Hello, everyone, and welcome to our earnings call for the third quarter of our fiscal year. Today it will be me and our CFO, Anders Morén, will do the presentation. The agenda will be first a short introduction about Biovica. We'll go through the highlights, then Anders will go through the financials, and then we'll end with a summary and a Q&A session. The Q&A session will be done in a way that we will have Filip Lindkvist , our analyst from Redeye, on the call asking questions, but you can also submit questions that will be answered in writing and appended to the presentation that will be put on our homepage after the call. I'll start with Biovica and our product DiviTum.
DiviTum measures what's the core of cancer, which is cell proliferation, and the way we do it is through a blood sample from the patient that is analyzed using our assay in our lab or in an external lab. By doing so, you will get an precise understanding how the tumors are proliferating, which is an indication of how aggressive the disease is, which is, of course, important when making treatment decisions. Also, it has proven to be an excellent tool for monitoring of treatments and to get feedback over time, and we get quick feedback earlier than with other methods like imaging. This has been proved in several clinical trials.
We have more than 30 peer-reviewed articles, and that has been studies that have been performed with some of the leading oncologists in the business at some of the most world-renowned institutions and, like, Johns Hopkins, WashU, Mayo Clinic, et cetera. The majority of these trials are within our first application, the breast cancer area, although there are potential also outside to expand into to other large area where the DiviTum can add benefits, both to patients being on treatment and as well as treatment physicians and payers, because you will also have will be able to reduce waste for expensive treatments, also benefits society and payers.
These clinical trials create a solid foundation for our commercial activities and our go-to-market process and also create demands from pharma companies developing new therapies within this area that are using our product in that phase. As I said, the first application is in the breast cancer area, more specifically in the metastatic breast cancer, where we have our 510(k) clearance and that we are active, especially so on the U.S. market, that we serve the market from our U.S. CLIA lab situated in San Diego, serving all the 50 states here in U.S. Lately also, we have presented clinical data showing that we have a strong application also in early phases of breast cancer when monitoring so-called adjuvant treatment, a market which is significantly larger.
We also developed a second version of the test, the so-called LDT, that we can provide from our lab in San Diego, within this space as well. There's potential here to expand into other areas, and we see several mega trends that is playing to our advantage. One is that people are staying longer and longer on treatment and also on more expensive treatments with severe side effects, and you want, of course, to improve the precision of monitoring. This is especially true for our two main focus area, targeted treatment and also immuno-oncology treatments. Same thing with the precision oncology. You have more and more precise treatments that has more narrow target, and also that drives the demand for more precise monitoring.
The third trend would be pharma integration, that pharma is using biomarkers and biomarker tests more and more when they develop new therapies and the diagnostic product is very closely related to the new drug, then that drives also demand for improved monitoring. You could also add a fourth trend maybe, which is dose optimization, something that the FDA is pushing through their Project Optimus initiative, which has the focus to not overdose, but to give enough to maintain efficacy, and of course you need then good efficacy biomarkers. This all boils down to that we are well positioned to meet these new trends and has a unique product that measure what's really essential in cancer and also have the ability to impact great values.
Currently, according to IQVIA, more than $200 billion per year are spent on oncology treatments within this area. There's also potential not only to improve to help patients with a better treatment outcome, but also to be more efficient when spending these large resources on cancer therapies. If we move into our third quarter and the highlights for that, we start with the financials. Anders will go through these more in detail. If you compare year-on-year for the third quarter, we had a 40% growth. It's even more if you compare it in local currency. That local currency would be dollars. The majority of our sales, more than 90% is in dollars.
When the dollar currency is affected, you can see that in our top line as well. If you look accumulated over the first three quarters, it's also still a strong improvement in local currency. One important KPI is our operating cash flow. We have been reducing this steadily during the last two years. If you compare versus same quarter last year, it's a significant reduction. If you compare for two years, I think we brought it down from SEK 25 million-SEK 30 million per quarter to SEK 11.5 million. That's a trend that we welcome, and that's an important KPI for us moving forward as well. Our cash position at the end of the quarter is SEK 88 million.
If you look at the clinical area in U.S. and in Europe, we continue to sign commercial agreements with our target customer category, which is the NCI, NCCN designated cancer centers. We announced that in December. We believe more and more we're getting traction on the U.S. market and is focusing our resources. That meant that we agreed jointly with our Nordic distributor to terminate the distribution agreement in the Nordics. The activities that we're currently doing in the Nordics, we can do ourselves also. Pharma Services has had a great momentum now for quite some time. That is continuing, which we'll get into on a separate slide.
When it comes to the clinical area, we are continuing to present new clinical studies, especially in these areas that are important to us, CDK4 inhibitors, dose reduction, and monitoring. Just this morning, we had a PR out that we will be presenting a study within immuno-oncology or immune checkpoint inhibitors on the upcoming AACR conference. We also have initiated a CEO succession, and at the last slide, I'll give a little bit background and my thoughts around that. In general, I think we're seeing momentum in both our areas. We see strong growth, and we expect to continue growing going forward. If you look at the U.S. highlights, if you compare it quarter by quarter, you see maybe not such a positive trend.
I will still wanna claim that we overall see a strong growth. All quarters are not the same in our business. Especially quarter three is a little bit of slow quarters with both Thanksgiving, and then you have the Christmas and New Year's holiday. If you add that, a storm in U.S. last week in January, where all the samples from the East Coast had to be thrown away, of course you can have short-term impact.
I think, if you break down the numbers, you can see that we've had a weak October due to what we communicated lastly, that we lost some revenue from the clinical trial, which takes some time until we turn that around to clinical use. That was the commercial agreement we signed then in December. We see the pickup. We still have such low. It's still a bit volatile, our business, so we'll get impacted by events like that. Since November, we see a steady trend that we are improving and also, beginning our Q4, is better. I would say that in general, we see a strong momentum in our U.S. business as well.
It's taken a bit longer to get to this point than expected, but more and more we are seeing an increase in demand and also more spontaneous accounts opening up from both patients and oncologists getting knowledge about DiviTum from already users that recommends, and that is growing our business. We also seen actually patients choosing oncologists that can offer DiviTum versus oncologists that are not offering DiviTum. Yeah, we see an increased momentum, and we're very pleased with that. On top of that, we also have several initiatives that we are convinced that will further drive the growth. One thing is the large IDN that we have been talking about now for quite some time. We have completed the protocol.
It's been pretty intense period the last couple of months. We worked together with them to ensure that what we now write in the protocol, the way we design the trial, that we optimize for a successful outcome of the trial. I think it's worth that extra time to make sure that it is a successful outcome. The next step is submission to IRB. That will take place now very soon. Then if we can do that, we believe we can initiate the trial this summer. This has a great potential, both during the actual trial but also after the trial, to unlock this large organization for a system-wide adoption and also becoming a very strong reference case for others.
The early breast cancer, we also see that this is starting to happen more and more. We see for instance we have a center in Florida that has made a decision to expand usage into the early breast cancer area for adjuvant monitoring. They will over certain time here increase patients from today's 20 to around 100. That illustrates the impact that having earlier breast cancer expanding to that one can have. That also is done like an observational trial, so we will get some important data because that's an area where we don't have as much data, and it's essential to strengthen the clinical data in that area to further strengthen our value proposition. Tempus.
Tempus completed their market research, which is preparation for our go-to-market work. As communicated earlier, we expect to launch this together with them in the fall of 2026. They have both significant sales organization and also a very efficient process to target with sophisticated IT systems. This is a great opportunity to us to leverage on a totally different scale sales organization to target the big community oncologist segment. This morning we did a PR about the upcoming AACR. We have two abstracts that will be presented as posters. One is personalized dosing in the CDK space, both the existing 4/6, but also next generation.
This is an important area for us because this is an area that the FDA is pushing through their Project Optimus, and I think we have a unique offering here. It's very, very good that we also can prove that with data in more trials than we have achieved so far. Very positive. Another area that's interesting for the future is the immune oncology area. Here's a collaboration with a few Italian institution, and also here, DiviTum performs very well. It's an area interesting for the future where we have ongoing patents and also now ongoing collaboration with both academia and pharma companies. Moving over to pharma, that's also one important area of our business.
We're currently active in the left-hand phase of the process here, service and kit sales. We are working with the majority of companies developing next generation CDK inhibitors. We have a portfolio of around, yeah, I would say 20+ projects. We see here that the volumes are increasing month by month. It's very positive. That we can add value here. Companies are coming back for the next project, and the business is growing over time as they're moving also forward from. We're involved already in preclinical phases until phase I, phase II, and going forward also phase III, hopefully. Strong momentum in this business. The CDK area is an exciting area.
It is currently an area with a $12 billion of yearly sales from three leading drugs. Pfizer, Novartis, and Eli Lilly have their respective drugs in this area. The future market is expected to be even bigger with about five times the volume, and it's driven both by new drugs coming to the market and the expansion into the earlier phases of breast cancer for adjuvant treatment. We're well-positioned here. We're working with the majority of the companies developing these new drugs, and we're participating both in preclinical and clinical trials, and we're used as a treatment efficacy marker. There's a lot of events here during this quarter that just passed.
I'm here in the U.S., so I can see every day in the lab, we're receiving samples, and we've been able to bring in extra personnel at the end of the period, and so we'll do so also during this fourth quarter. We're seeing that the momentum is growing, and it has been a trend that has now been ongoing for several quarters. Here's also an area where we think we can drive the revenues even further by extending our commercial organization. We're looking to increase our commercial organization with a U.S.-based rep specifically for the pharma business. That was my highlights. Anders, if I can leave it to you to go through the financial updates, then I'll be back and do the summary and Q&A.
Perfect. Thank you very much, Anders. Quick look at the financials. Q3 sales, about SEK 3.3 million in total. If you look in local currency, as Anders said, that's mainly or 90+% being U.S. dollars. It's more than 60% growth. IVD tests grew about 21% on a yearly basis, even though the challenges that Anders mentioned with converting that clinical trial into IVD or clinical use, and also on top of that, the snowstorm that hit mid and eastern U.S. that actually made us lose about one and a half weeks of samples not receiving our CLIA lab in California due to the snowstorm late January. Pharma Services grew about 57% in Swedish kronor. It's about 70%+ in local currency. The major growth driver there is the pharma test services.
We see that trend. That's a trend that we have seen now for quite some time. Most of the really large Tier 1 pharma companies are preferring to send the samples to our CLIA lab, mainly in the U.S., but also to our lab here in Uppsala, where I'm sitting right now. We are still supplying kits to some smaller pharma customers, but we expect that kit supply to actually increase a little bit going forward because we see quite a lot of interest from Chinese CROs that are planning to start initiating trials for really large pharma companies in China. In China, there is a prohibition of exporting human samples out of mainland China.
That's why they need to buy the kits from us to be able to perform the sample or testing in China, on the Chinese trials. Go to the next slide, Anders. This is an overview of the year-to-date sales, about SEK 8.6 million. That's a growth of 36% in Swedish and a little bit more than 50% in local currency. Here you see that the IVD tests in U.S. grew about 46% year-to-date. It's about 60% in local currency, and our Pharma Service grew 40%. And as you can see here, it's the same pattern that the pharma test service is growing significantly, whereas the pharma kit supply is slightly declining. Go to the next slide, Anders. Last slide on financials. As Anders mentioned, improved cash flow.
Of course, that's very important for us to try to minimize cash burn. Our operating cash flow before change in working capital improved with about SEK 4.4 million versus the same period last year. That's of course then driven by increased sales and lower operating expenses, and net operating cash flow improved by SEK 5.9 million versus same period last year. We closed the quarter with SEK 88 million in our bank at the end of the reporting period. That's it in terms of financials. I'll hand it back to you, Anders, to do a summary and then a Q&A session.
All right. Thank you very much, Anders. To summarize, U.S. clinical business. We have reestablished a strong trend, and we expect to see this in sequential quarterly growth, especially that we have multiple initiatives also that we expect is gonna be positively impact the sales development during the coming months and quarters. I guess we're now laying a foundation to be able to scale this on the U.S. market, and especially after with the Tempus partnership and also with the big IDN on top of the foundation that we already have.
Pharma Services, we have now had momentum for several months, and we've built up this portfolio of agreements that we're now seeing also that we are executing, and we see the revenues and samples coming in every day. I think the position here in CDK inhibitor development, especially the next generation, is very interesting. It's an area with a lot of tension. It's a large part of the oncology therapy spend. So there's a lot of potential here. Also looking further ahead on the checkpoint inhibitor area, it's even greater potential. I would say that we're well-positioned, and I think we can grow with more resources, and we're looking to close that. Good momentum across both segments, and also events going forward that would further accelerate growth.
I also wanna reflect a little bit and also give a background to the succession. Now, I've been here in the U.S. nonstop for 2.5 months now, and it's given me access to people and companies in the business and a better understanding of the U.S. market. I think it's been very inspiring. I've seen. I mean, we brought in people that has challenged us and see what we can do to improve that has been part of very successful companies in the business. There are several companies here on the West Coast that has been gone from zero to billion-dollar companies in oncology diagnostics. Of course, you wanna learn, see what they have done, what we can learn from them.
You can see that, to a great extent we're following their path, and also both with the combination of setting up your CLIA lab, having control over the reimbursement, making sure that you have a solid science foundation, targeting the right type of oncologists in the beginning, and also complementing your business with Pharma Services. We have all those pieces in place. You can also see that the initial sales on the clinical market has been slow in the beginning, and then after a few years, you see that you start getting the momentum. We're following that path.
We can see that, on this beginning, we have a lot of building blocks that is in place, which is the foundation I was talking about about on the previous slide. We have constraints also. Our main constraints are resources. I strongly believe in the strategy. We're doing a lot of stuff with little resources. I think we have a strategy that is also addressing this. When we see that we have a model that is scaling, like now on pharma, where every rep can bear their own cost and some margin, we're extending the organization, and we're also improving efficiency on our U.S. clinical sales.
I think we have doubled the sales over if you look back a few years, and we have reduced the cost to one-third. Efficiency-wise, we're taking big steps. Now when we're getting momentum and traction and together with partnerships, I see that we can build on this. It's very inspiring to do that, to see that. Also, I realize that the U.S. is where we have the momentum, where people have built this kind of companies, their experience and their reference cases.
I'm even more convinced that the next CEO should do something that I have difficult to do but to spend more time in the U.S. market and preferably also have the relationship that I've been developing now over some time to have a strong network from the start, coming from the business, having this network. I think this is a great foundation for the next CEO to continue to build on this journey and be able to create an impact company that can both create significant value for patients, for healthcare providers and society, as well as the shareholders. That is a little bit of a background and some reflection and lessons learned. With that, I'd like to open up for the Q&A session with Filip. Are you there?
Yes, I'm here. Thank you for taking my questions. Let's start with one of the bright spots in the quarter, which was Pharma Services. You said in the Q2 earnings call that you expected pharma sales to pick up in Q3 and Q4, which was true now for Q3. Do you expect this to continue even beyond Q4 and onwards?
Yes. First of all, we hope to do a strong Q4. We're not giving away, as you know, financial target at this point. But we know your target, and we're aiming to be in that, yeah, in the vicinity of that. With the Q4 that we have ahead of us, we think there's a good chance that we'll be able to do that. The good thing with the Pharma Services business is that we have the agreements, and we have plans. We know when we'll receive the samples, so we're able to forecast that pretty good. Although sometimes there are delays outside of our control, so it's not 100%.
We know for sure that we'll get a lot of that volume. We know that will happen. Of course, if it's a delay in a couple of weeks, it can spill over to the next quarter. Yeah, so the answer to that question is yes. Since we have those agreements, we have it planned with our customers, we're pretty sure that those revenues will come, yes.
Yeah. All right. I see that time is running out, but maybe a couple more from my end.
Sure.
What are your expectations on costs in your Q4 and also for your next year?
Anders, maybe you could elaborate a little bit on that. See if you can switch.
Sure. We are not giving away any guidance on that, as we have earlier communicated. I would say that, you know, my guess is that we will be in the same range that we are right now. It might vary a little bit, million up and down from that perspective, but we should be fairly stable. Of course, the most difficult part there is the dollar exchange rate. A couple of weeks ago, it was down to 8.70 on Swedish Krona. Now it's somewhere around 9.40, which is a significant change. We still have a lot of expenses in dollars, from our U.S. subsidiaries.
It's very, very hard to say exact numbers in terms of that because there's a lot of things that has an impact on our spend level.
Yeah.
I can't tell you any more than that. I'm sorry for that.
No, if I can build on that, if you get the picture back. I agree with Anders. If you take a step back, we're not looking to significantly change our organization other than in areas where we will get a payback with more, we can increase revenues by investing. The good example is the Pharma Services. Otherwise, we're looking to maintain the organization and the spending until we have a more secure and forecastable cash flow and a more solid financial position. No big change. On top of that, it's a very uncertain world with both a dollar currency rate that is flipping up and down and also tariffs on top of that. It is not game changing.
It's on the margin.
Yeah, sure. The last question for me, quite a broad one, and you can give a high-level answer, but can you elaborate on your high-level plan to achieve a reimbursement in the U.S.? I mean, you're taking steps towards it, but what's the high-level plan?
This is something that also when we did these workshops with people who have built these big companies, we got, I mean, the clinical data is the foundation for all commercial activities in this business, you say. We're looking also into doing clinical trials with payers that generate that kind of data. Because we already have reimbursements from Medicare, we have client billing agreements, so then it would be the private payer segment to generate targeted data towards that. We have ongoing initiatives looking into that, and we have ongoing clinical trials already that I think will improve that as well.
I think that is not something that will take place immediately, but over a few years, I think we will be able to show a very strong health economic business case for payers. I think it will be a strong side of ours. Currently, private payers is not a very big volume of ours, so Medicare and client billing is the majority. It's not that we're leaving so much on the table right now, but over time, this becomes an important factor to put in place and we're working on. We have a plan on that.
Yeah. Super. Yeah, that's all for me. Thank you once again.
Thank you very much. Thank you everyone for listening to our call and over and out from San Diego and Uppsala.