CELC Celcuity Inc.

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Celcuity Inc. Q3 F2026 Earnings Call Transcript

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Marissa
Conference Call Operator
Good afternoon, ladies and gentlemen, and welcome to the CellQ&E third quarter 2026 financial results call and webcast. At this time, all lines are in listen only mode. Following the presentation, we will conduct a question and answer session. If at any time during this call you require immediate assistance, please press star zero for an operator. This call is being recorded on Thursday, November 5th, 2026. and I would now like to turn the conference over to Jodi Sievers. Please go ahead.
Jodi Sievers
Investor Relations, Celcuity
Thank you, Marissa, and good afternoon, everyone. Thank you for joining us to review Salcuity's third quarter 2026 financial results and business update. Earlier today, Salcuity Inc. released financial results where the quarter ended September 30th, 2026. The press release can be found on the investor section of Salcuity's website. Joining me on the call today are Brian Sullivan, Salcuity's chief executive officer and co-founder, Vicky Hahne, our chief financial officer, as well as Igor Gorbatchevsky, our chief medical officer, and Eldon Mayer, our chief commercial officer, who will both be available during Q&A. Before we begin, I would like to remind listeners that our comments today include some forward-looking statements. These statements involve a number of risks and uncertainties, which are outlined in today's press release and in our reports and filings with the FCC. Actual events or results may differ materially from those projected in the forward-looking statements. Such forward-looking statements and their implications involve known and unknown risks, uncertainties, and other factors that may cause actual results or performance to differ materially from those projected. On this call, we also refer to non-GAAP financial measures. These non-GAAP measures are used by management to make strategic decisions, forecast future results, and evaluate the company's current performance. Management believes the presentation of these non-GAAP financial measures is useful for investors' understanding and assessment of the company's ongoing core operations and prospects for the future. You can find the table Reconciling the Non-Gap Financial Measures to Gap Measures in today's press release. And with that, I would like to turn the call over to Brian Sullivan, CEO of Selcuity. Please go ahead, Brian.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Thank you, Jodi. And good afternoon, everyone. Thank you for joining our third quarter 2026 operating and financial update conference call. 2026 has been a transformative year for Selcuity as we transition to a commercial stage company. RaptorPIC is now available to US physicians to prescribe for use in combination with Silvestrin with or without palbocycline for the treatment of HR-positive HER2-negative locally advanced or metastatic breast cancer without a PIK3CA mutation detected following progression on or after treatment with at least one line of endocrine therapy in the metastatic setting. The unprecedented efficacy results and favorable safety profile reported from the PIK3CA wild-type cohort of the VICTORIA-1 study provide physicians with a compelling rationale to utilize a get a thalassa regimen to address a significant unmet need for the tens of thousands of patients affected each year by advanced breast cancer. And we're pleased to report and provide our first update on the results of the foundational work our commercial and medical teams have been performing for the past two years to prepare for the commercial launch of Revtropin. Our launch is off to a great start and results to date are all very encouraging. To provide insight into the effectiveness of our field team's launch activities, particularly since the drug became commercially available on September 30th, we can share the following key metrics. Since Revtropik became commercially available on September 30th, 78% of the top 36 strategic accounts have ordered Revtropik. These accounts treat roughly 50% of the total addressable patient population. Over 3,400 sites, many of which are affiliated with one of the top 36 strategic accounts, have directly engaged with cell acuity oncology cell specialists. These sites treat 82% of breast cancer patients. Over 1,100 healthcare providers have attended RevTropin educational programs. Our MacroAccess and medical affairs teams have also been very effective. Their efforts have resulted in obtaining early and broad payer coverage and inclusion in major provider pathways so that nearly all eligible patients are now have access to RevTropin. Within two weeks of approval, we obtained a preferred category one recommendation in the NCCN guidelines for the RevTropic triplet and doublet as a second-line treatment option for HR-positive, HER2-negative, advanced breast cancer patients lacking a PIK3CA mutation. With this NCCN recommendation and the direct engagement of our team, and it has had with nearly all U.S. payers over the past 18 months, 91% of U.S. commercial and Medicare lives are in healthcare plans that cover RevTropic. Now given the complexity of managing care for cancer patients, most healthcare providers adhere to treatment guidelines, most commonly referred to as treatment pathways, that provide guidance and recommendations for the physician to work within a specific healthcare system or network. Inclusion in these pathways eliminates a critical potential barrier to physician utilization of a medicine, and this process can take, in some cases, up to 12 months. Our team, though, was able to get RevTropic Incorporated in three of the four largest healthcare provider pathways within just 30 days of becoming commercially available. And these results reflect the groundwork we've been laying for the past 24 months. During this period, we've engaged over 1,000 key opinion leaders and community breast cancer experts, key accounts, major oncology organizations, including GPOs, state societies, and special interest groups, as well as patient advocacy groups. Our unbranded marketing campaign at PAMPathway.com drove awareness of the PAM pathway with metrics that tracked well ahead of industry benchmarks. CME and third-party peer-to-peer programs and regional events have further increased levels of awareness about the importance of comprehensive PAM inhibition and the unmet need in the second-line setting. With the build-out of the commercialization infrastructure needed to support the successful launch of RevTurbPIC completed, commercial launch activities for RevTurbPIC commenced immediately after approval. Our 88 oncology sales specialists who have an average of 24 years of industry experience, are calling on physicians, supporting installation of RevTorPIC order sets within the electronic health record systems of their accounts, and in servicing infusion centers and pharmacies. Our strategic accounts, payer reimbursement, medical science liaison, and KOL focused teams are following through on the groundwork they laid prior to RevTorPIC approval. All of these efforts are designed to offer patients and providers with rapid access and seamless support. to enable treating physicians to obtain, get it solicited on behalf of their eligible patients after we received FDA approval and prior to commercial availability of Revtropik. So Acuity opened an expanded access program in mid-August, and now nearly all of the patients enrolled in this program have been transitioned to commercial product. Shipments of Revtropik, which began on September 30th, at a wholesale acquisition cost of for $10,000 per vial or $30,000 per 28-day cycle of treatment. Published epidemiological data estimates there are 37,000 patients in the U.S. receiving second-line treatment for HR-positive HER2-negative advanced breast cancer, and that based on the data from the VICTORIA-1 trial, patients treated with the Gettysburg regimen in this setting will remain on therapy for an average of 10 treatment cycles. Assuming net receipt of 80% of our $30,000 WAC price per cycle, We estimate the total addressable market for Revtropik in the second line setting, including both PIK3CA wild type and mutant patients, is approximately $9 billion annually. Most health care providers will order Revtropik through specialty distributors using buy and bill reimbursement. Revtropik is then drop shipped directly to the treatment location, which is typical for infused therapies rather than through specialty pharmacies. By selling the product through this channel, We do not obtain access to granular information such as the number of doctors prescribing or the number of patients receiving Rift or Pick. As a result, when we report sales results beginning next year, the data we will be able to provide will be limited to metrics such as gross and net sales, file shift, and market access related metrics. We expect to provide a flash report on fourth quarter sales in mid-January. And we look forward to providing further updates next year. I'd like now to turn to an update on the status of our clinical development programs and recently reported data. Based on the positive data from the PIK3CA mutant cohort of the Phase 3 Victoria 1 study, we submitted a supplemental MDA to the FDA in the third quarter of 2026. And we expect to submit Victoria 1 Phase 3 data for both the wild type and mutant cohorts to global regulatory authorities later this year or early next year. In October, updated results from the Phase III Victoria I study were presented in a late-breaking rapid oral presentation at ESMO. The key results included medium PFS of 21.5 months with the getotelicib triplet and 11.5 months with the getotelicib doublet versus 9.1 months with opalypsib plus fluvestrin in patients who had no liver metastases. The hazard ratio for the getotelicib triplet and doublet versus the opalypsib doublet was 0.46 and 0.71, respectively. And this is a particularly important result since patients lacking liver mets represent approximately 70% of all patients treated in the setting according to real-world analyses. Now, results for patients with liver mets were also very favorable and consistent with the primary PFS analysis, but again, it was a triplet and doublet versus the epilepsy doublet. The hazard ratio was 0.47 and 0.38, respectively. The objective response rate for patients with a valuable disease, updated to include both confirmed and unconfirmed responders, was 59% and 43% for the Gettys-Lissett triplet and doublet, respectively, versus 33% for the opalypsib doublet. And for these patients, the median duration of response for the Gettys-Lissett triplet and doublet was 19.4 and 27.8 months, respectively, versus 7.5 months for opalypsib plus fulvestrin. The discontinuation rate for Gettysalicib due to adverse events was 5% and 4%, with the Gettysalicib triplet and doublet respectively, compared to 19% for Opalipsib plus Fulvestrin. The Gettysalicib treatment discontinuation rate for the mutant cohort was lower than was reported for the wild-type cohort. The higher discontinuation rate for the wild-type cohort versus the mutant cohort largely reflects the activity in one region early in the study that enrolled a significant proportion of patients in the first six months. Discontinuations fell in this region as physicians gained experience. Since a much larger proportion of wild-type patients were enrolled during this period than mutant patients, the impact of this initial higher discontinuation rate early in the study fell disproportionately on the wild-type cohort. The mutant cohort, which enrolled more slowly initially and over a longer period of time than the wild-type cohort, we did not see disparity in discontinuation rates across regions. Thus, we believe the treatment discontinuation rate for getotelicib reported for the mutant cohort which was four to 5%. Best represents what we expect to see in a real world setting. And consistent with the data from the PIK3Ci wild type cohort, the stomatitis events observed occurred primarily in the first cycle and were transient. By the second cycle of treatment, less than 3% of patients had grade three stomatitis and all grade three events improved within one to two weeks. Discontinuations due to stomatitis for the gadotelicid triplet doublet were minimal, 1% and 0% respectively. Additionally, at ESMO, Dr. Sarah Talaney, Chief of the Division of Breast Oncology at the Dana-Farber Cancer Institute, presented a comparative analysis of data for the gadotelicid regimens from the PIK3CA wild-type cohort of VICTORIA-1 and other regimens evaluated in patients with HR-positive or T-negative advanced breast cancer. Eight studies were included in this network meta-analysis comparing progression-free survival outcomes in randomized controlled trials of systemic treatments evaluated among patients with HR-positive HER2-negative breast cancer who had prior CDK4-6 exposure and had PIK3CA wild-type tumors. And this analysis found that the GERA-telicib triplet and doublet each demonstrated statistically significant or numerically superior improvement of PFS and a progression-free survival rate at six months relative to all of the non-GERA-telicib regimens evaluated. Of note, the analysis found that patients treated with the GERA-telicib triplet and doublet were two times more likely and 1.5 1.5 times more likely, respectively, at a statistically significant level to survive without disease progression or death compared to imunestrogen plus adenomycin. We expect to provide further updates to results from both the mutant and wild type cohorts of VICTORIA-1 at the upcoming San Antonio Breast Cancer Symposium later this year. The guided solicit regimens have now demonstrated the potential to improve the standard of care in the second line setting regardless of the PIK3CA status of a patient's tumor. and we believe the results from the VICTORIA-1 study validate our pioneering approach to targeting cancers involving the PI3K, AKT, mTOR or PAM pathway. Additionally, these results all go well for the Phase 3 VICTORIA-2 trial we have underway to advance development of getotelicin for two different HR-positive for two negative advanced breast cancer populations in the first-line setting. Results from our Phase 1B clinical trial provided strong evidence that the PAM pathway is an important disease driver in treatment-naive patients with advanced breast cancer. In the early phase one study, we evaluated getofelicid plus pavaciclib and letrozole as first-line treatment in 41 patients with endocrine-sensitive, HR-positive, HER2-negative advanced breast cancer. Median PFS was 48.6 months, which compares favorably to historical data of approximately 25 months for pavaciclib plus letrozole, the therapy we are using as the control in a Victoria 2 trial. The objective response rate was 79% for the gadotelicid triplet, which again compares favorably to historical data of 53% for rivociclib plus letrozole. In light of the positive results for the PIK3CA wild type of mutant cohorts in Victoria 1 and the promising preliminary data for a gadotelicid triplet as first-line treatment, we're optimistic about the results of both the first-line studies. In successful development in the first-line setting, would offer the potential to advance the standard of care for the approximately 90,000 women each year who are diagnosed with late-stage HR-positive HER2-negative advanced breast cancer in the U.S., irrespective of their endocrine sensitivity or PIK3CA status. The total addressable market for getotelicib in the first-line setting is well over $10 billion annually. Our advancement of a subcutaneous getotelicib formulation is ongoing with the goal of demonstrating clinical equivalence to the current intravenous formulation of getotelicib. Subcutaneous Formulation is aimed to support potential future indications for get explicit regimens that may result in duration of treatment periods greater than several years. I'd like now to turn to our Phase 1B2 clinical trial. That's evaluating get explicit in combination with darolutamide in men with metastatic castration-resistant prostate cancer. So Acuity presented updated data from this study during a poster session at last month's ESMO Congress in 2026. Key results included Median progression-free survival, or RPFS, was 15.7 months, and the six-month RPFS rate was 82.2% in patients with prior exposure to ibuprofen. Median PFS was 9.1 months, and the six-month RPFS rate was 62.5% in patients with prior exposure to enzalotamide. Both sets of results compare favorably to published data for patients with either a novel hormonal therapy or docetaxel in this setting. Now the difference in results between patients with prior exposure to abiraterone versus enzalatamide was expected and reflects differences in the mechanism of action of these two drugs. For patients who had more than 50% decreases from baseline PSA, we observed them consistently across all dose levels. PSA response rates were 36%, 47%, and 67% at the 120, 180, and 240-milligram dose levels, respectively, in patients with prior exposure to either abiturone or enzalotamide. Geta-felicipal sterolutamide demonstrated a manageable safety profile across the evaluated dose levels of 120, 180, and 240 mg with only one dose limiting toxicity, which was grade 3 rash. no grade four or five treatment related as for adverse events or TRIEs and no TRIEs leading to discontinuation of GETA or death. Grade three TRIEs occurred in 20% of patients with only rash and varitis occurring in more than one patient. A randomized phase two study to determine the recommended phase three dose level of get solicit in combination with darolutamide in patients with metastatic castration resistant prostate cancer. is expected to begin in the first half of 2027 after completion of the phase 1b part of this study. Now with programs in both breast cancer and prostate cancer reflecting the important role of the PAN pathway in these diseases, CellCurity is well positioned to build an important pharmaceutical company over the next few years. And that concludes my remarks. I would like now to hand the call over to Vicky, our CFO, to review our finances.
Vicki Hahne
Chief Financial Officer, Celcuity
Thank you Brian and good afternoon everyone. I'll provide a brief overview of our financial results for the third quarter of 2026. Our third quarter net loss was $73.3 million or $1.33 per share compared to a net loss of $43.8 million or $0.92 per share for the prior year period. Our non-GAAP adjusted net loss was $66.8 million or $1.21 per share for the third quarter of 2026 compared to non-GAAP adjusted net loss of $37.2 million or $0.78 per share for the prior year period. Shipments of Reptorpic commenced on September 30, 2026. We recognized revenue when control of Reptorpic transferred to the treatment location, which generally occurs upon delivery. Because no product was received at the treatment location until after September 30, 2026, we did not recognize any product revenue during the third quarter of 2026. Total operating expenses were $77.3 million for the third quarter of 2026, compared to $42.8 million for the prior year period. Research and development expenses were $37.5 million for the third quarter of 2026 compared to $30.4 million for the prior year period. The $7.1 million increase was primarily due to a $5.3 million increase in employee-related and consulting expenses and $2.1 million increase in manufacturing and other costs. These increases were partially offset by a 0.3 million decrease in clinical trial costs. Selling, general, and administrative expenses were $39.8 million for the third quarter of 2026 compared to $12.4 million for the prior year period. The $27.4 million increase was primarily due to a $14.4 million increase in employee-related expenses primarily driven by the hiring of additional personnel within our commercial function to support the commercialization of RevTorpic. The remaining $13 million increase was primarily due to $11.1 million increase in cost to support the commercialization of RevTorpic, including consulting expenses, expanding infrastructure costs, and a $1.9 million increase in other administrative expenses. In the aggregate, $25.3 million of the $27.4 million selling general and administrative increase related to commercial headcount additions and other activities to support the commercialization of RevTorpec. Net cash used in operating activities for the third quarter of 2026 was $66.2 million compared to $44.8 million for the prior year period. The additional cash used in operating activities quarter over quarter of $21.4 million was primarily due to non-GAAP adjusted net loss of $29.7 million, partially offset by working capital changes of $8.3 million. In addition, we made a $50 million payment to Pfizer, which was triggered by receipt of the FDA approval for RevTorpec per our exclusive global license agreement for Getta Tulissa. This payment was classified as investing activity on the condensed statement of cash flows during the third quarter of 2026. Cash equivalents and short-term investments were $642.7 million at the end of the third quarter compared to $441.5 million as of December 31st, 2025. The 201.2 million increase was primarily driven by the convertible note offering completed in June, 2026. This resulted in gross proceeds of 575 million and net proceeds of 557 million. The proceeds were partially offset by 172.7 million of cash used in operating activities the repayment of $137 million term loan and the $50 million payment to Pfizer for the license milestone payment. Additional cash provided by investing and financing activities of $3.9 million was primarily driven by proceeds from the exercise of common stock options and employee stock purchases. We expect cash, cash equivalents and investments to finance our operations through 2029. I will now hand the call back to Jodi.
Jodi Sievers
Investor Relations, Celcuity
Thank you, Vicky.
Marissa
Conference Call Operator
Marissa, could you please open the call for questions? Absolutely. Ladies and gentlemen, we will now begin the question and answer session. Should you have a question, please press start, followed by one on your touchtone phone. You will hear a prompt that your hand has been raised. and should you wish to remove your hand from the queue, please press star followed by two. Just a moment for your first question. Your first question comes from Mari Raycroft with Jefferies. Please go ahead.
Maury Raycroft
Analyst, Jefferies
Hi. Congrats on the early progress and thanks for taking my questions. I was going to ask for your initial prescribers, can you say what proportion of these prescribers had prior experience with the drug through the EAP or your clinical programs? and how broad is adoption beyond those physicians?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
I would say a very small percentage of the doctors prescribing were those who had participated in the Victoria 1 study or who had prescribed medicine with EAP. We had significant participation by those prescribers, but they did not comprise a significant proportion of the total. based on our analysis of the number of files, but we don't see specific data by doctor. So, you know, again, we can only kind of estimate what we think the impact of their involvement in the initial uptake was.
Maury Raycroft
Analyst, Jefferies
Got it. Okay. And then for the number of patients who enrolled in the EAP, can you say if that's a handful or a meaningful number, or are you sharing any more specifics on that?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
I would say it was a handful. And again, I think as I've indicated earlier, the program became active mid-August and with the idea that it was going to become irrelevant or no longer available by the end of the third quarter or roughly six weeks. And so that essentially led many physicians to indicate that they kind of work to get approval from their IRB facilities. was not going to yield their ability to enroll the patients in the EAP program before our drug became commercially available. And so while some doctors did take advantage of it, the short timeframe when the program was believed to be relevant really disincented most doctors to participate in the program. But it did allow those who had either you know the ability because of their systems flexibility or willing us to do the work up front to participate and that was one of the goals was to you know for those who institutionally or personally were able to over this short period of time take advantage of the program then and that that was a good outcome.
Maury Raycroft
Analyst, Jefferies
Got it okay and then I'll ask one more question and then hop back in the queue just Wondering if you can clarify if the second manufacturing site is fully operational and is there any perspective you can share on inventory and whether there are any gating factors to maintaining a steady supply of the truck?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Yeah, I would just say that we have sufficient production to handle our planned or higher than planned demand from the field. and we indicated that we don't expect the second site to be approved until sometime middle of 2027. And that's been consistent with what we've stated previously.
Maury Raycroft
Analyst, Jefferies
Got it. Okay. Thanks for taking my questions.
Jodi Sievers
Investor Relations, Celcuity
You're welcome.
Marissa
Conference Call Operator
Your next question comes from Anupam Rama with JP Morgan. Please go ahead.
Anupam Rama
Analyst, J.P. Morgan
Hey guys, thanks so much for taking the question and congrats on the progress here. I know in the press release you talked about 78% of your top sort of 36 priority accounts have ordered the ReporPIC. Can you give us a little bit more color on the balance of the centers and kind of what are the gating factors for them to kind of get their first order in? Thanks so much.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
I would say the primary gating factor, I mean, to be frank, to put that in context, we've spoken with some people and these accounts can be the ones that can take several months to get on. And so to get 78% in the first month is quite significant. But for those that didn't place an order, it was less about their lack of interest in doing so and more to do with, you know, essentially the specific organizational requirements, whether it's getting the order set fully embedded in their systems. Some of these institutions have, you know, are complex organizations or other kind of, again, more bureaucratic implementations to make the drug available. So we don't anticipate that there are any true barriers other than just getting them institutionally prepared to have their doctors prescribe the medicine.
Jodi Sievers
Investor Relations, Celcuity
Great. Thanks so much for taking our question.
Marissa
Conference Call Operator
Your next question comes from Tara Bancroft with TD Cowan. Please go ahead.
Tara Bancroft / Amanda (for Andrew Berens)
Analyst, TD Cowen / Leerink Partners
Hi, good afternoon. So obviously your team has had a lot of touch points with the treating community. So I'm curious to hear from those experiences what your updated thoughts or expectations are for seeing any potential for a bolus at all either this quarter in wild type or in mutant patients once approval is reached there. and if you're so far seeing or expecting any off-label use in the mutant segment prior to that approval or if you think physicians will wait for the formal label.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Thanks so much. I kind of know what you're getting at with the bolus, but again, these are sick patients and they're not stacked up, ready to go. and so I would say that the demand almost completely reflects patients who require a new treatment option whether that's in the second or third line setting. We know great bulk just based anecdotally on feedback we've received from reps and information that report back to us that the bulk of the patients receiving the medicine are in the second line setting which is as we would expect but of course there's a lot of patients in the third line setting who don't have great treatment options, and so doctors are taking advantage of the availability of RetroPIC to treat them. As far as mutant usage in patients who have PIC3CA mutations, We've certainly heard physicians have an interest. They're very excited about the data. They would like to use it. And obviously we're not approved to treat those patients. And so our sales force does not engage in those discussions as you'd expect. And to the extent that The physicians make the decision based on the data that has been reported that they have that that has ability and then they'll have to work through reimbursement for the patient. But other than that, I can't really comment on prescribing behavior with that population.
Tara Bancroft / Amanda (for Andrew Berens)
Analyst, TD Cowen / Leerink Partners
Okay, great. Yes, understood. That's very helpful. Thank you.
Jodi Sievers
Investor Relations, Celcuity
You're welcome.
Marissa
Conference Call Operator
Your next question comes from Michael Schmidt with Guggenheim. Please go ahead.
Michael Schmidt
Analyst, Guggenheim
Oh, hey. Good afternoon. Thanks for taking my question. Yeah, just a few more questions if you could share as an anecdote in terms of how you're seeing the drug use early on in terms of, you know, the types of patients that are going on to therapy. have relative to the VICTORIA-1 study and any insights on usage in ESR-1 mutant versus wild-type patients and perhaps split between the triplet and the doublet?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Sure. We haven't really gotten much visibility on usage according to ESR-1 status, to be frank. So I really don't have anything to offer there. But regarding the usage of the triplet versus the doublet, that is something that our oncology sales specialists have discussed with the doctors that are looking for input and help in sorting through the data to make that decision. And again, this is anecdotal, but we see a pretty consistent pattern based on the self-reporting that we obtained from our OSSs. that the triplet is the preferred regimen by most of the doctors for most of the patients that they treat. And that's consistent with the surveys we've done over the course of the past year with docs where we present the data and ask for their decision about which therapy they would select first. And over time, we would expect that pattern to hold, but it's early. And again, we don't get precise data and it's primarily anecdotal, but so far consistent with what our expectations were.
Michael Schmidt
Analyst, Guggenheim
Okay, great. And how should investors think about sort of the launch trajectory, perhaps over the next 12 months relative to some of the recent breast cancer launches? When you think about, you know, unique dynamics around J-code, for example, do you expect that to be a significant bonus for uptake next year?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Well, you know, again, because of we're an infused drug, we have to work on a temporary J code because we were approved, you know, after the halfway point of the year, you know, our J code won't become active until April 1st. We'll see the J code itself January 1st, but it's not active. A lot of community sites, for instance, are the ones that can be particularly affected by or Viri of prescribing drugs that don't have a permanent J code because of the reimbursement risk in their view. But we have not found that to be a huge obstacle at this point, certainly some. We expected that. We have a reimbursement specialist in our rest and quick support service group that has been effective in helping community sites, for instance, navigate some of the challenges or concerns that some of these sites have about reimbursement. We also have a program that is offering these sites extended payment terms so that they're not at risk of essentially going upside down from a cash flow standpoint with Get It Solicit with RevTripX. And so while it will be an obstacle for a certain number of accounts. We baked that into the plan, but it's not an immovable object. And so, you know, we think certainly that friction will be removed when the J code comes, but it's not an all encompassing barrier in general.
Marissa
Conference Call Operator
Okay.
Jodi Sievers
Investor Relations, Celcuity
Thank you.
Marissa
Conference Call Operator
Your next question comes from Gail Bloom with Needham. Please go ahead.
Gil Blum
Analyst, Needham
Good afternoon, everyone, and thanks for taking our question. Really kind of a similar topic as everyone else. Have you gotten any early feedback from your early prescribers and their experiences with the drug and how it affected their patients? Thank you.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
We have. That's actually one of the requirements that we've asked our reps to follow through on. Once they learn that a doctor or that an order has been placed to a specific site, but typically no early on at least, it'll be easy for them to know which doctor it was. They're expected to follow up with the doctor to make sure the site is ready, has what they need. The X-methadone mouth rinse is available at that site or that pharmacy for the patient before they come in. And then also to follow up with either the doctor or an appropriate individual at the site, the treating center, to see how the patient experienced the infusion and get up. and so far, based on those types of conversations, which should be happening every day across the country, the feedback has been very positive. The patients are having a very good experience, nothing anomalous. And I think our group has done a very good job of educating the relevant healthcare providers to help them understand what to expect from an adverse event standpoint to make sure that the guidelines that we've put in place for stomatitis management have been put in place. So there have been no surprises, which is important, either for the providers or for the patients. And so I would say almost universally from the feedback we've received to date, The patient experience and the doctor's perspective on the patient's experience has been very positive.
Jodi Sievers
Investor Relations, Celcuity
Thank you. Very helpful.
Marissa
Conference Call Operator
Your next question comes from Lee Wacek with Kantor. Please go ahead.
Li Watsek
Analyst, Cantor
Hey, good afternoon. and Daniel Brown are on for the WhatsApp. Thank you for taking our question and congrats on the update. We were wondering if you could comment on the potential future implications of last night's update on 340B for RestorPix launch right now, but then also as you expand into the mutant population.
Jodi Sievers
Investor Relations, Celcuity
Thank you.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Well, since our drug got approval prior to this program becoming effective, we are grandfathered in to the current discounts offered to the 340B. So we do not expect this new program to infect our reimbursement rate for those hospitals. essentially what we've communicated to date regarding our gross to net estimate is consistent. We knew that that program was in place, but we were able to avoid it impacting us by getting our approval in time to get the appropriate paperwork filed so that we would be grandfathered into the current system or the system that preceded this one.
Jodi Sievers
Investor Relations, Celcuity
Thank you.
Marissa
Conference Call Operator
Your next question comes from Andrew Behrens with Lear Inc. Partners. Please go ahead.
Tara Bancroft / Amanda (for Andrew Berens)
Analyst, TD Cowen / Leerink Partners
Hi, guys. This is Amanda.
Marissa
Conference Call Operator
I'm for Andrew Behrens. Maybe one quick question from us. What is the latest progress on the subcutaneous formulation and how that program is going? Thank you. Sure.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
It's going well. I mean, as I think discussed previously, there's a lot of different steps in this development of this new formulation. And so far, we're on track to the plan that we have. We've got a number of milestones that we've identified that we need to meet in order to keep the program on track. And so far, so good. So again, you know, it's a lot of internal work, a lot of chemistry, and other formulation work, and then work to essentially isolate and quantify the general PK profile of different formulations, different approaches. And there's a lot of work to do to assess stability of different formulations. So there's a lot of variables you're optimizing, and some of them can take a meaningful period of time. There's also significant complexity, which is the case always when you're developing a new formulation, you know, to transfer from, you know, essentially lab scale to larger scale. And so all of those components of the program are factored into our timelines and we're on track with the program overall.
Marissa
Conference Call Operator
Got it. Thank you.
Jodi Sievers
Investor Relations, Celcuity
Cool.
Marissa
Conference Call Operator
Your next question comes from Steven Willie with Stifel. Please go ahead.
Stephen Willey
Analyst, Stifel
Yeah, good afternoon. Thanks for taking the questions. Maybe just to follow up on the last question, should we expect any kind of quantitative disclosure around progress being made on the sub-Q formulation, say over like the next 12 months or so, or will the progress updates here kind of continue to be mostly qualitative in nature?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
I think for the foreseeable future they'll be qualitative. It's a development project and a development project is really kind of too many moving pieces to provide play by play because it's hard to interpret externally. But again, we're confident about the development. We're on track with it. Some major milestones have been achieved that we expected to achieve, but it's nice to get them in the bag. So again, so far so good.
Stephen Willey
Analyst, Stifel
And then maybe just can you say if the study two data updates that were presented at ESMO, were those included in the SNDA submission? And I guess just any updated thoughts on how a mutant label might read with respect to either both or one of the regiments, thanks.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
So we're in the middle of providing additional data to the agencies. This is part of the normal review cycle. And so we provided a variety of analyses, additional analyses, including some of the data that you saw in the ESMO presentation. As far as the label, again, I don't want to speculate. It's less straightforward than the the wild type because the wild type had two primary endpoints with alpha assigned. The doublet was a secondary endpoint but with no alpha assigned. So that makes it less and, again, we've discussed that because of the nature of, you know, the expectations the agency has for powering studies to support an indication on the label. But, you know, those are the types of discussions we'll be having with the agency and we'll see what we see.
Jodi Sievers
Investor Relations, Celcuity
All right.
Stephen Willey
Analyst, Stifel
Thanks for taking the questions.
Jodi Sievers
Investor Relations, Celcuity
You're welcome.
Marissa
Conference Call Operator
Your next question comes from Sylvain Turcan with Citizens. Please go ahead.
Sylvain Turgel
Analyst, Citizens
Hey, good afternoon. Congrats on the quarter and thanks for taking my question. I may be a little rusty on my CMS rules. I just want to follow up on that change in the rule. How exactly does it work that you grant further into the current discount? Do you have qualifying pass-through status or how does that work? How much roughly do you expect utilization to be through the 340B hospitals? And then a second question is how much inventory do you think sites will build in the near term? And do you have any visibility into how many weeks that could be? Thank you.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Okay, so we don't expect sites to really build much inventory. We drop ship within essentially next day to the sites. And so it's very quick turnaround time. There's no reason, most sites I think will conclude there's no reason to build inventory. So any orders that we're getting in our view are linked to a particular patient and not putting drug on the shelf. As far as the 340B, again, I can say what I said before, but what I said before is what's the case. So we won't be exposed to these new rules. And so as far as the percentage of 340B, It can vary depending on the indication. I think other companies have reported 30 to 40% of business can be 340B. We're early in the process. I don't want to make a number up, but that's a useful benchmark to consider. And we have an assumption in our estimate along that range that allowed us to estimate that we think the gross to net will be 80%, 20% discount. Great.
Jodi Sievers
Investor Relations, Celcuity
Thank you for taking my question. You're welcome.
Marissa
Conference Call Operator
Your next question comes from Oliver McKemmon with LifeSci Capital. Please go ahead.
Oliver McCammon
Analyst, LifeSci Capital
Hi. Thanks for taking my questions. I'm just curious if you can remind us on the timeline to mature overall survival data from Victoria 1, the process for potentially adding these data to the FDA label in the future, and then any early feedback you're hearing on how meaningful OS could be for the launch curve. Thanks again.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
So as far as the OS data, we've indicated previously that we expect that sometime the first half of 27. And so again, it's event driven and we follow the trends, but the events and OS analysis can be a little bit more unpredictable than in progression. So we have to have, we're using a fairly wide time band for that estimate. As far as the label, it would only really get incorporated in the label if it's positive. So again, until we see the data, we won't know. As far as the impact it can have. I mean, certainly if it's positive, it would be impactful because the best I know, and again, to the best of my knowledge, there has been no second line indication showing, at least with an endocrine backbone therapy, a favorable OS advantage over the control. And so certainly if we achieve that, that would be helpful, but I don't, and important for the patients, But I don't think there's an expectation, at least as we've discussed GEDA and the results with doctors, an expectation that that's required for them to make a decision on use of GEDA-Felicit, essentially. progression-free survival has really been the data that's been used and then subgroup analyses to help better understand treatment effects for particularly important clinical populations. But certainly if we were to achieve it, it would be a big deal. We've also indicated that because our study one, the PIK3CA wild-type cohort allowed patients to cross over from the fulvestrin arm to learn control that creates a confounding effect. And so while we showed a favorable trend and we were encouraged by that in the interim analysis, whenever you have crossover, you just have to expect that there's going to be confounding. And so again, we don't want to create any expectations that the of anything. We'll see it when we see it. But, but I don't think it's, it's not a positive result. You know, I don't think that will have any impact on the launch.
Jodi Sievers
Investor Relations, Celcuity
Very helpful. Thank you.
Marissa
Conference Call Operator
Your next question comes from Kalpit Patel with Wolf Research. Please go ahead.
Kalpit Patel
Analyst, Wolfe Research
Yeah. Hey, good afternoon and thanks for taking the question. A couple from us. Last time, I think, Brian, you mentioned that the NCCN guidelines could potentially include the mutant population before that approval happens. I'm just curious if you have any latest thoughts on that and whether that timing could be before the year end. And then second question, from your early experience you have so far, Do you have a good sense on what the average time from a new prescription to a patient actually starting a drug might be or is it too early to comment on that?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Thank you. Sure. Thanks for the questions. So regarding the NCCN guidelines for mutant patients, that's dependent on publication being available. They will only consider a publication or rather for an additional expansion of the recommendations based on the peer-reviewed journal article. We expect to have that available this quarter. We would submit to the NCCN asking for a recommendation. And the timing of that is difficult to project because it's somewhat dependent on their Meeting schedule, since this won't be linked to a label, you know, it's not clear to us whether they would call an ad hoc meeting as they did for, you know, the wild type indication. But it's not unreasonable to expect that prior to an approval decision by the FDA that NCCN would incorporate some recommendation in their guidelines.
Jodi Sievers
Investor Relations, Celcuity
Okay, and regarding the average time.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
So we think it's quite quick. Again, this is all anecdotal. This is all self-reported from our reps. Our reps are very intimately involved, particularly in these early patients, you know, because they've been working to essentially ride shotgun on the process with the patient. But we think it's fairly quick based on experience that when doctors identify a patient, they want to put them on therapy as soon as they can. There's not a kind of a wait and see approach. So we're receiving demand that we think is real time reflection of a patient requiring treatment and the intention of giving them that treatment as soon as it's available.
Kalpit Patel
Analyst, Wolfe Research
Okay, and if I can squeeze in a follow up here, do you have any granularity on how many sites have actually ordered? I know you gave the number for the strategic balance, but any...
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
So we'll be providing those types of updates. Yeah, no, I appreciate the question. We'll be providing those types of updates when we provide an overview in January of the full quarter.
Jodi Sievers
Investor Relations, Celcuity
Okay, thank you. You're welcome.
Marissa
Conference Call Operator
Your next question comes from Sylvain Turcan with Citizens. Please go ahead.
Sylvain Turgel
Analyst, Citizens
Thanks so much for taking my follow up. I just want to know if you have any takeaways from ESMO from your doctors maybe that you engaged there with given the presentation that you had from Victoria breaking out these different patient populations in terms of if they understand how wide you cast your net in terms of patients that you enrolled versus, you know, some of these maybe mutant selective trials that are ongoing. Do you have any feedback on this patient appreciated?
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Sure. No, we've had conversations with since we've had our approval, obviously, with a broader group of doctors. But I would say there's a general understanding or recognition that we enrolled a patient population with significant disease burden that wasn't necessarily representative of the typical patient that they'll see. And really, I think the most telling statistic relates to the presence of liver mets. 70% of patients typically don't have liver mets. And liver mets are probably one of the most important factors that correlate to worse prognosis and lower or less favorable treatment effect on an absolute basis. And so in our case, we had over 50% or 50% or so of patients in the mutant setting as well as the wild type that had liver mets. So essentially that can act as a depressant in your absolute number. It doesn't affect the hazard ratio as it turns out when you look at the subgroups and you see the hazard ratios are comparable across subgroups depending on, you know, the treatment burden or rather disease burden. But the data that we presented, you know, roughly 21 and a half months meeting in PFS for the no liver mets was really important for two reasons as I indicated in my remarks. were essentially representative of roughly 70% of patients. And so that was really a fantastic result. It also highlighted and was clarifying for many docs and understanding the contribution of polycyclic because certainly the intent to treat PFS was very similar for the doublet and triplet and so somewhat confounding. At the same time, OS trend was more favorable in the triplet than in the doublet. But again, interim analysis, so immature. People are reluctant to draw too many conclusions about that. But in this case, with the triplet versus the doublet showed a 10-month advantage relative to the doublet, which is obviously very meaningful clinically. And so that really, I think, clarifies for many doctors, a question they've had, what should I start with? Should I start with the doublet or the triplet? And the feedback I think was fairly consistent that this really motivates them, indicates to them that it makes sense to start with the triplet. And again, that's what we're seeing in the Wild Tech cohort so far, anecdotally recorded. But with the data at ESMO, it kind of filled in some blanks that led most of the physicians we spoke to, I think almost every one, to prioritize use of the triplet for patients, unless there are other factors that may warrant avoidance of neutropenia, for instance.
Jodi Sievers
Investor Relations, Celcuity
Thank you, Brian. Thanks for the details. You're welcome.
Marissa
Conference Call Operator
There are no further questions at this time. I would like to turn the call back over to Brian Sullivan for closing remarks.
Brian Sullivan
Chief Executive Officer and Co-Founder, Celcuity
Thank you, everyone, for your interest in Cellcuity. We look forward to reporting back in the January timeframe. Take care.
Marissa
Conference Call Operator
Thank you everyone for your participation. This concludes today's webcasting conference call. You may now disconnect.