Form 8-K

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported) July 9, 2013

 

 

A.P. Pharma, Inc.

(Exact name of registrant as specified in its charter)

 

 

 

Delaware   001-33221   94-2875566

(State or other jurisdiction

of incorporation)

 

(Commission

File Number)

 

(I.R.S. Employer

Identification No.)

123 Saginaw Drive

Redwood City CA

  94063
(Address of principal executive offices)   (Zip Code)

Registrant’s telephone number, including area code (650) 366-2626

N/A

(Former name or former address, if changed since last report)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

 

 


ITEM 8.01 Other Events.

A.P. Pharma, Inc. (the “Company”) will deliver a corporate presentation at the 8th Annual JMP Securities Healthcare Conference on July 9, 2013. The slides from the presentation are attached hereto as Exhibit 99.1. The attached materials have also been posted on the Company’s website at www.appharma.com. The Company does not undertake to update this presentation.

 

ITEM 9.01 Financial Statements and Exhibits.

(d) Exhibits.

 

Exhibit

No.

  

Description

99.1    Corporate Presentation, dated July 2013


SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

    A.P. Pharma, Inc.
Date: July 9, 2013    

/s/ Stephen R. Davis

    Stephen R. Davis
    Executive Vice President and Chief Operating Officer
EX-99.1
Company Overview
OTCBB: APPA
July 2013
Exhibit 99.1


Legal Disclaimer
This presentation contains "forward-looking statements" as defined by the Private
Securities Litigation Reform Act of 1995.  These forward-looking statements
involve risks and uncertainties, including uncertainties associated with timely
development, approval, launch and acceptance of new products, satisfactory
completion of clinical studies, establishment of new corporate alliances, progress
in research and development programs and other risks and uncertainties identified
in the Company's filings with the Securities and Exchange Commission.  Actual
results may differ materially from the results expected in our forward looking
statements.  We caution investors that forward-looking statements reflect our
analysis only on their stated date.  We do not intend to update them except as
required by law.
2
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Company:
A.P. Pharma, Inc.
Ticker:
OTCBB: APPA.OB
Stock Price:
$0.39 (7/5/2013)
Market Capitalization:
$119.2
million
1
Cash:
$46
million
2
Debt:
$4.8
million
2
Stock Summary
1
Based on 305.6 million common shares outstanding.  Does not include outstanding warrants for 81.1
million shares with weighted average exercise price of $0.22/share, nor shares issuable upon
conversion of notes convertible for up to 120.3 million shares based on a rate of 25,000 shares for
every $1,000 of principal, nor currently exercisable employee stock options for up to 27.1 million
shares with weighted average exercise price of $0.38/share.
2
As of March 31, 2013
3
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Barry D. Quart, Pharm.D.
Chief Executive Officer
Ardea Biosciences
Agouron Pharmaceuticals
Pfizer
Robert Rosen
President &
Chief Commercial Officer
Bayer Healthcare
Sanofi-Synthèlabo
Imclone
Steve Davis
Chief Operating Officer
Ardea Biosciences
Neurogen
Mark Gelder, M.D.
Senior Vice President &
Chief Medical Officer
GE Healthcare
Bayer Healthcare
Wyeth
Senior Management
4
July
2013
©
2013. A.P. Pharma, Inc. All rights reserved.


A.P. Pharma Highlights
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
5
Lead product candidate, APF530, is long-acting, injectable
product for chemotherapy-induced nausea and vomiting (CINV)
Incorporates
widely
used
5-HT3
antagonist
-
granisetron
(Kytril
®
)
5-day delivery profile
Reduces both acute-
and delayed-onset CINV with single injection
Patent coverage into 2024
APF530
shown
to
be
non-inferior
to
market
leader
Aloxi
®
1,341-patient, randomized, controlled, Phase 3 study
APF530 targets a large market opportunity, with approximately
7 million doses of chemotherapy annually in US alone*
Recent competitive setbacks could enhance commercial uptake
Could be second, long-acting, injectable product on market
A.P. Pharma has the potential to leverage its Biochronomer™
drug delivery technology, its development capacity and
commercial expertise into other opportunities
*TDR August 2006 internal report


Clinical Summary
6
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


A Pivotal, Phase 3, Randomized Clinical Trial of the Efficacy and
Safety
of
APF530
Compared
to
Palonosetron
(Aloxi
®
)
for
CINV
1428 chemotherapy
patients stratified by
HEC or MEC
First
Randomization
Primary
Endpoint*
Cycle 1
Cycles 2-4
Second
Randomization
All patients received
dexamethasone as appropriate to
their chemotherapy stratum.
©
2013. A.P. Pharma, Inc. All rights reserved.
7
1,341 patients in primary efficacy
population
Placebo SC +
Palonosetron
0.25 mg IV
APF530 5 mg
SC + Placebo IV
APF530 10 mg
SC + Placebo IV
APF530
5 mg SC
APF530
10 mg SC
APF530
5 mg SC
APF530
10 mg SC
* Primary end point compared complete response between groups in both the acute (day 1) and delayed 
(days 2-5) phase; Complete response defined as no emesis and no rescue medications.
July
2013


APF530 Pharmacokinetics
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
8
Granisetron is released rapidly following injection of APF530 and continues to be released
over at least 5-days, with therapeutic concentrations observed out to 6 days
*Data from patent application 20120258164 for transdermal granisetron
Time after Dosing (h)
Minimum
therapeutic 
concentration of
granisetron*


Primary Efficacy Results: Complete Response
Patients Receiving Moderately
Emetogenic Chemotherapy
Acute
Delayed
APF530 10mg
Acute
Delayed
Difference in Complete Response
APF530-Aloxi (97.5% CI)
9
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Primary Efficacy Results: Complete Response
Difference in Complete Response
APF530-Aloxi (98.33% CI)
Acute
Delayed
APF530 10mg
Patients Receiving Highly
Emetogenic Chemotherapy
Acute
Delayed
10
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Safety Summary
1
Safety results with the 5 mg dose of APF530 studied in separate arm of the phase 3 study are not included
2
>90% of injection site reactions were reported as mild; one patient discontinued due to injection site reaction
Reported in Cycle 1
11
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
APF530 10 mg
Aloxi 0.25 mg
N
%
N
%
Drug Related Serious Adverse Events
0
0
0
0
Discontinued Due to Adverse Event
1
0.2
0
0
Frequent Adverse Events
Gastrointestinal Disorders
Constipation
Diarrhea
Abdominal pain
72
44
13
15.4
9.4
2.8
62
39
28
13.4
8.4
6.0
Nervous System
Headache
47
10.0
45
9.7
Injection Site
Placebo (NaCl)
Bruising
Erythema (redness)
Nodule (lump)
Pain
93
51
50
33
19.9
10.9
10.7
7.1
41
14
3
5
8.9
3.0
0.6
1.1
2
1


Efficacy through Multiple Chemotherapy Cycles
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
12
1
Overall Complete Response defined as no emesis and no rescue medications during 0 to 120 hours
following chemotherapy
Moderately Emetogenic
Chemotherapy
Highly Emetogenic
Chemotherapy
Overall Complete Response Rates
1
for APF530 10 mg


Sustained
Efficacy
of
APF530
in
Cycles
1-4
*Sakai et al (Ann Oncol.
2008;19)
Complete Response Rates for Delayed-Onset CINV in Patients
Receiving Highly Emetogenic Chemotherapy
351
315
254
117
100%
90%
72%
33%
240
171
130
95
100%
71%
54%
40%
N =
% of Cycle 1
APF530 500 mg
Palonosetron 0.75 mg*
©
2013. A.P. Pharma, Inc. All rights reserved. CONFIDENTIAL
13
*Source: Majaro Tables, 14_2_1_91b and 14_2_1_14_1
July
2013


APF530’s Efficacy with Difficult Chemo Regimens
1
Treatment
Chemotherapeutic Regimen
APF530 10 mg
Aloxi 0.25 mg
Moderately
Emetogenic
Acute
Cyclophosphamide/Doxorubicin
70.7%
65.7%
All other regimens
84.4%
85.0%
Delayed
Cyclophosphamide/Doxorubicin
47.4%
46.3%
All other regimens
72.9%
70.0%
Highly
Emetogenic
Acute
Cisplatin regimens
81.1%
75.5%
Carboplatin/Paclitaxel
85.4%
89.8%
All other regimens
75.4%
67.6%
Delayed
Cisplatin regimens
66.0%
60.4%
Carboplatin/Paclitaxel
70.8%
71.4%
All other regimens
65.2%
57.4%
1
Data from post-hoc analysis. Not statistically significant.
Highlighted MEC regimen changed to HEC in 2011 ASCO Guidelines
14
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Efficacy Maintained With Reanalysis of HEC
Protocol Specified HEC Population
Acute
Delayed
15
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
Acute
Delayed
ASCO 2011 Guideline HEC Population


Summary of Clinical Results
Bioerodible polymer technology releases granisetron to prevent CINV
over at least 5 days
Large, randomized, Phase 3 study conducted with APF530 showing
non-inferiority to Aloxi with the 10 mg of APF530
For both acute-
and delayed-onset CINV
With both moderately and highly emetogenic chemotherapy
APF530 was well-tolerated
Incidence of adverse events comparable to Aloxi
Injection site reactions where predominately mild
Good response rates were observed in difficult chemotherapy
regimens
Efficacy was maintained with reanalysis using ASCO 2011 guidelines
and through multiple cycles of chemotherapy
TQT study showed APF530 has no effect on QT; differentiated from
Zofran (most common dose restricted) and Anzemet (CINV claim
removed)
16
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Regulatory Status
17
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


APF530 NDA Status
Submitted NDA in May 2009 under 505(b)(2) filing pathway
Received Complete Response Letter in March 2010
FDA raised major
issues in three main areas:
Dosing system
Chemistry, Manufacturing, and Controls (CMC)
Clinical/statistical
Resubmitted NDA in September 2012
Addressed issues raised in Complete Response Letter
Received Complete Response Letter March 2013 raising three
main issues:
CMC: correction of PAI issues and revision of one in-vitro release method
Requirement for Human Factors Validation Study with commercial product
Re-analysis of the existing Phase 3 study using the ASCO 2011 guidelines
for catagorization of MEC and HEC
18
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


New Management Team is Addressing the CRL
Chemistry, Manufacturing, and Controls
Sites with PAI issues are being eliminated from the supply chain, with
work transferred to well established site with no PAI issues
Secondary benefit of consolidating manufacturing and release efforts:  
substantial improvement in COGS
New in-vitro release method has been developed and being validated
Plan to produce three validation batches of finished product in advance of
re-filing to supply Human Factors Study
Human Factors Study
Will be conducted as soon as commercial material available
Re-analysis of Phase 3 using new ASCO 2011 Guidelines
Re-analysis complete
Complete dataset and programs ready to supply to FDA
Re-submission is now planned for 1Q2014
19
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Commercial Opportunity
20
©
2013. A.P. Pharma, Inc. All rights reserved.
July
2013


Continuing Unmet Need in CINV
Need for long-acting antiemetic
therapies
Delayed CINV (days 2-5) remains particularly
challenging to manage
Significant portion of patients fail to respond
to Aloxi
Need for antiemetic therapies with
sustained efficacy
CINV risk increases over multiple
chemotherapy cycles
1
Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/nausea/HealthProfessional/page6#Section_183
“Despite the use of both first-generation
and
second-generation
5-HT
3
receptor
antagonists, the control of acute CINV, and
especially delayed nausea and vomiting,
is
suboptimal,
and
there
is
considerable
opportunity for improvement
with either
the addition or substitution of new agents in
current regimens.”
NCI Statement On The Existing
Unmet
Need
in
CINV
21
©
2013. A.P. Pharma, Inc. All rights reserved.
1
July
2013


Addressing Debilitating Effects of CINV
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
22
More than 7 million cycles of
chemotherapy administered each
year*
~27% are highly emetogenic
~46% are moderately emetogenic
Most chemotherapy patients will
undergo 4-15 cycles of
chemotherapy
5-HT3 antagonists are standard-
of-
care for CINV
Recommended in ASCO, NCCN
and ONS guidelines
NK-1 antagonists are only indicated
in combination with 5-HT3
antagonists
An Injectable 5-HT3 antagonist is
co-administered with more than
90% of MEC and HEC regimens
If initial regimen is non-effective,
drugs are added or changed to
address CINV in subsequent cycles
*TDR August 2006


5-HT3 Antagonists Have Made a Substantial Impact
The use of high-dose
metoclopramide
Introduction of first-generation
5-HT3 antagonists (short-acting)
Approval of second-generation
5-HT3 antagonist (long-acting)
Approval of first
NK-1 antagonist
Adapted from Hawkins et al, Clinical Journal
of Oncology Nursing 2009, Volume 13, Number 1
FDA withdrawal of Anzemet and 32 mg dose of
ondansetron (Zofran) due to QT prolongation risk
5-HT3 receptor antagonists approved for CINV
©
2013. A.P. Pharma, Inc. All rights reserved.
23
Chemotherapy
Acute CINV
Delayed CINV
Highly
Emetogenic
granisetron (Kytril)
ondansetron (Zofran)
Aloxi
None
Moderately
Emetogenic
granisetron (Kytril)
ondansetron (Zofran)
Aloxi
Aloxi
July 2013


24
U.S. CINV Market Dynamics
Source:  WK 07/2013
July 2013
* US Oncology data added starting 1/2009.
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
Q2'06
Q4'06
Q2'07
Q4'07
Q2'08
Q4'08
Q2'09
Q4'09
Q2'10
Q4'10
Q2'11
Q4'11
Q2'12
Q4'12
ALOXI
ANZEMET
KYTRIL
KYTRIL Generic (GRANISETRON)
ZOFRAN
ZOFRAN Generic (ONDANSETRON)
EMEND
Injectable Drugs for the Prevention of CINV
Number of Package Units Sold by Quarter


Aloxi Market Performance
Zofran went
generic
Pricing
Average Selling Price = $175
Medicare Reimbursement = $186*
Wholesale Acquisition Cost ~ $380
Orange Book Patent Exclusivity
One patent expires April 2015
Three patents expire January 2024
25
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
*ASP plus 6%
Aloxi Sales


~80% of Aloxi Is Used in Clinics
Hospital
Other
Clinics
1
2.2 million units
2
0.5 million units
0
3
0.1 million units
U.S.
Aloxi
Units
by
Class
of
Trade
12
Months
Ending
June
30
2012
IMS Health and Source Healthcare Analytics (WKH) data and Eisai Co., Ltd. published sales figures
26
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
th


>90% of Aloxi Units Contracted Through GPOs
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
27
2.2 Million Clinic Units
8%
23%
48%
21%
Misc
Onmark
ION
USO
IMS Health and Source Healthcare Analytics (WKH) data and Eisai Co., Ltd. published sales figures
Clinic
Units
by
GPO
12
Months
Ending
June
30
th
2012


WKH
Data
Oct.
2012
Clinic
Analysis
Aloxi Clinical Use Is Largely Concentrated
Cumulative Number of Accounts
32
1% accts
87
4% accts
161
7% accts
252
11% accts
500
22% accts
674
29% accts
904
39% accts
1246
54% accts
2305
100% accts
362
15% accts
80% of units (1.7M) comes from 39% of accounts (904)
50% of units (1.1M) comes from 15% of accounts (362)
28
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2,200


No New Injectable 5-HT3 Drug on Horizon
29
2012
*Company reports, Leerink Swann; **Clinical Trials.gov NCT01339260 FDC = Fixed Dose Combo; PDUFA date expected 12-15 months post P3 data
2013
2014
2015
EUR-1025 development program uncertain (once-a-day oral modified-release formulation of ondansetron)
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
Rolapitant P3
Oral Data
Expected  2H 2013
Rolapitant Oral
FDA Approval
Expected Q4 2014
Rolapitant IV
Study Data 1H 2014
Rolapitant IV
FDA Approval
Expected 2H 2015
FDC P3 Oral
Data Expected Q1 2013
FDC Oral
FDA Approval 1H 2014
Candidate
Class
Indication
Sponsor
Possible Launch
APF530
5-HT3 Extended
release
Prevention
of CINV in MEC/HEC
A.P. Pharma
2H 2014
FDC**
FDC combines netupitant
(NK-1)
with
palonosetron
(Aloxi) in a single oral tablet
Prevention of CINV in MEC/HEC
Eisai / Helsinn
Oral 2H 2014
Rolapitant*
Long-acting NK-1
Prevention
of CINV in MEC/HEC
only in combination with 5-HT3
Tesaro
Oral 2H 2014
IV
2H 2015


APF530 Proposed Label
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
30
Proposed indication submitted in NDA
INDICATIONS AND USAGE
1.1 Chemotherapy-Induced Nausea and Vomiting
APF530 is indicated for:
Moderately emetogenic cancer chemotherapy (MEC)-
prevention of acute and delayed nausea and vomiting
associated with initial and repeat courses
Highly emetogenic cancer chemotherapy (HEC)-
prevention of
acute nausea and vomiting associated with initial and repeat
courses


CINV Market
July 2013
31
©
2013. A.P. Pharma, Inc. All rights reserved.
*Indications requested in previous submission
Acute Onset
(0-24 Hours)
Delayed Onset
(24-120 Hours)
Moderately
Emetogenic
Highly
Emetogenic
Moderately
Emetogenic
Highly
Emetogenic
APF530*
Aloxi
Kytril
Zofran


Summary
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
32
CINV market is a large commercial opportunity, with approximately 7
million doses of chemotherapy per year in US
APF530 demonstrated non-inferiority to the market share leader Aloxi,
with 2012 annual sales of $440M
and ~50% unit market share
APF530 product profile
5-day release PK profile
Good response in difficult chemotherapy regimens
Efficacy through multiple cycles of chemotherapy
Clean QT results
Current market dynamics are stale with minimal investment providing
opportunities to become the market leader
Competitive landscape creates opportunity with the removal of Anzemet
and Zofran 32mg
Greater
than
80%
of
Aloxi
sales
are
in
the
community
setting
and
highly
concentrated consistent with other supportive care products
1. TDR August 2006 internal report; 2. 2012 Eisai Annual Report; 3. Wolters Kluwer
1
2
3


A.P. Pharma Product Lifecycle Considerations
33
APF530 covered by multiple patents
2 patents covering combination of polymer, excipients and drug expire in
2021
3 patents covering APF530 expire in 2024
Polymer-based injectable products are difficult to copy
independent of IP
ANDA FDA requirements for injectable products
Must have same inactive ingredients in the same concentration as
the
reference listed drug
Polymers are complex mixtures of varying-length molecules, making
characterization for “sameness”
very challenging
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.


Financial Summary
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.
34
Expect cash sufficient to fund through resubmission of APF530 NDA
Summary Statement of Operations
(In thousands, except per share data)
Three Months Ended
March 31, 2013
Revenue
$      –
Operating expenses
12,752
Other income (expenses)
(201)
Net loss
$ (12,953)
Net loss per share
1
$   (0.04)
Condensed Balance Sheet Data
(In thousands)
March 31, 2013
Cash and cash equivalents
$ 45,722
Total assets
$ 48,979
Total stockholders’
equity
$ 41,383
1
Based on 305.1 million weighted average common shares outstanding for the period ended
March 31, 2013.


Thank You
A.P. Pharma, Inc.
OTCBB: APPA
July 2013
35
July 2013
©
2013. A.P. Pharma, Inc. All rights reserved.