On December 12, 2023 ESSA Pharma Inc. ("ESSA", or the "Company") (NASDAQ: EPIX), a clinical-stage pharmaceutical company, focused on developing novel therapies for the treatment of prostate cancer, reported a corporate update and announced financial results for the fourth quarter and fiscal year ended September 30, 2023 (Press release, ESSA, DEC 12, 2023, View Source [SID1234638508]).
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"We are pleased with the progress made in 2023 with masofaniten (EPI-7386), our first-in-class N-terminal domain androgen receptor inhibitor for the treatment of prostate cancer, which culminated recently in the presentation of Phase 1 dose escalation data at two medical meetings where we showed that the combination of masofaniten with enzalutamide was well-tolerated and demonstrated deep and durable reductions in prostate-specific antigen ("PSA") in patients with metastatic castration-resistant prostate cancer ("mCRPC")," said David Parkinson, MD, President and CEO of ESSA. "Looking ahead, we will be focused on executing the Phase 2 combination study of masofaniten and enzalutamide in mCRPC patients as well as investigating masofaniten in combination with other standard of care antiandrogens to further elucidate its potential as a new treatment for prostate cancer patients at earlier stages of the disease. We are entering 2024 with a strong cash balance and a runway that is expected to fund our planned operations through 2025."
Fourth Quarter Fiscal 2023 and Recent Highlights
Masofaniten Combination Studies
Reported updated Phase 1 dose escalation data from the four cohorts of its ongoing Phase 1/2 study evaluating masofaniten in combination with enzalutamide in patients with mCRPC naïve to second-generation antiandrogens but may have been treated with chemotherapy in the metastatic castration-sensitive setting. The results demonstrated that the combination continues to be well-tolerated with deep and durable reductions in PSA. Across all dose cohorts (n=16) including patients in the recently enrolled Cohort 4, 88% of patients achieved PSA50, 81% of patients achieved PSA90, 69% of patients achieved PSA90 in less than 90 days, and 56% of patients achieved PSA <0.2ng/mL. These data were presented at the 2023 Prostate Cancer Foundation Scientific Retreat and at the European Society for Medical Oncology 2023 Congress.
Initiated the Phase 2 portion of its Phase 1/2 study evaluating the combination of masofaniten and enzalutamide compared to enzalutamide monotherapy in patients with mCRPC naïve to second-generation antiandrogens but may have been treated with chemotherapy in the metastatic castration-sensitive setting. The Phase 2 portion of the study is an open-label randomized study comparing 160 mg once-daily of single agent enzalutamide to the combination of masofaniten with enzalutamide, and is expected to enroll approximately 120 patients. The recommended Phase 2 combination dose was identified as masofaniten 600 mg twice-daily combined with enzalutamide 160 mg once daily. ESSA plans to provide guidance for timing of the public disclosure of initial data once the Phase 2 portion has been underway for several months.
Initiated two additional masofaniten combination arms as part of the ongoing Phase 1 masofaniten study. One arm will evaluate masofaniten in combination with abiraterone acetate and prednisone in patients with either metastatic castration-sensitive prostate cancer ("mCSPC") or mCRPC while the second arm will evaluate masofaniten in combination with apalutamide in patients with non-metastatic CRPC after 12 weeks of masofaniten single agent.
An investigator-sponsored neoadjuvant study was also initiated evaluating neoadjuvant use of the combination of masofaniten and darolutamide compared to darolutamide monotherapy in high-risk patients undergoing prostatectomy.
Masofaniten Monotherapy Study
On track to complete the Phase 1b masofaniten monotherapy study evaluating masofaniten in patients with late-line mCRPC. The initial results from the study were reported at the 2023 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Genitourinary Cancers Symposium and demonstrated that masofaniten monotherapy was well-tolerated, achieved clinically significant exposures, and showed preliminary signals of anti-tumor activity in a subset of patients. ESSA plans to present the complete Phase 1a and 1b monotherapy results in 2024 at a medical conference.
Summary Financial Results
(Amounts expressed in U.S. dollars)
Net Loss. ESSA recorded a net loss of $26.6 million for the year ended September 30, 2023 compared to a net loss of $35.1 million for the year ended September 30, 2022. For the year ended September 30, 2023, this included non-cash share-based payments of $5.0 million compared to $7.9 million for the prior year, recognized for stock options granted and vesting. Net loss for the fourth quarter ended September 30, 2023 was $5.5 million compared to a net loss of $6.3 million for the fourth quarter ended September 30, 2022. The decrease in the fourth quarter was primarily attributed to a decrease in general and administration expenditures and an increase in interest and other income.
Research and Development ("R&D") expenditures. R&D expenditures for the year ended September 30, 2023 were $21.3 million compared to $24.4 million for the year ended September 30, 2022, and include non-cash costs related to share-based payments ($2.6 million for the year ended 2023 compared to $4.3 million for the year ended 2022). The decrease in R&D expenditures for the year ended September 30, 2023 was primarily attributed to decreases in preclinical and data analysis, share-based payments and manufacturing costs. R&D expenditures for the fourth quarter ended September 30, 2023 were $5.2 million compared to $4.4 million for the fourth quarter ended September 30, 2022. The primary drivers for the increase were due to increased clinical costs as the Company advances masofaniten through its clinical trials.
General and administration ("G&A") expenditures. G&A expenditures for the year ended September 30, 2023 were $10.8 million compared to $12.5 million for the year ended September 30, 2022, and include non-cash costs related to share-based payments of $2.4 million for the year ended 2023 compared to $3.6 million for the year ended 2022. G&A expenditures for the fourth quarter ended September 30, 2023 were $1.9 million compared to $2.8 million for the fourth quarter ended September 30, 2022. The decrease for the fourth quarter was primarily due to decreased share-based payments and lower insurance renewal premiums.
Liquidity and Outstanding Share Capital
At September 30, 2023, the Company had available cash reserves and short-term investments of $148.1 million. The Company’s cash position is expected to be sufficient to fund current and planned operations through 2025.
On November 6, 2023, the Company announced that it had entered into an Open Market Sale AgreementSM (the "ATM Sales Agreement") with Jefferies LLC, effective as of November 3, 2023. Under the ATM Sales Agreement, ESSA may, within the period that the ATM Sales Agreement is in effect, sell its common shares from time to time for up to $50.0 million in aggregate sales proceeds. No offers or sales of common shares will be made in Canada, to anyone known by Jefferies LLC to be a resident of Canada or on or through the facilities of any stock exchange or trading markets in Canada.
As of September 30, 2023, the Company had 44,100,838 common shares issued and outstanding.
In addition, as of September 30, 2023, there were 2,927,477 common shares issuable upon the exercise of warrants and broker warrants. This includes 2,920,000 prefunded warrants at an exercise price of $0.0001, and 7,477 warrants at a weighted average exercise price of $42.80. There were 8,112,774 common shares issuable upon the exercise of outstanding stock options at a weighted-average exercise price of $4.97 per common share.