Good morning. My name is Chris, and I'll be your conference operator today. At this time, I'd like to welcome everyone to the Clovis Oncology fourth quarter and year-end 2021 operating results. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a Q&A session. If you'd like to ask a question during this time, simply press star then the number one on your telephone keypad. To withdraw your question, please press star one again. Thank you. Anna Sussman, Vice President of Investor Relations. Thank you, Chris. Good morning, everyone, and welcome to the Clovis Oncology fourth quarter and full year 2021 conference call. Thank you for joining us. You've likely seen this morning's news release, and if not, it's available on our website. As a reminder, this conference call is being recorded and webcast. Remarks may be accessed live on our website during the call and will be available in our archive for the next several weeks. Today's agenda includes the following corporate update, and then Dr. Thomas Harding, our Chief Scientific Officer, will present an update on the FAP-2286 and targeted radionuclide therapy development programs. Dr. Lindsey Rolfe, our Chief Medical Officer, will discuss the anticipated upcoming clinical milestones for Rubraca and FAP-2286. Dan Muehl, our Chief Financial Officer, will cover the financial results for the quarter and year in greater detail. Patrick will then make a few closing remarks, and then we will open the call for Q&A, during which time Pat, Dan, Tom, and Lindsey will be available to answer questions. Before we begin, please note that during today's conference call we may make forward-looking statements within the meaning of the Federal Securities laws, including statements concerning our financial outlook and expected business plans. All of these statements are subject to risks and uncertainties. Our actual results could differ materially due to a number of factors, including the extent and duration of the effects of the COVID-19 pandemic and the timing and extent of recovery from it. Please refer to our recent filings with the SEC for a full review of the risks and uncertainties associated with our business. Forward-looking statements speak only as of the date on which they are made, and Clovis undertakes no obligation. Note that we'll be discussing cash burn, a non-GAAP financial measure, during today's conference call. Required disclosures related to this are in today's news release, which can be found on our website. Now I'll turn the call over to Patrick Mahaffy. Thanks, Anna. Excuse me. Good morning. Welcome, everybody. Appreciate your time today. As usual, I'll start today's call with a review of Rubraca sales for the quarter. Sales in Q4 2021 were $36 million, 5% lower than the prior quarter and 17% lower year- over- year compared to Q4 2020. As seen over the previous quarters, this year-over-year decline is primarily due to fewer diagnoses and fewer patient starts in the U.S. and Europe, primarily caused by the ongoing COVID-19 pandemic. Despite the continuing impact of COVID-19, we believe we have maintained our U.S. market share for Rubraca in the second line maintenance ovarian cancer setting. We do expect that as patient visits begin to rise, diagnoses increase, and the urgent need to more actively manage this often fatal disease grow, maintenance treatment of ovarian cancer patients will increase, including the use of Rubraca for women with advanced disease. Perhaps even more importantly, we see a significant opportunity to move into earlier lines of therapy with Rubraca in both the U.S. and Europe. We anticipate three phase III readouts this year. ATHENA-MONO as monotherapy in the first-line ovarian cancer maintenance treatment setting, now expected in Q2 based on a slower than expected pace of progression-free survival events or PFS events. ATHENA-COMBO in combination with Opdivo in the first-line ovarian cancer maintenance treatment setting in Q4. TRITON3 in the second-line prostate cancer treatment setting for selected patients in Q2. These trials potentially allow Rubraca to address larger patient populations in earlier lines of therapy for both ovarian and prostate cancer and could drive growth in Rubraca sales in both the U.S. and Europe. Lindsey will provide an update on these clinical programs. For FAP- 2286, the phase I portion of LuMIERE continues to enroll, and we are committed to maintaining our lead in the clinical development of an FAP-targeted radionuclide therapeutic candidate. We and our investigators remain extremely enthusiastic about this program and look forward to presenting data at nuclear medicine meetings during 2022 and initiating the phase II portion of the LuMIERE study later this year. Tom and Lindsey will speak in more detail to developments about the FAP-228 6 program. In fact, to that end, I'll turn the call over to Tom, Thomas Harding. Sorry, Thomas, our Chief Scientific Officer, to discuss the FAP-2286 and targeted radionuclide therapy development programs. Thomas? Thanks, Pat. Hello. It's a pleasure to speak with you again today. As we've discussed in prior calls, a key strategy for Clovis is to be a leader in targeted radionuclide therapy. FAP-2286, our lead targeted radiotherapeutic compound licensed as part of our ongoing collaboration with 3B Pharmaceuticals, is the first peptide targeted radiotherapy candidate or PTRT targeting fibroblast activation protein, also known as FAP, in clinical development. As Pat mentioned, in 2022 we will report the first phase I clinical data for the program. We plan to advance the program into phase II expansion cohorts. FAP is highly expressed on cancer-associated fibroblasts or CAFs, which represent one of the most abundant cell components in tumors and are found in the majority of solid tumor types. CAFs play a critical role in tumor initiation, progression, metastasis, and therapeutic resistance. For example, recent studies have demonstrated FAP-expressing CAFs exert a potent immunosuppressive activity that can promote tumor progression and confer resistance to immune-based therapies such as PD-1 and PD-L1 blockade. As we highlighted last quarter, we have presented non-clinical data describing a high expression level of FAP across 9/16 solid tumor types screened using immunohistochemistry. High FAP expression was observed in pancreatic ductal adenocarcinoma, cancer of unknown primary, salivary gland, mesothelioma, colon, bladder, sarcoma, squamous non-small cell lung, as well as squamous head and neck cancers. In these tumor types, high FAP expression was detected in both primary and metastatic tumor samples and was independent of tumor stage or grade. The analysis also demonstrated that in most tumor types, FAP expression was predominantly localized to cancer-associated fibroblasts surrounding the tumor cells and integrated into the tumor microenvironment. In addition, in cancer of mesenchymal origin, including sarcoma and mesothelioma, FAP expression was observed in tumor cells in addition to the CAFs population. These data support the investigation of FAP- 2286 in multiple tumor types in the planned phase II expansion cohorts of LuMIERE. Additional presentations of non-clinical data are anticipated at medical oncology and nuclear medicine meetings over the next few quarters. As interest in FAP as a target increases and the field grows larger, we are pleased to be in the first mover position with FAP- 2286 to be the first peptide targeted radionuclide therapeutic targeting FAP to enter into the clinic. Clinically, we are focused on FAP-2286 monotherapy development in our ongoing LuMIERE study. However, pre-clinically, we are evaluating a number of FAP-2286 drug combinations. Given the role of FAP-expressing CAFs in mediating resistance to immune-based therapies such as PD-1 and PD-L1 blockade, combinations with these agents will be a priority. We are evaluating in preclinical studies the efficacy and mechanism of action of FAP-2286 and a PD-L1 monoclonal antibody in syngeneic mouse tumor models. In addition to immune checkpoint inhibitors, there are a number of publications reporting preclinical data that support the combination targeted radiotherapy with PARP inhibitors to augment efficacy. This makes sense since radiotherapies work by causing DNA damage via radioactive emission. If this damage is not repaired, the cell will eventually die. One of the critical proteins for repairing radiation-induced damage is PARP, and it, in addition, augments efficacy in combination with multiple targeted radiotherapy agents. We are currently preclinically evaluating the combination of FAP-2286 with our own PARP inhibitor, rucaparib, in multiple tumor models. Lastly, radiation is known to synergize with a number of agents that are currently approved as a standard of care in specific cancer, sorry, in specific cancer indications. For example, gemcitabine, used as a first-line chemotherapy in pancreatic cancer and other carcinomas, is a well-known radiosensitizer and could have utility in combination with FAP-2286. We are currently performing a high-throughput screen of approved oncology drugs in combination with radiation to identify promising combinations for FAP-2286 development. We look forward to reporting the results of this pre-clinical work at upcoming scientific meetings. To support our commitment to this emerging field, we have created educational materials about targeted radiotherapy. The first of these materials are a microsite and an introductory video that provide more information about targeted radiotherapy, FAP-2286, and Clovis' targeted radionuclide development program. To learn more, please visit targetedradiotherapy.com. Lastly, we are collaborating with 3B Pharmaceuticals on a discovery program directed at three additional targets for targeted radionuclide therapeutic development, to which we have global rights. Now with that, I'll turn the call over to Lindsey Rolfe for a clinical update. Thanks, Tom. Good morning, everybody. I'm glad to be here with you today to highlight the key clinical milestones expected for Rubraca and FAP-2286 in 2022. For Rubraca, based on a slower-than-expected PFS event count, we are now expecting data from ATHENA-MONO in the second quarter of 2022. Data from ATHENA-COMBO, the combination arm of Rubraca plus Opdivo versus monotherapy, are expected in the fourth quarter of 2022. As a reminder, ATHENA is a phase III 1,000-patient study in first-line newly diagnosed advanced ovarian cancer maintenance. With ATHENA, we believe we are uniquely positioned to evaluate Rubraca in terms of two independent outcomes, monotherapy versus placebo in the first-line maintenance setting, as well as any potential advantage of the combination of Rubraca and Opdivo over Rubraca alone in the same first-line maintenance setting. We believe this study offers an opportunity to truly differentiate Rubraca in the first-line maintenance setting. Once top-line monotherapy results are available, and should the data be supportive, we plan to file an sNDA and variation to the European MAA shortly thereafter. Continuing with near-term milestones for Rubraca, top-line data from the TRITON3 trial are expected in the second quarter of 2022. TRITON3 is a phase III study evaluating Rubraca versus physician's choice of chemotherapy or second-line androgen deprivation therapy in patients with mCRPC with BRCA or ATM mutations. This trial is expected to serve as a confirmatory study for Rubraca's current approval in the prostate indication, as well as a potential second-line label expansion, and we plan to file an sNDA shortly after results are available. These three anticipated data readouts, ATHENA-MONO, ATHENA-COMBO, and TRITON3, provide the potential to reach larger patient populations in earlier lines of therapy for both ovarian and prostate cancers. Beyond the opportunity for Rubraca in first-line ovarian cancer, the ATHENA-COMBO study represents the potential to introduce an anti-PD-1 containing regimen for the first time to a broad population of ovarian cancer patients. As a reminder, the timing for each data readout is contingent upon the occurrence of the protocol-specified progression-free survival events. I'd like to discuss our FAP-2286 program next. Tom provided an overview of the non-clinical work, and now I'll review the clinical work underway. In our ongoing phase I/II LuMIERE study, FAP-2286 is used as both an imaging agent and a therapeutic agent, a concept often described as a theranostic. For the imaging agent, FAP-2286 is attached to the isotope gallium-68 to allow positron emission tomography or PET imaging and selection of patients for inclusion in the study. For the therapeutic agent, FAP-2286 is attached to the isotope lutetium-177, an emitter of beta particle ionizing radiation that causes DNA damage and cell death. The phase I portion of the LuMIERE study continues to enroll patients, and the second dose cohort is currently enrolling patients. As a reminder, for this first in-man study, this is a dose escalation study, with each of the five dose cohorts being enrolled sequentially, with a six-week safety follow-up period after the last patient in each cohort has enrolled to ensure it's safe to move to the next dose cohort. While this six-week period is longer than in phase I trials of other oncology agents, it is standard for targeted radiotherapies. Following the phase I evaluation of the safety of FAP-2286 and determination of the recommended phase II dose, expansion cohorts are planned in multiple tumor types and are expected to begin in 2022. In addition to our own program, a separate investigator-sponsored imaging study with FAP-2286 is underway at UCSF and being led by Dr. Thomas Hope, who is also the principal investigator of the LuMIERE study. The imaging-only study is evaluating FAP expression in multiple tumor types and is currently enrolling patients. Results from this study, along with the preclinical data we are generating, are expected to help inform selection of tumor types for our phase II expansion cohorts. We look forward to Dr. Hope's presentation of his initial imaging data from this study at the upcoming virtual SNMMI Mid-Winter Meeting later this week. In addition to initiating LuMIERE phase II expansion cohorts during 2022, we anticipate several key milestones for the program, including the first presentations of phase I data for LuMIERE at nuclear medicine-focused meetings, the launch of our combination study program to explore FAP-2286 in combination with other oncology compounds. Given the role of FAP-expressing CAFs in mediating immunosuppression, exploring the combination with PD-1 or PD-L1 blockade is a priority. As noted by Tom, we are exploring multiple combination studies in preclinical animal models to inform our choice of combinations for clinical development. Finally, a potential IND filing for FAP-2286 linked to an alpha emitting isotope in 2023. I'd like to recognize again the dedicated efforts of the teams involved in our clinical trials, both employees and investigators and the patient participants, as our clinical programs advance. With that, I'll turn the call over to Dan to discuss fourth quarter financial results. Thanks, Lindsey, and hello, everyone. We reported net product revenues for Rubraca of $36 million for Q4 2021, which included U.S. product revenues of $27.6 million and ex-U.S. product revenues of $8.4 million, respectively. This represents a sequential 5% decrease from Q3 2021 and a 17% decrease year-over-year compared to Q4 2020 net product revenues of $43.3 million, which included U.S. product revenues of $36.4 million and ex-U.S. net product revenues of $6.9 million. We reported net product revenue for Rubraca of $148.8 million for the full year ended December 31, 2021, which included $115.7 million in U.S. and $33.1 million in ex-U.S. product revenues, respectively. This represents a 10% decrease compared to 2020 net product revenues of $164.5 million, which included $146.3 million in the U.S. and ex-U.S. net product revenues of $18.2 million. Gross net adjustments totaled 30.6% globally in Q4 of 2021 compared to 27% in Q3 2021. Increasing GTN in the ex-U.S. and public health service discounts in the U.S. were the main drivers. This metric fluctuates quarter- to- quarter and is difficult to estimate on future revenues, but the high 20% to low 30% level seems likely depending on the revenue and distribution mix for the U.S. and Europe. As previously discussed, as European revenues increase in proportion to the U.S., global GTN will increase correspondingly. Research and development expenses totaled $41.8 million for Q4 2021 and $186.6 million for fiscal year 2021, down 26% and 28% respectively, compared to $56.7 million and $257.7 million for the comparable periods in 2020. Research and development expenses decreased for the quarter and the year compared to the same periods in the prior year, primarily due to lower spending on Rubraca clinical trials. Selling general and administrative expenses totaled $33.3 million for Q4 2021 and $128.4 million for fiscal year 2021, down 18% and 22% respectively, compared to $40.8 million and $163.9 million for the comparable periods in 2020. Selling general and administrative expenses decreased during the quarter and the year compared to the prior periods, the same periods in the prior year, with savings due to the COVID-19 situation globally and overall cost reduction efforts. We reported a net loss for Q4 2021 of $64.4 million or $0.50 per share, and a net loss of $264.5 million or $2.29 per share for fiscal year 2021. Net loss for Q4 2020 was $99 million or $1.02 per share, and $369.2 million or a net loss of $4.38 per share for fiscal year 2020. Turning now to a discussion on cash and debt. Clovis had $143.4 million in cash and cash equivalents as of December 31st, 2021. During Q4 2021, we raised $3 million in net proceeds, and in Q1 2022 so far have raised $27.2 million in net proceeds through our previously established at-the-market equity offering program. We have capacity to issue additional shares of common stock under this ATM program. In addition, we paid off our 2.5% convertible senior notes due in 2021 at full maturity. Our next convertible debt maturity is August 1, 2024, and has a conversion price of $7.29 per portion at a conversion price of $6.24 for the remainder. As of December 31st, 2021, we had drawn $147.2 million under the Sixth Street Partners ATHENA clinical trial financing and had up to $27.8 million available to draw under the agreement to fund expenses of the ATHENA trial. The first royalty payment to Sixth Street Partners will be in Q4 of this year after determination of Q3 2022 revenues, subject to the applicable payment caps in the agreement. Net cash used in operating activities was $41.3 million for 4Q 2021, down from $56.1 million reported in 4Q 2020. Cash burn in Q4 2021 was $31.6 million, down 23% from Q4 2020 quarter cash burn of $40.9 million. Similarly, net cash used in operating activities for the full year 2021 was $196.1 million, compared with $252.7 million for the full year 2020. Cash burn for the full year was $148.6 million, down 24% from the prior year cash burn of $195.6 million. We have and will continue to manage expenses carefully, and we currently expect R&D and SG&A expenses in 2022 to be generally consistent with 2021. We remain focused on our liquidity position and recognize that we will need to raise additional capital in the near term to fund our operating plan for the next 12 months and beyond. Now I'll turn the call back to Pat. Thanks, Dan. In summary, we've set the stage for a very important year. We're on track to announce top-line data from three phase III Rubraca data readouts, ATHENA-MONO, ATHENA-COMBO, and the TRITON3 study that offer the potential for label expansions in ovarian and prostate cancers. This includes the ATHENA-COMBO readout that should definitively inform whether adding an anti-PD-1 to Rubraca monotherapy in the first line maintenance treatment ovarian cancer setting extends Rubraca's progression-free survival. In addition, our commitment to targeted radiotherapy is significant and offers the potential to be transformational in 2022. When we present data from the phase I LuMIERE study of FAP-2286, the first peptide-targeted radionuclide therapy targeting FAP to enter clinical development. We intend to maintain our lead as we advance LuMIERE into phase II and begin our combination development program. These anticipated pipeline events and our commitment to improving our balance sheet support our efforts to execute our three core strategies, expand the Rubraca label to drive revenue growth, emerge as a leader in targeted radionuclide therapy, and achieve long-term financial stability. With that, we're happy to answer any questions you may have. As a reminder, if you'd like to ask a question, please press star then one on your telephone keypad. Our first question is from Paul Choi with Goldman Sachs. Your line is open. Good morning, everyone. This is Charlie on for Paul. Thank you so much for taking our questions. I just had a question on the FAP-2286 opportunity. You know, it's exciting that we'll be seeing this data this year. As we start to think about what the potential market opportunity is for this product, we're just wondering, are there any nuances in terms of considering the commercial potential for the imaging modality versus the therapeutic modality? Is there anything we should be considering there in terms of, you know, differences in how that might be priced or the potential patient populations that would be up for either the imaging or the therapeutic modality? Thank you very much. You know, I'll take a shot at that, Tom or Lindsey may wanna add in. It's a really interesting and timely question for us. We have, up to now, primarily thought of the imaging opportunity with FAP-2286 to be limited to its potential as a necessity as a companion diagnostic. That is, as we seek to develop FAP-2286 as a therapeutic. We would simultaneously be developing for a given indication, the same peptide labeled with gallium-68 as an imaging modality for patient selection. We have been evaluating at the guidance and request of the clinical community with whom we interact, the nuclear medicine community. Whether or not FAP-2286 could be seen on its own as an imaging modality, particularly in tumor types where standard imaging, for instance, FDG PET, are not as effective. As we have evaluated this, and we've looked at the reimbursement for a standalone imaging agent, it clearly has emerged as a potential opportunity. Haven't made a firm commitment yet to entering into this field, but we're getting there. The workup we've done suggests it's a pretty interesting opportunity financially. The cost of development is markedly lower than the cost of development for a therapeutic. It is an earlier and quicker path to market for us as an opportunity to generate revenue for FAP-2286 prior to when we would expect to see an accelerated approval for any given therapeutic opportunity. Interested. More to come on this. We'll probably be able to provide an update on our next quarterly call. Tom or Lindsey, anything you'd add to that? The only thing I'd mention is to completely support what you're saying, there is some preliminary data that will be presented at the SNMMI Mid-Winter Meeting later this week from Thomas Hope. Take a look at that data. Thank you very much. That's very helpful. Our next question is from Cory Kasimov with J.P. Morgan. Your line is open. Thank you. This is Gavin on for Cory. Just I had a question on ATHENA and then a follow-up to the previous question. I guess starting there, just curious how the process for the gallium-68 in patient selection, you know, how efficient is that process and how long does it take? And then just you mentioned some tumor types where the standard is unable to meet the need. You know, what tumor types are those? Lindsey or Tom, do you wanna talk about kind of the logistical side? We have not yet determined exactly which tumors we would initially approach. We have a list. I probably don't wanna share that yet, but again, I will update on specific programs in the upcoming quarterly calls. On the logistics, Tom or Lindsey? So- Yeah, I'll make. I'll talk. Lindsey. Go ahead, Lindsey. Go ahead, Lindsey. Sorry. Regarding the gallium scans, the gallium scanning, because gallium has a very short half-life, the sites manufacture the imaging product on-site on the day that it's used for the imaging. Our phase I sites are all highly experienced in this kind of process, and so it's bread and butter for them. Again, a new scanning agent set up. Does that answer your question? Great. Yeah. Thank you. Just quickly on the ATHENA-COMBO study. In your conversations with the community, is it possible to quantify how much you need to extend PFS for utilization in that setting? Um- That's. I'll try that. Go ahead. Lindsey, you go ahead and then I'll answer. That's obviously a difficult question to answer ahead of time. We always expect the results to be clinically significant as well as statistically significant in order to drive uptake. You know, given that there are multiple options available now in frontline maintenance, I would expect the combination of Rubraca and Opdivo to be useful, if the advantage over Rubraca alone is substantial either in the whole population or in a subgroup. I might add to that. The anticipation is growing now for that result. There's a great amount of interest in it, and I think it speaks to the fact that, as is true for every tumor type now, hardly any patient fails to ask the question, "Can I get immunotherapy?" It's on commercials, it's in the news. People are aware of it, and as you're probably aware, there are no immunotherapies approved today in ovarian except in a very, very small subset. I agree with Lindsey. Obviously, we have to show a benefit. It has to be statistically significant. I think the demand from the patient and from the prescribing community will be high, in particular, Lindsey said in subgroup populations, and that's true. I'd also add, as is true for a lot of bio, if the difference at the median is perhaps not substantial, but obviously needs to be statistically significant, but the tail for the combo looks to be providing significant benefit in a hard-to-identify subset, I think the demand for the combination would be quite high. Okay, great. That's very helpful. Thank you very much. You bet. We have no further questions at this time. I'll turn the call back over to Ms. Sussman for any closing remarks. Thank you, Chris. Thanks everyone for your interest in Clovis Oncology today. If you have any follow-up questions, please call me at 303-625-5022 or Breanna Burkart at 303-625-5023. This call can be accessed via a replay of our webcast at clovisoncology.com beginning in about an hour and will be available for 30 days. Again, we appreciate your interest and time. Thank you and have a good day. Ladies and gentlemen, this concludes today's conference call. Thank you for participating, and you may now disconnect.
Loading workspace