Chiasma (CHMA) 10-Q 7 May 20 2020 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2020	May 04, 2020
Cover [Abstract]
Document Type	10-Q
Entity Interactive Data Current	Yes
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Entity Registrant Name	CHIASMA, INC
Entity Central Index Key	0001339469
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	true
Entity Common Stock, Shares Outstanding		42,265,341
Trading Symbol	CHMA
Security Exchange Name	NASDAQ
Title of 12(b) Security	Common Stock
Entity Address, State or Province	MA

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets
Cash and cash equivalents	$ 42,555	$ 27,855
Marketable securities	36,707	64,520
Prepaid expenses and other current assets	4,877	3,881
Total current assets	84,139	96,256
Property and equipment, net	590	334
Other assets	1,993	2,236
Total assets	86,722	98,826
Current liabilities
Accounts payable	5,450	3,253
Accrued expenses	7,238	7,576
Other current liabilities	716	546
Total current liabilities	13,404	11,375
Long-term liabilities	1,575	1,682
Total liabilities	14,979	13,057
Commitments and contingencies (Note 9)
Stockholders' equity:
Common stock, $0.01 par value; authorized 125,000,000 shares at March 31, 2020 and December 31, 2019; issued and outstanding 42,265,341 shares at March 31, 2020 and 42,078,416 shares at December 31, 2019	423	421
Preferred stock, $0.01 par value; authorized 5,000,000 shares; none outstanding
Additional paid-in capital	359,637	358,245
Accumulated other comprehensive income	3	37
Accumulated deficit	(288,320)	(272,934)
Total stockholders' equity	71,743	85,769
Total liabilities and stockholders' equity	$ 86,722	$ 98,826

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	125,000,000	125,000,000
Common stock, shares issued	42,265,341	42,078,416
Common stock, shares outstanding	42,265,341	42,078,416
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares outstanding	0	0

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating expenses:
General and administrative	$ 7,582	$ 2,450
Research and development	8,125	6,471
Total operating expenses	15,707	8,921
Loss from operations	(15,707)	(8,921)
Other income, net	(398)	(184)
Loss before income taxes	(15,309)	(8,737)
Provision for income taxes	77	13
Net loss	$ (15,386)	$ (8,750)
Earnings per share
Basic	$ (0.36)	$ (0.36)
Diluted	$ (0.36)	$ (0.36)
Weighted-average shares outstanding:
Basic	42,187,694	24,466,617
Diluted	42,187,694	24,466,617

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net loss	$ (15,386)	$ (8,750)
Other comprehensive income (loss):
Unrealized gain (loss) on available for sale securities, net	(34)	18
Total other comprehensive income (loss):	(34)	18
Comprehensive loss	$ (15,420)	$ (8,732)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Accumulated Deficit [Member]
Beginning balance at Dec. 31, 2018	$ 34,124	$ 245	$ 270,509	$ (16)	$ (236,614)
Beginning balance, shares at Dec. 31, 2018		24,456,120
Stock-based compensation	622		622
Exercise of stock options	3		3
Exercise of stock options, shares		33,839
Additional paid in capital on account of vested portion of restricted stock	16		16
Other comprehensive income (loss)	18			18
Net loss	(8,750)				(8,750)
Ending balance at Mar. 31, 2019	26,033	$ 245	271,150	2	(245,364)
Ending balance, shares at Mar. 31, 2019		24,489,959
Beginning balance at Dec. 31, 2018	34,124	$ 245	270,509	(16)	(236,614)
Beginning balance, shares at Dec. 31, 2018		24,456,120
Net loss	(36,300)
Ending balance at Dec. 31, 2019	85,769	$ 421	358,245	37	(272,934)
Ending balance, shares at Dec. 31, 2019		42,078,416
Stock-based compensation	1,162		1,162
Exercise of stock options	232	$ 2	230
Exercise of stock options, shares		186,925
Other comprehensive income (loss)	(34)			(34)
Net loss	(15,386)				(15,386)
Ending balance at Mar. 31, 2020	$ 71,743	$ 423	$ 359,637	$ 3	$ (288,320)
Ending balance, shares at Mar. 31, 2020		42,265,341

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating Activities:
Net loss	$ (15,386)	$ (8,750)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation	26	16
Stock-based compensation	1,162	622
Accretion on marketable securities, net	(65)	(131)
Amortization of right-of-use asset	121	39
Benefit for deferred income taxes	(24)	(10)
Changes in operating assets and liabilities:
Prepaid expenses and other current assets	(1,298)	1,015
Accounts payable and accrued expenses	2,924	(751)
Other assets	(19)	9
Other current and long-term liabilities	(31)	(9)
Net cash used in operating activities	(12,590)	(7,950)
Investing Activities:
Purchases of marketable securities	(8,927)	(12,282)
Maturities of marketable securities	36,771	17,250
Purchases of property and equipment	(282)	(7)
Net cash provided by investing activities	27,562	4,961
Financing Activities:
Exercise of stock options	232	3
Payments of short-term borrowing	(504)
Net cash provided by (used in) financing activities	(272)	3
Net increase (decrease) in cash and cash equivalents	14,700	(2,986)
Cash and cash equivalents, beginning of period	27,855	13,060
Cash and cash equivalents, end of period	$ 42,555	$ 10,074

Description of Business and Sum

Description of Business and Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Description of Business and Summary of Significant Accounting Policies	1. Description of Business and Summary of Significant Accounting Policies Chiasma, Inc. is a clinical , late top-line Acromegaly is a rare and debilitating condition that is caused by the body’s production of excess growth hormone. Octreotide is an analog of somatostatin, a natural inhibitor of growth hormone secretion. Octreotide capsules have been granted orphan designation in the United States and the European Union for the treatment of acromegaly. We retain worldwide rights to develop and commercialize octreotide capsules. We are also currently conducting an international Phase 3 clinical trial, referred to as MPOWERED, of oral octreotide capsules for the maintenance treatment of adult patients with acromegaly to support regulatory approval in the European Union by the European Medicines Agency (“EMA”). The MPOWERED trial is a global, randomized, open-label and active-controlled 15-month six-month run-in In April 2019, we completed a follow-on In August 2019, we completed a follow-on In April 2020, we entered into an Open Market Sales Agreement (“ATM Agreement”) for “at the market offerings” with Jefferies LLC (“ Jefferies ”), which allows us to offer and sell up to $60.0 million in gross proceeds of common stock from time to time, through Jefferies, acting as our sales agent or principal. To date, we have not sold any common stock under the ATM Agreement. In April 2020, we entered into a Revenue Interest Financing Agreement (the “Revenue Interest Financing Agreement”) with Healthcare Royalty Partners IV, L.P. (“HCR”) for up to $75.0 million. The initial funding of $25.0 million, less certain transaction expenses, was completed in April 2020 (see Note 6). Consideration of Going Concern and Management’s Plans Under the existing accounting guidance, management must evaluate whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the Company’s ability to continue as a going concern within one year after the date the condensed consolidated financial statements are issued. This evaluation initially does not take into consideration the potential mitigating effect of management’s plans that have not been fully implemented as of the date the condensed consolidated financial statements are issued. When substantial doubt is determined to exist, management evaluates whether the mitigating effect of its plans sufficiently alleviates substantial doubt about the Company’s ability to continue as a going concern. The mitigating effect of management’s plans; however, is only considered if both (1) it is probable that the plans will be effectively implemented within one year after the date the condensed consolidated financial statements are issued, and (2) it is probable that the plans, when implemented, will mitigate the relevant conditions or events that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the date the condensed consolidated financial statements are issued . We have incurred substantial operating losses since inception, and we expect our operating losses and negative operating cash flows to continue for the foreseeable future. For the three months ended March 31, 2020, we had a net loss of $15.4 million and used $12.6 million of cash in operations. For the year ended December 31, 2019, we had a net loss of $36.3 million and used $35.0 million of cash in operations. At March 31, 2020, we had cash, cash equivalents and marketable securities of $79.3 million and an accumulated deficit of $288.3 million. We expect to continue to incur significant costs in the upcoming year as we prepare for the potential approval and commercial launch of octreotide capsules in the United States. The FDA has assigned a PDUFA target action e condensed c onsolidated financial statements are issued. Accordingly, we believe these conditions, in the aggregate, raise substantial doubt regarding our ability to continue as a going concern for a period of one year from the date th e condensed c onsolidated financial statements are issued. In order to fund these efforts, in part, we entered into a $75.0 million Revenue Interest Financing Agreement with HCR, $50.0 million of which funding remains contingent upon the achievement of certain milestones. We expect to further finance our cash needs through equity financings, and we will also opportunistically consider license and collaboration agreements with potential partners or convertible debt financing to the extent such sources are identified and available. If FDA approval is obtained, we also plan to use revenues, if any, generated from the sale of octreotide capsules in the U.S. to fund our operations. While we believe our plans to achieve the Revenue Interest Financing Agreement funding milestones, to raise additional funds and generate product sales will alleviate the conditions that raise substantial doubt, these plans are not entirely within our control and cannot be assessed as being probable of occurring. Further, while we have received a PDUFA target action date from the FDA, there can be no assurances that FDA approval of octreotide capsules will be received . Basis of Presentation We have prepared the accompanying unaudited condensed consolidated financial statements pursuant to the rules and regulations of the SEC regarding interim financial reporting. Accordingly, certain information and footnote disclosures required by accounting principles generally accepted in the United States (“U.S. GAAP”) for annual financial statements have been condensed or omitted. The information included in this quarterly report on Form 10-Q 10-K year-end Cash Equivalents Cash equivalents consist of highly liquid instruments that mature within three months or less from the date of purchase. Marketable Securities Our investments primarily consist of commercial paper and corporate and government debt securities. These marketable securities are classified as available-for-sale, If a decline in the fair value of a marketable security below our cost basis is determined to be other than temporary, such marketable security is written down to its estimated fair value as a new cost basis and the amount of the write-down is included in earnings as an impairment charge. The cost of securities sold is based on the specific identification method. Concentrations of credit risk Financial instruments that potentially subject us to significant concentration of credit risk consist primarily of cash, cash equivalents and marketable securities. We routinely maintain deposits in financial institutions in excess of government insured limits. Management believes that we are not exposed to significant credit risk as our deposits are held at financial institutions that management believes to be of high credit quality and we have not experienced any significant losses in these deposits. We regularly invest excess operating cash in deposits with major financial institutions and money market funds and in notes issued by the U.S. government, as well as in fixed income investments and U.S. bond funds, both of which can be readily purchased and sold using established markets. We believe that the market risk arising from our holdings of these financial instruments is mitigated based on the fact that many of these securities are either government backed or of high credit rating. Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes during the reporting period. We base these estimates and assumptions on historical experience when available, and on various factors that we believe to be reasonable under the specific circumstances. Significant estimates relied upon in preparing the accompanying condensed consolidated financial statements include, but are not limited to, accounting for stock-based compensation, income taxes, and accounting for certain accruals. We assess the above estimates on an ongoing basis; however, actual results could materially differ from those estimates. Recently Issued Accounting Pronouncements In June 2016, the FASB issued new guidance which will require more timely recording of credit losses on loans and other financial instruments held by financial institutions and other organizations. The new guidance requires the measurement of all expected credit losses for financial assets held at the reporting date based on historical experience, current conditions and reasonable and supportable forecasts. The new guidance also requires enhanced disclosures regarding significant estimates and judgments used in estimating credit losses. On January 1, 2020, we adopted this standard. The adoption of this standard did not have a material impact on our condensed consolidated financial statements.

Investments

Investments	3 Months Ended
	Mar. 31, 2020
Investments, All Other Investments [Abstract]
Investments	2. Investments Our investments consisted of the following as of March 31, 2020 and December 31, 2019: As of March 31, 2020 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value ($ in thousands) Money market funds $ 41,312 $ — $ — $ 41,312 Corporate notes 21,527 1 (17 ) 21,511 Commercial paper 15,177 19 — 15,196 Total $ 78,016 $ 20 $ (17 ) $ 78,019 As of December 31, 2019 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value ($ in thousands) Money market funds $ 23,012 $ — $ — $ 23,012 Corporate notes 45,584 20 — 45,604 Commercial paper 20,899 17 — 20,916 Total $ 89,495 $ 37 $ — $ 89,532 As of March 31, 2020, we consider those securities that are in an unrealized loss position are temporary and are not due to credit losses. We have the ability to hold such investments until recovery of the fair value. We utilize the specific identification method in computing realized gains and losses. We had no realized gains and losses on our available-for-sale The fair values of our investments by classification in our condensed consolidated balance sheets as of March 31, 2020 and December 31, 2019 were as follows: March 31, 2020 December 31, 2019 ($ in thousands) Cash and cash equivalents $ 41,312 $ 25,012 Marketable securities 36,707 64,520 Total $ 78,019 $ 89,532 Cash and cash equivalents in the table above exclude cash of $1.2 million and $2.8 million as of March 31, 2020 and December 31, 2019, respectively. The contractual maturity dates of all of our investments are less than one year.

Fair Value Measurements of Fina

Fair Value Measurements of Financial Instruments	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements and Fair Value of Financial Instruments	3. Fair Value Measurements of Financial Instruments Certain assets and liabilities are reported at fair value on a recurring basis. Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. The fair value accounting guidance requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories: • Level 1 • Level 2 • Level 3 To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the degree of judgment exercised by us in determining fair value is greatest for instruments categorized in Level 3. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. The fair value measurements of our financial instruments are summarized in the table below: Fair Value Measurements at March 31, 2020 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total ($ in thousands) Cash equivalents: Money market funds $ 41,312 $ — $ — $ 41,312 Total cash equivalents $ 41,312 $ — $ — $ 41,312 Marketable securities: Corporate notes $ — $ 21,511 $ — $ 21,511 Commercial paper — 15,196 — 15,196 Total marketable securities — 36,707 — 36,707 Total $ 41,312 $ 36,707 $ — $ 78,019 Fair Value Measurements at December 31, 2019 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total ($ in thousands) Cash equivalents: Money market funds $ 23,012 $ — $ — $ 23,012 Corporate notes — 2,000 — 2,000 Total cash equivalents $ 23,012 $ 2,000 $ — $ 25,012 Marketable securities: Corporate notes $ — $ 43,604 $ — $ 43,604 Commercial paper — 20,916 — 20,916 Total marketable securities — 64,520 — 64,520 Total $ 23,012 $ 66,520 $ — $ 89,532 Our cash equivalents are classified as Level 1 assets under the fair value hierarchy as these assets have been valued using quoted market prices in active markets and do not have any restrictions on redemption. Our marketable securities are classified as Level 2 assets under the fair value hierarchy as these assets were primarily determined from independent pricing services, which normally derive security prices from recently reported trades for identical or similar securities, making adjustments based upon other significant observable market transactions. At the end of each reporting period, we perform quantitative and qualitative analysis of prices received from third parties to determine whether prices are reasonable estimates of fair value. After completing our analysis, we did not adjust or override any fair value measurements provided by our pricing services as of March 31, 2020 or December 31, 2019. We did not have any Level 3 assets being measured at fair value on a recurring basis as of March 31, 2020 and December 31, 2019.

Earnings per Share of Common St

Earnings per Share of Common Stock	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Earnings per Share of Common Stock	4. Earnings per Share of Common Stock All common stock warrants and stock options have been excluded from the computation of diluted weighted-average shares outstanding because such securities would have an anti-dilutive impact due to net losses reported during the three months ended March 31, 2020 and 2019.

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2020
Payables and Accruals [Abstract]
Accrued Expenses	5. Accrued Expenses As of March 31, 2020 and December 31, 2019, accrued expenses consisted of the following: March 31, 2020 December 31, 2019 ($ in thousands) Accrued general and administrative expenses $ 1,488 $ 647 Accrued research and development expenses 3,964 4,219 Accrued payroll and employee benefits 1,451 1,872 Short-term borrowing 335 838 Total accrued expenses $ 7,238 $ 7,576

Deferred Royalty Obligation

Deferred Royalty Obligation	3 Months Ended
	Mar. 31, 2020
Text Block [Abstract]
Deferred Royalty Obligation	6. Deferred Royalty Obligation In April 2020, we entered into the Revenue Interest Financing Agreement with HCR whereby HCR will receive payments from us at a tiered percentage (the “Applicable Tiered Percentage”) of future net revenues of MYCAPSSA and any of our other future products, including worldwide net product sales and upfront payments, and subject to the FDA approval of MYCAPSSA for the maintenance treatment of adults with acromegaly before the first anniversary of the initial closing (the “FDA Condition”) and customary closing conditions and an additional $15.0 million upon the certain conditions related to commercial drug supply availability and first commercial sale of MYCAPSSA subject to customary closing conditions . We are also entitled to receive an additional $10.0 million in early 2022 subject to the achievement of a commercial milestone and customary closing conditions . In exchange for the total investment amount (“Investment Amount”) received, HCR will receive a tiered royalty starting in the low double digits on worldwide annual net revenues of MYCAPSSA and any other future products, subject to step-downs upon the achievement of certain annual revenues. HCR’s rights to receive the Revenue Interests shall terminate on the date on which HCR has received payments equal to 195% of the funded portion of the Investment Amount including the aggregate of all payments made to HCR as of such date, unless the Revenue Interest Financing earlier we Financing ten-year we we If HCR has not received 60% of the Investment Amount by September 30, 2023 or 100% of the Investment Amount by September 30, 2024, we must make cash payment s Financing Agreement requires us to maintain a minimum of $20.0 million in securitized cash and investment accounts during any quarter that the trailing four quarters of net revenue of MYCAPSSA is below a certain threshold . Our obligations under the Royalty Interest Financing Agreement are secured by a first priority perfected security interest in all of our Chiasma, Inc. cash and cash equivalents (as defined in the Royalty Interest Financing Agreement), all present and future net revenues of MYCAPSSA and all MYCAPSSA-related assets .

Warrants

Warrants	3 Months Ended
	Mar. 31, 2020
Text Block [Abstract]
Warrants	7. Warrants As of December 31, 2019, there were 3,567,015 common stock warrants outstanding with exercise prices ranging from $0.09 per share to $9.13 per share. Such warrants were issued between October 2012 and February 2015 with expiration dates ranging from March 2022 through December 2024. There were no warrants issued or exercised during the three months ended March 31, 2020. There were 3,567,015 outstanding warrants as of March 31, 2020.

Stock Incentive Plans

Stock Incentive Plans	3 Months Ended
	Mar. 31, 2020
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Incentive Plan	8. Stock Incentive Plans In 2008, our board of directors adopted the 2008 Stock Incentive Plan (the “2008 Plan”), which provided for the grant of incentive stock options, nonqualified stock options, and restricted stock to employees, directors, and nonemployees of the Company up to 3,547,741 shares of common stock. Option awards expire 10 years from the grant date and generally vest over four years but vesting conditions can vary at the discretion of our board of directors. In July 2015, the Company approved the 2015 Stock Option and Incentive Plan (the “2015 Plan”), which became effective upon our initial public offering. The 2015 Plan allow the grant of incentive stock options, nonqualified stock options, and restricted stock to employees, directors, and nonemployees of the Company initially up to 3,566,296 shares of common stock. In connection with the adoption of the 2015 Plan, no further option grants were permitted under the 2008 Plan and any expirations, cancellations, or terminations under the 2008 Plan are available for issuance under the 2015 Plan. On January 1, 2020, the number of shares reserved and available for issuance under the 2015 Plan increased by 1,683,136 shares of common stock pursuant to a provision in the 2015 Plan that provides that the number of shares reserved and available for issuance will automatically increase each January 1, beginning on January 1, 2016, by 4% of the number of shares of common stock issued and outstanding on the immediately preceding December 31 or such lesser number as determined by the compensation committee of the board of directors. As of March 31, 2020, the total number of shares authorized for stock award plans is 9,775,418 of which 1,598,475 remain available for grant. There are 7,408,536 stock options outstanding as of March 31, 2020. Stock-based compensation for the three months ended March 31, 2020 and 2019 consisted of the following: Three Months Ended March 31, 2020 2019 ($ in thousands) General and administrative $ 953 $ 311 Research and development 209 311 Total $ 1,162 $ 622 The fair value of each stock option issued was estimated at the date of grant using the Black-Scholes option model with the following weighted-average assumptions: Three Months Ended March 31, 2020 2019 Expected volatility 85 % 101 % Expected term (years) 6.3 6.0 Risk-free interest rate 1.44 % 2.52 % Expected dividend yield 0 % 0 % We granted approximately 1,158,900 stock options in the three months ended March 31, 2020. The weighted-average grant date fair value per share of stock options granted during the three months ended March 31, 2020 was $3.35. We granted approximately 492,000 stock options in the three months ended March 31, 2019. The weighted-average grant date fair value per share of options granted during the three months ended March 31, 2019 was $2.99.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Manufacturing Commitments As of March 31, 2020, we had outstanding purchase orders for the acquisition of API in the aggregate amount of $10.2 million. The payments on these orders will occur following the deliveries of the API which are anticipated during 2020.

Leases

Leases	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Leases	10. Leases We determine if an arrangement is a lease at inception. We have operating leases for our office spaces and certain automobiles. R ight-of-use right-of-use non-lease Three Months Ended March 31, 2020 2019 ($ in thousands) The components of lease expense were as follows: Operating lease expense $ 167 $ 47 Supplemental cash flow information related to leases was as follows: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 72 $ 45 Right-of-use Operating leases $ 94 $ 27 March 31, 2020 ($ in thousands) Supplemental balance sheet information related to leases was as follows: R ight-of-use $ 1,346 Other current liabilities $ 628 Long-term liabilities 938 Total lease liabilities $ 1,566 Weighted average remaining lease term - 28 Months Weighted average discount rate - 10.7 % Our lease right-of-use Future lease payments under noncancelable leases as of March 31, 2020 are as follows: ($ in thousands) Remainder of 2020 $ 587 2021 715 2022 487 Total future minimum lease payments 1,789 Less: imputed interest (223 ) Total $ 1,566

Description of Business and S_2

Description of Business and Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Consideration of going concern and management's plans	Consideration of Going Concern and Management’s Plans Under the existing accounting guidance, management must evaluate whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the Company’s ability to continue as a going concern within one year after the date the condensed consolidated financial statements are issued. This evaluation initially does not take into consideration the potential mitigating effect of management’s plans that have not been fully implemented as of the date the condensed consolidated financial statements are issued. When substantial doubt is determined to exist, management evaluates whether the mitigating effect of its plans sufficiently alleviates substantial doubt about the Company’s ability to continue as a going concern. The mitigating effect of management’s plans; however, is only considered if both (1) it is probable that the plans will be effectively implemented within one year after the date the condensed consolidated financial statements are issued, and (2) it is probable that the plans, when implemented, will mitigate the relevant conditions or events that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the date the condensed consolidated financial statements are issued . We have incurred substantial operating losses since inception, and we expect our operating losses and negative operating cash flows to continue for the foreseeable future. For the three months ended March 31, 2020, we had a net loss of $15.4 million and used $12.6 million of cash in operations. For the year ended December 31, 2019, we had a net loss of $36.3 million and used $35.0 million of cash in operations. At March 31, 2020, we had cash, cash equivalents and marketable securities of $79.3 million and an accumulated deficit of $288.3 million. We expect to continue to incur significant costs in the upcoming year as we prepare for the potential approval and commercial launch of octreotide capsules in the United States. The FDA has assigned a PDUFA target action e condensed c onsolidated financial statements are issued. Accordingly, we believe these conditions, in the aggregate, raise substantial doubt regarding our ability to continue as a going concern for a period of one year from the date th e condensed c onsolidated financial statements are issued. In order to fund these efforts, in part, we entered into a $75.0 million Revenue Interest Financing Agreement with HCR, $50.0 million of which funding remains contingent upon the achievement of certain milestones. We expect to further finance our cash needs through equity financings, and we will also opportunistically consider license and collaboration agreements with potential partners or convertible debt financing to the extent such sources are identified and available. If FDA approval is obtained, we also plan to use revenues, if any, generated from the sale of octreotide capsules in the U.S. to fund our operations. While we believe our plans to achieve the Revenue Interest Financing Agreement funding milestones, to raise additional funds and generate product sales will alleviate the conditions that raise substantial doubt, these plans are not entirely within our control and cannot be assessed as being probable of occurring. Further, while we have received a PDUFA target action date from the FDA, there can be no assurances that FDA approval of octreotide capsules will be received .
Basis of Presentation	Basis of Presentation We have prepared the accompanying unaudited condensed consolidated financial statements pursuant to the rules and regulations of the SEC regarding interim financial reporting. Accordingly, certain information and footnote disclosures required by accounting principles generally accepted in the United States (“U.S. GAAP”) for annual financial statements have been condensed or omitted. The information included in this quarterly report on Form 10-Q 10-K year-end
Cash Equivalents	Cash Equivalents Cash equivalents consist of highly liquid instruments that mature within three months or less from the date of purchase.
Marketable Securities	Marketable Securities Our investments primarily consist of commercial paper and corporate and government debt securities. These marketable securities are classified as available-for-sale, If a decline in the fair value of a marketable security below our cost basis is determined to be other than temporary, such marketable security is written down to its estimated fair value as a new cost basis and the amount of the write-down is included in earnings as an impairment charge. The cost of securities sold is based on the specific identification method.
Concentrations of credit risk	Concentrations of credit risk Financial instruments that potentially subject us to significant concentration of credit risk consist primarily of cash, cash equivalents and marketable securities. We routinely maintain deposits in financial institutions in excess of government insured limits. Management believes that we are not exposed to significant credit risk as our deposits are held at financial institutions that management believes to be of high credit quality and we have not experienced any significant losses in these deposits. We regularly invest excess operating cash in deposits with major financial institutions and money market funds and in notes issued by the U.S. government, as well as in fixed income investments and U.S. bond funds, both of which can be readily purchased and sold using established markets. We believe that the market risk arising from our holdings of these financial instruments is mitigated based on the fact that many of these securities are either government backed or of high credit rating.
Use of Estimates	Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes during the reporting period. We base these estimates and assumptions on historical experience when available, and on various factors that we believe to be reasonable under the specific circumstances. Significant estimates relied upon in preparing the accompanying condensed consolidated financial statements include, but are not limited to, accounting for stock-based compensation, income taxes, and accounting for certain accruals. We assess the above estimates on an ongoing basis; however, actual results could materially differ from those estimates.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In June 2016, the FASB issued new guidance which will require more timely recording of credit losses on loans and other financial instruments held by financial institutions and other organizations. The new guidance requires the measurement of all expected credit losses for financial assets held at the reporting date based on historical experience, current conditions and reasonable and supportable forecasts. The new guidance also requires enhanced disclosures regarding significant estimates and judgments used in estimating credit losses. On January 1, 2020, we adopted this standard. The adoption of this standard did not have a material impact on our condensed consolidated financial statements.

Investments (Tables)

Investments (Tables)	3 Months Ended
	Mar. 31, 2020
Investments, All Other Investments [Abstract]
Schedule of Investments	Our investments consisted of the following as of March 31, 2020 and December 31, 2019: As of March 31, 2020 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value ($ in thousands) Money market funds $ 41,312 $ — $ — $ 41,312 Corporate notes 21,527 1 (17 ) 21,511 Commercial paper 15,177 19 — 15,196 Total $ 78,016 $ 20 $ (17 ) $ 78,019 As of December 31, 2019 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value ($ in thousands) Money market funds $ 23,012 $ — $ — $ 23,012 Corporate notes 45,584 20 — 45,604 Commercial paper 20,899 17 — 20,916 Total $ 89,495 $ 37 $ — $ 89,532
Schedule of Fair Value of Investments	The fair values of our investments by classification in our condensed consolidated balance sheets as of March 31, 2020 and December 31, 2019 were as follows: March 31, 2020 December 31, 2019 ($ in thousands) Cash and cash equivalents $ 41,312 $ 25,012 Marketable securities 36,707 64,520 Total $ 78,019 $ 89,532

Fair Value Measurements of Fi_2

Fair Value Measurements of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements of Company's Financial Instruments	The fair value measurements of our financial instruments are summarized in the table below: Fair Value Measurements at March 31, 2020 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total ($ in thousands) Cash equivalents: Money market funds $ 41,312 $ — $ — $ 41,312 Total cash equivalents $ 41,312 $ — $ — $ 41,312 Marketable securities: Corporate notes $ — $ 21,511 $ — $ 21,511 Commercial paper — 15,196 — 15,196 Total marketable securities — 36,707 — 36,707 Total $ 41,312 $ 36,707 $ — $ 78,019 Fair Value Measurements at December 31, 2019 Quoted Prices in Active Markets for Identical Assets (Level 1) Significant Other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Total ($ in thousands) Cash equivalents: Money market funds $ 23,012 $ — $ — $ 23,012 Corporate notes — 2,000 — 2,000 Total cash equivalents $ 23,012 $ 2,000 $ — $ 25,012 Marketable securities: Corporate notes $ — $ 43,604 $ — $ 43,604 Commercial paper — 20,916 — 20,916 Total marketable securities — 64,520 — 64,520 Total $ 23,012 $ 66,520 $ — $ 89,532

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2020
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	As of March 31, 2020 and December 31, 2019, accrued expenses consisted of the following: March 31, 2020 December 31, 2019 ($ in thousands) Accrued general and administrative expenses $ 1,488 $ 647 Accrued research and development expenses 3,964 4,219 Accrued payroll and employee benefits 1,451 1,872 Short-term borrowing 335 838 Total accrued expenses $ 7,238 $ 7,576

Stock Incentive Plans (Tables)

Stock Incentive Plans (Tables)	3 Months Ended
	Mar. 31, 2020
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Stock-based Compensation	Stock-based compensation for the three months ended March 31, 2020 and 2019 consisted of the following: Three Months Ended March 31, 2020 2019 ($ in thousands) General and administrative $ 953 $ 311 Research and development 209 311 Total $ 1,162 $ 622
Schedule of Fair Value Calculation of Option Granted	The fair value of each stock option issued was estimated at the date of grant using the Black-Scholes option model with the following weighted-average assumptions: Three Months Ended March 31, 2020 2019 Expected volatility 85 % 101 % Expected term (years) 6.3 6.0 Risk-free interest rate 1.44 % 2.52 % Expected dividend yield 0 % 0 %

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Summary of Operations in Leased Facilities	Three Months Ended March 31, 2020 2019 ($ in thousands) The components of lease expense were as follows: Operating lease expense $ 167 $ 47 Supplemental cash flow information related to leases was as follows: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 72 $ 45 Right-of-use Operating leases $ 94 $ 27 March 31, 2020 ($ in thousands) Supplemental balance sheet information related to leases was as follows: R ight-of-use $ 1,346 Other current liabilities $ 628 Long-term liabilities 938 Total lease liabilities $ 1,566 Weighted average remaining lease term - 28 Months Weighted average discount rate - 10.7 %
Schedule of Future Lease Payments Under Noncancelable Leases	Future lease payments under noncancelable leases as of March 31, 2020 are as follows: ($ in thousands) Remainder of 2020 $ 587 2021 715 2022 487 Total future minimum lease payments 1,789 Less: imputed interest (223 ) Total $ 1,566

Description of Business and S_3

Description of Business and Summary of Significant Accounting Policies - Additional Information (Detail) $ / shares in Units, $ in Thousands	1 Months Ended					3 Months Ended		12 Months Ended
	Apr. 30, 2020USD ($)	Aug. 31, 2019USD ($)$ / sharesshares	Jun. 30, 2019Patient	Apr. 30, 2019USD ($)$ / sharesshares	Jul. 31, 2018Patient	Mar. 31, 2020USD ($)SubsidiariesPatient	Mar. 31, 2019USD ($)	Dec. 31, 2019USD ($)
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Number of subsidiaries owned by the company | Subsidiaries						2
Stock issued during period, shares, new issues | shares | shares		10,166,427		7,263,158
Shares issued, price per share | $ / shares | $ / shares		$ 5.50		$ 4.75
Net proceeds received after underwriting fees and offering expenses		$ 52,300		$ 32,200
Net loss						$ (15,386)	$ (8,750)	$ (36,300)
Net cash used in operating activities						(12,590)	$ (7,950)	(35,000)
Cash, cash equivalents and marketable securities						79,300
Accumulated deficit						(288,320)		$ (272,934)
Proceeds From Remaining After The Initial Funding						50,000
Jeffries LLC ("Jeffries") [Member]
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Maximum Proceeds of Sales of Common Stock under Sales Agreement	$ 60,000
Healthcare Royalty Partners IV, L.P. ("HCR") [Member]
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Maximum Proceeds Under Investment Agreement	75,000					$ 75,000
First Funding Of Proceeds Under Investment Agreement	$ 25,000
MPOWERED Trial [Member]
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Number of adult acromegaly patients completed to enroll in trial | Patient			146
First trial period for adult acromegaly patients expected to randomize					6 months
Additional trial period for adult acromegaly patients expected to randomize					9 months
MPOWERED Trial [Member] | Minimum [Member]
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Number of adult acromegaly patients expect to randomize | Patient					80
MPOWERED Trial [Member] | Maximum [Member]
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Number of adult acromegaly patients expected to enroll in trial | Patient						150
Trial period for adult acromegaly patients expected to enroll						15 months
CHIASMA OPTIMAL Trial [Member]
Nature Of Operations And Summary Of Significant Accounting Policies [Line Items]
Number of adult acromegaly patients completed to enroll in trial | Patient						56
Trial period for adult acromegaly patients expected to enroll						9 months

Investments - Schedule of Inves

Investments - Schedule of Investments (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Gain (Loss) on Securities [Line Items]
Amortized Cost	$ 78,016	$ 89,495
Gross Unrealized Gains	20	37
Gross Unrealized Losses	(17)
Estimated Fair Value	78,019	89,532
Money Market Funds [Member]
Gain (Loss) on Securities [Line Items]
Amortized Cost	41,312	23,012
Estimated Fair Value	41,312	23,012
Corporate Notes [Member]
Gain (Loss) on Securities [Line Items]
Amortized Cost	21,527	45,584
Gross Unrealized Gains	1	20
Gross Unrealized Losses	(17)
Estimated Fair Value	21,511	45,604
Commercial Paper [Member]
Gain (Loss) on Securities [Line Items]
Amortized Cost	15,177	20,899
Gross Unrealized Gains	19	17
Estimated Fair Value	$ 15,196	$ 20,916

Investments - Additional Inform

Investments - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Investments, All Other Investments [Abstract]
Realized gains and losses on available-for-sale securities	$ 0
Cash excluded from cash and cash equivalents	$ 1,200,000	$ 2,800,000
Contractual maturity period of investments	1 year

Investments - Schedule of Fair

Investments - Schedule of Fair Value of Investments (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Net Investment Income [Line Items]
Total	$ 78,019	$ 89,532
Cash and Cash Equivalents [Member]
Net Investment Income [Line Items]
Total	41,312	25,012
Marketable Securities [Member]
Net Investment Income [Line Items]
Total	$ 36,707	$ 64,520

Fair Value Measurements of Fi_3

Fair Value Measurements of Financial Instruments - Fair Value Measurements of Company's Financial Instruments (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Cash equivalents:
Total cash equivalents	$ 41,312	$ 25,012
Marketable securities:
Total marketable securities	78,019	89,532
Total	78,019	89,532
Corporate Notes [Member]
Cash equivalents:
Total cash equivalents	21,511	2,000
Marketable securities:
Total marketable securities		43,604
Commercial Paper [Member]
Marketable securities:
Total marketable securities	15,196	20,916
Marketable Securities [Member]
Marketable securities:
Total marketable securities	36,707	64,520
Money Market Funds [Member]
Cash equivalents:
Total cash equivalents	41,312	23,012
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]
Cash equivalents:
Total cash equivalents	41,312	23,012
Marketable securities:
Total	41,312	23,012
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Money Market Funds [Member]
Cash equivalents:
Total cash equivalents	41,312	23,012
Significant Other Observable Inputs (Level 2) [Member]
Cash equivalents:
Total cash equivalents		2,000
Marketable securities:
Total	36,707	66,520
Significant Other Observable Inputs (Level 2) [Member] | Corporate Notes [Member]
Cash equivalents:
Total cash equivalents	21,511	2,000
Marketable securities:
Total marketable securities		43,604
Significant Other Observable Inputs (Level 2) [Member] | Commercial Paper [Member]
Marketable securities:
Total marketable securities	15,196	20,916
Significant Other Observable Inputs (Level 2) [Member] | Marketable Securities [Member]
Marketable securities:
Total marketable securities	$ 36,707	$ 64,520

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Accrued general and administrative expenses	$ 1,488	$ 647
Accrued research and development expenses	3,964	4,219
Accrued payroll and employee benefits	1,451	1,872
Short-term borrowing	335	838
Total accrued expenses	$ 7,238	$ 7,576

Deferred Royalty Obligation - A

Deferred Royalty Obligation - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2024	Sep. 30, 2023	Apr. 30, 2020
Healthcare Royalty Partners IV, L.P. ("HCR") [Member]
Deferred Royalty Obligation [Line Items]
Proceeds from first investment amount			$ 25
Royalty payments applicable tiered percentage			195.00%
Royalty guarantees commitments percentage	100.00%	60.00%
Variable rate of total return			95.00%
Minimum Cash Covenant			$ 20
Food and Drug Administration [Member]
Deferred Royalty Obligation [Line Items]
Proceeds from second investment amount			$ 25
Food and Drug Administration [Member] | Healthcare Royalty Partners IV, L.P. ("HCR") [Member]
Deferred Royalty Obligation [Line Items]
Royalty payments applicable tiered percentage			113.50%
Commercial Drug Supply And First Commercial Sale [Member]
Deferred Royalty Obligation [Line Items]
Proceeds from third investment amount			$ 15
Commercial Milestone [Member]
Deferred Royalty Obligation [Line Items]
Proceeds from fourth investment amount			$ 10

Warrants - Additional Informati

Warrants - Additional Information (Detail) - $ / shares	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Class of Warrant or Right [Line Items]
Warrants outstanding	3,567,015	3,567,015
Warrants issued	0
Warrants exercised	0
Minimum [Member]
Class of Warrant or Right [Line Items]
Warrants exercise price per share		$ 0.09
Warrants expiration date		Mar. 31, 2022
Maximum [Member]
Class of Warrant or Right [Line Items]
Warrants exercise price per share		$ 9.13
Warrants expiration date		Dec. 31, 2024

Stock Incentive Plans - Additio

Stock Incentive Plans - Additional Information (Detail) - $ / shares	Jan. 01, 2020	Jan. 01, 2016	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock authorized for issuance			9,775,418
Shares of common stock available for grant			1,598,475
Number of stock option outstanding			7,408,536
Number of stock options granted			1,158,900	492,000
Weighted average grant date fair value of stock options per share			$ 3.35	$ 2.99
2008 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock authorized for issuance			3,547,741
2008 Plan [Member] | Employee Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options expiration period			10 years
Stock options vesting period			4 years
2015 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock authorized for issuance			3,566,296
Increase in number of shares reserved and available for issuance	1,683,136
Percentage of shares issued and outstanding under plan		4.00%

Stock Incentive Plans - Schedul

Stock Incentive Plans - Schedule of Stock-based Compensation (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Stock-based compensation expense:
Stock-based compensation expenses	$ 1,162	$ 622
General and Administrative [Member]
Stock-based compensation expense:
Stock-based compensation expenses	953	311
Research and Development [Member]
Stock-based compensation expense:
Stock-based compensation expenses	$ 209	$ 311

Stock Incentive Plans - Sched_2

Stock Incentive Plans - Schedule of Fair Value Calculation of Option Granted (Detail)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Expected volatility	85.00%	101.00%
Expected term (years)	6 years 3 months 18 days	6 years
Risk-free interest rate	1.44%	2.52%
Expected dividend yield	0.00%	0.00%

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Active Pharmaceutical Ingredient [Member]
Loss Contingencies [Line Items]
Outstanding purchase commitment amount	$ 10.2

Leases - Summary of Operations

Leases - Summary of Operations in Leased Facilities (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Leases, Operating [Abstract]
Operating lease expense	$ 167	$ 47
Operating cash flows from operating leases	72	45
Operating leases	94	$ 27
Right-of-use assets	1,346
Other current liabilities	628
Long-term liabilities	938
Total lease liabilities	$ 1,566
Weighted average remaining lease term - operating leases	28 months
Weighted average discount rate - operating leases	10.70%

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Rental Commitments for Operating Leases (Detail) $ in Thousands	Mar. 31, 2020USD ($)
Leases, Operating [Abstract]
Remainder of 2020	$ 587
2021	715
2022	487
Total future minimum lease payments	1,789
Less: imputed interest	(223)
Total	$ 1,566