Vaxart, Inc. (VXRT) Earnings Call Transcript & Summary

Greetings, and welcome to the Vaxart Business Update and Full Year 2023 Financial Results Conference Call. [Operator Instructions] As a reminder, this conference is being recorded. I would now like to turn the webcast over to your host, Ed Berg, Senior Vice President and General Counsel.

Good afternoon, and welcome to today's call. Joining us from Vaxart are Dr. Michael Finney, Interim Chief Executive Officer; Dr. Sean Tucker, Chief Scientific Officer; Dr. James Cummings, Chief Medical Officer; and Phil Lee, Chief Financial Officer. Before we begin, I would like to remind everyone that during this conference call, Vaxart may make forward-looking statements, including statements about the company's financial results, financial guidance, its future business strategies and operations and its product development and regulatory progress, including statements about its ongoing or planned clinical trials. Actual results could differ materially from those discussed in these forward-looking statements due to a number of important factors, including uncertainty inherent in the clinical development and regulatory process, and other risks described in the Risk Factors section of Vaxart's most recently filed annual report on Form 10-K and also on other periodic reports filed with the SEC. Vaxart undertakes no obligation to update any forward-looking statements after the date of this call. I'll now turn the call over to Dr. Michael Finney. Mike?

Thanks, Ed, and thanks to all of you for joining us today. It's a pleasure to be speaking with you at this exciting time in the company's development. As this is my first quarterly call with you, I will begin with a brief introduction of myself and my observations of our company, and then I'll transition the call to the rest of the team to move through our recent accomplishments, clinical programs, upcoming planned milestones and full year performance. First, this is my second installment as Vaxart's CEO, having served in a similar capacity from 2009 to 2011. I've been a Vaxart Board member since 2007 and Board Chair since March 2023. Throughout my time with Vaxart, I've seen the company go through many periods of clinical and corporate growth and take on a variety of new challenges. Never have I been more confident in our team and in our trajectory than I am right now. I firmly believe 2023 was a transformational year for this company in our mucosal technology. We made solid progress on our oral vaccine platform, completing 2 Phase II clinical studies for our norovirus oral vaccine candidates, and we have now established proof of concept in 2 challenged studies on both respiratory and GI viruses. Based on the totality of the data, we have produced through these and our other reported clinical trials. I think it's clear that what we have our hands on. Our oral pill vaccines hold a very real promise of offering several advantages compared with injectables, including the ability to vaccinate people faster, easier and painlessly without the need for cold chain storage or trained medical professionals to administer the vaccines as well as the promise of mucosal immune response. We've already determined in preclinical and clinical trials that our candidates have a favorable immune profile, induce serum antibody and serum-neutralizing antibody responses, induced potent T cell responses, create mucosal immune responses and can inhibit virus shedding, which may have an impact on virus transmission. Looking at the current landscape and particularly given our recent BARDA contract award, we are now poised to make some major stride forward with our COVID-19 program. James will go over the details of the preparations and the study design, but it is clear that the federal government believes we need better vaccines that harness the power of mucosal immunity more strongly combat the current XBB and future variants of the virus. The first generation of vaccines was a start but the virus is continuing to evolve. We can do much better, and Vaxart is prepared to accept that challenge and demonstrate our technologies promise. At the same time, we're making steady progress on our norovirus program. We've completed our analysis of the recent challenge study data and have identified a potential correlate of protection, which will inform our upcoming meeting with the FDA to discuss the optimal path forward for this program. We continue to believe we have the most advanced norovirus vaccine candidate in clinical development that is both formulated for oral administration and designed for delivery to the [indiscernible]. Norovirus carries a tremendous economic burden in this country and globally, and we look forward to creating an oral vaccine that eases this burden for millions of societies most vulnerable. Finally, I can say with great pleasure that last week, we announced the appointment of a permanent President and Chief Executive Officer, Steve Lo. Steve brings a wealth of biopharma experience to Vaxart with more than 25 years in health care, biotech and pharmaceuticals, including more than 12 of those years in the C-suite. He's had a particular focus on development and commercialization, having helped 2 companies bring their first product to market. Vaxart is in a tremendous position to advance its mission. We are excited to add a high-caliber experienced CEO to elevate this company to greater heights and create value for our shareholders. And currently, I will be stepping down as CEO and retaining my position as Chair of the Board. Steve joins Vaxart's -- effective March 18, and we are thrilled to welcome him. I'll now turn over the call to James to review the recent progress for our coronavirus program.

Thanks, Mike. First, I want to thank our clinical, regulatory, CMC and research teams, who've worked tirelessly for nearly 4 years on our COVID-19 program. Their perseverance and dedication to our cutting-edge research have been crucial in laying the groundwork for this program's recent progress. All of us here at Vaxart were encouraged in January to receive a $9.27 million contract from BARDA to prepare for a 10,000 subject Phase IIb clinical trial, evaluating our company's oral pill XBB COVID-19 vaccine candidate against an approved mRNA vaccine comparator. This award is part of the federal government's Project NextGen effort to boost our nation's pandemic preparedness and improve upon our collective ability to combat COVID-19. Vaxart is one of only a handful of companies to receive funding from BARDA to date, to prepare for a Phase IIb clinical trial under this very important initiative. We're heartened by the government's support, which we think is indicative of the potential of our differentiated approach to the continuing challenge that is COVID-19. This support will empower Vaxart to move forward with our oral COVID-19 program. Currently, we are engaged in preparations to initiate this Phase IIb trial. This trial, which may start as early as Q2 in 2024, is a Phase IIb double-blinded, multicenter, randomized, comparator-controlled clinical trial to determine the relative efficacy, safety and immunogenicity of Vaxart's investigational oral SARS-CoV-2 XBB vaccine tablet against the currently approved mRNA COVID-19 needle injected booster vaccine in adults previously immunized against COVID-19 infection. As we continue our clinical trial preparations, we're working to secure additional funding, which would support the initiation and conduct of the Phase IIb study. We will provide the timing and amount of any additional funding as events warrant. Commensurate with additional funding. We hope to be among the first of the Project NextGen recipients to initiate our Phase IIb head-to-head clinical trial. Last month, we continued to demonstrate a cross-protective potential of our COVID-19 vaccine candidates with the publication of previously announced data in the journal vaccines. This preclinical nonhuman primate data showed that our vaccine candidates could protect against multiple SARS-CoV-2 variance of concern. As a elicited strong antigen-specific serum IgG and IgA responses with neutralizing activity. Vaccination also reduced SARS-CoV-2 shedding following infectious challenge in both the upper and lower airway of nonhuman primates. Publications in highly respected journals such as vaccines are really important because they continue to show that our ground-breaking research is being recognized by the scientific community. These data also serve as the foundation for our current COVID-19 vaccine candidate, which will be evaluated during the upcoming Phase IIb clinical trial. Vaxart's VAAST platform and technology has great potential. We believe this platform could transform the landscape not only for COVID-19 vaccines but also for other infectious diseases that present significant threats to global public health, such as norovirus and influenza. We're very proud of our entire team as we continue to lead the way in mucosal vaccine science. I'll now hand the call over to Dr. Sean Tucker, our Chief Science Officer and Founder, for an update on our norovirus vaccine program. Sean?

Thanks, James. We made significant progress in our norovirus program in 2023, delivering top line data from 2 Phase II studies, including a challenge study of our GI.1 monovalent candidate. We have evaluated most of the data, and we believe we are on track for identifying potential correlates of protection that will aid in the advancement of our bivalent norovirus candidate. We believe the data we have shared to date is promising for this vaccine candidate and for our vaccine platform overall. Late in the fourth quarter, we completed enrollment in our Phase I clinical trial to evaluate the ability of our norovirus vaccine candidate to induce antibodies in lactating mother's breast milk and transfer those antibodies to young infants. Recall that this study is being supported partially by the Bill & Melinda Gates Foundation. This Phase I multicenter, randomized, double-blind, placebo-controlled dose-ranging study is designed to evaluate the safety, tolerability and immunogenicity of our oral administered bivalent GII.4 vaccine in healthy lactating females of at least 18 years of age. The study enrolled 76 subjects at 5 sites in South Africa. These subjects were randomized into high or low-dose vaccine or placebo. The primary endpoint for this study is frequency, duration and severity of solicited symptoms for 1 week following the study drug dose, the frequency duration and severity of unsolicited treatment adverse events, serious adverse events, adverse events of special interest and new onset of clinical illness through the active period. In particular, and what's most exciting is that this study will look for VP1 specific IgG1 and IgG4 IgA in the serum and in the breast milk. We are currently expecting to announce top line results in this Phase I trial in mid-2024. Going forward, we plan to meet with the FDA during the second quarter of 2024 to discuss our data on potential correlates, a Phase IIb dose confirmation study and potentially a GII.4 challenge study. We currently believe a Phase IIb study would generate sufficient safety data to have an end of Phase II meeting with the FDA. An end of Phase II meeting will allow us to gain concurrence with the FDA on the scope and design of a Phase III pivotal efficacy study in adults over 18 years of age. That said, the type and timing of our next clinical study will be determined following our meeting with the FDA in Q2. We plan to provide an update on the next steps for this program as soon as we were able to after that meeting. I'll now hand the call over to Phil Lee, our CFO, for a brief discussion of our financials. Phil?

Thank you, Sean. The details of our financial results for the full year 2023 are summarized in today's press release. Revenue for 2023 was $7.4 million compared to $0.1 million in 2022. Revenue in 2023 was primarily from revenue recognized for work performed under Vaxart's grant on the Bill & Melinda Gates Foundation and noncash royalty revenue from increased sales of Inavir in Japan. Vaxart ended 2023 with cash, cash equivalents and investments of $39.7 million. This cash balance does not include approximately $15 million net proceeds raised in early 2024. Vaxart anticipates current cash runway into the fourth quarter of 2024. Thank you all for your time today. We will now open the call for your questions.

[Operator Instructions] Our first question comes from the line of Charles Duncan with Cantor Fitzgerald.

This is [indiscernible] on for Charles. We have a question regarding the lactating mother study. Can you talk about possibly what you would like to see from this Phase I study that could further differentiate the oral norovirus to target product profile and possibly supporting approval in the future?

Sean, do you want to handle that one?

Yes, I'll start, and then I'll let James jump in. Yes, I mean, the key thing about this experiment or I should say, this clinical study is by giving the vaccine to lactating mothers. We hope to see antibodies in the breast milk and those breast milk antibodies will be transferred to young infants. As you might know that one of the main -- I should say, young children are probably the most susceptible to norovirus infection. And by getting the antibodies into kids, whether it be a breast milk, we think that's going to have a big impact. We hope that this -- not only by protecting the mother and the kids, we could also protect essentially by -- if these antibodies are going to be very good and great efficacy. We could also have ability to block transmission to other people in the community. James, do you want to add anything?

Thanks, Sean. There's a rich history of maternal immunization to assist with covering children. But I think the interesting thing about our VAAST platform is it does such a compelling job on mucosal immunity and on IgA production. So taking a look at those levels in the breast milk in a more formalized way and then taking a look at potentially how the children do with that breast milk [indiscernible] with maternal antibodies should go a long way to bettering our understanding of how this platform could work to potentially impact that pediatric population.

Our next question comes from the line of Roger Song with Jefferies.

This is Liang Cheng on for Roger Song. So we have a couple of questions. So I guess maybe the first one is -- could you remind us of the economics of the broader NextGen funding? And how would that impact your runway down to the year? Then I have some follow-up questions.

Well, the BARDA contract we announced in January provides funding to prepare for a Phase IIb COVID-19 trial. We can't speculate about BARDA's award process or timing. Other companies have announced that they're -- they were subject to an option agreement with BARDA, where BARDA might provide something in the neighborhood of $400 million to execute on the contract. We believe that as we execute against the milestones in this contract, we'll be in a position to receive additional funds. The details are not things that we can -- that we have an ability to talk about right now. We'll provide an update as we gain additional visibility.

Sure. So my next question is about the protection correlate. So I wonder how would that protection correlate impact your Phase III study plan?

Sean, I think you're the expert on that.

Yes, I'm going to -- I'll start and again I'll let James follow it -- follow-on. I think the key thing about understanding what immune parameters are important is good for a variety of reasons. But one of the things is that if you have an established correlative protection of your vaccine, so you know that this measuring this immune parameter leads to protection, it could lead to a reduction in out of subjects that you need to test in a Phase III efficacy study because that correlate can be used essentially to understand what's protective and you can use it to bridge between different age groups. James, would you like to add to that?

Thanks, Sean. So we're very excited about the work that Sean and his team is doing there. And as Sean had mentioned, defining a correlate is an impressive piece of work. With further discussion, there is a potential to consider that as a surrogate for protection. And as Sean mentioned, it would impact both the numbers required for a clinical field study in Phase III as well as potentially the duration of time that, that study would go on looking at those immune correlate parameters and not just field efficacy. So more to follow as we have that discussion in the near future. Thank you.

Got it. Maybe my last question is about the potential GII.4 challenge study. So what would be some key considerations or discussions regarding the necessity of this study?

James, can you answer that?

Certainly. So thanks, Roger. So I think that we'll gain a lot of information in our conversation with the agency. If they require additional information from an additional challenge, GII.4 would be a challenge study that could be performed. It's something that we've looked into in a just in case scenario, if it is required. And if it's not, it's not, right? I think we'll have a lot more clarity on if we are required to do an additional challenge study after we have that meeting with the agency.

Our next question comes from the line of Mayank Mamtani with B. Riley Securities.

Madison on for Mayank. Congrats on the progress. And if I can ask a follow-up to the previous question. In the event that you do have a GII.4 challenge study. I'm just wondering how fast do you think you'll be able to get that study up and running. And then secondly, an unrelated, could you -- maybe you mentioned, I'm not sure. For the BARDA Phase II, will you be using a commercial-grade material for your [indiscernible]?

Mike, would you [indiscernible] to go forward on that?

I sure will. So in terms of your second question -- first, I guess, this Phase IIb study that would be executed is just that it's a clinical trial under the auspices of the good clinical practice guidelines and rules and regulations from the FDA. So it requires GMP manufactured material, which is what we use in all of our clinical trials. So I think that should square that away. The comparator vaccine will be an approved mRNA needle injected vaccine. And we'll be comparing the efficacy of both of those vaccines [indiscernible] against one another. We'll also be looking at safety. We, and our platform have a very fortunately, a very clean safety profile and we'll be comparing that to the solicited and unsolicited adverse events, both from our product but also from that needle-based injection of an mRNA booster. And we'll be looking at that data as well. What was your second question?

And secondly, a follow-up to the prior question. In the event -- after your meeting with the FDA, in the event that you were to run a challenge study. Just curious how fast you guys could initiate, yes?

Well, I think there's -- it just depends on what the guidance of the FDA really tells us, right? So I don't want to speak for the agency or make any assumptions until after we have that meeting. But that said, the good news is that there are groups that have been refining what is that challenge model in the United States. So I think we could in relatively short order move forward with a challenge study. I can't be more specific than that until we have the dialogue with the agency.

I would now like to turn the call back over to Ed Berg for further questions.

Thank you, operator. We'll now turn to questions submitted by our shareholders. So the first question is for Mike Finney. Incoming CEO, Steve Lo, has had success in first product commercialization. Was that the primary factor in your search? Or what other attributes did you consider? And how did you make this selection?

Well, regulatory and commercialization experience are, of course, important, but the Board was looking for an all-around performer, and I think we found that with Steve.

Thanks, Mike. Our next question, what is the timing for next steps for norovirus? This is on timing following your FDA meeting in Q2. And James, I think you've answered some portion of this, but I'll turn to you.

Sure. So timing and next steps will, as I mentioned, be dependent on the dialogue with the FDA, right? We'll assess at that time and look forward to providing an update to anyone really is interested after we have that meeting. There's -- the nice thing is there's a couple of ways we see looking at the impact of how a next step would be, whether it's with the Phase IIb dose confirmation study for more safety data, whether it's for a challenge study that may be required or may not be required to give more information on correlates of protection. And then with the whole idea of looking down range to a potential Phase III study. That's the goal.

Thanks, James. Another question on norovirus. Will you be disclosing the results of your norovirus data analysis and the correlate of protection? Sean, I think this is yours.

Yes, obviously, very excited about the work we've done. And of course, we will share our findings with the A after we gather its input, and then we'll next assess the next steps for the program. And once all that's done, we also plan to submit a peer-reviewed manuscript. And again, the timing of that will be determined at a future date.

Thanks, Sean. Next question. Please elaborate on the preparations for the Phase IIb COVID trial. When do you expect to complete preparations? James, I believe this is yours.

Sure. So we've been coordinating with our colleagues at BARDA and we've done, I think, a great job in terms of moving forward, progressing with preparation for what is a really significant endeavor. A Phase IIb study of 10,000 enrollees. Once we have that completed, we will update you.

Okay. Thanks. That is all the questions we have at this time. So I want to thank everyone today for joining us, and this concludes today's call.

Thank you.

Thank you, Ed.

You may disconnect your lines at this time, and have a wonderful day. We thank you for your participation.