UroGen Pharma Q1 2024 Earnings Call Transcript

Quartr
Provided by Quartr
May 13, 2024

There are 10 speakers on the call.

Operator

Good morning, ladies and gentlemen. Thank you for standing by. Welcome to the UroGen Pharma First Quarter 2024 Earnings Call. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Vincent Perron, Head of Investor Relations.

Operator

You may begin.

Speaker 1

Thank you, operator. Good morning, everyone, and welcome to UroGen Pharma's Q1 2024 Financial Results and Business Update Conference Call. Earlier this morning, we issued a press release providing an overview of our corporate highlights and financial results for the quarter ended March 31, 2024. The press release can be accessed on the Investors portion of our website. Joining me today are Liz Barrett, President and Chief Executive Officer Doctor.

Speaker 1

Mark Schoenberg, Chief Medical Officer Jeff Bova, Chief Commercial Officer and Don Kim, Chief Financial Officer. During today's call, we will be making certain forward looking statements. These may include statements regarding our ongoing commercialization activities related to Gelmido, our ongoing and planned clinical trials, commercial and clinical milestones, market and revenue opportunities, our commercialization strategy and expectation as well as potential future commercialization activities for UGN-one hundred and two if approved anticipated data including ENVISION durability data, regulatory filings and decisions, including UGN-one hundred and two potentially receiving priority review. UGN-one hundred and two being the primary growth driver for UroGen, if approved future R and D efforts, our corporate goals and 2024 financial guidance among other things. These forward looking statements are based on current information, assumptions and expectations that are subject to change.

Speaker 1

A description of potential risks can be found in our earnings press release and latest SEC disclosure documents. You are cautioned not to place undue reliance on these forward looking statements and UroGen disclaims any obligations to update these statements. With that, I'll turn the call over to Liz. Liz?

Speaker 2

Thank you, Vincent, and thank you everyone for joining us this morning. As we look ahead to 2024, we have several near term catalysts, including the planned release of the 12 month duration of response data from the ENVISION study in June with our expected NDA submission this year. We have assembled a strong body of data that demonstrates a compelling clinical profile for UGN-one hundred and two. The ATLAS and ENVISION trials both met their primary endpoints, and if approved, we believe UGN-one hundred and two will advance the standard of care in low grade intermediate risk non muscle invasive bladder cancer from repetitive surgery to a minimally invasive routine non surgical option. Our research reflects overwhelming support from both urologists and patients with the intent to use by over 90% of surveyed urologists and over 90% of surveyed patients in the ENVISION study preferred UGM-one hundred and two to a TURBT.

Speaker 2

We are pleased to announce that we will host our virtual event to share the ENVISION durability data on June 13. The database lock will occur later this week, and we are very much looking forward to sharing the final results from Envision at that time. Earlier this year, we announced initiation of a rolling NDA submission, and we believe the upcoming Envision data will support completion of the NDA in Q3 of this year. Assuming priority review, we could launch as early as Q1 in 2025. The commercial opportunity is significant.

Speaker 2

We estimate that the overall market is approximately 10 times the size of the urothelial carcinoma market that Jalmydo currently addresses. We intend to seek a broad indication for UGN-one hundred and two. Conservatively, we estimate the size of the market opportunity to be over $3,000,000,000 This represents a substantial market opportunity for our company and a chance to meaningfully impact the treatment paradigms and improve patient outcomes. Our ongoing commercialization plan will include an incremental sales force expansion. Pricing analysis and market research are currently ongoing, but we expect pricing to be in the $16,000 to $19,000 range per dose.

Speaker 2

Given the response and feedback we have received, we believe patients will strongly welcome a minimally invasive nonsurgical alternative to TURBT. While we don't expect to replace TURBT in all patients, UGN-one hundred and two will be the 1st and only medicine approved for patients with low grade intermediate risk non muscle invasive bladder cancer, and we believe we'll offer an advance in treatment if approved. Jeff will provide more details on our commercial strategy in a few minutes. In April, we announced FDA acceptance of the IND for UGN-one hundred and three, an important next step in our life cycle management strategy. 103 is our next generation formulation of UGN-one hundred and two, which combines proprietary RTGel technology with Medac's proprietary formulation of mitomycin.

Speaker 2

A key aspect of this program is the potential for extended patent coverage for our next generation urothelial cancer franchise. MEDAC has intellectual property protection into 2,035 and UroGen's pending U. S. Patent applications, if approved, could extend patent coverage until December of 2,041. We are preparing to initiate clinical endpoint studies to support NDAs for UGM-one hundred and three and UGM-one hundred and four, the latter being our next generation formulation of JALMIDO.

Speaker 2

We anticipate dosing patients in the planned Phase III trial of UGN-one hundred and three by end of this year and UGN-one hundred and four shortly thereafter. As reported, Jomita revenues were $18,800,000 for the quarter, an approximate 10% increase over Q1 2023. More importantly, patient enrollment forms or PES in Q1 were the highest ever, indicating demand continues to grow. As we have experienced in the past, seasonality in Q1 results in a delay in patients being treated due to resetting of insurance. We have seen conversions accelerate in March April, providing support for continued growth of JALMAYDO.

Speaker 2

We are very excited by a recent post hoc analysis from the OLYMPUS trial that evaluated the long term efficacy of JALMIGHTO in patients who experienced a complete response. Mark will elaborate on this momentarily, but at a high level, findings suggest that JALMIDO can offer extended disease free periods with some patients experiencing no recurrence for approximately 48 months. We recently released this data to the field and are optimistic about its impact with urologists. Lastly, our balance sheet remains a priority and our cash position is strong with $164,500,000 in cash, cash equivalents and marketable securities as of March 31. Our capital allocation strategy continues to prioritize the ramp up of UGM-one hundred and two supply and its commercial launch alongside bolstering our belief that our current balance sheet is robust enough to sustain our operations through anticipated breakeven.

Speaker 2

So we do not need to raise additional capital with our current plan. Having said that, there is a plethora of opportunities to further study our medicines across new patient populations and position our company for longer term sustained growth. We will remain diligent with capital deployment and opportunistically strengthen our balance sheet to accelerate and execute those potential growth opportunities. I will now turn the call over to Doctor. Mark Schomburg, our Chief Medical Officer for clinical update.

Speaker 2

Mark?

Speaker 3

Thank you, Liz. I'd like to start by previewing results from a non GAAP published post hoc analysis from the OLYMPUS trial Liz mentioned earlier. The post hoc analysis evaluated long term outcomes of gel Mito use for primary chemoablation in patients with low grade UTUC based on results from the OLYMPUS trial and a subsequent long term rollover trial. After receiving 6 weekly doses of gel Mito, 41 of 71 patients in Olympus achieved a complete response and their health outcomes were tracked for up to 12 months. 20 of the patients remaining in complete response at 12 months enrolled in a 5 year rollover trial.

Speaker 3

Results for all 41 patients who initially achieved complete response indicated a promising median duration of response of 47.8 months based on a median follow-up of 28.1 months. Among the 20 patients enrolled in the long term rollover trial, the median duration of response was not estimable as 75% of these patients continued to show no signs of disease recurrence or progression by the data cutoff date. We plan to submit these results for peer review and look forward to sharing additional updates when available. UroGen had a significant presence at the recent American Urologic Association meeting, which took place in San Antonio with a total of 4 abstracts presented. The first of these was a post hoc analysis from the ATLAS trial of UGN-one hundred and two, which was highlighted in a podium presentation by Doctor.

Speaker 3

William Wang from NYU Langone. The analysis showed that UGN-one hundred and two used with or without TURBT improved disease free survival and duration of response compared to TURBT alone. This analysis revealed that both new and recurrent low grade intermediate risk NMIBC patients who received UGN-one hundred and two achieved similar outcomes. Specifically, DFS rates were 77.4 percent for new patients and 63.2% for recurrent patients at 15 months, while durable complete response rates were 87.5 percent for new patients and 69.1% for recurrent patients at 12 months. Gel Myta was featured in 3 presentations at the AUA.

Speaker 3

This product is approved for the chemoablative use in low grade disease of the upper urinary tract. Independent long term real world analyses that were presented demonstrated 86% recurrence free survival at 24 months

Speaker 4

with

Speaker 3

the gel myto treatment for patients who responded to initial induction. And there does not appear to be a difference in recurrence rates between annegrade and retrograde methods of administration, original tumor size, multifocality or tumor location. The long term analysis also evaluated the value of maintenance use of GelMaito. Although the analyses consisted of a 13 patient cohort, 100% of these patients maintained a complete response at 24 months. The authors concluded that administration of maintenance appears to be associated with significantly better recurrence for survival.

Speaker 3

I would now like to spend a few moments talking about the progress made in the UGN-one hundred and two program. As Liz mentioned, the next milestone for this program is evaluation of the secondary endpoint of the ENVISION trial, duration of response at 12 months following a complete response. We intend to share these results at a company sponsored virtual event on June 13. Database lock is scheduled for later week and we look forward to sharing the results next month. I'd like to summarize the value proposition for UGN-one hundred and two and the rationale supporting our belief in the strength of our regulatory application and if approved widespread adoption by urologists.

Speaker 3

UGN-one hundred and two has demonstrated consistency in the 3 month complete response rate across ATLAS and VISION as well as our prior Phase 2b study OPTIMA-two. Moreover, the ATLAS data suggests UGN-one hundred and two is superior to surgery once a complete response is achieved. In the ATLAS ITT population, 80% of patients who received UGN-one hundred and two plus or minus TURBT were still disease free at 12 months following complete response, compared to only 50% of patients who had a TURBT alone. A significant benefit of UGN-one hundred and two lies in its innovative RTGel delivery mechanism, which provides sustained release treatment directly to the bladder tissue for up to 6 hours. This extended dwell time facilitates treatment of both visible lesions and underlying abnormal cells that predispose to disease recurrence.

Speaker 3

This attribute is critically important because despite their expertise, urologists may not be able to detect all such cells during surgical procedures. We believe UGN-one hundred and two offers a clinically meaningful improvement over surgery in reducing recurrence risk and prolonging disease free intervals for patients, while lowering the overall treatment burden on patients. As Liz mentioned, we are actively advancing the development of next generation formulations of UGN-one hundred and two and gel Mito. The investigational new drug application for UGN-one hundred and three was accepted by the FDA, enabling us to proceed to clinical trials. We plan to initiate a Phase III trial of approximately 87 patients before year end.

Speaker 3

Additionally, we are progressing with the development of UGN-one hundred and four, a next generation formulation of gel Mito to begin sometime thereafter. Beyond our lead programs, we continue to develop our immuno oncology candidate, UGN-three zero one. UGN-three zero one is comprised of an anti CTLA-four antibody delivered using our proprietary RTGL technology. We are conducting a Phase 1 clinical study to evaluate the safety, tolerability and establish a recommended Phase 2 dose for UGN-three zero one as mono as well as combination therapy. We hope to report safety and tolerability data from the monotherapy arm by late 2024.

Speaker 3

We have also initiated combination therapy arms evaluating UGN-three zero one plus gemcitabine and UGN-three zero one plus UGN-two zero one, our proprietary formulation of emiquimod, a TLR7 agonist in high grade NMIBC patients. We believe we have a unique approach in this area and look forward to providing updates as the program moves forward. Now over to Jeff for a commercial update.

Speaker 1

Thank you, Mark. JALMIDO net sales were $18,800,000 in Q1. Seasonality trends in the Q1, which are characterized by deductible resets in January February, were magnified compared to prior years. As Liz mentioned, patient enrollment forms were the highest ever in Q1, indicating strong demand. We're seeing an improvement in the conversion trend in Q2 with a normalized path to new patient start, leading to a reduction in the gap between enrollments and units sold.

Speaker 1

The data from the current quarter is on track with expectations of continued growth for JALMIDO sales and remain aligned with full year revenue guidance. We anticipate typical seasonality dynamics throughout the rest of the year. As Mark stated, AUA was very productive meeting with multiple the value of gel Mito. We have promptly integrated the post hoc long term follow-up data from the OLYMPUS trial into our field operations to further enrich engagement with urologists. These data, which complement the already robust body of real world outcomes data, will serve as a powerful evidence based resource reinforcing discussions about Jalmyto's ability to deliver complete response rates and prolonged durable disease free periods.

Speaker 1

For UGN-one hundred and two, the pre commercialization plan is well underway, targeting an early 2025 launch. As we get closer to the approval date, we will add a modest number of additional reps to our existing field sales force. There's approximately a 95% prescriber overlap with Jomaito and we plan on leveraging our commercial organization to execute its streamlined launch. As mentioned earlier, there's a strongly recognized unmet need amongst both urologists and patients for a new treatment option that has the potential to reduce recurrence risk and prolong disease free intervals. Importantly, our research indicates a strong patient preference for non surgical options that can reduce their overall treatment burden.

Speaker 1

Subverted by a simple method of administration and robust clinical data, if approved, we are poised to transform the way patients with low grade intermediate risk non muscle invasive bladder cancer are treated. UGN-one hundred and two provides sustained chemoablation directly to the bladder tissue to treat both visible lesions and the underlying pathology. And the clinical data we have generated suggest that UGN-one hundred and two appears to be superior to the current surgical standard of care. We know that 70% of patients face multiple cycles of recurrence and surgical resection over time. Our market research reflects urologists' concern about high recurrence rates and a strong desire for new treatment options that may prolong disease free intervals.

Speaker 1

We also anticipate that economic factors will not hinder urologists' adoption of UGN-one hundred and two as the treatment will be delivered in the physician's office. Our launch preparations are sharply focused on removing any logistical, operational and financial barriers to use so the urologist can use 102 worry free based on their conviction behind clinical merit alone. UGN-one hundred and two also has the advantage of being easy to administer either by the doctor, nurse or extender, offering a substantial benefit in terms of patient and doctor convenience. This streamlined approach enhances the experience for the patient and simplifies the treatment process considerably. Based on market research, we believe the fastest adoption for UGN-one hundred and two will initially occur in 3 groups of patients.

Speaker 1

These are patients who have had multiple recurrences, those that would be considered surgical failures patients with early recurrence and patients who are ineligible or unwilling to undergo surgery. Our goal for UGN-one hundred and two, if approved, is to achieve broad adoption, and we are confident physicians will have a positive experience and broadly adopt. We will keep you updated as we address key insights into our plans as we prepare for launch. I will now turn the call over to Don Kim to discuss our financial results.

Speaker 4

Thank you, Jeff. Revenue comprised of GeraMito sales for the 3 months ended March 31, 2024 was $18,800,000 compared with $17,200,000 in the comparable period in 2023. Cost of revenue was $1,700,000 in the Q1 of 2024 compared with $2,300,000 in the comparable period of 2020 3. The overall decrease of $600,000 is primarily attributable to certain nonrecurring payments made in connection with our supply arrangement in the prior year, decrease in mixing fees and decrease in the germanite per unit cost. R and D expenses were $15,500,000 $12,500,000 for the first quarters of 2024 and 2023, respectively.

Speaker 4

The year over year increase was primarily a result of regulatory related expenses in connection with the UGN-one hundred and two as well as R and D expenses in connection with the initiation of our Phase III study for UGN-one hundred and three. Selling, general and administrative expenses for the Q1 of 2024 were $27,300,000 including non cash share based compensation expense of $2,200,000 This compares to $24,500,000 including non cash share based compensation expense of $1,800,000 for the same period in 2023. The increase year over year was primarily attributable to Uxian 1ozu brand marketing costs. Interest expense was $2,400,000 $3,600,000 for the 1st quarters of 2024 and 2023, respectively. The decrease was primarily attributed to the decrease in the margin interest rate and the related impact to amortization of the discount on the Pharmakon loan as a result of the amended and restated loan agreement in March 2024.

Speaker 4

Net loss was $32,300,000 or $0.97 per share and $30,200,000 or 1 $0.30 per share for the 1st quarters of 2024 and 2023, respectively. As of March 31, 2024, we had $164,500,000 in cash, cash equivalents and marketable securities. During the Q1, we utilized our ATM facility for gross proceeds of approximately $56,000,000 Today, we are reiterating our full year 2024 net product revenues guidance from Germytel to be in the range of $95,000,000 to $102,000,000 We expect full year 2024 operating expenses in the range of $175,000,000 to $185,000,000 including non cash share based compensation expense of $6,000,000 to $11,000,000 subject to market conditions. The anticipated full year 2024 non cash financing expense related to the prepaid obligation to RTW Investments are expected to be in the range of $21,000,000 to $26,000,000 Of this amount, approximately $12,400,000 to $13,300,000 is expected to be in cash. For further details of our financials, please refer to our quarterly report on Form 10Q, which has been filed with the SEC.

Speaker 4

We are now ready to open the call for questions. Operator?

Operator

Thank you. Our first question comes from the line of Tara Bancroft of D. C. Cowen. Your line is now open.

Speaker 5

Hi, good morning. So I'm wondering if you could tell us approximately how many patients are included in each of the 3 buckets that you mentioned of initial adopters and which of those you think may be the most robust users? And then from there, how do you imagine adoption to look over time, especially as you continue your education and awareness efforts?

Speaker 2

Thank you. Jeff, why don't you take that?

Speaker 1

Yes. I think the first thanks, Tara. So the unwilling or unfit for surgery is around 10% of patients. We believe that's a conservative number because really there are no other choices but to have to do a surgery. But in a conservative number around 10% 10% to 15% are unwilling or unfit for surgery.

Speaker 1

About 25%, 23% from Medicare data tells us that they have 5 or more recurrence. So your frequent recurs and then that same number is also early recurrence. So a quarter of the patients will have a recurrence within 6 to 9 months. So a good number of patients that physicians have told us really UGN-one hundred and two will have a benefit for. And then your second question was around adoption.

Speaker 1

Certainly, I think those three areas will be where it's adopted the soonest. And then it's imperative that the commercial team drive that adoption to have 1 or 2 available to every patient, whether it's dually depending on the label, whether it's dually diagnosed or someone that's had a previous TURBT.

Speaker 2

Yes. And I guess the only thing I'll add to that is we do expect adoption curve to be faster than what we've seen with JALMAYDO for a few reasons that, I mean, mainly what Jeff has talked about in the sense of the how much easier it is to give and that being the case and the knowledge and experience that a lot of these physicians already have with our current medicines. So we expect that to be much quicker than it was for JALMAYDO. But even if it were the same adoption over $80,000,000 in revenue for, for JALMIDO, if you just said it was the same in the 3rd year on the market, what would it look like? It's something like that.

Speaker 2

So that would be a good analog.

Speaker 5

Okay. Thanks so much.

Operator

Thank you. One moment for our next question. Our next question comes from the line of Raghuram Selvaraju of H. C. Wainwright and Co.

Operator

Your line is now open.

Speaker 6

Thanks very much for taking my questions. Just with respect to reimbursement for UGN-one hundred and two, I was wondering if you could give us some granularity on the following. Firstly, do you think that there might be potential upside to your envisaged pricing range and what factors might influence that from a clinical data efficacy profile perspective? Secondly, maybe Jeff, you could explain a little bit about how a J code might work in the case of UGN-one hundred and two or if it's not applicable, why it might not be applicable? And then lastly, if you're talking about an incremental expansion of the sales force, can you just remind us what the sales force headcount is currently and how you expect that to change as and when UGN-one hundred and two is approved and being launched?

Speaker 6

Thank you.

Speaker 2

Sure. Thanks, Ram. I'll take this first one on pricing and then turn it over to Jeff for the other two questions. But yes, we do see upside versus what we've communicated in the past. I think it's going to be a real balance.

Speaker 2

Again, this treatment is for low grade disease. So low grade disease versus high grade disease, so the pricing is different. But we absolutely will and I think the final data that's going to be shared in June will also have an impact on that. So to your point, what factors impacted? Obviously, when our data came out last year, we had already done pricing research.

Speaker 2

That gave us an opportunity to push the upper bounds of that. And I think given the data that we expect in June, it may be the same thing. So we will finalize the pricing, obviously, before launch, but we haven't now. But I can tell you that we're looking at the higher range and even a little bit higher than what we've talked about in the past. So

Speaker 1

Jeff? Yes. And let me comment on the J code. So yes, we will eventually have a permanent J code. Like all Part B drugs though, we will have a miscellaneous code until CMS reviews.

Speaker 1

The nice thing as we saw with JALMIDO, we were approved in the Q2 of 2020. You then apply for that permanent J code the following quarter. They take a quarter to review and we had a permanent J code January of 2021. So depending on our approval timing, that will be the process. But the nice thing is that they're reviewing these quarterly now versus annually.

Speaker 1

So I expect that same process to take place for UGN-one hundred and two. Current headcount, we do have around 7 regions, 45 territory business managers. Those are the reps supported by reimbursement team, nurses as well as key account directors and FRMs. We will expand one region. We will go from 7 to 8, and we're kind of finalizing now the number of representatives, but anywhere between 10 15 representatives as well, followed up by support those support functions as well.

Speaker 1

So hopefully that helped.

Speaker 6

Very helpful. And just as a quick follow-up to that, I don't know whether Liz or Don you want to comment on how you expect the G and A infrastructure of the company to change in the wake of UGN-one hundred and two's approval or if you don't really expect much change on that front? Thank you.

Speaker 2

Yes. Don, do you just want to comment on G and A?

Speaker 4

Absolutely. So thanks, Ram. So basically, we don't see actually there much difference after this year. So this year, we are going to spend some money to build inventory and build some sales force, but then it will be pretty consistent. Liz, do

Speaker 2

you want to add? No, I think that's correct.

Speaker 7

Thank you.

Operator

Thank you. One moment for our next question. Our next question comes from the line of Matt Kaplan of Ladenburg Thalmann. Your line is now open.

Speaker 7

Hey, good morning guys. Just as we now we're nearing months out, the ENVISION study, 12 month durability data. Can you give us a little bit more detail in terms of what we should be looking for? And then Liz, you commented on depending on that data, some pricing upside and what would drive that in terms of the durability data as well?

Speaker 2

Yes. So, I mean, I guess, I'm not really sure if you're saying what do we expect the number to be or what do we expect to see just from a perspective of what you'll see. Obviously, we'll share the 12 month durability and any update on safety and what our current expectations are even beyond. So we'll be estimating. So we'll be able to share sort of estimates of kind of median where we expect the median to be.

Speaker 2

And so a lot of great data and my point around pricing is obviously the better that data is, the better value that we'll be giving patients and physicians in the practice and the healthcare system. And that will that's where we've been from a pricing standpoint. So that's our expectation. For what would be a win, I would say, without saying too much, we believe that if you look at the ATLAS data and where we were on the 12 month data there, those patients are 69% for all recurrent patients and the patients that had a prior TRBT was 66%. So anything in that area or above, we would definitely feel like would be a home run.

Speaker 2

So we're excited again to share that data in June.

Speaker 7

Thanks, Elizabeth. That's really helpful. And then in terms of maybe for Don, the impacts of the discounts associated with the Medicare refunds and for unused drug and 340B purchases, what was the magnitude of that impact in the quarter? And then what should we expect kind of going forward throughout the year?

Speaker 2

Yes. So Don?

Speaker 4

Yes. So I think it's probably better Jeff to answer. But in general, we expect a similar number in terms of overall gross net. But we got more specifically like 340B or Oasis provision, we expect more favorable to EuroGen for 1 or 2 over Germita. And Jeffrey, do you want to add anything?

Speaker 1

Yes. I think the percentage for Gelmido will remain the same from the wastage provision. Obviously, the more we sell, that will be impacted. But I don't see 340B. It does vary quarter to quarter.

Speaker 1

But I just want to reiterate, Matt, that 102 should not have that either one of those impacts from the bladder can expand and we can deliver all of 102, so we won't be impacted there as well as most of this will eventually be given

Speaker 8

in the

Speaker 1

clinic, so not as impacted from a 340B standpoint. Okay.

Speaker 7

Okay. That's good. And then last question maybe for Mark in terms of development pathways for next gen products, 103 and 104. I guess what will it take to get these products in market? Are you contemplating just single Phase 3 studies for each?

Speaker 3

Matt, thanks. So I think it's probably a little bit premature for us to say exactly how this is going to play out because we are, as you know, not only developing information about 301 for monotherapy, but the basis of this program is really a combination program using 2 drugs of different types. So it might be a combination immunotherapy with 2 immunomodulators, immuno plus chemo. So we know we're going to have, as Liz has alluded to earlier, safety data and a Phase 2 recommended dose later this year and we'll report on that for 301. But as we elaborate more data on the combinations, we'll probably be able to talk a little bit more about what the development pathway looks like for the most promising of these combinations.

Speaker 3

It's probably as much as I should say, but Liz may want to comment as well.

Speaker 2

No, nothing additional unless you've had any additional questions. Just making sure you were talking about 301 and not 103104.

Speaker 7

Yes. I had kind of targeted 103, 104, but Oh,

Speaker 4

I'm sorry. I'm

Speaker 2

sorry. I misheard it.

Speaker 3

Yes, I apologize. Yes, single Phase 3 studies smaller than what we were required from our original approvals, smaller for example than ENVISION, but we expect Phase 3 studies to be adequate to achieve approval for those new next generation products for both gel Mito and for 102. Sorry, I misunderstood the question.

Speaker 2

Yes, which is why we expect the approval to be obviously much quicker because we don't have to enroll as many patients and therefore our enrollment should we will finish our enrollment for 102 and 25 and therefore be have follow-up in filing in 2026 for UGM-one hundred and three, which is the next generation for UGM-one hundred and two.

Speaker 7

Got it. Thanks, guys.

Speaker 2

Thank you.

Operator

Thank you. We'll move on for our next question. Our next question comes from the line of Glenn Gershell of Oppenheimer. Your line is now open.

Speaker 9

Hey, good morning. Thanks for taking our questions. A couple from us. 1st, the company in the past has said that there's sort of a 50% bar with respect to the 12 month program where we gave it to Envision. I'm just wondering how we should best interpret what that means when you say bar and how we should think about that number versus the higher numbers that you mentioned to your prior question on this call with respect to level of enthusiasm or urologists to adopt 102?

Speaker 9

And then just another question for Mark. I wasn't sure if you mentioned when we would see the data and if you plan to see data for 301, we would like to know when we might see that. Thank you.

Speaker 2

So Mark, do you want to talk about sort of the 50% that we've always talked about kind of our expectations, that'd be great and then answer that.

Speaker 3

Sure. Yes, Leland, thanks. So with respect to the bar, maybe just to clarify, and I think many people on this call have heard Liz say publicly before that when we started the 102 program, the 50% number was a number we came up with as a projection of what we thought would be clinically meaningful. We know from conversations with urologists and I can say independently, from a clinical perspective that a number lower than that would be clinically meaningful in terms of its practical utility in taking care of this chronically recurrent patient population. Nonetheless, this 50% number was our projection.

Speaker 3

Now as you noted, the data we've provided from our clinical trials are actually better than that 50% number. And as Liz was saying, remember also that Envision unlike ATLAS, Envision is a pure recurrent population of patients. So when we look at the ATLAS subgroup of recurrent patients, we know that for those who had a prior QRBT and that is essentially the ENVISION population in microcosm, the durability data were 66% at that 12 month that important 12 month follow-up time point. So we think, as Liz said earlier, that something in the mid-60s is likely to be what we would be looking for and what we would consider to be very successful and consistent with our prior experience. So again, the 50% was a projection, the 66% is what we actually know empirically from our own clinical trials program.

Speaker 3

That's what we're projecting. We'll see something like that in ENVISION. And then just to answer the final question with respect to 301, later this year is what we've said in terms of when we'll be able to provide safety data and a recommended Phase 2 dose. When exactly is not clear, but likely certainly by the time we have the SUO meeting at the end of the year, which is where we would probably present those data. I hope that's helpful.

Speaker 9

No, thank you. And then one more, if I may. Given other chemo agents, like the JEM, cytobean, does the textile regimen in BCG naive high grade shown to have benefit. I'm wondering if you're looking at other chemo agents as part of the gel formulation compared to real time and perhaps better results.

Speaker 3

Liz, do you want to talk about that?

Speaker 2

Yes, please go ahead. I'll add anything.

Speaker 3

Yes. So, Leland, if I understood you, the question is, have we thought about putting gemcitabine in the gel? And the answer is, we've certainly talked about this. Liz may want to comment on some of the commercial NIP issues related to that. But we know from a formulation perspective that our chemists are able to formulate a lot of different drugs in the gel.

Speaker 3

As we've said before, we know we can do combination therapy as well where we can put more than one agent in the gel. So we certainly had that conversation. But again, I'm going to defer to Liz in regard to any future plans regarding the formulation of Gem Imigel.

Speaker 2

Yes. So the comment I'll make on Gem specifically, but then I'd like to just comment on kind of the broader utility in other ways. There won't be any IP protection by the time we would get to market. So gemcitabine in our current gel is not something that we would be moving forward with. Having said that, we actually are in the process of looking at many other agents that are either in the market or in development in the market, frankly, at all stages and all types, whether it be chemotherapy or target agencies or biogenesis, we're doing a whole landscape about what would be our next product, but particularly as we move into high grade disease.

Speaker 2

And the 301 program, very important in high grade disease, because we do have long IP with the CTLA-four. So anything in combination with that would allow us to have that case and that being the case, which is why you'll see that and you'll see combinations with CTLA-four that will give us some IP as we move into high grade disease. So a lot of things that we're looking at both for low grade disease and for high grade disease, many different, I think the complexity bladder cancer is not necessarily really understood and appreciated by everybody, but there are a lot of different patients. And as you start to look at the TAR data, you start to look at the CG data, it really, really does show that everything works in different patient populations in different ways. And so we will definitely be prosecuting multiple products as we go forward across these many different patient types.

Speaker 2

But looking forward to hopefully sharing more about that later in the year as we prioritize where we want to go next. But and then also suffice it to say that given what we expect with UGM-one hundred and two, there's also opportunity to move UGM-one hundred and two into high grade disease. But even within populations like unwilling and unable and the broader low grade, low risk patient population. There's a lot of opportunity in this space and we expect to begin to prosecute against that with our priorities obviously being our next generation, which allows us that extended IP allows us to do more with UGN-one hundred and 3 and UGN-one hundred and four. So hopefully that's helpful, Leland.

Speaker 8

Thank you.

Operator

Thank you, one more for next question. Our next question comes from the line of Paul Choi of Goldman Sachs. Your line is now open.

Speaker 8

Hi, everyone. Thank you so much for taking our question. This is Kaleel calling in for Paul. I guess a quick confirmative question for us and then a quick follow-up. You mentioned that the potential commercial launch of VGN-one hundred and two might be more rapid than JALMIDO just given the prescriber overlap and the slightly higher sales force.

Speaker 8

Just wanted to if you could like maybe add some granularity on that and maybe just confirm that's what we're that's what you're trying to say? And then for 301, you mentioned that you might provide some safety data later this year. That's for the monotherapy data. Any granularity on the timing of when you might provide an update regarding the combinations? And just maybe some more granularity on your general idea about expansion into higher risk populations or high grade disease?

Speaker 8

Thank you so much.

Speaker 2

Sure. Yes, I'll just turn it over to Mark to talk about 301 and sort of what our expectation is there and then Jeff can answer the first question. So sorry, going backwards, but go ahead, Mark.

Speaker 3

Yes, sure. Thanks, Liz. So as Liz has said earlier in the call, the 301 program is targeting high grade disease. And as I'm sure the audience is aware, when you start looking at patients with high grade disease, the natural place to take this sort of a program would be into the BCG unresponsive or refractory population. So with respect to timing of data on 301, again, that's probably the end of the year.

Speaker 3

The combinations sometime in 'twenty five, we haven't been more specific than that, but we will provide whatever we have on those combinations with respect to any kind of efficacy signal and safety data that we would have in 'twenty five. And then in terms of the program, my expectation, Liz may want to comment as well, is that this would then roll out into initially a BCG refractory population of patients for a variety of reasons. But that seems to me to be from a clinical perspective most logical fit for a first approach to that population of patients.

Speaker 2

Thanks, Mark. And Jeff, you just want to talk about the adoption of UGM-one hundred and two?

Speaker 1

Yes. I think the biggest the one thing we hear with regards to gel Mito is just the number of patients that are out there and physicians will tell us, particularly with this data that we saw from AUA, they're very positive in and around the 4 year long term, medium long term follow-up. But the biggest objection we get is I just I don't have a lot of these patients. We won't have that with 102. In fact, we've seen in market research, instead of 2 to 3 patients a year with JALMIDO, they have 2 to 3 patients a month that fit the intermediate risk category.

Speaker 1

And so the most common, I don't even call it objection, but it is, as I like what I hear clinically about JALMIDO. I just don't have many patients. We won't hear that. And then the second, as Liz alluded to earlier, the operational lift. So these accounts already are they'll have BCG days, they'll have Gemcitab they have days where they'll bring in these patients, the nurse or extender will give the dose and will fit right into that sort of already established way operationally that they treat.

Speaker 1

And so a lot of this will be given in the clinic. We won't have as many hospital bureaucracies to get through formulary. Obviously, we'll support that. If they want to give it in the hospital, we will support that and get it on formulary. But the operational lift is much different and then the objection of I don't have a lot of patients goes away.

Speaker 8

Got it. That's helpful context. Thank you so much.

Operator

Thank you. I'm showing no further questions at this time. I'd like to turn it back to Liz Barrett for closing remarks.

Speaker 2

Thank you. Thank you, operator. Thanks again for everybody joining us today. I just want to reiterate how excited we are with the data that was just presented at AUA. It was a great AUA for us.

Speaker 2

And very importantly, as I mentioned and Mark as well, we're really looking forward to the data event on June 13. So hope to see here see all of you there, although virtually, but hope see you there. So have a great day. Operator, you can now disconnect.

Operator

Thank you for your

Speaker 4

participation in today's conference.

Operator

This does conclude the program. You may now disconnect.

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Earnings Conference Call
UroGen Pharma Q1 2024
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