Onkos Surgical | Patrick Treacy, CEO

(Transcription)

Patrick Treacy  0:04  

Thanks very good morning. We start every discussion we ever have about the company with a slide. And what you see behind me here today is what we refer to as Onkos as our why it's not our mission. It's not our vision, but it's our why it's why we do what we do every day. And for far too long, the musculoskeletal tumor patient has really been neglected by the development innovation that's been going on in orthopedics and the patients and the surgeons that treat them have had to really settle for products that weren't specifically designed to meet their needs. Now, if we look at, you know, in contemporary orthopedics today, just looking at the aging population, looking at improvements in surgical techniques, looking at improvement in pain management, we see a lot of focus in primary joint replacement, and also that migration and movement to the outpatient surgery center and focus on robotics. But in doing so, a whole class and opportunity of patients, the more complex orthopedic conditions have really been left behind. And just to touch on a few of them that that we're addressing at Onkos. It's not well understood, but 20% 20% of all of the entire cancer spend in this country today goes toward musculoskeletal events for the patients with cancer. Another really tough situation and market and therefore an opportunity when we look at revision hip in the market. So when a primary joint needs to be done over again, that market is continuing to grow strong through 2030. And if you look at why revisions are happening, they're loosening but both in hip and knee top two reasons are infection, hideous, hideous problem. And if we look at the burden of what's referred to as pre prosthetic joint infection, by 2030, it's estimated to be almost $1.9 billion of cost to the healthcare system. Today, it's probably about 1.6 billion, but it's worse than just the numbers. It is a hideous affliction. So the survival rate of patients with a deep joint infection is worse than prostate cancer, melanoma, and breast cancer. And in many studies, it's actually similar to that of colon cancer. So terrible problem and 25%. Were heard some stats earlier in, in valve issues, but 25% of patients that are diagnosed with pre prosthetic joint infection will be dead in five years. So what did we do? And how do we look at that? Again, lots of focus on primary joints, robots, you know, big, big, big red oceans. If we look at what we're focused on. Initially, we started with the musculoskeletal oncology space, so bone tumor space. But as we were developing our products and building our company, we quickly realized that there was a whole market opportunity in these complex conditions that are in revision, things like deformity, some big trauma cases, and they're all treated the same way as tumors. But between the two of them infection, again, is this absolutely hideous complication. So when we started the company, there were innovations that we needed to bring to market to improve how these implants and these procedures were done. First was reattaching, soft tissues to implants. So there hadn't been any meaningful innovation in the types of implants that are used in probably 25 or 30 years. The second was, many of these patients are living longer with their disease disease due to new therapies immunotherapies. So how do you get these implants to last longer in the patients and then treating infection. Now, when you look at these types of procedures, and again, we really look at this as, as quite a nice blue ocean. Part of it is, is the focus, the focus on the patients the focus on the surgeons that do them in the focus on the institutions as to where they're done. So you can see some of the the institutions where we're currently supporting surgeons and patients, but it really is in the major academic medical centers, the tertiary care centers and cancer centers, that is a hyper focused call point for us. So when we look at at the market, if we would say we've got musculoskeletal oncology and then these more complex conditions, we look at them in three ways limb reconstruction, so that is our implant system. You can think of it as a very sophisticated joint replacement system for replacing diseased bone. We currently are marketing products now in lower extremity, and we've got the upper extremity in the pipeline, but then we move to the middle column there and metastatic disease. He's, so that's cancer that spreads to the bone. Right now cancer that starts in the bone 80% of patients that are diagnosed with cancer will have had that cancer spread to the bone. And a lot of these patients with metastatic disease have poor prognosis, they're very, very sick, they can't undergo a large operation, and is a great opportunity that has been largely ignored by all the convince incumbents both in the orthopedic field as well as some of some of the others. But then we move further to the right, and we look at this whole opportunity in advanced reconstruction, we currently have a product in with the FDA, and big pelvic reconstruction where we take a CT scan design, an implant specifically for that patient, and 3d printed in titanium. But if we look how that all pairs out, in musculoskeletal oncology, this is the portfolio that we're looking at. So these areas are applicable to the bone tumor patient, and again, with an antimicrobial technology that we also have in with the agency. But if you look at how we look at this in the complex condition, patient, same sort of thing. But what is also in our favor at this point is if we look at the hip and knee marketplace, it's been mature, you know, 40, some odd years now. But then, so we're addressing some conditions in the pelvis for those big revisions, but then start to work your way down shoulder market. Now 2025 years being mature, you have these big bone loss and these big cavernous defects. Now in shoulder revisions, same thing, foot and ankle, right now, maybe 15 years mature. So the upper extremity and lower extremity market are probably the two fastest growing markets in orthopedics, we're now going to be seeing that also in the revision space. So I'll just take you through for the last few minutes, some of the products and a little bit more of the portfolio. So if you look at that skeleton and down, you know, at the end of the knee there, the magenta circle would represent a bone tumor, the way they are treated today, if you look at our Illios, which is the brand name of our limb reconstruction system, so you can see that part of bone is replaced with with an implant that replaces that disease, bone and implants and artificial knee joint. Looking further to the right. That is an innovation that we launched two years ago now it's under our my 3d personalized system. In this situation, we can actually precisely remove just the tumor and sparing the joint. So now we can provide reproducible effective joint sparing surgery, these patients have cancer, not arthritis. So to actually take out an entire joint is criminal. So what are some of the innovations that we've brought to Illios. So soft tissue attachment in the upper left there, that's, that's a hip we've got some patented features in there to reattach the muscles and tendons in the direction that that they pull. On the lower left, that is a 3d printed proximal tibia, we hear a lot about 3d printing and personalization, it is also quite helpful in making off the shelf implants as well. In this case, we're able to engineer a surface on the front of it, where either bone or a tendon attaches to reattach the kneecap tendon. On the right, that was one of the innovations that we launched last year. And having these implants last longer. That's a stem that fixes it to the bone. But you can see that dark area that is a 3d printed, porous collar that the bone can grow into and have it lasts longer. These innovations that you see on the screen prior to us founding Onkos, there hadn't been any innovation in this space for probably, you know, 15-20 years. So the way it works on the personalized cases is we will get a CT recreate the patient's anatomy and then move on provide the tools and the graft to replace it. I do want to touch quickly on the antimicrobial technology. This is game changing. We talked about all the hideous issues that arise from you know from infections. It's you know, billion and a half dollar cost right now to the to the health care system. We own the rights to this technology and the $2 billion plus revision market globally. Just where we've been and I'll start to wrap up here, but during COVID first year COVID, we grew about 24%. So we are commercial Stage Company second year COVID. We accelerated and grew over 30%. We've got a plan for 42% CAGR. And you can see a budget of of $27 million this year with a steady drumbeat of new product innovation to address these areas. So I would just wrap up by saying to you that what we're doing it's a playbook of focus. We've seen it historically in orthopedics where it was first probably in trauma then you saw it in spot And then you saw in extremities pediatric so we're just running a playbook of hyper focus in an area that is in need of meaningful innovation so if anyone would like to learn a little bit more we will be across the hallway thank you so much