Spectrum Pharmaceuticals Inc (SPPI) 2009 Q2 法說會逐字稿

Good day everyone and welcome to the Spectrum Pharmaceuticals Inc., Second Quarter 2009 Earnings Results Conference Call. This call is being recorded. At this time for opening remarks and introductions, I would like to turn the call over to Spectrum's Senior Manager of Investor Relations Paul Arndt. Please go ahead, sir.

Thank you and good morning and welcome to Spectrum Pharmaceuticals second quarter 2009 corporate update conference call. I am Paul Arndt, Senior Manager of Investor Relations for Spectrum Pharmaceuticals. Let me give you a quick agenda for today's call. First, our Vice President of Finance, Shayam Kumaria is going to give us an overview of our second quarter financial highlights. Second, our CEO Dr. Rajesh Shrotriya will go over the second quarter events and achievements. Third, Dr. Andrew Sandler our Chief Medical Officer will briefly speak on ZEVALIN. Amar Singh, our Chief Commercial Officer will provide an update on our commercial efforts for ZEVALIN and FUSILEV. We will then open up the call to questions after which Dr. Shrotriya will offer final comments and wrap-up.

Before I hand the call over to Shayam, I would like to remind everyone that during this call we will be making forward-looking statements regarding future events of Spectrum Pharmaceuticals including statements about the product sales, profits, losses and the safety, efficacy, development time line and clinical results of our drug products that involve risks and uncertainties that could cause actual results to differ materially. These risks are described in further detail in the Company's reports filed with the Securities and Exchange Commission. These forward-looking statements represent the Company's judgment as of the call today, Thursday, August 13, 2009, and the Company disclaims any intent or obligation to update these forward-looking statements, however, we may choose to update them and if we do so, we will disseminate the updates to the investing public. For 10-Ks, 10-Qs, press releases, corresponding 8-Ks and additional information including other SEC filings please visit our website at SPPIRX.com.

I would now like to hand the call over to Shayam.

Thank you, Paul, and good morning to everyone on the call. Please note that dollar amounts I am going to cite are all approximates. So, to start off the second quarter revenues were $8.1 million. This revenue was comprised of product sales of $6 million, $3.3 million from ZEVALIN and $2.7 million from FUSILEV, and $2.1 million attributable to the amortization of the Allergan license fee. This compares to $20.7 million in one-time non-recurring revenue in the same period of 2008. The Company recorded a net loss of $9.7 million or $0.28 per share compared to net income of $10.7 million or $0.34 per share in the second quarter of 2008. For the six months ended June, we had $22.3 million in revenues. This was comprised of product sales of $18.1 million, $5.9 million from ZEVALIN and $12.2 million from FUSILEV, and $4.2 million attributable to the amortization of the Allergan licensing fee. This compares to $20.7 million in one-time non-recurring revenue in the comparable period of 2008. The Company recorded a loss of approximately $9 million or $0.27 per share compared to net income of $2 million or $0.06 per share in the same period of 2008.

Net cash provided by operations in the six month period ended June was $4.3 million. The positive operating cash flows are primarily due to sales of FUSILEV, arbitration proceeds related to ZEVALIN and the contribution to R&D expenses by Allergan. Also during the second quarter June 2009, the Company sold 8.5 million shares of common stock for $51 million in gross proceeds. As of June 2009, the Company had cash, cash equivalence, marketable securities and financing proceeds receivable aggregating $106 million, this compares to $64 million at the end of March 2009. As of August 7, there were 42 million shares issued in outstanding.

I will now hand the call over to Dr. Shrotriya.

Good morning, everyone. Thank you Shayam. 2009 has been a transformation year for Spectrum. As we now have two proprietary oncology drugs, not only helping cancer patients but also generating revenue for us. With two cancer drugs bringing sales revenue, a lead pipeline drug in registration trials for bladder cancer with a substantial financial support from a strong partner, a proven team of experienced and competent professionals fully in place, we now have a strong balance sheet that enables us to execute on our strategy. We continue to distinguish ourselves from our peers in this financially challenging times while we continue to build value for our shareholders. During the quarter, we raised $51 million at a two year high stock price in order to strengthen our financial reserves and our ability to execute on our stated corporate strategy.

We also received $4.3 million upon winning an important arbitration related to our acquisition of ZEVALIN and in June, Spectrum was added to the Russell Global, Russell 3000 and the Russell 2000 indexes. On July 2, the FDA showed a complete response letter regarding our supplemental biological license application for ZEVALIN. It is important to note three things about this letter from the FDA. Number one, no addition clinical studies were requested. Number two, the addition data requested did not involve any new data analysis and finally, the FDA received our formal response letter within three business days of our receipt of the complete response letter. The FDA considers this submission a Class I response with up to 60 days for regulatory review. The new decision date is September 7, 2009, which is less than four weeks from now. We remain confident that our submission will satisfy the requirements of the complete response letter, and we continue to expect a favorable regulatory decision. We also remain very excited about the commercial opportunity for ZEVALIN, and we are confident that the strategic and technical initiatives that we continue to implement will enable us to extract ZEVALIN full commercial potential in a timely and cost efficient manner.

At this time I would like to ask Dr. Sandler our Chief Medical Officer to comment further on ZEVALIN.

Thank you and welcome everyone to today's call. As you are all aware, Thursday July 2, 2009, the day before the three day National July 4 Holiday weekend was the PUDFA action date for our sBLA for ZEVALIN pertaining to a potential label expansion for first line treatment in low-grade or follicular non-Hodgkin's Lymphoma. At about the close of business day we received a complete response letter. The letter was short and succinct requesting that we provide only additional data sets for clarification and verification of parts of the submission that is currently under review to support the proposed labeling. We submitted our formal response within three days, and the FDA formally accepted the application for review less than a week later. Since this was considered a resubmission it started a new review cycle. As Rajesh mentioned earlier, the FDA has up to 60 days or until September 7, 2009 for its response.

I'd like to emphasize a few important points. The FDA did not request any new clinical studies or any new data analysis. The only request was to provide additional data sets to the FDA for the purpose of verifying parts of the sBLA package that is under review. We assembled the required data sets, had them formatted, published and submitted our full and formal response to the agency on Wednesday July 8, which, as Rajesh stated earlier was only within three business days from the time we received the complete response letter. We are confident that the submission will satisfy the requirements of the complete response letter. We continue to expect a favorable regulatory decision on our sBLA application for label expansion of ZEVALIN into first line treatment.

As a reminder, ZEVALIN is an FDA approved safe and effective drug for treating relapse or refractory low-grade or follicular B-cell non-Hodgkin's Lymphoma including patients with rituximab-refractory follicular non-Hodgkin's Lymphoma. ZEVALIN combines the tumor targeting ability of an anti-CD20 monoclonal antibody and the tumor destroying power of localized Yttrium-90 radiation. The radiolabeled antibodies can specifically bind to the tumor killing both the CD20 targeted cells and its neighboring Lymphoma cells, thus destroying the tumor to multiple cell killing mechanisms. This treatment also focuses the drug's activity at tumor cites with minimal systemic effects from the radioactivity. Although, ZEVALIN is currently FDA approved in the relapse and refractory setting, for a number of reasons it is unfortunate currently used only in the salvage setting. Many patients who should be receiving ZEVALIN are not. We hope to change that.

If ZEVALIN is approved in the first line setting we believe it will be an important first step in bringing the treatment of non-Hodgkin's Lymphoma in line with the standard of care and other hematologic malignancies. For decades doctors have been treating acute leukemia's with induction therapy to wipe out as much bulky disease as possible followed by consolidation therapy to further reduce any minimal residual disease and to provide the patient with the best quality response possible and maintenance therapy to sustain the consolidation response thus improving the duration of response. The value of using ZEVALIN in the first line consolidation setting was demonstrated in the FIT study or First Line Indolent Therapy Study. The FIT study achieved all of its end points and showed an impressive roughly two year advantage in progression free survival for patients with either a complete or partial response who received ZEVALIN after induction therapy. Notably, updated data was presented at the American Society of Hematology or ASH Meeting last December by Dr. Morschhauser, one of the principle investigators of the FIT study. The two year progression free survival was updated to reflect a three year progression free survival. A three year progression free survival advantage is very significant in this patient population.

As you all know, many cancer treatment regimens measure their successes in only weeks, not years. The FIT study also demonstrated an unprecedented rate-of-conversion from a partial response to a complete response as a result of consolidation with ZEVALIN. Of the patients that achieved a partial response after induction therapy, 77% were converted to a complete response after ZEVALIN consolidation. This is important because many doctors consider a complete response after induction therapy to be a surrogate for overall survival. So why haven't doctors rushed to give ZEVALIN to their patients. The reason typically given by physicians for not using ZEVALIN fall into three broad categories. Clinical, logistical and financial. Clinically one of the most cited barriers is the misperception is that once the patient is given ZEVALIN all the therapeutic options have been sacrificed. The concern has been that radioimmunotherapies damage the bone marrow such that patients would not be able to withstand further downstream chemotherapy, rituxin or stem cell transplants.

Additional new data presented by Dr. Morschhauser at the previously mentioned ASH Meeting last December. The data shows that in patients who receive ZEVALIN there is no difference in safety both in Second Line or Third Line downstream treatments including even stem cell transplants thus making ZEVALIN an appropriate and safe first line therapy. We believe that educating doctors on its favorable risk reward profile may help increase usage of ZEVALIN not only in the first line setting but in the currently approved relapse and refractory setting as well. We are also working at the FDA request to complete an analysis, the results of which may ultimately lead to the removal of a cumbersome bioscan requirement. The bioscan is not a required element of the ZEVALIN therapeutic regimen in many countries outside the US, specifically in the EU. In the FIT study alone the majority of patients did not receive indium scan. If you were able to remove the bioscan successfully, the process of giving ZEVALIN in the ZEVALIN therapeutic regimen would be reduced from the current seven or eight days to no more than a couple of hours in a physician's office, significantly simplifying the treatment process.

With that, I will now hand the call to Amar Singh for a commercial update on ZEVALIN and FUSILEV.

Thank you Andy and good morning to all. My goal is to provide you first with a quick update on ZEVALIN, sales followed by an date on our commercial efforts including some important perspectives on the tactical initiatives we have instituted in order to address the historical barriers related to the use of this drug. I will then conclude my presentation with the brief on FUSILEV sales.

I am pleased to state that ZEVALIN sales in the second quarter were approximately $3.3 million which represents about a 25% increase over the first quarter sales of approximately $2.6 million. On a real growth or unit basis sales in the second quarter were up about 20% over the first quarter. Although this growth is of a small base, we are encourage by the strong signal we have received from the market after just one full quarter of marketing and sales under Spectrum's leadership.

So let me put this in perspective for you. First, the average growth in unit sales over the prior three years where we compare only the first and second quarters the rate stood at a negative 12%, despite the fact, that two out of three years the drug was previously sold by a company much larger than Spectrum. Second, this improvement from a three-year average decrease of 12% to an increase of over 20% was achieved in the first full quarter since Spectrum acquired 100% commercial rights to ZEVALIN. Importantly, we accomplished this at a time of heightened competition for the launch of TREANDA and the refractory NHL setting last fall. Fourth, we accomplished this in the absence of receiving regulatory approval of ZEVALIN in the front line setting. Although it may be too early to be making definitive conclusions, it appears that we are well on our way to achieving our previously stated goal of stabilizing sales. It is also worth pointing out that this stabilization was accomplished well ahead of our original target time frame which was at the end of this year. I should add that we continue to remain confident with respect to ZEVALIN, the opportunity it brings and in our ability to place a therapy at a sustainable growth trajectory.

At this time, I would like to update you on the ZEVALIN commercial initiatives that we have implemented to address and overcome the historical barriers associated with the therapies adoption by physicians. Let's look at the reimbursement environment which has until now been one of the major source of confusion and an obstacle for ZEVALIN. There are several ways in which ZEVALIN is currently reimbursed. It should be noted that reimbursement standards as they relate to radioimmunotherapy such as ZEVALIN have undergone numerous changes since the approval thereby creating an unstable, unpredictable reimbursement environment. At times, there has been a significant hurdle to the drug utilization as well as in creating patient access. Medicare reimbursement is different and specific to the sight of administration. In the hospital outpatient setting, for instance, ZEVALIN is reimbursed on a cost-to-charge ratio methodology which varies by hospital. In the community clinics, ZEVALIN is reimbursed by one of two ways either at a percentage of AWP or average wholesale price or invoice depending on the state. On the private pay side, it's reimbursed according to payor policies which vary by payor.

With such diversity in reimbursment methodologies it is not surprising therefore that there have been instances where ZEVALIN is under reimbursed creating patient access issues and affecting physician adoption of the therapy. As you can see, there are instances where the reimbursement environment has not only been suboptimal but has also become increasingly complex. This has served as a clear impediment until now to the drug utilization and adoption. Since our involvement with ZEVALIN, our focus has been to simplify Medicare reimbursement for hospital outpatient providers and patients by presenting to CMS the Center for Medicare and Medicaid Services an option to reimburse ZEVALIN under the ASP methodology, which is the average setting price.

As you may know, this is also the basis under which most injectable chemotherapeutic agents are currently reimbursed by Medicare in the community setting. If adopted by Medicare, the reimbursement standard for ZEVALIN in the hospital outpatient setting will be streamlined and predictable for the first time which we believe would enhance not only patient access but also product adoption. We are pleased to see that CMS announced on July 1, that it is proposing moving reimbursement for radioimmunotherapy such as ZEVALIN towards the aforementioned ASP methodology, which we believe will go a long way in getting this important drug to patients who can benefit from the extended progression free survival offered by ZEVALIN. If all goes well we expect that ASP final rule to be completed in November with the final implementation and practice to be in January 2010.

With respect to other aspects that dictate the guidelines for reimbursement, you should know that private and government payors are also using NCCN guidelines which is the National Cancer Care Network, as an impartial reference base to facilitate reimbursement decisions. Earlier this year, the FIT study was used as a basis for category one recommendation and the NCCN guidelines supporting the use of radioimmunotherapy such as ZEVALIN post chemotherapy. Keep in mind category one is the highest recommendation available. We view this achievement as a note worthy milestone for ZEVALIN.

Let's now look at some of the tactics we implemented to address the logistical issues surrounding ZEVALIN. Firstly, logistical concerns around the use of ZEVALIN range from those we consider unfounded such as the fear on the part of oncologists of losing patients by referring them to radiation oncologist, to more creditable concerns foremost of which is lack of knowledge about which practices offer ZEVALIN and are willing to accept patient referrals. To overcome this barrier to adoption we have developed targeted ZEVALIN treatment and referral centers. These centers would accept patient referrals, administer ZEVALIN, and then most importantly send the patient back to refer a physician for follow-up. As Andy mentioned earlier we also are making progress toward the removal of the bioscan requirement for ZEVALIN. If we are able to remove the scan requirement, the time frame to administer the ZEVALIN therapeutic regimen would be vastly reduced from one week to a couple of hours. In addition, the patient will be released of the risk, hassles and expenses associated with administration of an additional radioisotope.

Now our market research continues to indicate positive receptivity to the strategic and tactical solutions we have implemented for overcoming the many resistant factors governing ZEVALIN uptake and we remain confident in the continued success of our commercial efforts with this drug. The strategic and tactical initiatives I have described to you are by no means exhaustive and our hope is that what I have described to you gives you at least a flavor for the important efforts underway.

Moving on to FUSILEV. As you know the approved indication for methotrexate rescue in osteosarcoma is relatively a small market. We expect to grow FUSILEV sales upon its approval in the metastatic colorectal cancer. We also continue to expect a favorable outcome on or around October 8, which is a PDUFA date for a supplemental NDA.

In November of last year we learned that many hospitals and community based clinics around the country were unable to get adequate quantities of leucovorin to meet the patients needs. In response to this shortage, Spectrum worked together with the FDA to face the medical emergency created by such shortage. Additionally in early January, both ASCO as well as ASHP the American Society of Hospital Pharmacists provided the requisite guidance explaining the shortage as well as FUSILEV application in this period. We successfully mobilized many of our resources to help the medical community address the serious medical emergency created during the shortage of this clinical drug. The shortage was effectively resolved during the first quarter of this year, thus sales the FUSILEV in the fourth quarter '08 and first quarter of this year clearly benefited from the leucovorin shortage that started last November. Since the launch of FUSILEV we have generated approximately $20 million in FUSILEV sales. We look forward to the opportunity of providing you with further updates on commercial programs, plans as well as milestones in the near future. It is my pleasure to turn this back to Rajesh.

Thank you. With two drugs in the market and one drug in final stage of registration trials including patients, a strong financial position and a strong team of competent professionals, we believe Spectrum is well positioned to deliver outstanding value to our shareholders. Let me highlight a few of the milestones and value drivers that you can expect over the next 12 to 18 months.

Firstly, related to ZEVALIN. We expect FDA decision for first line consolidation therapy in non-Hodgkin's Lymphoma by September 7, that is in less than four weeks time frame. We also expect to establish reimbursement standard with CMS or Centers for Medicare and Medicaid Services by early next year. That is also within less than five months. In fact we are pleased to let you know that last month CMS released their proposed 2010 hospital outpatient prospective payment system rule called HOPPS. They are proposed to use average selling price for therapeutic radiopharmaceuticals such as ZEVALIN dating generally beginning January 1, 2010. Secondly, let me talk briefly about FUSILEV. We expect a decision from the FDA for advance metastatic colorectal cancer indication by October 8.

Thirdly, related to our third key drug, Apaziquone or EOquin, we received Fast Track designation in July. We are excited about the Fast Track designation as it confirms that the Food and Drug Administration also sees non-muscle invasive blood related cancer as an unmet medical need. We look forward to continuing with our ongoing Phase III studies, evaluating the safety and efficacy of this important drug while working with the FDA to expedite the drug development, review approval process so we can help address this substantial unmet medical need of patients suffering from this type of bladder cancer. To date, we have enrolled more than 1200 patients and continue to expect to meet our enrollment target by the end of this year.

And we also plan to initiate one additional trial in patients with bladder cancer who have failed BCG treatment. We have requested a meeting with the FDA on the design of the BCG Failure study. We have a November date and would expect to begin enrolling patients in this study in Q1 of 2010. We have also requested scientific advice from the EMEA on this BCG Failure study. We expect to hear back from them before the end of this year. We also plan to sign an Asian partnership by the end of this year.

Fourthly, related to Ozarelix, we continue to enroll patients into our Phase II trial evaluating Ozarelix use in benign prostate hypotrophy, or BPH. We have approximately 20 sights in the US enrolling patients and about 35 sites in India that would start enrolling patients very soon.

And finally related to RenaZorb, we acquired 100% of the rights to this important phosphate binding agent. Given the limitations of existing phosphate binding drugs, the market opportunity for new safe and effective phosphate binding drug has significantly increased not only in the United States but in other major pharmaceutical markets such as Europe, Japan and China. Having full rights to this selective and potent nanotechnology based novel drug candidate will facility our development and partnering strategy for this asset. As part of our transition to the commercial state biotech company with the primary focus on oncology and as part of a balanced risk management and resource conservation effort, we will continue to balance internal development of proprietary products with the strategic monetization of selected assets. With that I will now like to open the call to questions

Thank you. [Operator Instructions). We will go first to Ren Benjamin from Rodman & Renshaw.

Good morning everyone and congratulations on a great quarter and a very thorough conference call. I almost have no questions, almost. One or two things. Going to the ZEVALIN sales, I thought it was a very good overview as to the issues that surround the radiopharmaceutical and what you are doing to tackle these issues and really does look like a good turn around in sales. Can you talk to us I guess a little bit more when we start looking at this market opportunity, how should we be thinking about how big this potential market is especially if the approval comes in and what should we be looking at given CMS's new decision, the reimbursement center, what sort of average if you will reimbursement price should we be thinking about?

Thank you. Good to hear your voice. Let me ask Amar to comment on this.

It's a twofold question obviously. I think from the standpoint of the patient numbers, what we have been communicating in general is that the population that is served right now with the current indication is approximately 6,000, and obviously this new opportunity should it emerge would extend the breadth of the education of the patient pool quite substantially. So it is very difficult to give you definitive number but suffice it to say this would be an increase in patient pool which would be quite substantive.

In terms of the actual reimbursement, I think your question was what sort of guidance one can expect. Currently we are certainly hopeful that the reimbursement that will occur from the CMS side would be ASP plus. We do not know whether it's going to be ASP plus 4 or ASP plus 5. That is the only guidance I can give you at this point in time but that's what's been averaging.

Can you give us a sense of the cost of ZEVALIN right now or what the price of ZEVALIN is right now?

This is a very difficult one to give you an answer to, and primarily for the reasons that really include what we have done with the patient ready dose. What we have done essentially is amalgamated several components associated with the patient ready dose which includes isotope compounding fees, the price of the drug itself, and the ranges that have occurred previously which should be all inclusive of all these different components have been in the vicinity of 25 to 29,000 in that range. What I think is very important for you to understand is that this is still substantially lower than many of the comparable costs associated with the likes of TREANDA, rituxin/CHOP, rituxin maintenance and the like

And to expand on that, is there any discussion or internal thinking to potentially increase the price to make it more, not competitive, but priced competitively to other drugs in the space?

We have to understand better what the market dynamics work for us moving down that path. I just point obviously this is something that would be a tactical consideration that we will employ as we see fit.

Terrific. Moving on to FUSILEV, you'd mentioned that the PDUFA date coming. There's also an application for the oral formulation of FUSILEV. Can you give us a quick update as to what is happening there?

Can you repeat?

I'm sorry Rajesh. Maybe I have it mixed up. But I thought there was an oral formulation sNDA that was submitted as well on top of the metastatic colorectal FUSILEV application.

That application is still under review by FDA.

Do we have any clarity as to when a decision will be made with that application?

No, at this time we don't have any more clarity. Once we have, we'll certainly make it public.

Regarding the FUSILEV numbers, can you give us some sort of a sense as to how many may be going to the colorectal application versus the prescribed indication?

You know, again, as you know, we do not promote FUSILEV for colorectal cancer indication. As Amar rightly pointed out that in last quarter of '08 and first quarter of '09, we got tailwinds and clearly FUSILEV availability was able to help many patients which otherwise would not have been able to help. Clearly in the second quarter we were not able to talk about anything but the approved indications which is a very small indication and we are hoping on October 8 we'll get the approval and we can start talking about the use of FUSILEV in colorectal cancer and it is well known that FUSILEV sales X-US add about $200 million a year in Europe and Japan combined. So I don't want to extrapolate just based on US sales. First things first. First we need to get approval for colorectal cancer which is approved in Europe and Japan for colorectal cancer. Without that, we have always said that we expect minimal sales.

Very good. Thank you very much. Congratulations and good luck going forward.

Thank you.

We'll go next to Shiv Kapoor with Morgan & Joseph.

Thanks for taking my question. I have a couple. We'll start on FUSILEV. With the current level of sales are you guys, is this a good base sales amount to project models off of? Or does this also include some colorectal cancer sales?

So let me understand. You said the current sales in -- the second quarter sales.

Second quarter sales, yes.

It's really hard to dissect. All I can tell you is that we are not promoting or selling this drug for colorectal cancer use. So my hunch would be that yes, this is only for the approved indication. Because you can see when the drug was being used for colorectal cancer, our sales were greater than $7 million, the $7 million to $12 million range for two quarters and that is a precipitous fall of sales in the second quarter, and I'm hoping this situation will reverse. Once we get approval within the next two, two and a half months time, which is October 8.

Hello?

Yes. Your question is how much sales, if any, were in colorectal cancer in second quarter. Is that the question?

Yes.

The answer is that I don't know the answer to this question because we are not promoting for colorectal cancer any more. The shortage (inaudible)towards the end of first quarter. So my expectation is that all of these sales are in approved indication, which is a smaller indication, and we have a smaller sales this quarter.

Okay. Fair enough. The second question on ZEVALIN. I do want to understand what the key reasons for the stabilization of this drug are. It's encouraging to see that you have stabilization without removing the reimbursement hurdle or removing the scan requirement. So I'd like to understand why this stabilization is happening, but before that, if you can help us understand how you analyze your marketing efforts on ZEVALIN (inaudible), how do you know that what you are doing in terms of marketing is working?

Well, I'll have Amar answer this question, but I can tell you from my point of view, we have 24 sales people, and then supported by what's called [SNOs] and medical science liaisons. We have some 35, 40 people not talking about ZEVALIN. If we look in the past, with the previous company, there were only 7 people in the field. The kind of report we get back from the field that some of the doctors have never ever used this drug before are now beginning to use this drug, or the people who use in one or two patients are using in larger number of patients. So maybe I will have Amar to give a little bit more clarity to this.

There is no single reason. There are a multitude of reasons, Shiv. First and foremost, we have, and I don't want this to be, I really want to emphasize this, the quality of the people that we have in the field are absolutely superb ranging from sales representatives to account managers to the clinical liaisons and these guys have done a [humongous] job to make sure that we are able to get awareness for this drug out there. This is a very promotionally sensitive product as you well know and we have had very targeted approach towards the physician community to institutions.

Just as a case in point, the treatment center, the centers of excellence that we have honed in on are actually providing some very important dividends. You should go to our website it clearly identifies the ZEVALIN centers if you will within the geographic radius that will now allow physicians to refer patients too. So this is working very well. I think the other aspect is the alignment that we have achieved between the physicians' office to the site where the drug is administered has been very critical but most importantly it has also had to do with the consistency of the message and the targeting of the customers in a very judicious manner.

Great. Thanks for answering my questions.

Thank you.

That's all the time we have for today's conference call. I would like to turn the conference back over to Dr. Rajesh Shrotriya for any additional or closing remarks.

Thank you. In closing, I would like to reiterate the following important points. Today, Spectrum Pharmaceutical is in a very strong position. We have a diversified revenue stream derived from sales of two different anti-cancer drugs, namely ZEVALIN and FUSILEV. Our third drug, Apaziquone, is in late stage registration trials for bladder cancer. We continue to focus in our business strategy of balancing proprietary development with the strategic monetization of assets. We have a strong management team with a solid track record in oncology development and marketing. And although all these people have been successful in their prior careers, they have decided to make Spectrum as a highlight of their career.

Last but not the least we maintain a strict financial discipline having approximately $106 million in cash and a continued commitment to creating shareholder value in a financially challenging environment. We look forward to updating you on our progress during the exciting transformative time. I would like to thank all of you for your time today. Once again thank you and we look forward to talking with you again during our next call.

Once again that does conclude today's conference. We thank you for your participation.