Good day, and thank you for standing by. Welcome to the ViewRay third quarter 2022 earnings call. At this time, all participants are in a listen only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star one one on your telephone. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Matt Harrison, Director of Investor Relations. Please go ahead.
Thank you, operator. Good afternoon, everyone, and welcome to ViewRay's third quarter conference call. Joining me today are Scott Drake, our President and Chief Executive Officer, and Zach Stassen, our Chief Financial Officer. Earlier today, ViewRay issued a press release and presentation for today's call. The presentation can be viewed live on our webcast or downloaded from our website. Today's call is being broadcast and webcast live. A replay will be available on our website for 14 days. Before we begin, I would like to remind you that the discussion during this conference call will include forward-looking statements. Facts that could cause actual results to differ materially are discussed in the company's most recent filings with the SEC. I will now turn the call over to Scott.
Thanks, Matt. Good afternoon, everyone, and welcome to our Q3 call. Today I'll begin with our financial results. Following that, I'll outline recent events including commercial wins, clinical highlights, China approval, and key takeaways from ASTRO. Zach will go into depth on our financials and provide an update to our 2022 guidance, and we look forward to opening the line to Q&A. In Q3, we added another eight orders highlighted by key wins at MD Anderson, the Houston VA, and SUNY Upstate New York. MD Anderson is one of the premier cancer centers in the world, and they're looking to take their MR-Linac program to a new level. We're excited to welcome them to the MRIdian family. Houston represents our third VA order, and we're highly motivated to bring the best care possible to our veterans.
GenesisCare announced their next two MRIdian centers at Birmingham and Guildford in the U.K., which brings their total number of orders to six. Our backlog now stands at $370 million, up 26% over prior year, and revenue grew 38%. Another highlight this quarter is gross margin, which came in at roughly 17% or 700 basis points over prior year. Solid execution from our team puts us in a position to deliver 40% revenue growth for full year 2022 and for a second consecutive year, improve gross margin by 750 basis points with perhaps a bit of upside this year. Cash used in the quarter was about $15 million.
Let me reinforce that we're utilizing cash to fuel growth, mitigating supply chain risk by advanced purchase of key components and investing in manufacturing processes and insourcing to improve gross margin. We expect that revenue growth we are seeing in our order book will continue to drive gross margin and operating leverage, and we're confident in our line of sight to break even without tapping equity markets. Turning to slide four. As we've shared many times, our mission is to treat and prove what others can't. Right in line with our mission and following the success of the SMART Pancreas trial, we announced LAP-ABLATE. LAP-ABLATE is a phase three global multicenter randomized controlled trial in locally advanced pancreatic cancer. The trial will compare current standard of care chemotherapy to chemo plus MRIdian SMART therapy.
It's important to note that conventional radiation has failed to prove survival benefit in several pancreatic cancer trials. Headlining these failures is the LAP07 trial, which examined a similar patient population to the one we're targeting in LAP-ABLATE. Survival in that trial was about 15 months in the radiation plus chemo arm versus 16 months for chemo alone. Conventional radiation proved no survival benefit. We are in the process of attempting to prove a meaningful survival increase where conventional radiation has failed. We are striving for this proof in both pancreas and central and ultra-central lung in LAP-ABLATE and LONESTAR respectively. With success, these trials will expand the addressable market for MRIdian therapy and provide a deeply valuable solution our customers seek and patients deserve. These clinical trials are critical in further differentiating MRIdian and accelerating our path of therapy adoption. Dr.
Mike Chuong states that he and other investigators are, quote, "Excited to launch the international LAP-ABLATE trial intended to provide randomized evidence that five fraction MRIdian SMART substantially prolongs two-year survival versus chemotherapy alone for locally advanced pancreatic cancer, and in doing so, change the paradigm of how this disease is fundamentally treated worldwide." End quote. Treat and prove what others can't. Indeed. Turning to slide five. We're excited to announce the Chinese approval of MRIdian. China is the second-largest and fastest-growing Linac market in the world. China currently has roughly one Linac per million people, leaving plenty of room to reach the industry recommendation of four Linacs per million. The Healthy China 2030 policy is focused on improving health, life expectancy, and the expansion of healthcare infrastructure. MRIdian is well positioned to help address cancer needs in China.
We're excited about this opportunity and the prospect of expanding access to the benefits of MRIdian therapy. Turning to slide six. ASTRO was a great show for ViewRay. We took the opportunity to highlight the remarkable clinical data our customers are generating. There was great response to the full 12-month MIRAGE prostate data. Quick punch lines include the fact that the MRIdian arm cut treatment margins in half, cut treatment volume by about 30%, and cut healthy tissue toxicity by about 60%. Acute toxicity for these patients takes the form of sexual dysfunction and the life-altering effects of incontinence. We are proud and grateful for UCLA taking on a head-to-head randomized controlled trial. Too often the calling card in this industry is good enough is good enough. Certainly, this isn't true if your loved one is on the table.
Clinical science will illuminate the path forward, and this is our calling card. There was also great feedback regarding the SMART Pancreas data. This is the first time anyone has proven in a prospective trial the ability to safely deliver an ablative dose in pancreatic cancer. Customers are also very encouraged by the survival signal. As I mentioned, we're building upon the considerable pancreas data our customers have demonstrated as the foundation for LAP-ABLATE, our phase III randomized controlled trial. Also at the show, there was a lot of buzz about A3i. Current A3i users shared their stories about both the ease of use and clinical enhancements of these innovations. We are now expanding the launch of A3i and look forward to our global rollout. All of the clinical and innovation enhancements have led to impactful commercial meetings. It's fair to say interest in MRIdian is high.
Take a step back to see the combined impact of our clinical and innovation pipelines. I'd highlight three points. Number one, three years ago, we had single-center studies or small datasets reported as posters or brief talks. This year we had two large prospective trials as main session presentations. Number two, these clinical outcomes are energizing the next generation of clinicians. Young, hungry radiation oncologists and physicists are highly motivated to change the field with MRIdian data and see this therapy very much as a career-defining opportunity. Number three, our strategy is working. Clinical data is driving demand. One West Coast customer saw a threefold increase in patients treated on MRIdian from Q2 of 2021 to Q2 of 2022, and an East Coast customer increased their prostate program four-fold in the last four years on MRIdian with zero marketing dollars. Both customers are preparing for more MRIdian systems.
I'm proud of our team and pleased with our progress as we pursue our strategy. With that update, I'll turn it over to Zach.
Thanks, Scott. Today, I'll cover our third quarter business results and updates to our 2022 guidance. Full details can be found in today's press release, and we will be filing our 10-Q subsequent to this call. Turning to slide eight. Our team delivered solid results with another eight orders in the quarter, totaling over $47 million in value. Our backlog increased 26% versus the prior year period, ending the quarter at roughly $370 million. The combination of our recently introduced A3i feature set, the clinical data we are delivering, and increasing patient awareness is impacting the market. The positive energy around MRIdian at ASTRO was evidence our strategy is working. Revenue in the quarter grew 38% to nearly $26.5 million, highlighted by 48% growth in product revenue driven by the increase in revenue units.
Gross margin during the quarter was approximately 17%, a nearly 700 basis point improvement versus the prior year period. Gross margin was led by a product margin of 19%, demonstrating the leverage driven by additional revenue units. Our team has done a tremendous amount of work to position us well for the gross margin expansion we expect, and this quarter is proof as to why we feel good about the path ahead. Gross margin will bounce around a bit from quarter- to- quarter based on the timing of installations, but the trend is solidly positive. For the second year in a row, we are in a position to deliver a more than 750 basis points improvement in gross margin. Operating expenses were $28 million in the quarter versus $25 million in the prior year period, demonstrating solid operating leverage.
We are continually looking for ways to operate more efficiently and expect sales growth to meaningfully outpace OpEx growth for the foreseeable future. Other income and expense was $2.1 million in the quarter. Other income was impacted by both a gain on the warrants on our balance sheet as well as increased borrowing costs. These increases are largely offset by the interest we are earning on our cash balance. Quarter was $26 million or $0.14 per share, compared to a net loss of $25 million or $0.15 per share in the prior year period. Turning to cash use. We used approximately $15 million in the quarter. Supply chain risks persist, and in order to mitigate those risks, we are deploying cash to solidify inventory to fuel growth.
We finished the quarter in a strong liquidity position with approximately $147 million of cash on hand. Let's discuss guidance on slide nine. Based on increased visibility and confidence on the revenue front, we are again raising the bottom end of our range from $90 million- $94 million. The new range is $94 million-$104 million, with an implied growth range of 34%-48%. We are proud of what our team is delivering in a challenging environment. Shifting to cash use. Year to date, we have utilized approximately $73 million of cash. We now believe the cash use for 2022 will be between $78 million and $92 million. The increase from prior year guidance is primarily derived from timing differences in a couple large system payments.
While system shipments for the year are on track, project timelines can and do routinely change related to construction and permitting, and can result in an impact to payment timing. We regularly deal with these types of issues and have high confidence in collection, but the inter-quarter timing can be dynamic. We expect the collection delay will benefit our 2023 cash, which allows us to remain confident in our long-term assumptions regarding cash. We believe, given our robust backlog and commercial pipeline, that our current available resources provide us with a clear path to break even, and we do not believe we will need to raise additional equity capital to meet these objectives. On slide 10, let's take a look at the progress we are making towards our financial objectives. We said we would deliver approximately 40% growth for the full year.
Year to date, we delivered 36% revenue growth and are encouraged by what we see ahead on our path to 40%. We said we would deliver gross margin improvement of 750-1,000 basis points. Year to date, we delivered 725 basis points and are set up well to drive additional progress in Q4. Finally, we said we would deliver meaningful operating expense leverage. Our revenue growth continues to significantly outpace OpEx growth as we realize the benefits of our strategy and continue to grow into our infrastructure. This year we took material steps forward on the innovation, clinical, and financial fronts. Our new innovations and clinical data are in the early stages of impacting the market.
On the financial front, the trends are positive, and we expect them to continue into future years and bolsters confidence in our ability to reach cash flow break even. Turning to slide 11. We look forward to diving deeper into our strategy, market opportunity, business outlook, and more importantly, for you to hear from some of our key users at our upcoming Investor Day. We hope you can attend in person in New York or virtually on November 17th. With that, operator, will you please open the line for Q&A?
Thank you. As a reminder, to ask a question, you will need to press star one one on your telephone. Please stand by while we compile the Q&A roster. Our first question comes from the line of Jason Bednar with Piper Sandler. Your line is now open.
Hey, good afternoon. Congrats on another quarter here, guys. A couple items I wanted to touch on, you know, maybe a big picture one to start here. Primarily as it relates to the data we just saw at ASTRO recently in the phase three trial you're launching pancreatic cancer. Maybe help us understand, I mean, and not question the decision, but, you know, why do you need to run another trial? What are you hoping to accomplish or show? I feel like with all the data you have out there and all the evidence from your customer partners, the evidence is there that patient safety and outcomes are clearly better for MRIdian than conventional radiotherapy. Same goes for survival benefits.
Again, the question is, you know, what does another trial provide that you don't already have? Do you think you need more data to drive more uptake? Or is an RCT for a single indication like this a sticking point to adoption? Just any color you have there, and then I have a couple follow-ups.
Yeah. Jason, thanks for the question. I guess, let me weigh in first from a macro perspective, and Paul Strong is with us, our VP of Clinical, and welcome him to add any kind of color that he would like. We spend a ton of time, as you're aware, with our MAB and our clinical consortiums. I would tell you that our customers believe this is an incredibly important and necessary trial to run, to change guidelines for pancreatic cancer. It's also one that is really engaging medical oncologists and others in the field beyond just radiation oncology. I think we have an opportunity, as I said in the prepared remarks quoting Michael Chuong, to really fundamentally change the landscape here.
I think we're doing that in tough to treat cancers, proving survival benefit in pancreas and central and ultra central lung. I think if we nail those, people will give us credit broadly in the toughest to treat cancers and also prove value in more common cancers, such that as we've done with
MIRAGE and SCIMITAR, and now we're pursuing SHORTER in FORT. It's very much part of the clinical strategy. Let me ask Dr. Strong to weigh in, and then you're welcome to ask any follow-up there, Jason.
Yeah. Thanks, Scott. Jason, I'd just add a little more color on Scott's point about medical oncology and surgery as referring physicians. We would agree that the data that we have is very powerful within radiation oncology, but we know many of these patients might not even make it to radiation oncology. The need to have level one evidence that convinces a larger set of the referring population moves MRIdian into the guideline and really differentiates. The idea of proving that in one of the toughest cancers to treat halos onto other tumor sites. It's a strategic investment in a clinical trial to really differentiate. Yeah, that's my only add there, Scott.
Thanks, Paul.
All right. That's very helpful, guys. Maybe, you know, another bigger picture one, but looking ahead to 2023, I know we don't have guidance here, but, you know, Scott, just wanted to maybe take your temperature. You know, the Street's modeling 40% revenue growth, on top of what you're doing here in 2022. I think you've mentioned in the past seeing that the P&L transition to one that, or maybe not transition isn't the right word, sustain, at a level less emblematic of, you know, top-tier growth in med tech and 40% fits that description. I guess we're a few months closer now to 2023 since you last made those comments.
Is that still a growth profile you're comfortable with at the top line? You know, in light of the strength we're seeing in the margins in the quarter you just reported, you know, a similar question for you and, you know, Zach, feel free to weigh in, just how you're feeling about the ability to take another big step forward in gross margins next year. Thanks.
Yeah. Of course. Jason, I'm gonna stop short of specific numbers, but what I can tell you and you'll hear more from us at our Investor Day here in a few weeks, we very much anticipate being able to deliver top-tier top-line revenue growth. That is completely being fueled by our innovation pipeline and our clinical pipeline, just as we drew it up three or four years ago, and you see that happening right before our eyes. We have also said that that revenue growth will really translate into very attractive gross margin expansion. You saw that happen last year at about 750 basis points. This year, I anticipate we'll do that maybe a bit better.
I think that top-line growth is gonna continue to drive gross margin expansion in the 2023 and 2024 timeframe. That's gonna be augmented out in that 2024, 2025+ timeframe with both our cost down program targeting to take out about $1 million of our cost of goods and concurrently insourcing. That top-line growth and gross margin expansion along with really tight OpEx discipline is what allows this business to flip to cash flow positivity in that 2025, 2026 timeframe. We feel really good about all of that. We feel really good that it's happening just as we drew it up several years ago. Again, I'll stop short of any specific comments, but we feel really good about where this business is going clinically from an innovation perspective and financially as well.
All right. Very clear. Thanks so much.
Thanks, Jason.
Thank you. Our next question comes from the line of Rick Wise with Stifel. Your line is now open.
Hi, Scott. Hi, Zach. Great to see all the progress. Scott, you talked about what a great ASTRO you had, and I was hoping you'd expand on what you described as the impactful commercial meetings. You know, what's that mean? Does that mean you received orders or just help us understand how having an excellent meeting where you had great data, obviously, a transformed company, you know, meeting with folks this year. How should we imagine that translates into orders? The second half of that, in a way, is maybe you can, as part of that, talk about logistics, the macro environment, your ability to install.
We're seeing the backlog accelerate, are you able to install at a faster rate going forward, given the backlog, given this commercial momentum?
Yeah. Absolutely, Rick. Let me take a cut at answering the ASTRO question first, and then we'll talk about logistics and installations as well. The best way that I think I can describe the conversations that we're having today, and ASTRO is just exemplary, is to contrast it in terms of where we were two or three years ago when the conversation centered around technology, which is really emblematic of where this industry has historically been. You find companies generally spending more time talking about what their technology is versus what their technology does in the form of prospective phase II and phase III data. I think we are making a significant impact in that.
The conversations that we're having with customers today, in stark contrast, are all about clinical data and how they can really get a MRIdian program off the ground if they're a new customer. If they're an existing customer, we're talking about strategies of deploying multiple MRIdians in a given area to really differentiate a cancer center. We've gone from kind of where the industry was, talking about technology, describing a MR-Linac, all of these kinds of things, to today talking about prospective phase II and phase III data. Hard to tell you how different that is, Rick. Hopefully that gives you a little bit of sense in terms of how things are changing, and we're most gratified in markets where there's multiple MRIdians, how the competitive dynamic is playing out. We feel very good about that.
As it relates to logistics and installations, you know, the environment continues to be challenging as it has been for the past couple of years. We're, you know, playing Whac-A-Mole, if you will, on supply chain items. Our team has done really a remarkable job managing through these challenges, and I think by and large they're abating, but we still run into difficulty here and there. From a capacity standpoint, I think we are very well positioned for the growth that we anticipate in 2023 and beyond. And we've got plenty of forewarning to expand that installation capacity, well in advance. I think we're very well positioned, Rick. I think we're building a really strong and solid company.
Kind of staying with the macro theme of your question and, you know, kind of building on where Jason was, a few years ago we were kind of an orders story. That's the way the street looked at us. Today, I think we're a revenue growth and gross margin story, and orders obviously feed that revenue growth. I think we switch relatively quickly into a revenue growth and adjusted EBITDA story given our balance sheet and where we're taking the business out into the future. I hope that's responsive, but happy to dig in in any of those areas as you wish.
Yeah. I mean, let me move on to one other question. I was hoping you'd expand, Scott, on your comments about the China approval. As you say, obviously huge, rapidly growing market. I know it's incredibly early days. You know, it's been a month or something since you got clearance, but maybe help us better understand your early commercialization plans. Does your partnership accelerate because your partner's an experienced one, does it accelerate the China order funnel in your mind? When will we start to see initial orders, and/or hopefully revenues start to be more visible? Thank you.
Yeah. Rick, we're really excited about the China opportunity. You know, the way I'm positioning it with investors is, you know, give us a little bit of an opportunity to dig in. Chindex has been preparing for this launch for a very long period of time. They're a very capable partner in China, very smart on all of the different facets of med tech that are required to succeed. I think until we get a little more time under our belt, I would view it as upside to everybody's model. That's how we're viewing it here. As I've said publicly before, it would not surprise me for us to see some orders come out of China in the relative near term. What really catalyzes markets for us is MRIdian programs that are working, that patients are traveling to.
We've talked about these examples before, you know, Florida, California, the U.K., upper Midwest and Northeast, you know, et cetera. That's gonna take us a little while to get to that point in China. I don't want any of that commentary to come across as us not being enthusiastic. We are, but I don't want the street to get ahead of us with this opportunity and the momentum that's building in our business beyond China.
I'm gonna sneak in one extra question, if you don't mind. Elekta, your competitor, Elekta's Unity system recently received CE mark approval for what they describe as comprehensive motion management with true tracking, automated gating functionalities. How do you want us to think about this announcement in the context of ViewRay's MRIdian? Is this a headwind for future commercialization, a validation of your strategy, a non-issue, some combination of all that? Thank you, Scott.
Yeah. Thank you, Rick. I think our customers' point of view is much more important than mine, candidly. Our customers are very clear in terms of their definition of clinical success. They want to, first and foremost, deliver an ablative dose, and they wanna do that safely. They wanna do it with tight margins, no fiducials in five or fewer fractions and low or no grade three or higher toxicity. We look consistently, Rick, for anybody that's able to deliver that kind of therapy and deliver the kind of clinical data that we are.
So far as I'm aware, I've not seen anybody else deliver that kind of therapy. I'm just gonna reserve judgment there and continue to point to clinical data, phase two and phase three data that really is meaningful for our customers as they make therapeutic decisions, and for patients that really deserve and require better care.
Thank you, Scott.
Thanks, Rick.
Thank you. Our next question comes from Marie Thibault with BTIG. Your line is now open.
Hi. Thank you so much for taking the questions. Maybe here's another high-level question for Scott. Wanted to get your take. Certainly sounds like the CapEx environment and the order funnel is quite open and healthy here in the U.S. Wanted to hear if you know, things are any different in any of your geographies. We're thinking particularly of Europe and APAC. Is there any hesitancy on spending there, or are you feeling similarly optimistic?
You know, Marie, first, thanks for the question. You know, I think we continue to see this area, this line of questioning in the same way that we did a quarter ago and in conversations that you and I have had in between. We very much have our eye on it. We really look for any kind of concerning signal. We haven't seen any as yet. You were at ASTRO, and we had, gosh, I couldn't even tell you how many customer conversations, really from all around the world. Even talking to for-profit hospitals, they seem to be very interested in MRIdian programs, and expansion thereof. We think being in that strategic bucket of capital is very advantageous for us, but I don't wanna be Pollyanna.
We definitely have our eye on it, but it continues to feel pretty good and pretty positive at the moment.
Okay. That's very clear. Thank you for that, Scott. My follow-up, maybe just a very brief two-part, both clarification questions. On the A3i rollout, glad to see that's underway. Is there any revenue involved with that? I'm forgetting, probably should go back and check my notes on that. Just wanna clarify. For Zach, on the risk around system-related payments and receipt of that payment, is there any impact at all to revenue, or is that completely decoupled from revenue recognition? Thanks again for taking the questions.
You got it, Marie. In terms of A3i, it has been a real driver for us for customers getting onto our highest level service plan that includes tech refresh. It has been a very attractive driver there, and I think future innovations will bolster that. In the event that a customer doesn't have tech refresh, there would in fact be revenue associated with it, and in fact, pretty significant revenue associated with an A3i upgrade. I think the vast majority of customers are selecting that high level of service. As it relates to system payments, I'll turn that one over to Zach.
Yeah. Marie, no revenue risk. I think we feel great about, you know, system shipments and machines moving on time. I think what happens in normal course as we get a little closer to install and really add definition to construction timelines is, you know, it can be impacted by months, sometimes a quarter here and there related to permitting delays or things of that nature and sometimes, you know, just the payment terms on any given deal. Yeah, no revenue risk, no impact to demand overall.
Perfect. Thank you.
Thank you. Our next question comes from the line of Chris Pasquale with Nephron Research. Your line is now open.
Hi, this is Dev on for Chris. Thanks for taking my question. Just one quick one. As far as hospital CapEx and budgets, just any qualitative commentary or updates there. I know some of your peers have seen backlogs grow because of supply challenges, and there was also some delays in installation due to staffing and scheduling challenges. Just wondering any updates you could provide there.
Yeah. I would share that, you know, I think we're in a little bit of a different spot than some of our larger industry peers, where these macro headwinds impact us differently, frankly. We find ourselves somewhat safe harbored in a strategic bucket of capital versus replacement capital. The area that probably is a bit similar, as we're alluding to here, to Marie's question on payment timing, these are very significant programs, and our customers from time to time have permitting delays or construction delays, and that can impact timing, but really not the certainty of either revenue or payments. I think we're relatively well protected there. Hopefully that's responsive to your question. Again, happy for a follow-up if you wish.
Nope, that's great. Thank you very much.
Thank you.
Thank you. As a reminder, to ask a question at this time, please press star one one on your touchtone telephone. Our next question comes from the line of Mike Ott with OpCo. Your line is now open.
Good afternoon. I'm on for Suraj. Thanks for taking our questions, Scott and Zach. No, you mentioned, hey, Scott, that the A3i launch is expanding, and I believe last call you guys were live at two customers have done over 100 fractions. Don't know if you have any updated numbers you can share there.
Oh gosh, Mike, we're at a bunch. I don't know what the number is, but our customers are cranking with it. We have our third customer that has A3i almost complete with their installation at this point. I don't know whether or not they've done their first treatments with it, but we're very much opening up the aperture here in Q4. And we feel very satisfied based upon customer feedback and very confident that we're ready to roll this out globally pending any kind of regulatory approvals that are required from one market to the next. Feedback is very positive and we're excited to get this into all of our customers' hands.
Excellent. Thanks, Scott. For the increased 2022 cash usage guidance up to the $78-$92, is it fair to characterize that as a mix of kind of the, you know, supply chain inventory investments that you're making as well as some of the collection timing issues that Zach mentioned?
Yeah. Exactly, Mike. It's really those two items. And I think it's important to understand cash for any newer investors in ViewRay from both a macro and a micro perspective. From a macro perspective, we've been saying now for years that our clinical and innovation pipeline would drive growth. We see that happening this year, approximately 40% growth, and we said that that growth would drive gross margin expansion. Mike, you've heard many times that that's yielded 750 basis points last year. We'll do that or better this year, and we're set up very well for expansion in 2023 and 2024. That top-line revenue growth and gross margin expansion, coupled with really tight OpEx discipline, is what allows this business to flip to cash flow positivity in the 2025/2026 timeframe.
From a macro perspective, that's the path that we see ourselves on. We do not believe we have to tap equity markets to get to that point of positivity. That's a real milestone for the company that we look forward to achieving. From a micro perspective, quarter-to-quarter fluctuations, as Zach has pointed out, both in prepared remarks and in Q&A, that's the stuff that's just indigenous to this business. You know, an installation will push out, a construction project will push out, and then cash collections go hand in glove with that. That's something that we deal with on a very regular basis. Those are the two components. You've nailed it, and I think it's really important for investors to understand both the macro and the micro from a cash perspective in this business.
All right. That's very helpful color. Thanks for the update, Scott.
Thanks, Mike.
Thank you. Our next question comes from Young Li with Jefferies. Your line is now open. Young Li, your line is open. Please check your mute button.
Oh, sorry about that. Thanks for taking the question. Among-
Young.
For Zach. I guess first question, I'm just kinda curious, you know, you have, you presented some really good data at ASTRO, I guess looking forward to 2023, you know, you have some more, clinical trials that's in progress. Was wondering if you can maybe update us on expected timing for some of the key ones like, SHORTER, LONESTAR and FORT.
You know what, Young, I'm gonna turn that over to Dr. Strong to touch on some highlights that are forthcoming. Paul?
Yeah, sure. Thanks, Scott. Yeah, really briefly, SHORTER nearing end of enrollment. We expect to see acute toxicity from that study in the following year. The SMART ONE study, which many know about, is a clinical trial looking at single fraction MRIdian treatment for multiple tumors in single patients. That data will come online in 2023. Very excited about that. LONESTAR is open for enrollment. That will take some time, so I can't project today when we'll see that data, but that is open and ongoing. I think some big data from some studies that we'll complete, and then we'll obviously continue to look at follow-up data for SMART Pancreas in the coming years. Hopefully that is responsive to your question.
Mm-hmm. Yeah, very helpful. I guess one quick follow-up. Was just wondering if you can give us some preview for what we should expect at the capital markets day in like two weeks.
Yeah, Young, I think you'll get a pretty good view of our overall strategy, how we're progressing on our clinical pipeline, our innovation pipeline, our commercial pipeline, how all of that rolls up to our P&L. We'll give for the first time a long-term view in terms of where we're gonna be taking this business in the next few years. Heretofore, it's always been a one-year kind of guidance that we provide at the beginning of a calendar year.
As Zach said, we're really excited to put some of our key opinion leaders in front of you to give investors the opportunity to ask questions about the kind of wonder of MRIdian, the clinical data that's being generated in the toughest to treat cancers and more common cancers alike. We will have an executive there to also answer business questions because the business of MRIdian is also very important, I think, for investors to understand how our customers are doing financially very well and why so many of them are reinvesting in a second, third or sixth MRIdian system. I think those will be the highlights of the event, and we really look forward to sharing that time and viewpoint with our investors.
All right, great. Looking forward to it. Thank you.
Thanks, Young.
Thank you. I'm currently showing no further questions at this time. I'd like to hand the call back over to Scott Drake for closing remarks.
Thank you very much, everybody. Thanks for your interest in ViewRay. Thanks. Look forward to seeing you November 17th in New York. Take care and have a good evening.
This concludes today's conference call. Thank you for participating. You may now disconnect.