Seres Therapeutics, Inc. (NASDAQ:MCRB) Q4 2023 Earnings Call Transcript

And as they see VOWST work, they see that it’s easy to use. They will broaden their use. They have — they told us that they would do that before launch. We’re already seeing that with the depth and repeat prescribing that we’re observing and observed in 2023. So it’s continuing to have the sales representatives on the Nestle side, encouraged their physicians to move the product earlier based on the amazing results that they’re seeing in the patients that they initially chose. So it’s a mixed bag of tactics, but we’re very focused there with Nestle this year.

Eric Shaff: Positive experience could have a cascading effect, and that’s…

Terri Young: Absolutely, big accelerator.

Peyton Bohnsack: Great. And I guess you kind of actually touched on my second question, which was — are you really seeing a lot of these first rCDI patients that you have not been treated? Are these largely coming from GIs or you’re like targeted group of high prescribers? Or are these single people that are maybe not as high prescribing or principal care providers or infectious disease stock? And any additional details that we get on that would be much appreciated.

Terri Young: Yeah, it’s actually been one of the most interesting aspects of the launch and one way that the launch has exceeded our expectations is the breadth of use that we’re seeing. Across physicians, across physicians the field representatives are calling on, also physicians that they’re not. And we’re seeing within the physician user pool a large variety of where physicians are choosing to use it first. So we’re not really seeing a pattern interestingly, which I think is highly encouraging for the launch. Every physician is basically choosing the patient that they think is at risk based on the patient that happens to be in front of them and their office at the moment, and we are seeing the utilization in first recurrence as well as in multiply recurrent. So we feel good about the patterns that we are seeing and that there is not a pattern other than the doctors choosing a high-risk patient, irrespective of number of recurrences.

Peyton Bohnsack: Great. Thanks for the additional color. Thank you for the additional color and for letting me ask a follow-up.

Eric Shaff: Thanks, Peyton. Thanks for the question.

Operator: And we will take our next question from Chris Shibutani with Goldman Sachs. Your line is open.

Chris Shibutani: Great. Good morning. I wanted to ask about SER-155 and how we should be thinking about the decision tree that you’ll have when the data is reported in the third quarter, in particular, when you think about kind of scale and the budget that would be required to further advance in the event of positive data, how are you thinking about your capacity to fund this? Is this something where you’re currently contemplating potential partnerships? And then secondly, I think you have access to a tranche of a loan from Oaktree. Can you help us understand any of the mechanics that would be involved so that we can understand how that might be a lever to also help support financing of continued success with SER-155 if positive data comes in the third quarter. Thank you.

Eric Shaff: Yeah, Chris, good morning, and thanks for the two questions. What I’d like to do is maybe invite Lisa to comment a little bit on what we are expecting in the 155 readout or what we hope for. I will say as it relates to resourcing Chris, what we said at the time of the restructuring last year was that we would pursue 155 to the clinical readout with the — both the clinical and microbiome analysis that comes with it. But that we were gaining investment beyond that to the readout itself. So our expectation is that 155 will basically stand on its own. If it’s successful, we think there are multiple ways in which we can support it and it could bring additional resources into the company. But if it’s not, then we’re not going to pursue it without being able to fund it, obviously. So maybe I can ask Lisa to comment on that and then David and I can take the question on Oaktree.

Lisa von Moltke: Yeah. Just a reminder that this study offers us the possibility to go in a number of different directions, depending on the results. We could have a play in acute GvHD as well as on the infection side where we think there are a number of different end points that could show us a way forward. And so we’d be looking to — most likely choose a particular route, either the infection side or the acute GvHD side, and then hopefully do a very focused and accelerated path forward. With the kind of results that we would be hoping to see, we would not expect that this would be a large, long trial that would be — we have to resource.

Eric Shaff: Yes. So we will follow the data and the resourcing piece we hit, I would just also mention as a reminder that we did receive Fast Track Designation. So we think that how we interact with the agency and thinking about the next study that Lisa mentioned, I think should be augmented as well. Maybe I can ask David to comment on the Oaktree question, I might add a couple of comments on top.

David Arkowitz: Great. Thanks, Eric. So when we established the debt facility with Oaktree now almost a year ago, we set it up in a way that it would provide access to capital for us, not just initially, but also as the company grew and as the company evolved. There’s actually two $45 million tranches that are available to us. Tranche B, which is based on six-month trailing VOWST sales of at least $35 million. And then tranche C, which is based on 12-month trailing sales of at least $120 million.

Eric Shaff: And I would just reiterate again, Chris, that — as we think about those potential sources of capital, I kind of think about that exclusive of 155. I think that 155 will stand on its own with positive results. But we think about the Oaktree somewhat differently.

Chris Shibutani: Great. And if I could just ask a follow-up on 155 amongst the different paths. Is there one that scientifically, you think you have the highest probability of success or at least you have a hypothesis that would be the case? And then is there one that may be from a regulatory progress standpoint might be a shorter duration and more sort of focused concise efficient from a cost standpoint path. I ask those two questions in that way because, hopefully, they’re related, but may not be the same. And again, looking for your perspective.