Humacyte, Inc. (HUMA)
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Earnings Call: Q4 2022

Mar 24, 2023

Operator

Good morning, ladies and gentlemen, and welcome to the Humacyte Fourth Quarter and Year-End 2022 Results Conference Call. Currently, all participants are in listen-only mode. Later, we will conduct a question-and-answer session, and instructions will follow at that time. As a reminder, this conference call is being recorded. I will now turn the call over to Lauren Marek with LifeSci Advisors. Please go ahead.

Lauren Marek
Advisor and Investor Relations, LifeSci

Thank you, operator. Before we proceed with the call, I would like to remind everyone that certain statements made during this call are forward-looking statements under U.S. federal securities laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations. Additional information concerning factors that could cause actual results to differ from statements made on this call is contained in our periodic reports filed with the SEC. The forward-looking statements made during this call speak only as of the date hereof, and the Company undertakes no obligation to update or revise the forward-looking statements except as required by law. Information presented on this call is contained in the press release we issued this morning and in our Form 10-K, which will be filed today and may be accessed from the Investors page of the Humacyte website.

Joining me on today's call from Humacyte are Dr. Laura Niklason, President and Chief Executive Officer, Dale Sander, Chief Financial Officer and Chief Corporate Development Officer, and Dr. Heather Prichard, Chief Operating Officer. Dr. Niklason will provide a summary of the Company's progress during the quarter and recent weeks, and Dale will review the company's financial results for the quarter and year ended December 31, 2022. Following their prepared remarks, the management team will be available for your questions. I will now turn the call over to Dr. Niklason.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Thank you, Lauren. Good morning, everyone, thank you for joining us for our fourth quarter and year-end 2022 financial results and business update call. Humacyte has made significant progress throughout 2022 in advancing our universally implantable bioengineered human tissue product candidate, the HAV or Human Acellular Vessel. We're very close to completing enrollment in two trials of the HAV, both in vascular trauma and in arteriovenous access. We also continue to advance our earlier stage programs. As we begin 2023, we remain focused on advancing our HAV towards regulatory milestones and commercialization, beginning with the vascular trauma indication. During this call, I will review our recent highlights and the progress of our key programs before turning the call over to Dale for a review of our financial results. We'll be happy to open up the call to your questions.

I'll begin with our HAV program in vascular trauma. We're pleased that our phase 2-3 VO5 trial is nearing enrollment completion. We currently have a total of 63 patients who've received the HAV in the VO5 trial, and an additional 17 patients who've been treated with the HAV under our humanitarian program in Ukraine, bringing the total patients treated with the HAV for traumatic injury to 80. All patient results will be included in our upcoming BLA filing with the FDA. The efficacy of the endpoint of the HAV in trauma will be based on the 30-day patency in 50 patients from the VO5 trial who suffered vascular trauma in an extremity, either the arm or the leg. The primary efficacy analysis will not include torso injuries or iatrogenic trauma, which is trauma caused by physicians in patients who were enrolled in the VO5 trial.

Although data from these patients will contribute to the safety database. Currently, in the VO5 trial, 46 patients comprising the extremity injury population have been treated with the HAV. We expect to enroll approximately 6 additional patients to support the BLA filing. This should bring us past the target of 50 patients that was discussed with the FDA in recent meetings. We're working expeditiously to enroll the remaining 6 patients in VO5. In addition to the recent addition of clinical sites in Israel, we now have efforts underway to add sites in Ukraine to the VO5 trial in order to speed enrollment. We've been pleased to partner with the U.S. FDA and map out our strategy for BLA filing and trauma.

Within approximately 4 months after completion of the VO5 trial with the additional 6 patients, we plan to file a BLA for accelerated approval for an indication in vascular trauma. The targeted indication will be an accelerated approval of the HAV for arterial repair following extremity trauma when synthetic graft is not indicated and when autologous vein is not feasible. Our plans for the BLA filing, including the primary efficacy analysis, are consistent with a recent pre-BLA meeting and other meetings that we've held with the FDA over the past several months. The potential of the HAV in vascular trauma, particularly in the wartime setting, was further highlighted in a webinar that we hosted in December, featuring Ukrainian surgeons Dr. Oleksandr Sokolov, Dr. Vasyl Shaprynskyi, and Dr. Oleksandr Stanko, who shared their experiences using the HAV to treat patients with wartime traumatic injuries.

As I mentioned previously, 17 patients in Ukraine have now been treated with the HAV, and our Ukrainian colleagues shared a series of case studies highlighting the types of injuries they're treating with the HAV and their successful outcomes to date. As highlighted in the webinar, results to date have demonstrated a 30-day patency that is excellent, with zero cases of infection in all the patients treated. A replay of the webinar can be found on the Investor's page of the Humacyte website. In addition to the webinar, our Ukrainian colleagues also presented patient outcomes at two vascular conferences in December of last year, the Congress of Vascular Surgeons, Phlebologists, and Angiologists in Ukraine and the Munich Vascular Conference in 2022. We extend our sincere gratitude to our colleagues for joining us for this webinar and sharing their positive experiences using the HAV for the medical community.

Similar to our vascular trauma trial, our phase three VO7 trial of the HAV and arteriovenous access in hemodialysis patients is also nearing completion. As a reminder, the VO7 trial is designed to assess the usability of the HAV for hemodialysis in comparison to autogenous fistulas. This will be done in up to 240 patients with end-stage renal disease. We're pleased to report that as of today, 238 patients have been enrolled in this trial, meaning that we are on track to complete enrollment with the remaining two patients very shortly. Top-line results are anticipated about one year after enrollment completion, and this is based on the one-year follow-up period that's built into the study. If successful, results from this trial will support a BLA filing for its secondary indication in dialysis access.

Turning to our earlier stage programs, we're happy to provide updates on our recent progress, particularly in peripheral arterial disease, coronary artery bypass grafting, and type 1 diabetes. Results from our phase 2 trial in peripheral arterial disease, or PAD, were recently published in the Journal of Vascular Surgery: Vascular Science. This publication describes the 6-year analysis of the phase 2 study. Researchers observed that HAVs provide long-term blood flow to patients with critical limb ischemia with a secondary patency rate of 60% at 6 years. Importantly, there was no evidence of graft rejection or infection over this follow-up period, and no patients underwent amputation of the treated limb. We're pleased that these results highlight the long-term durability of the HAV in a relevant and a clinically complex patient population. We also continue to make progress in our preclinical coronary artery bypass grafting, or CABG program.

In November 2022, Dr. Alan Kypson of UNC Rex Hospital presented a 6-month patency update of the HAV in a baboon CABG model at an oral presentation at the annual American Heart Association Scientific Sessions meeting. In his presentation, Dr. Kypson highlighted that the HAV maintained structural integrity and patency for up to 6 months post-implantation as a heart bypass graft and also showed evidence of robust host cell repopulation and remodeling. We're thrilled about the promising results of our small diameter HAVs in preclinical CABG models, and we look forward to providing additional updates on this exciting program as it continues to advance into IND-enabling preclinical studies. In addition, Humacyte is happy to announce a recently funded award from the Juvenile Diabetes Research Foundation, or JDRF. JDRF is the world's largest nonprofit funder of type 1 diabetes research.

Humacyte and the JDRF will collaborate on the development of Humacyte's product candidate, the BioVascular Pancreas, which is directed at the treatment of patients with type 1 diabetes. With that, I'll turn it over to Dale now for a review of our financial results and other business developments.

Dale Sander
CFO and Chief Corporate Development Officer, Humacyte Global

Thank you, Laura. As of December 31, 2022, we had cash equivalents, and short-term investments of $151.9 million compared to $225.5 million as of December 31, 2021. The $73.6 million net use of cash equivalents, and short-term investments for the year ended December 31, 2022 resulted from spending related to net operating activities for the period, including clinical and earlier stage research and development programs in preparation for our anticipated commercial launch. We have been prudent with our expenditures, and our use of cash for 2022 was approximately $8 million less than we had budgeted.

We will continue to monitor our rate of expenditure, and we believe that our cash equivalents, and short-term investments are adequate to fund operations through the end of 2024, past our current expected timelines for potential approval of the HAV in vascular trauma. There was no revenue for the fourth quarter of 2022 compared to $177,000 of revenue for the fourth quarter of 2021, and revenue was $1.6 million for the year ended December 31, 2022 compared to $1.3 million for the year ended December 31, 2021. Revenue in all periods related to grants supporting the development of the HAV.

Research and development expenses were $15 million for the fourth quarter of 2022 compared to $16.3 million for the fourth quarter of 2021, and they were $63.3 million for the year ended December 31, 2022 compared to $61.3 million for the year ended December 31, 2021. The decrease for the quarter ended December 31, 2022 compared to the prior year quarter resulted primarily from a decrease in non-cash stock-based compensation expenses. The increase during the year ended December 31, 2022 compared to the prior year resulted primarily from increased personnel and materials expenses designed to support expanded clinical and research initiatives in support of our clinical studies.

General and administrative expenses were $5.8 million for the fourth quarter of 2022 compared to $5.6 million for the fourth quarter of 2021, and were $22.9 million for the year ended December 31, 2022 compared to $21.1 million for the year ended December 31, 2021. The small current year increases resulted primarily from the transition to being a public company and preparations for the anticipated U.S. commercial launch of the HAV, including increased personnel costs, external services, and insurance costs.

Other net income was $17.1 million for the fourth quarter of 2022 compared to $64.2 million for the fourth quarter of 2021 and was $72.6 million for the year ended December 31st, 2022 compared to $54.7 million for the year ended December 31st, 2021. The reduction in other net income for the fourth quarter of 2022 and the increase in other net income for the year December 31st, 2022 resulted primarily from non-cash gains related to the remeasurement of the contingent earnout liability associated with the August 2021 merger with Alpha Healthcare Acquisition Corp.

Net loss was $3.7 million for the fourth quarter of 2022 compared to net income of $42.6 million for the fourth quarter of 2021, and net loss was $12 million for the year ended December 31, 2022 compared to net loss of $26.5 million for the year ended December 31, 2021. The increase in net loss for the current year fourth quarter compared to 2021 resulted from a decrease in other net income described previously. The decrease in net loss during the year ended December 31, 2022 compared to the prior year resulted from the increase in other net income described above, partially offset by operating expense increases also described previously. With that, I will turn it back to Laura for concluding remarks.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Thank you, Dale. To conclude, we've made significant progress throughout 2022 in both our clinical and our preclinical programs. We're excited to move closer to our BLA filing in vascular trauma, we will be pleased to close the enrollment soon in our AV access trial, the VO7 trial. 2023 is shaping up to be a significant year for Humacyte, we are poised to build on our momentum from the past year, we look forward to providing further updates as we approach clinical and regulatory milestones. Operator, we're now ready to take questions.

Operator

Thank you. If you'd like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you'd like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. Our first question comes from the line of Ryan Zimmerman with BTIG. Please proceed with your question.

Ryan Zimmerman
Managing Director and Medical Technology Analyst, BTIG

Good morning. Thanks for taking the questions, Laura and Dale, and appreciate it. Want to talk about the VO5 trial a little bit. You know, sounds like the FDA maybe had some feedback for you guys in terms of how you think about usage of the HAV in trauma. Laura, I was wondering if you'd kind of speak to that specifically and, you know, how that's, you know, impacts both utilization going forward, and commercialization once you get that product to market.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

We're really happy that we've gotten clarity and direction from the FDA as far as number of patients and the analysis in VO5, as well as the targeted indication statement. The indication statement is really based on the fact that our VO5 trial has always been designed for patients who do not have autologous vein, saphenous vein, for treatment of their vascular injury. The contraindication for saphenous vein and for synthetic grafts really falls out of both the VO5 trial design, but also the fact that most traumatic injuries actually are not deemed suitable for synthetic grafts. For example, penetrating injuries, but also many blunt injuries that have contaminated wounds are all known to be at high risk for infection.

If you speak with most vascular or trauma surgeons, most of these people will indicate that a synthetic graft is really not suitable in many or most cases of trauma. The limitation as far as the indication really speaks to patients who do not have available saphenous vein, which is the enrollment criteria in the VO5 trial. Something that we didn't speak to in our comments earlier is the fact that with an accelerated approval. The FDA also asked that we perform a confirmatory study after we gain approval, after we're granted approval in the trauma indication. We're currently designing that phase 4 confirmatory study with the FDA right now. Our anticipation is that the design of the confirmatory study would sort of throw the gates open to a broader patient population.

Completion of that study, we would anticipate, would allow us to broaden the indication. That said, the indication statement we do not believe is very narrowing from the standpoint that having something that's immediately available that doesn't require the hour of saphenous vein harvesting and that resists infection, is going to be highly sought after for surgeons who are treating acute traumatic injury.

Ryan Zimmerman
Managing Director and Medical Technology Analyst, BTIG

Okay. Just to be clear though, The HAV is limited to extremity injuries? Because you're I appreciate that you're including some of those other injuries in the safety data, but I just want to be clear about where you can or you think, you know, potentially you can or cannot use the HAV after BLA.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

The indication statement is focused on extremity injury because the data subset that we're analyzing in the trauma trial focuses on patients who have at least one anastomosis in an extremity. Some of these patients have an anastomosis also in the pelvis or the thorax, but at least one anastomosis is in the extremity.

Ryan Zimmerman
Managing Director and Medical Technology Analyst, BTIG

Okay.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

The FDA asked us to do this because traumatic injury, as you would imagine, is very heterogeneous. The focus on extremity injury was a way of sort of focusing on a slightly more homogeneous group of patients, although these patients still have a wide variety of injuries. The reality is that the current 6 millimeter diameter of the HAV is suitable for the anatomies that I've talked about. If you talk about, for example, aortic traumatic injury, the HAV really isn't suitable there 'cause the diameter isn't a good match. We believe that the extremity focus in the indication really doesn't change functionally where the HAV will be used very much.

Ryan Zimmerman
Managing Director and Medical Technology Analyst, BTIG

Yeah. No, that makes sense. Okay. Just last question for me, I'll hop back in queue. In terms of timing, you know, I think we're kind of thinking middle of this year previously in terms of getting enrollment complete. I know you're bringing up some sites in Israel and, you know, Ukraine. Do you think the timing for the HAV VO5 trial can still maintain completion kind of mid-2023? Or do you think you're, you know, maybe pushing back a little bit just because the nature of the patients you're targeting?

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Well, it's always hard to predict enrollment in a trauma trial. Certainly, we're going to work as hard as possible to get the remaining six patients enrolled. We're targeting six. Technically, the, we need a minimum of four more enrollments.

Ryan Zimmerman
Managing Director and Medical Technology Analyst, BTIG

Right.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

I will say that our prior enrollment rate of 1 per month has picked up a little bit recently with the addition of the Israeli sites. If we're able to bring up Ukrainian sites, I would expect that the enrollment would pick up above 1 per month because, frankly, the Ukrainian sites all by themselves enroll 1 per month or more. I again, hard to predict, but I would hope that in the next couple of months that we'll complete enrollment and then about 120 days after that, we would file.

Ryan Zimmerman
Managing Director and Medical Technology Analyst, BTIG

Okay. Thank you for taking the questions, Laura.

Operator

Thank you. Our next question comes from line of Matthew O'Brien with Piper Sandler. Please proceed with your question.

Phillip Dantoin
Analyst, Piper Sandler Companies

Hey, this is Phil on for Matt. Thanks for taking our questions. I guess just to piggyback off Ryan's question there. For the VO5 trial, that 63 patient number is current and not at the end of 2022, which would imply you're adding what? 7 over, call it a quarter and a half, almost 2 quarters. Can you just speak to the current pace of additions here for that remaining 6? Can you just touch on the delta between needing only 4 more, but you guys are gonna go for 6 there?

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Sure. Well, you know, as I mentioned, the, you know, historically, the pace of enrollment in VO5, which was negatively impacted by COVID for sure, just like every other trial in North America. But previously we've been around one patient per month. That has picked up a little bit in the last couple months with addition of these sites. Again, all I can say is that we think it will take a few months to enroll the 4 to 6 patients. The reason we're saying 6 right now is because, you know, with each of these patients and having very heterogeneous injuries, our current strategy is to provide a little bit of a buffer or cushion, slightly above the targeted number of patients of 50, that we've discussed with the FDA.

The reality is that we currently have 46 patients that fall into the category that the FDA would like us to focus on. We would need 4 more patients to hit that target number of 50. I think one thing I do want to emphasize is that, you know, we've really been able to partner very well in recent months with the FDA and have had a very active dialogue with them. Getting clarity on the subset of patients that they were most focused on and the types of analysis they would like us to do and the patient number has really allowed us to provide a lot more clarity on our glide path for filing.

Phillip Dantoin
Analyst, Piper Sandler Companies

That's helpful. Thank you. Then just shifting gears really quickly, are you preparing in any way for commercial activities? What's going on that front as you prepare for this stage and eventually making it to market for trauma?

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Well, I'll answer that a little bit, and then I'll ask Dale and also Heather to weigh in a little bit more. Essentially, as you may recall, we began filling out our commercial team even in the latter part of 2021. Currently we have staff in place to lead the commercialization effort with really a focus on health economics, and market access and reimbursement, although we are bringing on a VP of marketing in the next few weeks.

The groundwork that we're laying now is really around the cost benefit analysis and the health economic analysis that we'll be able to bring to payers and to healthcare providers around the benefits that the HAV can provide to patients and to the system. I'll let Dale speak to staffing up for commercialization, and I'll also ask our COO, Heather Prichard, to speak to our co, commercial manufacturing readiness.

Dale Sander
CFO and Chief Corporate Development Officer, Humacyte Global

Yeah. Thanks, Laura. Matt, certainly beyond B.J. Scheessele, our Chief Commercial Officer, we do have a core marketing team in right now. In addition to the budget impact model that Laura described, much of the emphasis are on the longer lead time items that need to be prepared for in advance of launch. That includes preparing for the NTAP pass-through reimbursement from CMS, which we think will be important to us. Also, you know, things that may seem mundane like naming the product, but are long lead time items that, you know, that work is underway right now, which requires going through, you know, both trademark issues as well as the FDA.

Beyond that, you know, there's certainly a great deal of effort going on to prepare from a manufacturing point of view, and I'll let Heather address that.

Heather Prichard
COO, Humacyte Global

Thanks, Dale and Laura. From a manufacturing standpoint, we're on track as you know, to be able to produce our product for commercialization. We don't anticipate any complications, but we continue to prepare, for our pre-approval inspection and also, update our modules to our BLA filing.

Phillip Dantoin
Analyst, Piper Sandler Companies

Very helpful. Thanks so much.

Operator

Thank you. Our next question comes from line of Josh Jennings with TD Cowen. Please proceed with your question.

Joshua Jennings
Analyst, TD Cowen

Hi. Good morning. Thanks for taking the questions. Sorry to trauma indication again, but just wanted to make sure that or get an update or just reiteration of the total addressable market. That hasn't changed, has it, in just with this update from the FDA? I assume no, but just wanted to get clarity there. Also any incremental thoughts on ultimate pricing of the HAV once you get BLA approval.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Yeah. Again, we don't see the total addressable market really being materially impacted by this initial indication statement. You know, as you know, the HAV at 6 millimeters in diameter really is most suited for injuries in the upper and lower extremities. As I mentioned earlier, aortic injury was never anything that we really contemplated in any of our financial models. I think that the TAM really isn't impacted here. Again, although Humacyte would never advocate or market the product for any off-label use, I think the reality is that, you know, in trauma centers, the HAV will get pulled off the shelf and will get used in instances where surgeons feel it's best for the patient, you know, independent of the letter of the indication statement.

I don't think that TAM is really addressed, by these clarifications. I'll let Dale speak to product pricing.

Dale Sander
CFO and Chief Corporate Development Officer, Humacyte Global

Josh. good to talk to you. As you know, as you know, pricing is a complex decision that generally isn't announced until the time of launch. I guess if you were to dig back to our earliest SEC filings, where we were required to put placeholders in there is commentary about potential price ranges, which at that time suggested something in the $25,000 per HAV range, although, you know, decisions around pricing will be made at the time of launch.

That being said, I can tell you that, you know, the work we've done to date in terms of looking at the budgetary impact of using the HAV versus standard of care or other treatments. Also, our discussions with hospital administrators would suggest the price and the straw man that we originally had, is certainly acceptable, and pricing could be even somewhat higher than that, particularly within the vascular trauma market.

That, you know, everything we've seen kind of progressed since our original SEC filings close to 2 years ago, nothing has changed that other than to indicate even more so the viability of the pricing at that level within this indication due to the major cost savings associated with things such as avoidance of amputation and, you know, avoidance of infection and the impact those have on length of stay in the hospital and other costs.

Joshua Jennings
Analyst, TD Cowen

Excellent. Thanks for that. Wanted to just follow up on, we get some questions on the pace of enrollment for VO5 and our understanding just in terms of connecting the dots with the ultimate market opportunity. I mean, could you just review some of the hurdles in enrollment? I mean, our understanding of talking to vascular surgeons, these patients are very hard to consent. Once you have approval, you know, that total addressable market you guys have laid out is realistic. Just wanted to get your thoughts on just the pace of enrollment and how that translates into the total addressable market and some of the hurdles that your investigator sites face enrolling these patients.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Yeah, Josh, you know, that's a really excellent question. You know, the number of vascular injuries in the U.S., you know, is what it is. It's tens of thousands per year, even in peacetime. Again, the hurdles and the difficulties that we've encountered enrolling VO5 really just highlights the reason that extremely few interventional trials have ever been done in this type of traumatic injury. You know, by definition, if a patient is injured enough that they require acute repair of an artery that is big enough to be treated by the HAV, that means that this patient is essentially bleeding to death. Typically, these events occur in the off hours in the middle of the night.

Also, by definition, if a patient is bleeding that much, they're typically not able to provide consent. Targeting patients with injuries severe enough to require acute repair, but finding patients who are not sedated or who are conscious and able to give consent or have a family member standing right next to them who can give consent, that just becomes a vanishingly small pool. You know, the realities of human clinical research are that, of course, you know, we have to abide by all regulations and consent every patient, but for this type of trial, it just places enormous hurdles on enrollment. Humacyte continues to believe that the realities of the marketplace are very different from that sort of tightly constrained limitations that we've had to deal with in this trial.

Joshua Jennings
Analyst, TD Cowen

Well, appreciate that. Just lastly, thinking about the pipeline and the different indications that you're pursuing for the HAV, is there any way to think about a prioritization or is it in terms of how you're going to allocate investment dollars to each of those pipeline projects? Thanks for taking all the questions.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Well, the pipeline products that we're focused on most intensely, are the coronary artery bypass graft, the small caliber vessel, as well as the BioVascular Pancreas. Both of those product candidates are in large animal trials, so we're in primates and for both of those candidates, which is very exciting. We're certainly pushing forward with large animal implantations in the CABG application and really filling out the preclinical database for that indication. The same thing is true in the BioVascular Pancreas. That said, the total dollars, even for primate work, because the numbers of primates aren't hundreds, you know, it's single digits or low double digits.

So that's on the order of $several million for those programs, which is really a small total fraction of our total spend, because obviously, you know, with active phase 3 clinical programs in a couple different areas and, you know, fully scaled manufacturing, the vast majority of the spend is still going there. We've made strategic decisions to continue to push forward what we believe are incredibly important programs for building the value in the company. The total spend for 2023 on these pipelines as a fraction of the total budget is actually pretty small. We think there's outsized value there.

Joshua Jennings
Analyst, TD Cowen

Thanks a lot, Laura.

Dale Sander
CFO and Chief Corporate Development Officer, Humacyte Global

Thank you. Our next question comes on the line of Suraj Kalia with Oppenheimer. Please proceed with your question.

Suraj Kalia
Analyst, Oppenheimer & Co.

Good morning, Laura, Dale. Can you hear me all right?

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Yep.

Suraj Kalia
Analyst, Oppenheimer & Co.

Yes. Perfect. Congrats on all the progress. Laura, just following up on VO5, and forgive me if I got my numbers wrong. Wasn't the trial originally supposed to enroll 75? I guess where I'm headed is, during your discussions with the FDA, were there any questions about efficacy in non-extremities, which led to the 50 number? Just trying to understand this new number and the difference in adjudication for efficacy versus safety, if at all.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Yeah, Suraj, those are very good questions. Guidance that we've been providing to yourself and to the market really since the summer of 2021 has been that we expected to enroll approximately 75 patients, give or take, in VO5 before we could file. That was really an estimate based on what was then ongoing discussions with the FDA about which patient subset and we would focus on and what the total number of patients required would be. Currently, as I mentioned, we're at 63 total patients. But the 50 number as a subset, again, was really an effort by the FDA to focus on a set of patients that was more homogeneous.

Just to be specific, the number of torso injuries that we have in the trial is actually pretty small. It's only 5 patients. The extent of the injury in those patients is really a very different ballgame, because if you have vascular disruptions, significant vascular disruptions in your torso, by definition, your survival and mortality is just a very different thing than if you have a limb vascular injury. The FDA wanted to focus again on a more homogeneous patient, set of patients, and that's also why they had us exclude the iatrogenic patients. We have, gosh, I don't know, 10 or 12 iatrogenic injury patients, which the FDA views as actually a healthier patient subset because these wounds tend to be in a more sterile environment. They tend to be more discreet.

The FDA actually asked us, for purposes of statistical analysis, to carve out patients with severe, oftentimes fatal injuries, which were the torso patients, and then perhaps more discreet injuries, which were the iatrogenic patients. That left sort of the majority of the patients in the middle with limb injuries. You know, vascular injuries in the limb really are the majority of vascular injuries that occur in both the civilian and military settings. Again, this is focusing on the majority, but trying to get a slightly more homogeneous population. But the number of... Yeah. But the 75 number was not a hard number. It was always our estimate.

Suraj Kalia
Analyst, Oppenheimer & Co.

Fair enough. Laura, on VO7, two additional patients remaining, to be enrolled. Obviously this is, you know, an open label. I'm curious, you know, just given what's happened in VO5, why do we still need? Is there some statistical issue that we need to get to 240? Just trying to understand the difference between, you know, and the FDA's approach here also.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Certainly the VO7 trial is open label, quote-unquote, but I just want to emphasize that Humacyte is not privy to the results. This is a prospective randomized trial that is open label to the investigators, but Humacyte and Humacyte staff are blinded. You know, we're just following the trial protocol that we agreed to with the FDA a number of years ago. The target patient number of 240 was based on the power calculations that we performed at the outset of the trial. We've just been trying to hew to what we agreed to with the FDA. Again, you know, dialysis patients are obviously not as acute as trauma patients.

These surgeries are elective and the enrollment rate really took a hit during COVID, as we know. We're just pleased to be finally wrapping up this trial and getting to the enrollment target that we agreed to with the agency.

Suraj Kalia
Analyst, Oppenheimer & Co.

Fair enough. Laura, finally from my side, I'll hop back in queue. JDRF, you know, congratulations on that partnership. The BVP, is that gonna involve, I shouldn't say plain vanilla iPSCs, but are you all gonna edit in any genes, knock out any genes? Any timelines, any additional color would be greatly appreciated. Thank you for taking my questions.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Yes. We are focusing on stem cell-derived islets. We're taking a sort of a multiplexed approach. We're looking at the potential of using cadaveric native islets as part of the BVP program, but we're also looking very closely at stem cell-derived islets because obviously that brings in manufacturability and control of islet supply, which is gonna be very important in any commercial setting. We are certainly looking at immune-privileged iPS cells. I do not believe we've yet shared with the broader investment community what exact types of immune privilege we're looking at. I will generally say that as a general rule, overexpressing genes and adding in new stuff into a cell line that's then going to be therapeutic for a patient is generally a little harder from a regulatory standpoint than taking stuff out.

In other words, removing genes that might be immunogenic, we anticipate will be an easier path forward rather than overexpressing or adding in new proteins, which might add more regulatory hurdles.

Suraj Kalia
Analyst, Oppenheimer & Co.

Got it. Thank you.

Operator

Thank you. Ladies and gentlemen, as a reminder, if you'd like to join the question queue, please press star one on your telephone keypad. Our next question comes from line of Bruce Jackson with The Benchmark Company. Please proceed with your question.

Bruce Jackson
Analyst, The Benchmark Company

Hi, good morning, and thank you for taking my questions. Quick follow-up on the pre-approval inspection for manufacturing. Is that scheduled yet?

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Heather, you wanna take that?

Dale Sander
CFO and Chief Corporate Development Officer, Humacyte Global

No, Bruce. Go ahead. Yeah.

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

No, Bruce, nice to talk to you. We have not had that scheduled yet. That pre-approval inspection will be scheduled by the FDA after they get our filing, our BLA filing. It will be scheduled by then after we file.

Bruce Jackson
Analyst, The Benchmark Company

Okay, great. And then, one quick follow-up on the earlier-stage programs. Will there be any publications, presentations, et cetera, on the CABG program or the BVP program this year?

Laura E. Niklason
Founder, President, and CEO, Humacyte Global

Yes. We certainly expect that. We have made submissions to various national/international meetings already on the BVP program, and we expect to continue to present on the CABG program. I'm not really in a position to let you know which meetings we're presenting at, but these are both active, you know, primate-level programs and so we're gonna continue to keep the market apprised.

Bruce Jackson
Analyst, The Benchmark Company

Okay, great. That's it for me. Congratulations again on the progress during the quarter.

Operator

Thank you. I'm showing no further questions in the queue at this time. This concludes Humacyte's fourth quarter and year-end 2022 results conference call. Thank you all for participating. You may now disconnect your lines.

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