Xbrane Biopharma AB (publ) (STO:XBRANE)
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Earnings Call: Q3 2020

Nov 13, 2020

Martin Åmark
CEO, Xbrane Biopharma

Welcome everybody to our call with regards to the Q3 report, which was released this morning. I would like to start with a brief update on where we are from a development perspective, and then our CFO, Margareta, will go through the financial details of the quarter. Okay. I think the key takeaway here is that we got the last patient into our phase III trial Xplore with our leading biosimilar candidate, Xlucane.

This was a major milestone for us as a company and for the development of that product. The recruitment was delayed due to COVID-19. We're very pleased that we were able to conclude the required recruitment despite challenging times due to COVID-19.

Now when that is in place, the clock is really starting to tick towards us being able to communicate top-line data from Xplore, expected mid next year, then after that proceed towards filing Marketing Authorization Application both in Europe and the U.S. Second big thing is that we during this week concluded on a directed share issue which also provides us the required funding to take us to communication of the top-line data and subsequent filing of Xlucane.

We're very pleased with the support that we've gotten from existing shareholders, but also we are welcoming new shareholders to the company. Primarily the second Swedish pension fund and Lancelot Asset Management as two new institutional investors in Xbrane. We're very pleased with that development and that we now have a clear path ahead towards top-line data on the Xplore and also subsequent filing.

Let's move on to next page. Just to recap a bit on Xplore itself. This, as many of you know, is an equivalence trial with our biosimilar candidate, Xlucane. We have recruited 580 patients with age-related macular degeneration globally. Primary endpoint is improvement in visual acuity week eight after initiation of treatment.

We need to relative the originator product and the comparative product, Lucentis , within a predefined equivalence margin with regards to improved visual acuity at week eight. We're following the patients in a 12 months treatment schedule with monthly injections and following up on certain secondary efficacy and safety endpoints throughout the study and at week 52.

To illustrate this further, on the right-hand side of this page, you can see clinical data from one of the pivotal trials of Lucentis, where you can see in the blue line placebo group with deteriorated vision throughout the study. Then you can see the two Lucentis arms where you can see an improvement in visual acuity throughout the treatment.

You can see here kind of illustrated as the black bar on week eight the equivalence margin which Xlucane needs to fall within a relative Lucentis at week eight in order to demonstrate equivalence with regards to efficacy compared to Lucentis. This is a rather wide margin agreed upon with EMA and FDA, and we are fully confident that we will be able to meet the primary endpoint with Xlucane. This is not uncommon that it looks like this for phase III trials with biosimilars.

In a recent study by Medicines for Europe, it was kind of a review of the 38 phase III trials for biosimilars conducted so far, and none of them actually have failed to demonstrate equivalent efficacy in these trials. I think that is a good picture of the risk level, let's say, with regards to demonstrating equivalent efficacy compared to the originator in biosimilar phase III trials.

That in combination with the very strong preclinical data we had coming into this phase III trial, where we have essentially demonstrated in a large set of analytical tests that there is a very high level of similarity of Xlucane compared to Lucentis. We feel fully comfortable around this trial and that we mid-2021 shall be able to report positive top-line data from the trial and having demonstrated equivalence with regards to improved visual acuity.

Okay, let's move on to next page. Just taking a glance back here with regards to the recruitment. As I said, we've been discussing this before in the previous calls we've had. The recruitment was delayed due to COVID-19. We saw a setback already in end of Q1 this year. Coming in after summer, in September, we also had some effects from second COVID-19 wave in some countries where we are recruiting patients.

We're very happy now to have been able to conclude the recruitment and that we enrolled the last patient, and very thankful to all the clinics that are participating and all the patients participating. It's a major milestone really for us as a company and for the development of Xlucane. This really then creates better clarity with regards to the timeline on the continued development of Xlucane.

We are going to do an interim readout when last patient has reached month 6 in the treatment schedule. We're going to need another roughly two months of statistical analysis before we can communicate top-line data. Mid-2021, we expect to be able to communicate top-line data from Xplore. The study is going to progress up until Q4 2022 as we're following the patients throughout the 12-month treatment schedule.

We are going to file the Marketing Authorization Application to both EMA and FDA on the basis of the interim readout. That's going to happen after we've been able to communicate top-line data then, of course. We still believe that we are on track to get the approval in place in line with the EU patent expiration of the originator product, Lucentis, which is in July 2022. This is now very good.

We have clarity on the timeline, we are on track to get the approval in time and then allow for subsequent launch of the product in respective regions. That was a brief update on Xlucane, we can move on to next page. Just to say a couple of words also on what we've been doing from a development perspective on our preclinical programs. We are progressing particularly our biosimilars to Cimzia and Opdivo in a preclinical development perspective.

Our Cimzia biosimilar, we are finalizing the development of the production process pilot scale here internally. We are during next year going to scale up the production process to commercial scale together with selected contract manufacturers. After that, being able to proceed into clinical trials most likely during 2022. We have ongoing discussions with potential commercialization partners for our Cimzia biosimilar.

Particularly looking at, as usual, the largest regions from a market potential perspective, Europe and the U.S. Our ambition is to find a commercialization partner in one or both of these two territories before we go into clinic with this program. Hopefully we'll be able to update on this one during 2021 with some kind of a partnership arranged when it comes to commercialization.

Opdivo biosimilar program is also progressing very nicely from a preclinical perspective. We have a little bit more time there up until patent expiration. Really most efforts last couple of months has been on the Cimzia biosimilar program as that is a shorter time to patent expiration of the originator and intended launch of the product.

We categorized here in this picture from a business development perspective, we put our Oncaspar biosimilar and the Spherotide program because these are programs as we currently view now as programs where we do not want to invest further into ourselves but rather seek arrangements with partners that are willing to continue the development of these two programs with own financing.

That's what we're looking for here, and I also hope to be able to update on progress on that during next year. Okay, good. That was a brief update on the development during last quarter, Xlucane and the other programs. Maybe I'm going to hand over to Margareta to go through some of the financial details.

Margareta Hagman
Interim CFO, Xbrane Biopharma

Yes. Thank you. Good morning. We start with the other operating revenues. On the left-hand side, we present total income quarter by quarter, and here we have both the license revenue and other operational income. In Q3, we had a total income of SEK 5.2 million, and the license revenue comes primarily from part of the milestone from the Bausch + Lomb agreement, which was signed in Q2 and is recognized over two years.

Other operational income comes from exchange rate gains on receivables and payables. Looking at administration expenses to the right, we had total expenses of SEK 7.1 million in Q3, which was an increase by only 1% compared to the same period of last year. It is an increase related to Xbrane's growing organization, but it was limited as Q3 2019 included extra expenses due to the Nasdaq listing that took place in September last year.

Let's move forward to page nine. We have the R&D expenses to the left, they amounted to SEK 52 million in Q3. This was an increase by 66% compared to Q3 last year. Almost all expenses are related to biosimilars and particularly to Xlucane. Of course, the increase is according to plan as we are going into a more intensive phase of the Xlucane project.

The expenses so far have mainly been related to the Xplore study but also to preparing for production and regulatory work. The expenses for the Xlucane project in the future will gradually be more focused on production and planning for the coming launch. If we look at the right, we have the net result, and it amounted to SEK -57.5 million, which is 55% lower than the net result for the same period last year. Let's move forward to page 10.

Here on the left, you can see the variation in operating cash flow quarter by quarter, and for Q3, the amount was -SEK 103.8 million. This is due to the loss in the quarter, of course, and also changes in current receivables and payables. We usually have quite big variations due to the reinvoicing structure we have with our partner, STADA, and this was also the case this quarter.

We did not have any prepayments from STADA during the third quarter, so that is why it was a decrease in deferred revenues. Looking at the cash balance to the right, we ended the quarter with a cash position of SEK 123.8 million. Cash balance has decreased since last quarter, mainly due to the negative operating cash flow. Let's move forward to page 11.

Looking at the summary figure of the balance sheet, you can see that it has decreased to SEK 316 million compared to SEK 437 million as of the end of the last quarter. Starting with the asset side, we had non-current assets of SEK 95 million, which is fairly in line with the previous quarter. Current assets amounted to SEK 98 million at the end of Q3, where SEK 90 million is prepayment primarily for the Xplore study.

The decrease from last quarter relates mainly from trade receivers from Bausch + Lomb, which have been paid during the quarter. Cash amounted to SEK 123.8 million, a decrease, as mentioned before, due to the negative operating cash flow. Moving over to the other side of the balance sheet, we have shareholders' equity that amounted to SEK 135 million, a decrease compared to last quarter due to the loss in the quarter.

Non-current liabilities amounted to SEK 14.7 million, fairly in line with the previous quarter. Finally, current liabilities amounted to SEK 167 million compared to SEK 232 million last quarter. That includes deferred income and accrued expenses amounting to SEK 147 million, where SEK 90 million is deferred income from STADA compared to SEK 130 million last quarter. As mentioned before, we did not receive any payments from STADA during the third quarter, that is the reason for the decrease in current liability. That was all on the financials. Back over to you, Martin.

Martin Åmark
CEO, Xbrane Biopharma

Thank you, Margareta. With regards to upcoming events, we have been participating this week in the LSX Investival Showcase. Next week, the Jefferies conference, which is around Digital, where we're going to participate. We have a presentation at the Redeye Life Science Day, 26th of November. We will present the company and where we're standing. Next upcoming event is the Swiss Nordic Bio event arranged by Vator Securities.

These are the upcoming events. If you have the opportunity to listen to us, particularly on the Redeye event, that's a great opportunity to get a further update on the company. I think that concludes today's formal presentation, and we can proceed to trying to answer the questions that are coming in. I'm going to start to read out the questions and then provide a short answer.

Do you see significant changes in the ranibizumab biosimilar race? Do you think it's going to get market approval before patent expire in E.U.? Yes, we are on track to get the approval in line with the patent expiration of Lucentis, which is July 2022. We're clearly on track of doing that. With regards to changes in the biosimilar race, as many of you know, we have two main competitors from ranibizumab biosimilar perspective. It's the Samsung Bioepis program and the Formycon Coherus program.

I do expect a situation where these three products are being launched more or less simultaneously in Europe after the patent expiration of the originate product. In the U.S., as many of you know, patent expired already this summer. We'll have to see. I think now it more can look like a more or less simultaneous launch by Bausch + Lomb, Coherus and Bioepis as there was news recently from Formycon that the filing to FDA was postponed to the first half of next year.

Second question. Does the blinded information from the study support that there is not any safety or efficacy issues so far? As you know, we're monitoring the study from a blinded perspective for ethical reasons. On the one hand, to ensure, of course, that there are no unexpected adverse events emerging which, in that case, would trigger a more detailed investigation and if there were to be such serious concerns, a potential halt in the study.

That has not been the case, and we have not been able, from a blinded perspective, of course, to observe anything that is deviating from normal usage of Lucentis from an adverse event perspective. From efficacy perspective is really from an ethical perspective observing the lower end of change in visual acuity, if I put it like that.

The potential part of the study population which has a significant deterioration of visual acuity. Looking at it from that perspective, we cannot see anything which deviates on a blinded perspective, of course, from normal usage of Lucentis. Okay. Third question. Is there any significant changes in the wet AMD market? Is there still room for ranibizumab? We are following the market very closely, of course, and we saw a decline overall in the market during the first half of this year due to COVID-19.

Looking at the Q3 figures from Novartis and Roche, considering Lucentis sales, it seems like they're back to pre-COVID-19 levels in Q3. Seems like EYLEA has returned to growth or is growing Q3. Bevacizumab, as many of you know, has been facing some issues due to unexpected adverse events. It still seems to be so that sales are not picking up really, as far as we can read from the quarterly report of Novartis.

Yeah, definitely we do believe that Lucentis has a strong position in this market and that there definitely is going to be place for ranibizumab biosimilars really playing in this whole anti-VEGF market for ophthalmic use of EUR 10 billion. We do believe that there is a significant need for cost-efficient products.

Judging actually from the extent usage of off-label Avastin, which of course is done due to cost reasons despite an inferior safety profile compared to the on-label drugs. Also looking at the currently untreated population. It's a big need for cost-efficient products in this market and definitely therefore a need for Lucentis biosimilars.

Okay. Fourth question. Could you comment what the timeline is with regards to potential license agreements for Japan and South America, I guess referring to Xlucane. This work is ongoing together with our partner STADA with regards to Japan and South America, and also on our own with regards to China. The work is ongoing, and hopefully we shall be able to during next year update you with some positive news on that then.

Our ambition is really to together with STADA take this product as globally as possible and trying to find the best possible commercialization partners in territories where STADA decides not to commercialize themselves in Japan and South America, such territories. Okay, question five. Could you tell about Xcimzane timeline? When is the clinical trial going to be started?

Next year is really going to be about scale-up of the production process together with the selected contract manufacturer, and then the clinical trial, we expect to be able to start in 2022. We still believe that we shall be able to bring this product to market at the time of patent expiration. Question 6, could you comment on the situation of Spherotide further? What is the strategy with the asset currently?

As I mentioned in the presentation, we have decided, and we did this one year ago, to really focus our resources on the development of our biosimilar pipeline. We are seeking a partner for Spherotide in the shape of form which allows the product to be developed further, but without further investments from Xbrane. That could be a complete divestment of our Italian subsidiary, Primm Pharma, or it could be a licensing arrangement where, as I said, a potential partner then would undertake all the coming required investments to take the development further.

Okay. Next question. Has the manufacturing process for Xoncane been finalized? Can you speak on scalability? Is a different pegylation technology being used for Xoncane? Is there anything regarding the manufacturing technology used in Xoncane that may give an advantage compared to Oncaspar? If yes, will we see this in future messaging?

Quite specific questions on our Oncaspar biosimilar program. We are in the process of finalizing the manufacturing process. It has not been scaled up to commercial scale, so I cannot comment on that. It is a pegylated product, Oncaspar. All we're trying to do with regards to our biosimilar development is to develop a biosimilar with as similar pegylation as possible as the originator, and thereby also no clinical advantage compared to the originator,

but really striving to get as similar product as possible from both an analytical perspective, but then also from a clinical perspective, of course. Next question. Several patients have at this stage been treated for more than 52 weeks in the Xplore study. Have you done any readout data on these patients? If you have, what is the result?

Is the result in line with equivalent margin to Lucentis agreed with EMA? The answer is no, we haven't done any readout on these patients. First readout is going to take place when last patient have reached month six in the treatment schedule. Next question. Regarding Xdivane, Xcimzane, there's a partnership established in May, June 2019, quoting the press release, during this period of evaluation, Xbrane has granted to STADA right of first refusal for a license of Xcimzane and Xdivane for Europe.

How long is this evaluation period and what is the current status of this? This is correct. STADA has been granted the right of first refusal for a potential European license of these two programs. I'm being caught a little bit off guard here. I think the evaluation period was up until initiation of clinical trial. That is the way I remember the prolongation of that right of first refusal. I might have to come back on that one. The next question.

How is the burn rate of capital expected the coming year? Current burn rate SEK 50 million-SEK 60 million per quarter is for a full-on phase III study. Can we expect this to drop as people reach the end of treatment, 52 months? Yeah. The burn rate related to the clinical trial Xplore will go down during next year, but there will be other expenses related to Xlucane, primarily related to preparing for a securing capacity for the launch volume of the product. I do expect that the current burn rate is the reasonable expectation also going forward.

The kind of type what we're going to invest into is going to shift with a decline in the spend on the phase III trial but then it's going to be spend on other required items to prepare for a successful launch. Okay, next question. Is the cash position presenting excluding recent directed share issue? Once the directed share issue has been received, what is the runway with current cash?

Okay. Yeah, the cash position which was presented in the Q3 report was as of last September, and this was SEK SEK 123.8 million . The directed share issue was conducted this week essentially, and provided an additional SEK 200 million before transaction costs. That gives us a cash runway up until the end of Q3 next year, executing on our business plan, investing in as we want to do, Xlucane as well as our two preclinical programs, Xcimzane and Xlucane. Next question. Did STADA participate in the directed share issue?

Answer to this one is, no, STADA did not participate. With regards to existing shareholders on the kind of, let's call it top 10 list probably. We had Söderberg & Partners and TIN Fonder participating. There were smaller existing shareholders participating but then also as I said in the beginning, a couple of new investors coming in, particularly on the institutional side, Lancelot and Andra AP-fonden. Okay. Good. I think that concluded all the questions that we have received. I, with that said, want to thank everybody for calling in and listening and providing good questions.

I did the best I could to answer them. Should there be any further questions, do not hesitate to reach out to me or to Margareta. We will do our best to answer. A transcript from this call will be published on our website in the near term future. With that said, thank you very much for calling in and listening. Thank you