Mitchell Steiner
Analyst · Cantor Fitzgerald. Please go ahead
Thank you, Sam, and good morning. With me on this morning's call are Michele Greco, CFO and CAO; Phil Greenberg, Executive Vice President, Legal; and Sam Fisch, Director of Investor Relations. Thank you for joining our call. We have made several important and exciting announcements this morning. It's been a busy quarter. We actually released two separate press releases this morning, our earnings release and an update on our oncology drug pipeline. This morning we will discuss these new announcements and its impact on Veru’s business strategy, the clinical development of our drug pipeline, and the commercialization of our products. We will also provide financial highlights for our record fourth fiscal quarter and record year-end fiscal year 2020. Veru has made the transformation into a late clinical stage oncology biopharmaceutical company focused on developing novel medicines for the management of two of the most prevalent cancers; prostate cancer and breast cancer. We continue to invest cash generated from our sexual health commercial business into the clinical development of our high value oncology drug candidates, so that our current shareholders can realize the maximum value of our oncology biopharmaceutical company. In fiscal year 2017, the year that the Female Health Company acquired Aspen Park Pharmaceuticals to create Veru, the annual revenues were $13.7 million. And this year, I'm pleased to report that we had a record year of $42.6 million in revenue. In fact, we expect fiscal year 2021 revenue generation will continue to grow robustly to what could be another record year. We accomplished this great and significant company milestone because we set a new commercial strategy for FC2 and launched PREBOOST. We focused on creating an FC2 commercial sector in the U.S. And in the U.S., we launched FC2 as a prescription product to retail pharmacies and partnered with multiple telemedicine and internet pharmacy partners. We decreased our reliance on the global public sector which was volatile and inconsistent. We launched PREBOOST, which is marketed online in the United States through a distributor arrangement under the Roman Swipes brand name by Roman Health Ventures Inc. Roman is a leading telemedicine company that sells men's health products via the internet website, www.getroman.com. PREBOOST is also marketed in the U.S. through bricks and mortar retail channel by Playboy Enterprises International as Playboy's intimate wipes. Now let's focus on some of the financial highlights on Veru's commercial segment which is made up of FC2, PREBOOST, Roman Swipes Playboy Intimate Wipes, and drug commercialization costs. We had net revenues in the United States FC2 prescription business in Q4 fiscal year 2020 of $8.7 million compared to $4.7 million in Q4 fiscal year 2019, which is up 87%. Net revenues for fiscal year 2020 were $42.6 million compared to $31.8 million in fiscal year 2019, which was up 34%. In fact, gross profit for fiscal year 2020 was $30.8 million compared to fiscal year 2019 of $21.7 million, which was up 42%. Operating loss was $14.7 million, which includes a $14.1 million impairment non-cash charge. Operating loss before adjustment for impairment was only $600,000 for all of fiscal year 2020 compared to the loss of $6.4 million in fiscal year 2019. In fact, the operating profit for Q4 fiscal year 2020 before adjustment for impairment was $2.8 million. Our compound annual growth rate since fiscal year 2017 has been 46%, and we're still growing this segment of our business. In fact, to give you a sense of our growth trajectory, for all of fiscal year 2019, we sold 159,000 units of FC2 in the U.S. prescription market, while in fiscal year 2020 we sold 342,000 units of FC2 in the U.S. prescription market, an increase of 115%. I'm pleased to report that we announced today, that we sold our PREBOOST business to Roman Health Ventures for $20 million, further strengthening our financial balance sheet. The sexual health business continues to generate record revenues and we expect robust and growing revenues from the sexual health business for another record year in fiscal 2021, which further enhances its potential value as a standalone business if the company were to decide to monetize this asset like we did with PREBOOST to streamline the company into a pure oncology biopharmaceutical company with significant cash resources. TADFIN, which is tadalafil 5mg finasteride milligrams combination capsule is being developed to treat lower urinary tract symptoms caused by benign prostatic hyperplasia. The company had successful pre-NDA meeting with FDA, and the required one year stability testing on three manufacturing commercial batches is being completed. Consequently, we expect to submit the NDA for TADFIN in early calendar year 2021, with a launch if approved via telemedicine channels in late 2021. This will be another near-term source of additional revenue for Veru. Consequently, I am pleased to report that based on current clinical development plans, we expect that the company will have sufficient resources generated from our sexual health business and existing sources of cash to fund the clinical development of all of the oncology drug programs that I will discuss without the need for new equity financing through the end of fiscal year 2022. By progressing our own pipeline and recently acquiring the worldwide rights to a Phase 3 ready novel breast cancer drug, Veru has made the transformation into a late clinical stage oncology biopharmaceutical company focused on developing novel medicines for the management of two of the most prevalent cancers globally, prostate cancer and breast cancer. Prostate cancer is the most commonly diagnosed cancer in men with an estimated 191,930 new cases and 33,330 [ph] deaths expected for 2020, in the United States. One in nine men is expected to develop prostate cancer in the lifetime. Prostate cancer has become a chronic disease with new challenges as prostate cancer develops resistance to current drugs and spreads through the body and as the patient suffers the long-term side effects of prostate cancer treatments like hot flashes, bone loss and fractures, loss of libido, erectile dysfunction, loss of muscle strength and frailty. Breast cancer is the most commonly diagnosed cancer in women, with an estimated 276,480 new cases and 42,170 deaths expected for 2020 in the United States. One in eight women is expected to develop invasive breast cancer in their lifetime. There are many different types of breast cancer with diverse clinical molecular characteristics. The most common type is hormone receptor positive where estrogen is one of the main drivers of breast cancer, proliferation, tumor progression, and metastasis. Consequently, treatments that target the estrogen receptor are the mainstay of breast cancer therapy, but unfortunately almost all women will eventually develop resistance to endocrine therapies and alternative treatment approaches will be required, including IV chemotherapy. Another form of breast cancer that occurs in 15% of all breast cancers is called triple negative breast cancer. Triple negative breast cancer does not have an estrogen receptor or progesterone receptor, and does not make something called human epidermal growth factor 2, also known as HER2. And as a consequence, triple negative breast cancer is an endocrine resistant, aggressive cancer that grows and spreads faster than hormone receptor positive breast cancers. Triple negative breast cancer also develops resistance to the currently use chemotherapy drugs like Taxanes, and as such, alternative treatment options for triple negative breast cancer are very limited. Accordingly, we are dedicated to the development and commercialization of drug candidates to address unmet medical needs for prostate and breast cancer management, and for which we have made great progress. We are excited to advance our prostate cancer drug candidate VERU-111, VERU-100, as well as our breast cancer drug candidates recently acquired enobosarm, and a new additional indication for VERU-111 into registration clinical studies. VERU anticipates the potential for four registration clinical trials before oncology indications commencing in calendar year 2021. In prostate cancer, the company continues to make strong clinical progress, advancing VERU-111 as a treatment for metastatic castration and androgen receptor targeting agent resistant prostate cancer, and VERU-100 for androgen deprivation therapy for advanced prostate cancer. First, an update on VERU-111 for the treatment of men with metastatic castration resistant prostate cancer, who've also become resistant to the androgen receptor targeting agent. VERU-111 is an oral first in class new chemical entity that targets cross links and disrupts alpha and beta tubulin subunits of microtubules to disrupt the cytoskeleton, we're calling it a cytoskeleton disruptor. VERU-111 is being evaluated in an open label Phase 1b and Phase 2 clinical studies in men, with metastatic castration and androgen receptor targeting agent resistant prostate cancer. And the Phase 1b clinical study completed enrollment of 39 men and is ongoing. The Phase 1b study has yielded promising efficacy and safety clinical results. Based on the Phase 1b study results, the recommended Phase 2 dose is 63 milligrams oral daily continuous dosing for 21 days, daily chronic drug administration appears to be feasible and safe. At the recommended Phase 2 dose, there were no reports of neutropenia, neurotoxicity, or Grade 3 diarrhea. The efficacy results show PSA declines and responses, as well as objective and durable tumor responses. Furthermore, the median treatment duration without cancer progression in man who have had at least four cycles of VERU-111 is greater than 11 months. We still have patients from the study. In September of 2020, the Phase 2 clinical study completed enrollment of approximately 40 men, with metastatic castrate resistant prostate cancer, who've also become resistant and androgen receptor targeting agents, such as abiraterone, enzalutamide or apalutamide, but prior to proceeding to IV chemo. Although the study is still ongoing, daily chronic drug administration appears to be feasible and safe. At 63 milligrams daily continuous dosing, there were no reports of neutropenia, single report of minor neurotoxicity and manageable cases of diarrhea. Like the Phase 1b, we have observed efficacy results including PSA declines and responses, as well as objective and durable tumor responses. We plan to report the results of the Phase 2 study in the first-half of 2021. As we have already enough safety and efficacy data selected dose for VERU-111 and to proceed to a Phase 3, the company had an FDA meeting in July of 2020, and received positive input from FDA on the pivotal Phase 3 trial design for VERU-111. The company received regulatory clarity that the indication of treatment in men with metastatic castration resistant prostate cancer who have failed one antigen receptor targeting agent but prior to IV chemotherapy was acceptable, that an open label randomized study using alternative androgen receptor targeting agent is an act of control is reasonable, and that the primary endpoint may be radiographic progression free survival. By allowing radiographic progression free survival as a primary endpoint, the sample size of the Phase 3 clinical study could be potentially around 200 men. The Phase 3 pivotal clinical study will evaluate VERU-111 for the men with metastatic castration resistant prostate cancer, they'll become resistant to one antigen receptor targeting agent and will be called the VERACITY Phase 3 study. Company anticipates starting the VERACITY Phase 3 study in the first quarter of calendar year 2021. Next, I will update you on VERU-100 as an androgen deprivation therapy to treatment of advanced prostate cancer. VERU-100 is a novel proprietary long-acting gonadotropin-releasing hormone, GnRH antagonist peptide, three months of subcutaneous depot formulation, designed to address the current limitations of commercially available androgen deprivation therapies also known as ADT. Androgen deprivation therapy is currently the mainstay of advanced prostate treatment, used as a foundation of treatment throughout the course of the disease. Furthermore, ADT is continued, as other endocrine chemotherapy or radiation treatments are added or stopped. Specifically, VERU-100 is a chronic long acting GnRH antagonist peptide, administered as a small volume three month depot subcutaneous injection without a loading dose. VERU-100 expected to immediately suppress testosterone with no testosterone surge upon initial repeated administration, a concern that occurs with currently approved luteinizing hormone releasing hormone agonist used for ADT. There are no GnRH antagonists depot injectable formulations commercially approved for treatment beyond one month duration. A Phase 2 study to evaluate VERU-100 dosing is anticipated to begin early in the first quarter of calendar year 2021, and the registration Phase 3 study in approximately 100 men is anticipated to start in the second-half of calendar year 2021. We have been opportunistic and we added a new late clinical stage breast cancer drug pipeline, which includes enobosarm and VERU-111. Enobosarm is a selective androgen receptor targeting agonists being developed for the treatment of androgen receptor positive, estrogen receptor positive and HER2- metastatic breast cancer but prior to IV chemotherapy. Veru has exclusively in licensed full worldwide rights to enobosarm from the University of Tennessee Research Foundation, and the Ohio State Research Foundation. Enobosarm is an oral first in class new chemical entity, selective androgen receptor targeted agent. Our first indication for the clinical development of enobosarm will be for the treatment of ER+, HER2- metastatic breast cancer but prior to IV chemotherapy. Enobosarm by targeting the androgen receptor, which is present in up to 90% of advanced hormone receptor positive breast cancers, represents the first new class of targeting endocrine therapies in advanced breast cancer in decades. Enobosarm has extensive non-clinical and clinical experience, haven't been evaluated in over 25 separate clinical studies in more than 2,100 subjects, including five prior Phase 2 clinical studies in advanced breast cancer involving more than 250 patients. Enobosarm bind to the androgen receptor of breast cancer tissue to inhibit AR/ER+ cancer cell proliferation in tumor growth, and this seen in Phase 2 human clinical studies as well as in animal models. Unlike testosterone, enobosarm cannot be aromatized estrogen, and enobosarm has additional selective clinical properties that it could have potential benefits in women with hormone receptor positive metastatic cancer. More specifically, preclinical studies have shown that a enobosarm builds and heals cortical and trabecular bone with a potential to treat hormone treatment induced osteoporosis and skeletal related cancer events, and enobosarm has also been shown to build muscle to reduce fat, to improve physical function and in clinical studies involving elderly subjects and patients with cancer cachexia, including breast cancer. Furthermore, the tissue selectivity of enobosarm also results in a favorable side effect profile, with no virilization that’s facial hair and acne, no increase in inadequate and no liver toxicity. The science supporting the efficacy of the enobosarm and targeting the androgen receptor and hormone receptor positive advanced breast cancer will imminently be published in Nature Medicine by an independent group of breast cancer experts. In the two Phase 2 clinical studies evaluating in enobosarm and advanced AR+ ER+/HER2- breast cancer, enobosarm is an oral endocrine therapy demonstrated significant anti-tumor efficacy in heavily pretreated cohorts and was very well tolerated with a favorable side effect profile. The first Phase 2 clinical study, G200801 was a single arm study evaluating a 9 milligram oral daily dose of enobosarm in a heavily pretreated endocrine resistant cohort of 22 patients with AR+, ER+/HER2- advanced breast cancer. The patients participating in the study on average had three previous lines of endocrine therapy, and 68% had previous chemotherapy. The clinical benefit rate at six months was 35.3%, the six month Kaplan-Meier estimate for radiographic progression free survival was 43.8%. Enobosarm was well tolerated without evidence of virilization, no increases in hematocrit and no liver toxicity. The second Phase 2 clinical study, G200802 was a two-arm study, evaluating 9 milligrams and 18 milligrams of enobosarm daily oral dosing in a 136 women, with ER+, HER2- advanced breast cancer. The patients in this study were also heavily pretreated, having failed an average of four endocrine treatments and 88% have received prior chemotherapy. Primary investigator for the study was Dr. Beth Overmoyer, Founder and Director of the Inflammatory Breast Cancer Program at Dana-Farber Cancer Institute in Boston, Massachusetts, and Assistant Professor of Medicine at Harvard Medical School. The completed Phase 2 study results will be presented as a spotlight presentation at the San Antonio Breast Cancer Symposium tomorrow, December 10th, at 2:15 p.m. by Professor Carlo Palmieri, Professor of Translational Oncology and Medical Oncology -- he's a medical oncologist in the University of Liverpool. The abstract is number 811, and it's entitled The Efficacy and Safety of enobosarm, a selective androgen receptor modulator to target endrogen receptor in women with advanced ER+ AR+ breast cancer, final results from an international Phase2 randomized study. Overall, these metastatic breast cancer clinical studies with enobosarm in heavily pretreated subjects, with hormone receptor positive breast cancer, strongly establish the relevance of targeting the endrogen receptor with a selective endrogen receptor agonist, both with efficacy and safety and with additional other benefits. Owing to its high tissue selectivity, enobosarm increases muscle and physical function, decreases fat, improves bone strength and lacks the androgenic adverse effects, including virilization, liver toxicity increases in hematocrit. By targeting the endrogen receptor and hormone receptor positive metastatic breast cancer, enobosarm introduces a novel endocrine therapy to patients with breast cancer that have exhausted endocrine therapies targeting the estrogen receptor, but prior to IV chemotherapy. The company met with FDA in October of 2020 to discuss the enobosarm Clinical Breast Cancer Program. The FDA has agreed to the Phase 3 registration clinical trial this study to evaluate the efficacy and safety of enobosarm versus inactive control, which will be either exemestane or tamoxifen physician's choice for the treatment of metastatic ER+/HER2 breast cancer in approximately 240 women that have failed a non-steroidal aromatase inhibitor, anastrozole or letrozole, fulvestrant and a CDK4/6 inhibitor. The Phase 3 study will be called the ARTEST study, A-R-T-E-S-T study. The primary endpoint is radiographic progression free survival. The pivotal Phase 3 open label randomized active control study is anticipated to commence in the first-half of calendar year 2021. It should be noted, that enobosarm has strong intellectual patent protection with U.S. composition of matter patents that expire in 2029, with a potential for five year patent extension for an NCE to 2034, and with method of use patents that will expire as early as 2033. Enobosarm is a large market opportunity as it represents the first new class of targeted endocrine therapy and hormone receptor positive advanced breast cancer in decades. Enobosarm targets the endrogen receptor and ER+/HER2- metastatic breast cancer, as a potential second line and/or third line oral daily dosing endocrine therapy option in breast cancer patients that have exhausted endocrine therapies targeting the estrogen receptor, but prior to IV chemotherapy. The global annual market for an oral agent in an ER endocrine resistant setting is expected to be $6 billion. Next, we have made a decision to advance VERU-111 into a Phase 2b clinical study for the treatment of taxane resistant metastatic triple negative breast cancer. As I mentioned, metastatic triple negative breast cancer is an aggressive form of breast cancer that's present in approximately 15% of all breast cancers. This form of breast cancer does not express the estrogen receptor, the progesterone receptor HER2, and is resistant to endocrine therapies. The first line of treatment usually includes an IV taxane chemotherapy. Almost all women will eventually develop taxane resistance. Over expression of P-glycoprotein pumps that cancer drug back out of the cancer cell to avoid cancer cell death. And this is a common mechanism that results in taxane resistance and triple negative breast cancer. VERU-111 on the other hand, is an oral cytoskeleton disrupter, cannot be pumped out of the cancer cell by P-glycoprotein drug resistance protein. Preclinical studies in human triple negative breast cancer grown in animal models, demonstrate that VERU-111 significantly inhibits cancer proliferation, migration, metastasis and invasion, the triple negative breast cancer cells and tumors that have become resistant to paclitaxel which is a taxane. In fact, a poster is being presented this morning at 9 a.m. Eastern at the San Antonio Breast Cancer Symposium virtual meeting on the preclinical efficacy data entitled, VERU-111 as an orally available tubulin inhibitor suppressing both taxane sensitive and taxane resistant triple negative breast cancer, and this will be presented by Dr. Wei Li from the University of Tennessee Health Science Center. Using the safety information from the Phase 1b and Phase 2 VERU-111 prostate cancer clinical studies in a total of 80 men, we will meet with the FDA in the first-half of calendar year 2021 to discuss the Phase 2 clinical trial design for possible accelerated approval for VERU-111 versus active control Trodelvy for patients with taxane resistant triple negative breast cancer, making the proposed trial a potential registration trial. The Phase 2b clinical study is planned to commence in the second-half of calendar year 2021. And as I mentioned, this would represent a second major clinical oncology indication for VERU-111. The number of new U.S. breast cancer cases in 2020 totaled 276,480, with triple negative breast cancer accounted for 10% to 15%, of approximately 41,472 patients. The majority of women will receive IV chemotherapy including taxanes, almost all of these women will develop taxane resistance and will be a candidate for VERU-111. The annual U.S. market for taxane resistant metastatic triple negative breast cancer is estimated to be over $1 billion. The company's other indications include VERU-111 for the treatment of SARS-CoV-2 in subjects and high risk for acute respiratory distress syndrome. VERU-111 is being evaluated in the Phase 2 clinical trial to assess the efficacy of VERU-111 in combating COVID-19 to prevent ARDS. VERU-111 by targeting microtubules may have broad antiviral and strong anti-inflammatory effects, including the potential to treat cytokine release syndrome that's associated with high COVID-19 mortality rates. Veru is currently enrolling a double-blind randomized placebo controlled Phase 2 clinical study, evaluating daily doses of VERU-111, 18 milligrams versus placebo for 21 days in 40 hospitalized patients who tested positive for SARS-CoV-2 virus and are at high risk for ARDS. The primary endpoint is the proportion of patients that are alive and without respiratory failure at day 22. Secondary endpoints include the measured improvements in the WHO disease severity scale, which is an 8 point ordinal scale and captures COVID-19 disease symptoms and signs including hospitalization, to progression of pulmonary symptoms, to mechanical ventilation as well as death. We expect enrollment to be completed this month. If the clinical results of the Phase 2 clinical trial are positive, the company intends to apply for grant funding third-party agencies. And as you know, COVID-19 is now worse than ever, and no effective treatments have been found. As for Zuclomiphene and the other drugs that are not in the oncology treatment drugs, now that we have four late clinical stage studies for three drugs in four premium oncology treatment indications, the company has even further focused and reprioritized resources to maximize shareholder value. Zuclomiphene citrate is an oral non-steroidal receptor agonist, being developed to treat hot flashes, a common side effect caused by ADT in men with advanced prostate cancer. The company's planning an end of Phase 2 meeting with the FDA will assess the next steps after that meeting. In light of the promising progress of the prostate cancer and breast cancer late clinical stage programs to achieve the company's strategic objectives, we do not plan to further develop tamsulosin DRS, VERU-722 and VERU-112 drug candidate assets. I will now turn the call over to Michele Greco, CFO, CAO to discuss the financial highlights. Michele?