On March 16, 2023 UroGen Pharma Ltd. (Nasdaq: URGN), a biotech company dedicated to developing and commercializing innovative solutions that treat urothelial and specialty cancers, reported financial results for the fourth quarter and full year ended December 31, 2022, and overview of recent developments (Press release, UroGen Pharma, MAR 16, 2023, View Source [SID1234628914]).

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"I’m proud of our progress in 2022 and encouraged by our pipeline advancement and expanded access to JELMYTO as we work to fundamentally change the treatment paradigm of urologic cancers," said Liz Barrett, President and Chief Executive Officer of UroGen. "Last year was a marked year for our exciting investigational product, UGN-102, with the potential to transform the treatment of bladder cancer as the only non-surgical therapeutic for LG-IR-NMIBC. As we have shared many times, we believe UGN-102 could be a transformational product, and one that represents a significant opportunity to address the estimated 80,000 patients suffering from LG-IR-NMIBC in the U.S. each year. In 2022, we initiated and completed enrollment of ENVISION, our Phase 3 pivotal study of UGN-102, and more recently shared long-term follow up data from the previously completed OPTIMA II study, which showed a 24.4-month median time to recurrence in evaluable patients who completed the study. Topline data from the ATLAS and ENVISION trials are expected mid-year 2023, and assuming positive results, we remain on track to submit a New Drug Application (NDA) in 2024. Supported by a growing body of real-world outcomes data, we delivered our strongest ever JELMYTO net sales in Q4 helping propel ~34% full-year growth for fiscal 2022. Looking ahead, we remain confident in the long-term success of JELMYTO in low-grade upper tract urothelial cancer (LG-UTUC) and the significant market opportunity of UGN-102, if approved, to drive growth in the years ahead."

Business Highlights:

UGN-102 (mitomycin) for intravesical solution:

Announced full enrollment in Phase 3 ENVISION pivotal study of UGN-102 for the treatment of LG-IR-NMIBC, which targeted enrollment of ~220 patients across 90 sites. Assuming positive findings, UroGen anticipates submitting an NDA for UGN-102 in 2024. Topline results from the primary endpoint evaluating the complete response rate at 3-months after first instillation are expected mid-year 2023.
Topline data from the ATLAS trial, the predecessor to ENVISION, is expected mid-year 2023 and will evaluate complete response, duration of response and safety from ~280 patients that completed the trial.
Shared new long-term follow up data from the Phase 2b OPTIMA II study at the Annual Society of Urologic Oncology (SUO) Meeting demonstrating a median DOR of 24.4 months (10.1 to 30.7 months) with UGN-102 in 15 of 25 evaluable patients.
Announced preliminary results of a study to assess the feasibility of home instillation of UGN-102. In this study, UGN-102 was suitable to administer at home by a visiting nurse under the supervision of a treating physician and resulted in 75% (n=8) of patients achieving a complete response, defined as no detectable disease 3 months after starting treatment.
JELMYTO (mitomycin) for pyelocalyceal solution in low-grade Upper Tract Urothelial Cancer (LG-UTUC):

JELMYTO generated net product revenues of $18.1 million and $64.4 million for the fourth quarter and full year 2022, respectfully, compared to $16.2 million and $48.0 million for the same periods in 2021.
Activated sites on March 1, 2023 were 983, compared to 930 on November 1, 2022, while repeat accounts on March 1, 2023 were 214, compared to 177 on November 1, 2022.
Highlighted results from the first and largest post-commercial utilization review of JELMYTO published in Urologic Oncology: Seminars and Original Investigations. The study evaluated 132 patients from 15 high-volume academic and community centers and describes several uses of JELMYTO that differ from the pivotal OLYMPUS trial, including for the treatment of large tumors (>3cm in 15% of cases), high grade tumors (9% of cases), ureteral tumors (35% of cases), and as a valuable multimodal adjunct following complete endoscopic ablation. JELMYTO is not approved for the treatment of high-grade upper tract urothelial cancer.
Shared new long-term follow up data from the OLYMPUS registration trial at the Annual Society of Urologic Oncology (SUO) Meeting demonstrating a median durability of response (DOR) of 28.9 months (14.6 to 47.6 months) with JELMYTO in 16 of 23 evaluable patients.
Retrospective, multi-center study of 32 patients evaluating the safety of antegrade administration of JELMYTO was published in The British Journal of Urology International showing a favorable safety and tolerability profile for JELMYTO when administered via nephrostomy tube. At a median follow-up of 15 months following initiation of induction therapy, ureteral stenosis occurred in only three (9%) patients, with none having recurrent stenosis at a median 16-month follow-up.
Fourth Quarter and Full Year 2022 Financial Results:

JELMYTO Revenue: UroGen reported JELMYTO net product revenues for the fourth quarter 2022 of $18.1 million, compared to $16.2 million for the same period in 2021. Net product revenues were $64.4 million for the full year 2022, compared to $48.0 million for the full year 2021.

R&D Expense: Research and development expenses for the fourth quarter 2022 were $14.5 million, including non-cash share-based compensation expense of $0.6 million as compared to $13.1 million, including non-cash share-based compensation expense of $0.9 million, for the same period in 2021. Research and development expenses for the full year 2022 were $52.9 million, including non-cash share-based compensation expense of $2.6 million. This compares to $47.6 million, including non-cash share-based compensation expense of $4.0 million, for the full year 2021.

SG&A Expense: Selling, general and administrative expenses for the fourth quarter 2022 were $21.6 million, including non-cash share-based compensation expense of $1.8 million. This compares to $21.4 million, including non-cash share-based compensation expense of $4.5 million, for the same period in 2021. Selling, general and administrative expenses for the full year 2022 were $82.8 million, including non-cash share-based compensation expense of $8.0 million. This compares to $87.5 million, including non-cash share-based compensation expense of $19.1 million for the full year 2021.

Financing on Prepaid Forward Obligation: UroGen reported financing expense related to the prepaid forward obligation to RTW Investments of $5.1 million for the fourth quarter 2022. Financing expense related to the prepaid forward obligation to RTW Investments totaled $21.6 million for the full year 2022. The rate for 2023 will be 13% based on $64.4 million of global net product sales of JELMYTO in 2022.

Net Loss: UroGen reported a net loss of $28.2 million, or basic and diluted net loss per ordinary share of $1.22, for the fourth quarter 2022 as compared to $28.5 million, or basic and diluted net loss per ordinary share of $1.27, for the same period in 2021. UroGen reported a net loss of $109.2 million, or basic and diluted net loss per ordinary share of $4.79, for the full year 2022 versus $110.8 million, or basic and diluted net loss per ordinary share of $4.96, for the full year 2021. Financial results subsequently filed on Form 10-K for the year ended December 31, 2022 may include immaterial changes related to income tax expense, which is still under review due to ongoing assessment of taxes as it relates to the $100 million term loan from funds managed by Pharmakon Advisors.

Cash & Cash Equivalents: As of December 31, 2022, cash, cash equivalents and marketable securities totaled approximately $100 million.

2023 Revenue, Operating Expense and Financing Expense Guidance: UroGen anticipates full year 2023 net product revenues from JELMYTO to be in the range of $76 to $86 million. UroGen anticipates full year 2023 operating expenses in the range of $135 to $145 million, including non-cash share-based compensation expense of $6.0 to $11.0 million, subject to market conditions. UroGen anticipates full year 2023 financing expense related to the prepaid obligation to RTW Investments in the range of $21.0 to $26.0 million, of which approximately $9.8 to $11.1 million will be in cash. Interest only payments on the $100 million term loan facility with funds managed by Pharmakon Advisors will be made quarterly and continue to accrue at a rate of LIBOR (or a replacement benchmark following the cessation of LIBOR in the first half of this year) + 8.25%.