NOVOCURE Earningcall Transcript Of Q2 of 2024


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Ingrid Goldberg -- Vice President, Finance and Investor Relations

Good  morning,  and  thank  you  for  joining  us  to  review  NovoCure's  second-quarter  2024

performance.  I  am  joined  this  morning  by  our  executive  chairman,  Bill  Doyle;  our  CEO,  Asaf

Danziger; and our CFO, Ashley Cordova. Other members of our executive leadership team will be

available for Q&A. For your reference, slides accompanying this earnings release can be found on

our website, www.NovoCure.com, and on our Investor Relations page under quarterly reports.

Before  we  start,  I  would  like  to  remind  you  that  our  discussions  during  this  conference  call  will

include forward-looking statements, and actual results could differ materially from those projected in

these statements. These statements involve a number of risks and uncertainties, some of which are

beyond  our  control  and  are  described  from  time  to  time  in  our  SEC  filings.  We  do  not  intend  to

update  publicly  any  forward-looking  statement,  except  as  required  by  law.  Where  appropriate,  we

will refer to non-GAAP financial measures to evaluate our business, specifically adjusted EBITDA, a

measure  of  earnings  before 

interest, 

taxes,  depreciation,  amortization,  and  share-based

compensation.

We believe adjusted EBITDA is an important metric as it removes the impact of earnings attributable

to our capital structure, tax rate, and material non-cash items, and thus reflects the financial value

generated by our business. Reconciliations of non-GAAP to GAAP financial measures are included

in our press release, earnings slides, and in our Form 8-K filed with the SEC today. These materials

can  also  be  accessed  from  the  Investor  Relations  page  of  our  website.  Following  our  prepared

remarks today, we will open the line for your questions.

I will now turn the call over to our executive chairman, Bill Doyle. 

William F. Doyle -- Executive Chairman

Thank  you,  Ingrid,  and  good  morning,  everyone.  Our  mission  at  NovoCure  is  to  extend  survival  in

some of the most aggressive forms of cancer. Through the development and commercialization of

our innovative therapy tumor-treating fields, we have built a strong foundation treating glioblastoma,

and  with  an  anticipated  approval  to  treat  second-line  non-small  cell  lung  cancer,  we  are  on  the

threshold of helping many more patients in need. As we approach this year's milestone, the urgency

of our mission is even greater for the entire NovoCure team.

Entering 2024, we identified three key objectives which would best position us for success this year

and  beyond.  One,  to  grow  our  commercial  business  in  glioblastoma.  Two,  to  launch  TTFields

therapy in non-small cell lung cancer. And three, to deliver on the promise of our clinical and product

development pipelines.

These  objectives  are  ingrained  in  our  business  units  and  have  been  rallying  points  for  our  global

teams. I am pleased to share that we are making significant progress on all three, and with the focus

and  dedication  of  the  entire  NovoCure  team,  we  believe  we  can  deliver  on  all  three  in  2024.  This

morning, we will review our progress on each objective, review our financial performance, and then

open the line for questions. We ended the second quarter with 3,963 active patients on therapy, our

highest number of active patients since commencing commercial operations.

Our  French  GBM  launch,  now  in  its  fifth  quarter,  continues  to  be  a  tailwind.  France  serves  as  a

blueprint for a successful launch, employing our new synchronized commercial structure, a blueprint

we  will  leverage  in  future  expansion  across  the  big  five  EU  markets.  Real  world  evidence  of  the

benefits of TTFields therapy is a key resource for engaging with prescribers. In June at ASCO, Dr.

Oliver Bahr of the General Hospital Aschaffenburg-Alzenau presented top-line data from the TIGER

trial. TIGER examined TTFields therapy in the routine clinical care of newly diagnosed GBM patients

in  Germany.  TIGER  is  the  largest  prospective  non-interventional  TTFields  trial  completed  to  date.

Dr.

Bahr reported a median overall survival of 19.6 months and median progression-free survival of 10.2

months,  corroborating  the  leading  survival  outcomes  observed  in  our  phase  3  EF-14  trial.  Last

month,  in  the  Journal  of  Neuro-Oncology,  Dr.  Mrugala  of  the  Mayo  Clinic,  published  updated

findings from a post-marketing safety analysis of over 25,000 TTFields patients. Dr.

Mrugala's analysis confirmed that TTFields therapy was well tolerated, and that no signs of additive

systemic  toxicity  were  detected  in  the  patient  population,  corroborating  the  safety  findings  of  the

EF-14  trial.  In  April,  in  the  journal  BMC  Cancer,  Dr.  Kumthekar  of  Northwestern,  published  a

qualitative review of key factors driving patient adoption of Optune Gio for the treatment of GBM. Dr.

Kumthekar's team found that the two most influential drivers for adoption are knowledge of Optune's

proven  survival  benefit  and  the  treating  physician's  opinion.  Real  world  evidence  from  trials  like

TIGER &Dr. Mrugala and Kumthekar's analyses, are important additions to the ever-growing body of

studies  supporting  Optune  Gio  for  the  treatment  of  GBM,  and  they  underline  our  commitment  to

generate and share data with physicians to support and broaden the adoption of TTFields. We are

also focused on product development to improve the patient experience.

We have rolled out our next-generation arrays in our key European markers, and patient feedback

continues to be positive. We submitted a PMA supplement to the FDA in December, and expect a

decision from the FDA later this year. After approval, we will commence U.S. rollout.

Our team is working on improvements to the digital experience for prescribers and patients, with the

goal of providing dashboards to streamline patient starts and optimize usage and persistence. We

believe  our  fully  aligned  commercial  approach,  supported  by  real  world  evidence  and  digital

innovation,  will  help  to  drive  strong  commercial  performance  in  the  second  half  of  the  year.  Our

second  key  objective  this  year  is  the  approval  and  launch  of  Optune  Lua  for  the  treatment  of

metastatic non-small cell lung cancer. Regulatory submissions have been filed, and we are engaged

with authorities in all of our major markets.

As  a  reminder,  prior  to  our  May  earnings  report,  we  had  recently  completed  our  100-day  meeting

with the FDA, with no indication that the PMA will be referred to a panel. To date, a panel has not

been requested, and our expectations remain unchanged. We eagerly await the FDA's decision later

this year. In Europe, we are waiting for CE mark approval.

The  new  MDR  process  in  Europe  has  lengthened  timelines,  and  we  continue  to  engage  with  new

reviewers at TÜV Rheinland, our EU-notified body. While the review process has taken longer than

originally  projected,  our  expected  outcome  has  not  changed,  and  we  anticipate  a  final  decision  in

the second half of 2024. Internally, our German and U.S. lung teams are hired and are preparing to

launch immediately following regulatory approval.

We plan to treat patients in the U.S. and Germany as soon as possible following approval using a

named  patient  reimbursement  process,  with  additional  country  launches  expected  next  year.

Non-small  cell  lung  cancer  represents  the  next  major  step  forward  in  the  NovoCure  story,  and  we

are eager to pursue this opportunity. Asaf will now review our clinical progress in the quarter.

Asaf Danziger -- Chief Executive Officer and Director

As Bill mentioned, our third key objective this year is to deliver on the promise of our pipeline. This

quarter,  we  made  significant  progress  toward  achieving  that  goal  across  our  clinical  programs  in

GPM, non-small cell lung cancer, and pancreatic cancer. We have reached a key milestone in our

non-small cell lung cancer program. Last month, Dr.

Minesh Mehta of Baptist Health South Florida, presented data from the phase 3 METIS trial at the

ASCO annual meeting in Chicago. METIS evaluated the use of TTfields therapy with best supportive

care for the treatment of brain metastases from non-small cell lung cancer. METIS met its primary

endpoint,  demonstrating  a  median  time  to  intracranial  progression  of  21.9  months  in  the  TTFields

arm compared to 11.3 months in the control arm. A positive trend in the majority of assessed quality

of life scales was also measured, and there was no evidence of worsening cognitive function in the

TTFields arm.

Consistent  with  prior  clinical  trials,  TTFields  therapy  was  well  tolerated,  with  no  additive  systemic

toxicity.  Final  analysis  of  the  METIS  trial  data  is  ongoing.  We  intend  to  publish  the  data  in  a

peer-reviewed  journal  later  this  year.  We  have  expanded  our  non-small  cell  lung  cancer  clinical

program to include another registrational phase 3 trial, LUNAR-2.

LUNAR-2  will  explore  TTFields  views  with  pembrolizumab,  and  platinum-based  chemotherapy  in

first-line  metastatic  disease.  This  trial  is  open  and  enrolling  at  initial  sites,  and  we  are  focused  on

expanding  the  clinical  footprint.  We  are  also  in  the  process  of  opening  a  phase  2  pilot  trial,

LUNAR-4.  This  trial  will  evaluate  immunotherapy  retreatment  in  metastatic  non-small  cell  lung

cancer.

Turning to KEYNOTE-B36, we are evaluating appropriate next steps for this trial, given its pace of

enrollment  and  our  focus  on  LUNAR-2.  Our  GBM  program  includes  two  additional  registrational

phase  3  trials,  TRIDENT  and  KEYNOTE  D58.  TRIDENT  is  exploring  the  use  of  Optune  Gio,

concurrent  with  chemoradiation.  If  TRIDENT  is  successful,  we  will  work  to  expand  our  label  and

enable physicians to prescribe TTFields therapy several months earlier with chemoradiation rather

than after chemoradiation, as is indicated today.

TRIDENT  is  fully  enrolled  and  will  read  out  in  2026  once  follow-up  is  complete.  We  are  also

preparing  to  open  KEYNOTE  D58.  KEYNOTE  D58  will  explore  the  addition  of  pembrolizumab  to

TTFields and temozolomide in GBM, and builds upon the promising results of the -- to the top phase

2 trial conducted by Dr. David Tran.

Finally, we are nearing an important readout in our pancreatic cancer program. In the fourth quarter,

we  expect  to  announce  the  top-line  data  from  the  phase  3  PANOVA-3  trial,  which  is  studying

TTFields together with gemcitabine and nab-paclitaxel for the treatment of first-line locally advanced

pancreatic cancer. We are also currently enrolling patients in our phase 2 PANOVA-4 trial. This trial

is  exploring  the  use  of  atezolizumab  with  TTFields,  gemcitabine,  and  nab-paclitaxel  in  metastatic

pancreatic cancer.

Pancreatic cancer is a devastating diagnosis with five-year survival rates of 10%. We are eager to

learn more about the potential benefits of using TTFields in the treatment of this aggressive disease.

So far this year, we have reached one successful phase 3 readout in METIS, and are hopeful for a

second in PANOVA-3. We are awaiting potential regulatory approvals in lung cancer, and our solid

commercial GBM business continues to fuel additional R&D initiatives.

We are launching several new clinical trials this year that have the potential to expand TTFields use

dramatically.  We  are  pleased  with  our  progress  this  year,  and  are  eager  to  continue  pursuing  our

goal  to  deliver  the  promise  of  the  clinical  pipeline.  I  look  forward  to  providing  further  updates  later

this year. Ashley will now review our financial performance for the second quarter.

Ashley Cordova -- Chief Financial Officer

Thank you, Asaf. The second quarter was a period of consistent execution as we drive toward our

three key objectives for 2024. our GBM business turned in the best quarter to date. We are laying

the  groundwork  to  launch  in  non-small  cell  lung  cancer,  and  we  continue  to  purposely  invest  in

clinical research and product innovation.

Walking down the P&L, we generated $150 million in Q2 net revenue, an increase of 19% year over

year,  and  ended  the  quarter  with  3,963  active  patients  on  therapy,  an  increase  of  11%  year  over

year.  The  French  market  continues  to  be  a  tailwind  to  growth,  and  contributed  $14  million  in  net

revenue this quarter, with 369 active patients. We also continue to see a benefit in average selling

price  from  improved  approval  rates  in  the  United  States.  I  want  to  call  everyone's  attention  to  two

important points on the revenue model.

Beyond the benefit in period, improved approval rates in the U.S. generated a $5 million benefit and

Q2  net  revenues  from  prior  period  claims.  In  addition,  we  received  $3  million  in  Q2  net  revenues

from a private payer in the United Kingdom where payments are not yet routine. We do not expect

these two benefits, totaling $8 million, to recur, and would remove them from baseline expectations

when projecting future revenues.

Gross margin for the second quarter was 77%. SG&A expenses totaled $94 million in the quarter, a

decrease of 5% year over year. This decrease was primarily driven by lower personnel expenses in

support functions, which more than offset our continued investment in sales force expansion ahead

of  a  non-small  cell  lung  cancer  launch.  Research,  development,  and  clinical  trial  expenses  totaled

$55 million in the quarter, in line with the same period in 2023.

Our net loss for the second quarter was $33 million or $0.31 per share. We ended the quarter with

cash and short-term investments of $951 million. This quarter, we saw positive adjusted EBITDA of

$1 million, an increase of $28 million from the same period in 2023. While this was in part due to the

one-time  revenue  contributors,  we  also  saw  material  benefits  from  reduced  operating  expenses

resulting from the strategic restructuring we undertook at the end of 2023.

As  we  actively  invest  for  growth,  profitability  remains  a  critical  goal  for  us  at  NovoCure  and

something we are actively driving toward. I would like to close this morning by highlighting one of our

Optune  Gio  users,  Marino  DiRienzo.  Marino  began  using  Optune  Gio  in  January  2022  following

debulking surgery. A father of twin adult sons, and a grandfather of three Marino, prides himself on

living  an  active  life  and  was  eager  to  get  back  on  his  feet  as  soon  as  possible  after  his  GBM

diagnosis.

Marino  was  able  to  integrate  tumor  training  fields  therapy  into  his  daily  activities  quickly  and  was

soon back on the baseball field with his sons and playing golf with friends. Marino is the embodiment

of living each day to the fullest and a great reminder of what's at stake in extending survival for our

patients. It is so fulfilling for our colleagues to be able to help Marino and his family, and I'd like to

personally thank Marino for allowing us to be a part of his journey. With that, we will open the call for

your questions.

Operator

Questions & Answers:



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