Earnings Labs

Kyntra Bio, Inc. (KYNB)

Q3 2015 Earnings Call· Thu, Nov 12, 2015

$7.08

+0.71%

Key Takeaways · AI generated
AI summary not yet generated for this transcript. Generation in progress for older transcripts; check back soon, or browse the full transcript below.

Same-Day

+3.72%

1 Week

+6.06%

1 Month

+16.67%

vs S&P

+16.57%

Transcript

Operator

Operator

Welcome to the FibroGen Quarter 3, 2015 Conference Call. My name is Kathy, and I will be your operator for today's call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session. Please note this conference is being recorded. I will now turn the call over to Greg Mann, Executive Director of Investor Relations. Mr. Mann, you may begin.

Greg Mann

Management

Thank you, operator. Good afternoon and thank you all for joining our call. On this call we expect to make forward-looking statements regarding our business including our collaborations with AstraZeneca and Astellas, financial guidance, the initiation enrolment design, conduct and result of clinical trials, research and development activities and certain other statements regarding the future of our business. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks, and changes that are difficult to predict, and many of which are outside of our control. We refer you to the risk factor section of our annual report on Form 10-K for the year ended December 31, 2014, our quarterly report on Form 10-Q for the quarter ended March 31, 2015, and June 30, 2015 and our quarterly report on Form 10-Q for the quarter ended September 30, 2015, each of which has been filed with the SEC for risks and uncertainties regarding our business, as well as the statements made on the call today. We undertake no obligation to update any forward-looking statement whether as a result of new information, future developments, or otherwise. A webcast to this conference call will be available for replay on the Investor Relations page at FibroGen's website, www.fibrogen.com. I'll now hand the call over to Tom Neff, Chief Executive Officer of FibroGen.

Tom Neff

Management

Thank you, Greg. Good afternoon, thank you for joining us today. On today's call, we will review key updates and our programs, discuss recent accomplishments and highlight our most important near-term and long-term goals. Joining me for this discussion are Dr. Peony Yu, VP of Clinical Development; Dr. Frank Valone, Chief Medical Officer and Pat Cotroneo, Chief Financial Officer. Let me begin with comments on FibroGen’s progress enrolling patients in our Phase 3 roxadustat studies and results of the latest roxadustat DSMB or Data Safety review. As we announced in our press release in 10-Q this afternoon, our roxadustat timelines remain on track. We continue to expect to file regulatory submissions for roxadustat in 2016 for China and 2018 for the U.S. We and our partners, AstraZeneca and Astellas are conducting a total of seven Phase 3 trials for registration in the U.S. EU and other territories. FibroGen is conducting three of these seven trials. As stated in our last call, the shareholders, the working assumption agreed with AstraZeneca was that FibroGen would meet target enrolment for its trials enrolled by March- April 16 as a base goal with a stretch goal of December 2015. We confirm our prior guidance in the one trials meeting target enrolments within the stretch goal, another trial will hit target between stretch and base goals and we expect the third trial to hit the agreed upon target of the base goal. Last quarter, we said that on a combined basis, the three Phase 3 trials were two thirds enrolled, now they are more than 80% enrolled. An independent data safety monitoring board or DSMB is overseeing all of the roxadustat Phase 3 studies and convenience periodically to review the roxadustat safety data. During its October 2015 review, the DSMB held a face to face…

Peony Yu

Management

Thank you, Tom. I'd like to comment briefly on the profile of roxadustat and its potential for treating patients with anemia and then describe the Phase 3 clinical program design. Roxadustat is our first-in-class hypoxia-inducible factor prolyl-hydroxylase inhibitor in development for the treatment of anemia in patients with chronic kidney disease. In response to hypoxic conditions such as high altitude of blood loss, the human body naturally makes more red blood cells to carry oxygen. Roxadustat pharmacologically turns on that response system to make red blood cells. The current treatment of CKD anemia using ESA is associated with cardiovascular MACE [ph] which goes up with high ESA growth. Iron is a necessary ingredient for making red blood cells and hepcidin as a hormone which blocks up the bodies iron stores and interferes with the bioavailability of iron. Information in patients with chronic kidney disease tends to lead to elevated hepcidin levels and higher ESA dose requirement. One problem with current anemia care is when IV iron is used to overcome the block of iron availability induced by hepcidin. IV iron inturn induces super physiologic hepcidin levels that blocks red blood cells production. First, creates a vicious cycle, increasing the need for more IV iron and more ESA. Both agents have those associations with worst patient outcome. In contrast, once they have used their triggers they coordinate a process for making red blood cells in the body reducing hepcidin, mobilising iron, increasing iron transport factor, like transferring which makes iron available, and with only a modest trends in elevation of injectable erythropoietin. As reported in our manuscript on the Phase 2 incident dialysis study published in the October issue of the Journal of the American Society of Nephrology, haemoglobin responses were similar between patients on overall iron and IV iron supplement…

Tom Neff

Management

Thank you, Peony. Now we'll turn to FG-3019. Dr. Frank, go ahead please.

Frank Valone

Management

Thank you, Tom. I’d like to review briefly our second major clinical program that focuses on treatment of fibrotic diseases and fibrotic cancers. Our lead product candidate FG-3019 a pro-human monoclonal antibody that blocks biologic activity of CTGF or Connective Tissue Growth Factor, CTGF has been shown to be central mediator of fibrosis and to contribute to tumor growth and metastasis;. A large body of preclinical and clinical data has led us to develop FG-3019 in four distinct areas, pancreatic cancer, idiopathic pulmonary fibrosis or IPF, Duchenne muscular dystrophy and liver fibrosis. As Tom reported we are running a trial patient's with inoperable stage 3 pancreatic cancer These patients has survival similar to patients with metastasis cancer, study showing only half of inoperable stage 3 patient are alive, approximately eight to 12 months after diagnosis. Survival is so poor, very few studies even report five-year survival. The outlook for patients with resectable pancreatic cancer is considerably better. Study show that half are alive between 17 and 27 months for diagnosis and 20% alive at five years. Tom presented data for per seven subjects in which more subjects in experimental arm containing FG-3019 converted to resectable status and underwent tumor removal. We intent enrol up to approximately 40 subjects in this study. To accomplish this we've expanded the study from where it started at Virginia Mason Medicine Clinic in Seattle to include Mayo Clinic in Georgetown University. Our secondary clinical development is IPF. We completed dose findings, single-arm open label trial with FG-3019 and subjects with moderate IPF. Results of this study show that 35% of subjects had stable, we've improved lung fibrosis after treatment with FG-3019 for 48 weeks. To our knowledge, no IPF clinical trial has shown lung fibrosis as measured by high resolution CAT scans. This includes trials…

Tom Neff

Management

Thank you, Frank. Now, we'll turn to financial matters, and Pat Cotroneo. Pat, please go ahead.

Pat Cotroneo

Management

Thank you, Tom. As we announced in our press release today, total revenue for the quarter ended September 30, 2015 was $19.5 million. For the same period, operating expenses were $63.3 million and net income was $45.1 million or $0.75 per basic share and diluted share. Included in operating expenses for the quarter ended September 30, 2015 was an aggregate non-cash portion totaling $8.3 million of which $6.8 million was a result of stock-based compensation expense. In terms of our cash balances, we had $365.6 million in cash, cash equivalents, investments, and receivables compared to $346.8 million at the end of 2014. Our investments consist primarily of two to three-year investment grade corporate debt. In connection with the cost sharing arrangement with AstraZeneca, FibroGen's total funding obligations for roxadustat excluding China are limited to $116.5 million, of which $104.7 million had been incurred and $11.8 million remained as of September 30, 2015. As Tom just discussed based on the current year projections, FibroGen expects to reach this $116.5 million cap before December 2015 on an accrual basis, at which time Astellas and AstraZeneca will be responsible for funding further roxadustat development in CKD through launch for all territories outside of China. Looking to year-end 2015, we continue to anticipate that our cash, cash equivalents, investments and receivables will be approximately $330 million. With that, I'll turn the call back over to Tom.

Tom Neff

Management

Thank you very much Pat. Operator, thank you. That's concludes our prepared remarks. We'd like to begin the question and answer session.

Operator

Operator

Thank you. We will now begin the question and answer session. [Operator Instructions] And it looks like our first question comes from Michael Yee from RBC Capital Markets. Michael, please go ahead.

Michael Yee

Analyst

Hey, thanks. Good afternoon Tom and Frank. Couple of questions, congrats on the 3019, I guess, initial data you talked about in pancreatic cancer, pretty exciting I guess, can you describe I guess what do we do with that data going forward and you have to finish off that Phase 2 study, is that endpoint of study you can do on Phase 3? Maybe just walk through what the next steps are there, because I think that's pretty new data that you just described. Second question was on NASH, which was a new development. Can you explain what that study design you're thinking that would be, I mean, first, I'd like to see a placebo controlled study, so can you talk about little of that? And my last question on roxadustat, there were some recent, I guess, delays or commentary made about GSK, they talked about their new program, this has been off radar, I think for a lot of people, so can you describe a little bit context about what you know that we should think about in terms of versus roxadustat? Thanks.

Tom Neff

Management

Okay. Thank you, Michael. Let's see if we can get through this stuff. So, I think, I'll try to answer the question on pancreatic. This is a pilot study wherein we plan to enrol up to 40 patients with the provided that once we were convinced of either efficacy and evidence enough to move forward or lack of efficacy we either to proceed or stop. So conceptually we could anywhere from now until 40 patients make a decision to go to the next step. The data so far is certainly of note. The numbers are too small however to be sure. And so, we will continue to looking at patients for a while. The feeling here is if what we've seen so far with three 3019 patients that had completed six months doing as they did effect. Patent continues, we'll probably go talk to the agency about the endpoint and how they like to see this addressed as a next step. We are quite willing to do whatever study is needed behind that, so there is no limitations in budget or anything else that would inhibit our ability to move forward, but I think we need to understand exactly how FDA looks at this is unmet need and how they look at this clinical benefit. I suspect that we'll need to make the judging process something that FDA is completely satisfied with. The rest of it I think looks very good right now, so we'll just be hoping in the next few patients.

Michael Yee

Analyst

Let's put it this way, do you think you need to enrol the 40 something patients. I'm just trying to think about timing, just like something …?

Tom Neff

Management

Michael, I don't. Yes, based on the data so far if it continues I don't think we need enrol the 40 patients to draw our conclusion, but we need to see more of the same here. So I don't want to get ahead ourselves. It could be with anything, so this kind of statistics for all we know the next 15 patients on 3019 strike out. I mean, we have to see what happens. But there's a point where it becomes apparent and obviously right now when we're expecting one or two patients in the control arm at most to have the perception your three out three, say, three out four but arguably three out three is the fourth patient discontinued really at some point the difference there that disparity will be one that everybody and their gut feels like we got to act on if and when the data come in along that line. So let me stop that line there and answer your next question about NASH. And I want to hand that to Frank to handle. And I think question were do we have a plan for study and will it be a placebo controlled study.

Frank Valone

Management

Yes. That's a good question. The answer about placebo always yes. We do plan placebo controlled trial and that was what we presented to be FDA was a standard randomized double-blind placebo controlled trial. Much of our discussion with the FDA dealt with what endpoints we should use. This still a bit of horse-trading, but I think we're going to end up is that they're going to ask us to make biopsy changes in fibrosis, our primary endpoint. We've already proposed that we'll be targeting patients that had advance liver fibrosis, not looking at early stage fibrosis rather patient who are brought stage 3 and 4, stage 4 being sclerosis. We're targeting advance fibrosis and asking can we make that better using FG-3019. There are other endpoints where we're going to include their focus on refunction, I think we have some good ways to access liver function and we probably looking for signals both in changes in fibrosis and function that commence us to move forward into further trials.

Tom Neff

Management

Okay. And let me try the roxadustat question. GSK sort of got more visible recently on their program. They set some things that we found very odd, the one our focus on for now is this idea the oncology envision causes cardiovascular events. And so the way we process this stuff are one of the cofounders company called leading expert our prolyl hydroxylase causes triple heel [ph] collagen or form and our view would be that in order to have any interference with collagen, meaningful magnitude you have to have continues addition of the prolyl hydroxylases that sit in the endoplasmic reticulum, so its two membranes you got to get through. And for our purposes roxadustat unlike everybody else we are doing intermittent dosing and so with intermittent dosing you don't have continuous blockade of collagen hydroxylase under any circumstance. And we done all sorts of models to try to evaluate this and at most we might have 1% effect on collagen in the most extreme stress example with intermittent dosing. The companies that have daily dosing have a different problem obviously because they need to wait 12 to 14 hours to get EPO Cmax, and when you think about that in the system resetting it never really resets at a 24 hour period and that's why we don't do daily dosing. But I would also say this, that we cannot find any examples of cardiovascular mortality, mobility outcomes associated with blockade of the human prolyl hydroxylase enzymes and to try to prevent the collagen customer from assembling and so we're mystified by the comments as a class effect and I would instead suggest perhaps is the compound series maybe GSK is looking or something like that. They have done a couple of studies that are very different than the ones that are required for anemia and it might be whatever they worried, whatever they choosing to one mail at and something there, but for us we've talk to our expert group were oncology and everybody says there is nothing here at all to report. So we were mystified about that. As far as their program, you know they are in Phase 2 somewhere and we don't know exactly what they are doing next. And I think that's all that we can say right now.

Michael Yee

Analyst

Understood. Thanks.

Tom Neff

Management

Okay. Thank you, Michael.

Operator

Operator

And our next question comes from Seamus Fernandez from Leerink. Seamus, you can go ahead.

Seamus Fernandez

Analyst

Thanks very much for the questions. So, Tom, I was wondering given the structure of the contingent payments, your updates for how we should be thinking about cash burn which I think if I hear the comments, right, it was basically by end of 2016 your expectation for cash would be in $295 million to $300 million range. With the contingent payment that's first come in from AstraZeneca, as I look at $300 million at the end of 2016 just before we get to sort of series of development in regulatory milestones. It would seem like upon the approval of an exciting start potentially in 2018 you would be operating with a very substantial cash balance. So I'm just trying to get a better sense of what those – what that cash balance could potentially and how those development and regulatory milestone kind of shape up and how much of a ramp off of what I think that $100 million estimated of just sort of cash burn would be in 2016 potentially on the basis of your comments, would we see a substantial ramp in other programs in 2017 as we look forward.? But that's really just one-one question, but just want to get a better sense how to think about the cash situation?

Tom Neff

Management

Yes. Let me try to pass this out and answer it. First, you're correct in hearing and repeating that we said, $295 million to $300 million of cash at the end of 2016 and I add up the caveat that as we get to the point of doing final budget next month for next year if thing change we will inform the relevant investors as soon as we can. But right now that's what we see. The overall assumptions that we use in our planning are that we assume with respect to 3019 that as long as we're doing the proof-of-concept Phase 2 type studies and we're not on the pivotal studies that it would not require additional financing for corporation. It changes obviously depending on what the – when you have enough data that's compelling that you can act on the pivotal program, what the cost structure is and what we're facing and so that scenario is the only one that we thought about is one that creates financing need. We mentioned LCM in China and potentially that's another factor is that hopefully didn't plays out, all safe for the moment that we put that to the side and just focus on what we're dealing with. There are a lot of milestones certainly, it’s on a $1 billion order going forward, a portion of them are pre-submission, I think working assumption there is – if you could get every milestone that's out there maybe a quarter of its pre-submission maybe a little more, not quite sure that the dominators should be there, but some like that and – but for our purposes we don’t plan under the assumption, those things are automatic and so we run the place the pretty tightly in terms of cash management. And so as…

Seamus Fernandez

Analyst

No, that’s perfect. And maybe just as a separate question. Can you just – what’s at this point – I think on the last conference call Peony you mentioned that the DMC at this point would be evaluating – or really only looking for highly in frequent events. But I just wanted to get a sense of when did the last DMC occur and at what frequency is it taking looks at this point? Are those occurring less frequently now every six months and previously with every three months or just any update on how the DMC is evaluating the studies?

Tom Neff

Management

So Seamus, let me try to handle that because the comment you referred to was actually mine from the last call.

Seamus Fernandez

Analyst

Alright. Sorry about that.

Tom Neff

Management

The DMC operates by a Charter. The DMC, DSM-IV as we call it, began in 2009 and the core membership has continued from that time regard of the few people to seven totals now but that’s essentially how it’s been operating. The Charter provides for four meetings a year and couple of those are face to face and we try to note that when it happens. The focus of the group is -- its wrong to say that it’s looking for very rare events. The comment there was more along the lines that patient years exposure aren’t quite far enough along that any real conclusions can be drawn was statistical power as it relates to the mason points and so a lot of effort is gone and to look for rare events at various times. This past meeting – this was a company presentation of about 3 hours and an equal amount of time in a close session and I got the impression that there was a very strong consensus to continue with the studies, no modifications and we got a lot of feedback, but I think that thus far as I’m willing to discuss this we are – because we are the holder of statistical center point and this was two larger partners. We’re under some very extreme structures about any disclosure going outside of clinical operations and safety have been into the commercial side of the company and so I think the parameters have been imposed by others and I’ve agreed to them and I just have to say that we observe this boundaries and I apologize if I can’t offer you more information at the present time.

Seamus Fernandez

Analyst

No, no. That’s perfect. Thank you so much.

Tom Neff

Management

Thank you.

Operator

Operator

And our next question comes from Terence Flynn from Goldman Sachs. Mr. Flynn, please go ahead.

Terence Flynn

Analyst

Thanks for taking the question. Maybe -- Tom, you mentioned, Roxa for MDS and CIA in China. Maybe just give us an update on how you and your partners are thinking about plans for these indications and other geographies. And then on the 3019 Phase 2 IPF trial, I know you guys previously discussed that you could expand it to include some potential combination drug use – in the current study. Is that still part of the plan or will that be separate study? Thanks a lot.

Tom Neff

Management

Thank you, Terence. So with regard to expansion of anemia activities I think in the past we’ve indicated that AstraZeneca has considered a lot of different scenarios and that still goes on. With regard to China the circumstances were such that there was a discussion that having between ourselves and the regulators that precipitated forward moment. And we want to make it very clear that we intend to follow through on a China pathway. At the same time, this was a little bit unexpected for us and as a result there wasn’t there are three parties involved with ourselves in AstraZeneca but also Astellas which will also rise in Japan and Europe. And so there needs to be meetings with pre-sided meetings in the future for non-China territories and as I said that’s the case that where China we weren’t expecting to be doing this -- at the time, we started doing in August, but we have follow through and we have -- what are now becoming concrete plans there and AstraZeneca has been outstanding on their own. And so – that’s a part I can report and the rest of it just has to be for the future. As it relates to the combination therapies with FG-3019, I’m going to let Dr. Frank Valone answer this question. The starting point is that we are indeed looking at combination therapies, but just specific. Go ahead, Frank, please.

Frank Valone

Management

Sure. And that’s a very good question. We still are looking very closely at combination therapy. We think that as we are looking forward to positive Phase 2 results and going under Phase 3 one root for approval would be an add-on. We are adding FG-3019 on top of one of the two approved drugs either pirfenidoneor nintedanib. We are looking at now as just logistics doing that. We want to get this done as fast as we can and we’re really trying to figure out whether it’s better to add a non recurrent trial or do we separately study and that’s what you just say active discussion in the group which result that soon and be able to move on in that area.

Tom Neff

Management

And we’ll report on that as soon as we have firm plan in the form of protocol agreement, an agreement on a protocol internally. And for the moment you should assume we’re just working away at the alternatives. So I think that’s it for Terence.

Terence Flynn

Analyst

Great. Thank you, guys.

Tom Neff

Management

Okay.

Operator

Operator

[Operator Instructions] And our next question comes from [indiscernible] at Stifel. Please go ahead.

Tom Neff

Management

Sorry, I couldn’t hear you. Could you just say that a little louder?

Unidentified Analyst

Analyst

[indiscernible] from Stifel. Thank you for taking my question. So I have a quick question about incidents dialysis paper that was recently published. So the paper indicated that there were about 6 patients that choose some hypertension signal as they had to readjust their anti hyptertension [ph] medication. So this was one of the contents of the ESA. How significant it is for you guys? How you plan on treating it in the coming Phase 3 trial?

Tom Neff

Management

Okay. This is study 053 adjacent article was publication of that study. So Peony, I’m going to ask you to take this on, please. Did you understand the question she asked?

Peony Yu

Management

Yes.

Tom Neff

Management

Okay.

Peony Yu

Management

So we have a patient population with chronic kidney disease and patients who are on dialysis who are undergoing a fluid shift three times a week. And hypertension has been identified as an issue with the use of ESA. In multiple studies, when we look at the rates of hypertension in patients treated with roxadustat in placebo controlled trials we have shown no difference between our drug and that of placebo. And we monitor patients of blood pressure very carefully throughout in Phase 2 and Phase 3 we have not identified hypertension as the signal in control trials.

Unidentified Analyst

Analyst

Okay. That’s perfect. Thank you. And I have an additional question, there were relevant comments about changing environmental total [ph] regulations in China basically to initiating a trial to allow marketing of the recession independent of manufacturing authorization, how does it affect FibroGen?

Tom Neff

Management

Could you just clarify that question, I think we had a bit of a panic here.

Frank Valone

Management

Yes we’re having a hard time hearing on the speaker; can you say it one more time please?

Unidentified Analyst

Analyst

The enrolment. Can you hear me?

Frank Valone

Management

Yes

Operator

Operator

And it looks like she did just get disconnected.

Frank Valone

Management

It’s okay.

Tom Neff

Management

Yes, she disappeared. I would suggest we follow up with her.

Frank Valone

Management

Separately.

Tom Neff

Management

We’re at the end of the hour.

Frank Valone

Management

Okay.

Tom Neff

Management

So, let me say thanks to everyone who’s still on the call for participating today. We realize you have many things you can do with your time everyday and we appreciate that you were willing to listen to what’s going on in FibroGen. We look forward to speaking with you again and providing future updates at our next report probably in early March 10-K filing into February. Thank you very much.

Operator

Operator

Thank you, ladies and gentlemen. This concludes today’s conference. Thank you for participating. You may now disconnect.