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Operator
Good afternoon, ladies and gentlemen, and welcome to Socuity's fourth quarter and year-end financial results conference call. At this time, all lines are in a listen-only mode. Following the presentation, we will conduct a question-and-answer session. Instructions will be provided at that time for you to queue up for a question. If anyone has any difficulties hearing the conference, please press star zero for operator assistance at any time. I would now like to turn the conference over to Maria Jankowski with ICR Westwick. Please go ahead.
Maria Jankowski
Thank you, Operator, and good afternoon to everyone on the call. Thank you for joining us to review Salcuity's fourth quarter and full year 2023 financial results and business updates. Earlier today, Salcuity released financial results for the fourth quarter and full year ending December 31, 2023. The press release can be found on the investor section of the website. Joining me on the call today are Brian Sullivan, Cellcuity's Chief Executive Officer and Co-Founder, Vicki Hahn, Chief Financial Officer, as well as Igor Gorbachevsky, Chief Medical Officer, who will be available during Q&A. Before we begin, I would like to remind listeners that our comments today will include some forward-looking statements. These statements involve a number of risks and uncertainties which are outlined in today's press release and in our reports and filings with the SEC. Actual events or results may differ materially from those projected in the forward-looking statements. Such forward-looking statements and their implications involve known and unknown risks, uncertainties, and other factors that may cause actual results or performance to differ materially from those projected. On this call, we will also refer to non-GAAP financial measures. These non-GAAP measures are used by management to make strategic decisions, forecast future results, and evaluate the company's current performance. Management believes the presentation of these non-GAAP financial measures is useful for investors' understanding and assessment of the company's ongoing core operations and prospects for the future. You can find the table reconciling the non-GAAP financial measures to GAAP measures in today's press release. And with that, I would now like to turn the call over to Brian Sullivan, CEO of Cellcuity. Please go ahead.
Brian Sullivan
Thank you, Maria, and good afternoon, everyone. In 2023, we made significant progress advancing development of Geta to Lissib while strengthening our balance sheet and adding to our leadership team. Our Phase III Victoria I trial remains on track to report top-line data from the PIK3CA wild-type patient subgroup in the second half of this year and top-line data for the PIK3CA mutated patient subgroup in the first half of 2025. We were also excited to begin development of Geta to Lissib for patients with metastatic castration-resistant prostate cancer this past year. Enrollment has begun in our Phase 1b2 trial, evaluating getatolizumab in combination with arlutamide, and we look forward to sharing preliminary data from this trial in the first half of 2025. Our Victoria 1 Phase 3 clinical trial is designed to evaluate getatolizumab in combination with fulvestrin with and without palbociclib in patients with advanced hormone receptor-positive HER2-negative breast cancer, whose disease has progressed after treatment with a CDK4-6 inhibitor. We're seeking to improve outcomes for this patient population, which today receives only limited benefit from current second-line standard of care therapies. We estimate that this initial potential target population represents over 100,000 breast cancer patients globally on an annual basis. Current standard of care for these patients includes endocrine therapies such as fulvestrant, and regimens that combine fulvestrin with an mTOR-specific or PI3K-alpha-specific targeted therapy. These therapies only offer modest progression-free survival periods, and in the case of the approved PI3K-alpha inhibitor, a very challenging safety profile. Significant unmet need for these breast cancer patients has led to development and subsequent investigation of a significant number of new therapies, an oral SIRG for patients with an ESR1 mutation, An AKT inhibitor for patients with a PIK3CA or AKT mutation was recently approved. Median progression-free survival, or PFS, for these two new therapies ranged from 3.8 to 5.5 months, respectively. In the same patient population, our Phase III trial is enrolling. While the availability of new drug alternatives for patients is always good news, based on the results reported for these drugs, the unmet need for these patients will still remain. To further elucidate the different therapeutic effects of gadotelicib versus other PI3K, AKT, mTOR, or PAM inhibitors, we performed a series of non-clinical studies using breast cancer cell lines. We presented the results of these studies during a poster session at the 2023 San Antonio Breast Cancer Symposium. In a panel of 28 breast cancer cell lines, gadotelicib was found to be more cytotoxic and at least 300-fold more potent on average compared to the single-node PAM inhibitors. Mechanistically, get a solicit decreased cell survival, DNA replication, protein synthesis, glucose consumption, lactate production, and oxygen consumption more effectively than the other PAM inhibitors. In vivo studies confirmed that PAM-PI3K mTOR inhibition by get a solicit reduced tumor cell growth more effectively than single-node inhibitors in breast cancer patient-derived xenograft models with and without PAM pathway mutations. We believe gettalizib's highly differentiated mechanism of action as an equipotent pan-PI3K mTOR inhibitor is uniquely suited to most effectively address this unmet need, especially since gettalizib has demonstrated activity independent of the PIK3CA or ESR1 mutational status of a patient's tumor. The results from our Phase 1b study and patients receiving the Phase 3 dosing schedule for gettalizib in combination with polycyclobin filvestrin was very promising. Median PFS was 12.9 months, and the objective response rate was 63%, both of which compares very favorably to published data for current standard of care regimens. Another important goal for us in 2023 was to begin development of getotelicib in a new tumor type. In the fourth quarter, we initiated a phase 1b2 clinical trial to evaluate getotelicib in combination with darolutamide, which is a potent androgen receptor signaling inhibitor, in patients with metastatic castration-resistant prostate cancer. We enrolled our first patient in the study in February, and we expect to report preliminary data in the first half of 2025. Treatment options for these patients are limited, and there's an urgent need for new drugs to treat them. Numerous preclinical studies have demonstrated interaction between the androgen receptor and PAM pathways, suggesting that combining a PAM inhibitor with an androgen receptor inhibitor may induce a synergistic anti-tumor effect in patients with prostate cancer. There's also compelling clinical evidence with an earlier generation TAM inhibitor providing a proof of concept of our hypothesis that combining Geta-thalysib with an androgen receptor inhibitor may be efficacious. And finally, as we get closer to having data for the PIK3CA wild-type patients in our Phase III breast cancer study, we need to begin laying the commercial and marketing groundwork necessary to bring Geta-thalysib to the clinic. To head up our commercialization efforts, Eldon Mayer joined our management team as our chief commercial officer in February. Eldon has over 30 years of biopharma commercial experience in companies ranging from early-stage biotechs to full-scale pharmaceutical companies across many therapeutic areas, including oncology. Eldon's an exceptional leader with a proven track record of building commercial organizations from the ground up to support the launch of a biotech company's first drug. And with that, I'll turn the call over now to Vicki Hahn, our Chief Commercial Officer, to review our financial results.
Vicki Hahn
Thank you, Brian, and good afternoon, everyone. I'll provide a brief overview of our financial results for the fourth quarter and full year 23, and I invite you to review our 10K, which will be filed later today for a more detailed discussion. Our fourth quarter net loss was $18.8 million, or $0.65 per share. compared to $11.6 million net loss or $0.69 per share for the fourth quarter of 2022. Net loss for the full year of 2023 was $63.8 million or $2.69 per share compared to $40.4 million net loss or $2.64 per share for the same period in 2022. Because these quarterly and full-year net losses include significant non-cash items, including stock-based compensation and non-cash interest, we also include in our press release non-GAAP adjusted net loss for the quarter and full-year ending December 31, 2023. Our non-GAAP adjusted net loss was $17.6 million, or $0.61 per share, for the fourth quarter of 2023, compared to non-GAAP adjusted net loss of 10.3 million or 61 cents per share for the fourth quarter of 22. Non-GAAP adjusted net loss for the full year 2023 was 57.8 million or $2.44 per share compared to non-GAAP adjusted net loss of 35 million or $2.27 per share for the full year 2022. Research and development expenses were $18.1 million for the fourth quarter of 23 compared to $10.6 million for the fourth quarter of 22. R&D expenses for the full year 23 were $60.6 million compared to $35.3 million for the prior year. Of the approximately $25.3 million increase in R&D expenses year over year, $22.9 million was related to activities supporting the Victoria 1 Phase 3 trial and the initiation of the Phase 1B2 clinical trial. The remaining $2.4 million increase in R&D expense is related to increased employee and consulting expenses. General and administrative expenses were $1.6 million for the fourth quarter of 23 compared to $1 million for the same period in 22. G&A expenses for the full year of 23 were $5.6 million compared to $4.1 million for the prior year. Of the approximately $1.5 million increase in G&A expenses, $1.1 million was related to increased employee-related expenses and $0.4 million related to professional fees and other expenses associated with compliance-related activities that support financing and clinical operations. Net cash used in operating activities for the fourth quarter of 23 was $18.5 million compared to $9.5 million for the fourth quarter of 22. This was the result of non-GAAP adjusted net loss of $17.6 million plus approximately $900,000 of working capital changes. Net cash used in operating activities for the full year 23 was $53.8 million compared compared to $36 million for the full year 22. This was the result of non-GAAP adjusted net loss of approximately $57.8 million, offset by working capital changes of approximately $3.9 million. We ended the year with approximately $180.6 million of cash, cash equivalents, and short-term investments, compared to $168.6 million on December 31, 2022. The increase in cash year-over-year is the result of two financing activities that occurred in the fourth quarter of 23 and yielded gross proceeds of $65 million, which was offset by cash used in operating activities of $53.8 million in 23. The first financing activity included a private placement offering through a pre-funded warrant arrangement, which generated $50 million in gross proceeds. The second financing activity generated gross proceeds of $15 million by accessing our at-the-market offering. We expect cash, cash equivalents and investments, and available funds under our debt facility to provide adequate capital to fund current operational activities into the first half of 2026. I will now hand the call back to Brian.
Brian Sullivan
Thank you, Vicky.
spk02
Operator, could you please open the call for questions?
Operator
Yes, thank you. Ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press the star followed by the one on your touch-down phone. You will hear a three-tone prompt acknowledging your request. Questions will be taken in the order received. Should you wish to cancel your request, please press the star followed by the two. If you are using a speaker phone, please lift your handset before pressing any keys. Your first question is from Tara Bancroft from . Please ask your question.
Tara Bancroft
Hi. Good afternoon. I was wondering if you could tell us more about the overlap of ESR1 and PIK3A mutations. And if the FDA still considers Arm C or fulvestrant alone the best comparator for Arms A and B? now a year into the launch of L-acestrin. So, I'm just basically trying to gauge your level of confidence in the RMB versus C endpoint or even the chances that you might go for an ESR1 wild type labeling for that subset or what. Thank you.
Brian Sullivan
Thanks for the question, Tara. We have not seen any variation in output outcomes for patients associated with ESR1 mutation. with the combination therapy that we're evaluating in this study. And so we don't anticipate a challenge on that front. We closely collaborated with the FDA when we were developing the design of our study. We reviewed the study with them on an ongoing basis through a series of Type B meetings where we are collaborating with them and in close contact to review not only, you know, the clinical development, but also work associated with what we hope is a future NDA. As far as, you know, changing the control, there's no discussion or consideration of that. You know, a drug was recently approved, capivaceturb, that used fulvestrin as a control just this past few months. And so, you know, we'll certainly have data available to us to report potential outcomes in patients according to their mutational status, but we don't anticipate, as I said earlier, to find any differences or clinically meaningful differences.
Tara Bancroft
Great. Thanks. Have you said which HR you're powering to for the B versus C endpoint? You commented on that.
Brian Sullivan
We haven't commented on that, but again, you know, we're powering the study sufficiently to support regulatory approval.
spk11
Okay. Thanks so much.
spk02
Thank you.
Operator
Thank you. Your next question is from from Jefferies. Please ask your question. Hi.
spk09
Thanks for taking my questions. It seems like the data timing is intact and on track. Is there anything else you're saying about enrollment rate? I think at one point you mentioned you aim to enroll 50% of the wild type patients by the end of the first quarter. I'm wondering if you've achieved that milestone, and is that something that you could announce for the wild type cohorts?
Brian Sullivan
You know, that milestone is associated with one of the terms of our debt facility, and we did achieve that milestone during this quarter. And so, you know, we remain on track. That is consistent with the guidance we provided about having data in the second half of this year.
spk09
Okay, great. And for the Phase 3 readout, can you provide an estimate for how much follow-up you think you will have by the time of the data readout?
Brian Sullivan
You know, that's not a number that we'll disclose at this point. You know, we anticipate, you know, obviously reporting the top-line data, you know, and the data readout will be triggered by achieving sufficient events, and that factors in follow-up period necessary to get a fulsome, mature set of data.
spk09
Okay. Yeah, it makes sense. Lastly, another question on mutations. When you analyzed the Phase 1B data, you reported similar efficacy in patients with or without PI3K mutations. But can you remind me if you looked at other mutations in the pathway, including AKT, mTOR, and PTEN loss? And for the Phase 3, have you had discussions with FDA on how you would evaluate patients with other non-PI3K mutations?
Brian Sullivan
We've done analysis of patients with these other mutations, but the numbers are small, and so we didn't feel that reporting those results would be scientifically rigorous enough to really discuss. But we have evaluated them, and based on at least our interpretation of the small sample sizes, we haven't seen anything that is concerning or inconsistent with the comparable results we saw with wild type PIK3CA versus mutated PIK3CA. And as far as other mutations and how that might interact with the FDA, essentially when you design a clinical trial, you know, phase three clinical trial, you have a very detailed protocol with statistical analysis that's well prescribed. And you essentially interact with the agency quite a bit, or at least we did, to get their feedback and to ensure that our assumptions and the statistical analysis plan would be satisfactory, subject to review, to support in NDA. And nothing on that front has changed. And, you know, the primary biomarker that we're using is primarily to assign patients to, you know, a study that's focusing on PIK3CA mutated patients and a study that's associated with or randomizing patients who lack a PIK3CA mutation. And we're using what the PIK3CA mutations that have supported approval of PIK3CA alpha inhibitor. So again, you know, we're relying on an approved PIK3CA test and have confidence that that test will support subject to review by the FDA and NDA submission.
spk02
Got it. That's helpful. Thanks for taking my questions. You're welcome.
spk11
Thank you. Your next question is from . Please ask your question.
spk02
Gil, I think that was for you.
Gil
I think my name was butchered pretty severely there. Sorry. So, okay. A quick question on the prostate cancer. So, just to understand, I mean, your first patients are a little far from this. What kind of signs of early efficacy would the company be looking for in that study? I mean, talking responses here or PSA activity?
Brian Sullivan
Sure. Well, the study is primary endpoint is PFS, the PFS rate after six months of treatment. And then there are a number of secondary endpoints, which include PFS at nine and 12 months, as well as, you know, evaluating, you know, PSA change. We think the most important milestone, or rather endpoint, is related to radiographic progressive free survival, since that's the regulatory endpoint that we would use for evaluation and a registrational study. And so we will be, I think, consistently reporting that number, and as that number matures with the number of patients who've achieved that, whether it's a six-month milestone, nine-month, or 12-month milestone, that will conduct, that will be a rhythm that we'll have for reporting data.
spk02
That's very helpful.
Gil
Maybe another detail on the enrollment here. Sounds like the wild type cohort is enrolling well. Any thoughts on the mutant cohort?
Brian Sullivan
Thank you. They enroll in tandem. Essentially, we're enrolling screening patients who have had prior CDK4-6. If they meet screening criteria that includes assessment of their PIK3CA status, they then get randomized. the enrollment of wild type and mutant are occurring concurrently. And so if our wild type is on track, then our mutant population is on track just because of the way the trial enrollment is designed.
Gil
Thank you. That's a very helpful clarification.
spk02
Thanks for taking our questions. You're welcome.
spk11
Thank you. Your next question is from Brad Pomino from Stiegel.
Operator
Please ask your question.
spk06
Hi. Good afternoon. I want to ask, is there any way you've been able to track adherence with the prophylactic mouthwash for stomatitis mitigation in Victoria 1?
Brian Sullivan
Well, we do. One of the primary advantages we have in managing that and monitoring compliance is when the three-week on, one-week off infusion. And so the treating physicians or the associated nurses are evaluating and including compliance with that prophylactic and standard questionnaire. And so we have a high degree of confidence based on that that If patients aren't compliant, we'll find out, but also we reinforce the value of that prophylaxis. And just as a reminder, that prophylaxis is only used and prescribed for the first two cycles of treatment. The data is fairly clear that for patients who may be prone to development of mucositis, it's in almost all cases likely to occur in the first two cycles of treatment. And so that if you are able to provide that prophylaxis for that first two cycles, that the manifestation of mucositis is much, much lower after that period. So it's not a requirement then for patients to remain on that prophylaxis beyond those first two cycles.
spk06
Okay. And then I'll try to ask another enrollment question, maybe in a slightly different way, because I think the continued reiteration of top line guidance for Victoria 1 is going to be important for investors. I think based on the enrollment pace you see, is there anything you can share about a time point that could be passed this year where you would reach that sufficient enrollment to fully secure the second half guidance for the wild type using the rate assumptions you've got for events?
Brian Sullivan
You know, I think, again, we've provided the guidance for the second half of this year. Obviously, as we get closer to that, we can get more granular. And I think, you know, we'll update that, you know, each quarter. And so the closer we get, I think the more descriptive we can be. But so far, again, we're monitoring enrollment. We're monitoring the event rates. And you make certain assumptions about the event rate, and we're tracking to what our assumptions are so far.
spk02
Thanks for the question. You're welcome.
Operator
Thank you. Your next question is from from HC Wainwright. Please ask your question.
spk03
Thank you. This is from HC Wainwright. Good afternoon, Brad. Good afternoon. Most of my questions have been answered. So when the data, when you're ready to publish the data from the wild type in the second half, would that, I'm just trying to figure out how would you disseminate that information? Would that be a medical meeting or do a press release and then follow up with a medical meeting at that appropriate time?
Brian Sullivan
It's somewhat situational depending on the timing of meetings and when the data will be cleaned and able to be released publicly. And so when the event threshold is triggered, we'll understand whether, you know, what the gross, not gross, but what the data is telling us. And we would finish up data cleaning at that point. Obviously, that's going on on an ongoing basis. But it would be our expectation that we would announce the top-line results, meaning whether or not we met statistical significance, whether the trial was positive, and probably characterize how clinically relevant those results are. But I think it's typical that you present these results of a phase three study at a medical meeting. That would be our current desire. But again, depending on the timing of when the data is available, we may reconsider. But we'll follow, I think, practice that's been used with other drugs. But I think it's fairly typical that if a major meeting isn't scheduled coincident with the availability of data that people will provide that top line and then wait until a medical meeting to provide the more fulsome description of the results.
spk02
Thank you. Thanks for taking my question. You're welcome.
Operator
Thank you. Once again, please press star one should you wish to ask a question. Your next question is from Alex Nelak from Craig Hallam Capital. Please ask your question.
Alex Nelak
Hey, Greg. Good afternoon, everyone. As we're getting close to the first Victoria readout here, you brought on your chief commercial officer. That's great. You know, just what other additional investment in the commercial talent, commercial resources do you need to plan for here over this year?
Brian Sullivan
Sure. You start to build out the team underneath Eldon. which I think typically includes a person who would head up your market access, a person who would head up your marketing, and a person who would head up commercial operations. And with that team, you can do the planning that's necessary to lay the groundwork for obviously a lot more significant efforts once the data reads out and you're really marching towards a specific date for launch. And so we factored that into the assumptions framework in our budget for this year. We've incorporated that in our forecast of cash requirements, and they're not extraordinary. They're appropriate relative to what needs to be done and when.
Alex Nelak
Okay. That makes sense. And then can you remind us the IP position of GETA within breast cancer and then the potential to expand that length within breast or, you know, potentially other cancer indications?
Brian Sullivan
Right. So, we have 11 different patents that have been approved for GETA. You know, we have several that are pending. The active pharmaceutical ingredient patent is, would provide an exclusivity period through December 34. But because GATT is formulated and because the formulation actually is critical to being able to deliver the drug, administer the drug, we think that patent will be very relevant. And that patent would have an expiration date of December 39. And so we think we'll have an extended exclusive period that would potentially carry for more than 15 years post-launch. That's our plan.
spk02
Excellent. I appreciate the update. Thank you. You're welcome.
spk11
Thank you. There are no further questions at this time. Please proceed.
spk02
Well, we appreciate your attendance to the call, and we look forward to updating you in the future.
Operator
Thank you. Ladies and gentlemen, the conference has now ended. Thank you all for joining. You may all disconnect.
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