in deaths from prostate cancer suggesting that men with advanced prostate cancer are progressing through current treatments and new effective treatments are urgently needed. We are delivering on our strategy to be the prostate cancer company. We are responding to this call to action and are dedicated to the development and commercialization of products to address unmet medical needs for the management of prostate cancer. The markets for prostate cancer management are well established as multi-billion dollar markets and given our core expertise and the number and type of drugs in our pipeline, we are uniquely positioned to understand, develop and commercialize medicines for these unmet medical needs of prostate cancer patients. Here is a brief update on the advancement of the prostate cancer drug pipeline. We have made significant progress with our open-label Phase 1b/2 clinical trial for VERU-111, a novel proprietary first-in-class oral selective antitubulin agent for metastatic castration-resistant prostate cancer patients who have also become resistant to the novel androgen blocking agents enzalutamide or abiraterone, but prior to IV chemotherapy also referred to as the pre-chemotherapy stage. These are the patients whose prostate cancer is progressing that is spreading after exhausting the benefits of currently available injectable and oral prostate drugs, but before they are offered IV Cabazitaxel taxane chemotherapy. Unfortunately, there is a large number of these affected men. According to the published scientific report, about 12% to 25% of men who have metastatic castration-resistant prostate cancer and who have been started on a novel androgen blocking agent will not respond at all to this therapy. And about 75% of men will initially respond to the treatment with an androgen blocking agent, but their tumor will start progressing in about 9 to 15 months. So essentially by 1 year, the majority of these men will have tumor progression and will be ready for the next therapy by VERU-111 to control their advancing prostate cancer. This pre-chemotherapy space in men who have failed in ADT and a novel androgen blocking agent is currently the fastest growing unmet medical need segment in advanced prostate cancer. According to Accuvia, oral drugs, abiraterone, enzalutamide for advanced prostate cancer had over $6 billion in 2018 global annual sales. Men who have failed these novel blocking agents or the patients that VERU-111 is currently targeting, which we estimate represents a $4.5 billion annual global market. There are currently no FDA approved, oral or IV drugs for the indication of men with advanced prostate cancer who have failed both ADT and one of the novel androgen blocking agents. In the Phase 1b clinical trial, we have treated 39 men to-date who have metastatic castration and androgen blocking agent resistant prostate cancer and have shown evidence of cancer progression by rising PSA levels and the spread of prostate cancer by CT and/or bone scans by the study design which is called a 3+3 design, the maximum tolerated dose or some side effect that indicates that higher doses may not be tolerated is determined by treating 3 patients in the time with an oral daily dose of VERU-111 for 7 days followed by 2 weeks off-drug which treatment schedule represents 1 cycle. For patients to tolerate treatment, we increased the schedule to 2 weeks on drug and 1 week off and then 3 weeks continuously on drug until there is evidence of prostate cancer progression. This will allow us to assess the durability of the anti-cancer response. The escalating doses of VERU-111 tested to-date of 4.5, 9, 18, 27, 36, 45, 54, 63, 72 and 81 milligrams a day. As for safety, VERU-111 appears to be generally well tolerated. There are no reports of neutropenia up to and including 72 milligrams which is the dose-limiting toxicity typically seen for IV taxanes. There have been no reported complaints of neurotoxicity or hypersensitivity reactions, which were also common side effects that occur with the IV taxanes. There have been a few isolated mild liver enzyme changes that in some instances, resolved while still on drug. There have been reported side effects consistent with VERU-111s and other antitubulin cytotoxic effects such as mild-to-moderate diarrhea, nausea and vomiting which appear to be dose-dependent. Further, we know that through oral dosing VERU-111 is being absorbed into the blood stream from the stomach as levels of VERU-111 are measurable in the blood which means VERU-111 has good bioavailability. VERU-111 concentrations are higher with increasing oral drug doses. In fact, we have achieved VERU-111 blood concentrations in humans that match the efficacy concentrations we have measured in the preclinical animal models with prostate cancer tumors shrunk. Although this is a safety study, we do see preliminary evidence of anti-tumor activity as we have mentioned in our prior earnings calls. As historically reported from the literature, men with metastatic castration-resistant and androgen blocking agent resistant prostate cancer have a median of 3.7 months before their CT and/or bone scan evidence of new cancer progression. This is called imaging based progression-free survival. In our Phase 1b, we have 20 men in the study that had the potential to be treated for 4.5 months. Even without having determined an optimal dose or a dose schedule yet, there are 4 men who are still ongoing in the trial with no tumor progression at 12, 10.4, 10.4 and 7.6 months. All of these men have experienced PSA reductions from peak or base values, another 6 men have progressed to 4.2 months. The patients still in the trial of 12 months has had a PSA reduction of 63% from peak and had two of its cancerous lymph node shrink as measured by an initial follow-up CT scan and confirmed by another follow-up CT scan 3 months later. We also have another patient who at the time of enrollment had progressing prostate cancer bone metastases now showing improvements of these bone metastases based on a bone scan following treatment with VERU-111. There was also evidence that these anti-cancer effects in the study have a dose and schedule response meaning higher doses and 3-week treatment cycles have more activity. Based on these results demonstrated from these preliminary clinical data, VERU-111 is a promising anticancer compound with a good safety margin and without the typical side effects seen with IV taxanes. Accordingly, VERU-111 appears to be a good candidate for an oral anticancer therapy in men with metastatic castration and novel androgen blocking agent resistant prostate cancer in the pre-chemotherapy space. An advantage of VERU-111 is that can be also potentially prescribed by the urologist who is the usual physician managing this type of patient. Once the Phase 1b is completed, we will present the full clinical dataset at an upcoming major scientific meeting. We are approaching a significant and an important clinical milestone in the development of VERU-111. We are finishing up the last cohort of the Phase 1b portion of the Phase 1b/2 clinical study and will continue to collect long-term clinical data from this portion of the clinical trial. We will soon initiate the Phase 2 portion of the clinical trial enrolling approximately 26 men with metastatic castration and novel androgen blocking agent resistant prostate cancer using the dose and schedule selected from the Phase 1b. Moreover, given the current efficacy and safety profile of VERU-111, we plan to expand the clinical program of VERU-111 in 2020 into Phase 2 studies with 2 to 3 additional tumor types or indications where anticancer activity was shown in preclinical animal models. We will update you further when we have more information on these studies showing anti-tumor activity in other tumor types, will increase the overall value of VERU-111 program. Next, I will update you on VERU-100, our proprietary peptide drug candidate for the treatment of hormone-sensitive advanced prostate cancer, an established multibillion dollar global market. The target product profile of VERU-100 is commercially and scientifically compelling as having a number of anticipated advantages over currently available androgen deprivation therapies. VERU-100 is a long acting gonadotropin releasing hormone, GnRH antagonist, designed to be administered at a small volume subcutaneous 3-month depot injection without a loading dose. As a GnRH antagonist, it is intended to immediately suppress testosterone with no testosterone surge upon initial or repeated administration and no testosterone micro increases which may adversely affect patient outcomes. This is a problem which potentially occurs with the approved LHRH agonist drugs like Lupron, Zoladex and Eligard. Currently, there are no GnRH antagonists commercially available for the treatment beyond 1 month making VERU-100, if approved, the only commercially available GnRH antagonist 3-month depot an attractive choice for androgen deprivation therapy. We have received agreement from FDA that the development program from VERU-100 may follow an expedited pathway. Based on this FDA input, the company plans to commence a single open-label, multi-center, dose-finding Phase 2 clinical trial in approximately 60 men followed by a single open label multi-center Phase 3 clinical trial in only approximately 100 men. VERU is in the process of scaling up GMP manufacturing drug products to prepare for the clinical trials of VERU-100. The company intends to submit an investigational new drug application in early 2020. So we can commence the open label Phase 2 clinical study by early summer. As it is an open label Phase 2 study, we will be able to periodically update you on our progress towards reaching the primary endpoint which is the reduction of testosterone to castrate levels in real time during 2020. The planned development pathway for VERU-100 agreed upon by FDA represents a lower cost investment opportunity for a major product that could address the shortfalls of the current $2.6 billion global ADT market. Our next product candidate in a clinical trial is zuclomiphene, a novel proprietary oral non-steroidal estrogen receptor agonist being evaluated to treat hot flashes, the most common side effect in men on androgen deprivation therapy for advanced prostate cancer and a major reason why men want to stop androgen deprivation therapy. We have enrolled 93 men in a multi-center double-blind placebo dose-finding Phase 2 clinical trial evaluating two doses, 10 milligrams and 50 milligrams of zuclomiphene versus placebo. We reported positive top line interim results a few weeks ago. We determined that the 10 milligram dose with the no effect dose and the 50 milligram dose of zuclomiphene demonstrated estrogenic activity and a reduction in the frequency of hot flashes from baseline at Day 42. We also reported on the safety from the current blinded aggregate clinical database from our placebo-controlled trial. And based on the study’s interim findings, zuclomiphene appears to be well-tolerated. We have not received any reports of gynecomastia, painful breasts or venous thromboembolic events, which are common side effects seen in men treated with high doses of estrogen. After having an end of Phase 2 meeting with FDA for the zuclomiphene program and obtaining agreement on the trial design that will be acceptable for approval. Our plan is to initiate a pivotal Phase 3 clinical study. We will provide details of the design and timing of this study after we have the FDA meeting. The expectation is that the Phase 3 design, will be very similar to the Phase 2 study and that will be a 12-week treatment study. Veru has determined that the peak U.S. revenue potential for zuclomiphene citrate is between $580 million to $630 million. This projection assumes a 25% to 33% of all ADT patients who experienced hot flashes take zuclomiphene with an annual patient cost between $4,000 and $5,000. This estimate is determined based on research estimates from Accuvia, medical marketing economics and DelveInsight. This independently confirmed as zuclomiphene with the indication of treatment of hot flashes in men on androgen deprivation therapy for advanced prostate cancer is a major market opportunity. Currently, there are no FDA approved drugs for this indication. We are very excited about our progress with zuclomiphene for this unmet indication. Veru’s ability to advance the clinical development of our proprietary prostate cancer drugs that address unmet medical needs in large markets is being substantially supported by investments from two commercial sources of revenue; the FC2 female internal condom as well as PREBOOST/Roman Swipes, which is a 4% benzocaine wipes for premature ejaculation. As you can see from the earnings release, in Q1 fiscal year 2020, we continue to have significant growth in revenue and gross profits from these commercial products. Although Ms. Greco will cover the detailed financial results highlights in a few moments, I would like to make a few comments. We continue to have robust grow in fiscal year 2020 and expect further increases of FC2 sales in both the public sector and prescription sales in the U.S. for the rest of the year as we have signed new agreements to supply FC2 by prescription through telemedicine companies. The strong growth in the U.S. FC2 prescription business remains noteworthy as it allows us to be less reliant on the intermittent ordering patterns typically seen in our traditional FC2 public sector business. We had $6.1 million in revenue from the prescription business for Q1 fiscal year 2020 compared to $2.4 million for Q1 fiscal year 2019, an increase of 148%. In fact, to give you a sense of our growth trajectory for all of fiscal year 2019, we achieved 159,000 FC2 prescriptions and for just Q1 of fiscal 2020, we had 81,000 FC2 prescriptions. For our premature ejaculation product marketed as Roman Swipes, the company entered into a multiyear U.S. distribution agreement with Roman Health Ventures, a premier and fast-growing men’s health and telemedicine company, that discreetly sells men’s health products via the Internet website called www.getroman.com. We have begun to see these revenues grow too. Focusing now on Veru’s commercial segment, which is FC2 PREBOOST/Roman Swipes and drug commercialization costs, we had net revenue increases in Q1 fiscal year 2020 to $10.6 million compared to $6.4 million in Q1 fiscal year 2019, which is up 66%. Gross profits for fiscal year 2020 were $7.3 million compared to $4.6 million in fiscal year 2019, which was up 57%. Our income from operations in this segment of the business was $5.8 million for Q1 fiscal year 2020, up from $3.4 million in Q1 fiscal year 2019, an increase of 73%. As you can see, our base commercial business is doing very well and as a standalone business would be quite valuable experiencing significant growing revenue. With continued revenue growth and profit and positive cash flow from this base commercial business, we have been able to substantially fund the development of our prostate cancer clinical programs and our urology specialty pharmaceuticals for the past year. We intend to continue this revenue growth trajectory with not only the current growth of revenues from FC2 and PREBOOST, but also from the revenues that we expect to generate in the commercialization of the company’s proprietary tadalafil, finasteride combination capsule for the treatment of the symptoms of BPH called TADFIN. We expect this to be the company’s first pharmaceutical urology asset to move into commercialization. We are collecting 12 month stability data on TADFIN manufacturing batches and expect to submit the NDA by the end of 2020. In the U.S., we are exploring commercially launching TADFIN through telemedicine channels. As you have seen, we have had great success with our products using this sales channel. We were also in discussions with potential commercial partners outside the U.S. and having TADFIN revenues from U.S. sales and potential partnerships with upfront payments and royalties from outside the U.S. should add substantial near-term revenues with high gross margins to the existing and growing revenues from FC2 and PREBOOST/Roman Swipes products. I will now turn the call over to Michele Greco, CFO and CAO to discuss the financial highlights. Michele?