Note 1 - Business | 3 Months Ended |
Mar. 31, 2015 |
Notes to Financial Statements | |
Business Description and Basis of Presentation [Text Block] | 1. Business |
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Heron Therapeutics, Inc. (“we,” “us” and “our”) is a biotechnology company using its proprietary technology and innovative efforts to develop products to address unmet medical needs. Our proprietary Biochronomer drug delivery technology is designed to improve the therapeutic profile of injectable pharmaceuticals. Our product development efforts focus on identifying current therapies with the potential to be reformulated to expand or extend therapeutic effect or duration of action, minimize drawbacks or to apply new delivery methods. In addition, we continually evaluate potential development programs, technologies or product candidates that may be complementary to or synergistic with our existing programs and product development goals. |
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Our Biochronomer technology, with which our lead investigational product candidate, SUSTOL (granisetron injection, extended release) (or “APF530”), and certain of our other product candidates are formulated, consists of bioerodible polymers designed to release drugs over a defined period of time, depending on the medical need of a given therapeutic target. We have demonstrated that our Biochronomer technology can deliver drugs over periods varying from days to weeks and that the technology is potentially applicable to a range of therapeutic areas, including the prevention of chemotherapy-induced nausea and vomiting (“CINV”) and pain management, among others. Furthermore, we have completed comprehensive animal and human toxicology studies that have established that our Biochronomer polymer is well tolerated. |
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At present, our clinical and preclinical development programs include SUSTOL, in advanced development for the prevention of CINV following administration of chemotherapeutic agents, as well as HTX-011 for the prevention of post-operative pain, HTX-019 for the prevention of CINV and HTX-003 for the management of chronic pain and opioid addiction. |
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APF530, which we intend to market as SUSTOL |
subject to regulatory approval, is being developed for the prevention of both acute- and delayed-onset CINV following the administration of moderately emetogenic chemotherapy (“MEC”) or highly emetogenic chemotherapy (“HEC”). Injectable 5-hydroxytryptamine type 3 (“5-HT3”) receptor antagonists have been shown to be among the most effective and preferred treatments for CINV, however, an unmet need remains for patients suffering from CINV during the delayed-onset phase, which typically occurs 1-5 days following administration of chemotherapy agents. For patients suffering from delayed-onset CINV, only one injectable 5-HT3 receptor antagonist is approved for use following the administration of MEC agents, and none are approved for use following administration of HEC agents. SUSTOL contains the 5-HT3 receptor antagonist granisetron, selected due to its broad use by physicians based on a well-established record of safety and efficacy, and because it is only currently approved for the prevention of CINV during the acute-onset phase. SUSTOL is formulated with our proprietary Biochronomer drug delivery technology, and in clinical studies has been shown to maintain therapeutic drug levels of granisetron for up to five days with a single subcutaneous injection. In 2014, we initiated a Phase 3 clinical study evaluating SUSTOL for the prevention of delayed-onset CINV following the administration of HEC agents (“HEC study”), which, if successful, would differentiate SUSTOL from the other currently approved 5-HT3 receptor antagonists. We completed enrollment of our HEC study in April 2015. |
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In May 2009, we filed a New Drug Application (“NDA”) for SUSTOL with the U.S Food and Drug Administration (“FDA”) under Section 505(b)(2) of the Federal Food, Drug, and Cosmetic Act. In March 2010, we received our first Complete Response Letter (“CRL”), which stated that the May 2009 NDA requesting approval for SUSTOL could not be approved as it was initially submitted. The primary points raised in the initial CRL were related to the dosing system, certain identified deficiencies in the chemistry, manufacturing, and control (“CMC”) review, and a request that we perform additional studies showing bioequivalence and metabolic rates, on human factors, and to perform a QT study. We met with the FDA in 2011 to clarify the comments and requests and subsequently performed additional work and data analyses which we believed addressed the concerns raised in the 2010 CRL. In September 2012, we resubmitted the NDA requesting approval for SUSTOL and, in March 2013, the FDA issued a second CRL. The FDA identified several additional issues precluding the approval of the SUSTOL NDA resubmission, including further issues relating to the CMC review and deficiencies at certain of our contract manufacturers, and requested that we repeat human factors testing using commercially equivalent material, as well to provide data to allow reanalysis of our Phase 3 clinical results under the revised American Society of Clinical Oncology guidelines for the prevention of CINV following the administration of MEC or HEC agents, published in 2011. We believe that we have substantially addressed the issues raised in the March 2013 CRL, which will be reflected in our upcoming SUSTOL NDA resubmission. We intend to include the results of our Phase 3 HEC study in the resubmission of our NDA for SUSTOL, which we anticipate filing mid-year 2015. |
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The lead product candidate in our pain management program is HTX-011. HTX-011, which utilizes our proprietary Biochronomer drug delivery technology, is a long-acting formulation of the local anesthetic bupivacaine in combination with the anti-inflammatory meloxicam for the prevention of post-operative pain. The effective management of pain with a reduction in the use of opioids, which can lead to post-operative complications, extended hospitalization and abuse, remains an important area of unmet medical need, and HTX-011 could potentially provide a differentiated therapeutic profile with advantages compared to currently available pain management options. In a Phase 1 clinical trial, completed in March 2015, HTX-011 achieved the desired pharmacokinetic profile for both bupivacaine and meloxicam. Therapeutically relevant plasma bupivacaine levels were sustained for 2-3 days in the absence of the large initial peak often observed with commercially available formulations of long-acting bupivacaine. The anesthetic effects of HTX-011 persisted through 96 hours, which closely correlated with plasma bupivacaine concentrations, and HTX-011 was well-tolerated with no serious adverse events. We plan to move HTX-011 into Phase 2 clinical development in the second quarter of 2015. |
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In November 2014, we announced our development program for HTX-019. HTX-019 is a proprietary injectable formulation of aprepitant, a neurokinin-1 (“NK1”) receptor antagonist for the prevention of CINV. NK1 receptor antagonists are typically used in combination with 5-HT3 receptor antagonists. At present, the only injectable NK1 receptor antagonist approved in the United States contains polysorbate 80, a surfactant, which may cause hypersensitivity reactions or other adverse reactions in some patients. Our formulation for HTX-019 does not contain polysorbate 80, and may have a lower incidence of infusion-site reactions than reported with the commercially available injectable NK1 receptor antagonist. We plan to discuss with the FDA our intent to develop HTX-019 utilizing the 505(b)(2) registration pathway. |
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In December 2014, we disclosed a second investigational product in our pain management program. HTX-003, which utilizes our proprietary Biochronomer drug delivery technology, is a long-acting formulation of buprenorphine for the management of chronic pain and opioid addiction. HTX-003 is designed to maintain therapeutic drug levels of buprenorphine for up to 30 days following a single subcutaneous injection with a low potential for patient abuse. We are presently evaluating our plans for further development of HTX-003. |
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Liquidity |
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We have incurred significant operating losses and negative cash flows from operations, and we had an accumulated deficit of $335.8 million as of March 31, 2015. Since 2011, we have completed a total of five rounds of equity and/or convertible debt financings, which provided us with cash of approximately $194.3 million in the aggregate, net of issuance costs, to fund operations (see Notes 4 and 5). As of March 31, 2015, we had cash and cash equivalents on hand of $55.6 million. |
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We believe that our current working capital is sufficient to fund operations through 2015, including pursuing regulatory approval for SUSTOL, completing Phase 1 and Phase 2 human clinical studies expected to commence in the second half of 2015 relative to our HTX-011 product candidate, and engaging in clinical and preclinical activities for our HTX-019 product candidate. In the event we were to pursue clinical product development in other areas, potentially acquire other strategic assets, or begin to make significant investments in preparing for commercialization of SUSTOL, we would need to raise additional capital. If we are unable to obtain sufficient financing on acceptable terms or otherwise, we may be required to reduce or defer our activities. Our capital requirements going forward will depend on numerous factors, including but not limited to: the scope, rate of progress, results and costs of preclinical testing and clinical trials, including completing our Phase 3 HEC study; an approval decision by the FDA with respect to SUSTOL; the timing of and costs associated with the commercial launch of SUSTOL, if approved; the degree of commercial success of SUSTOL; the number and characteristics of product development programs we pursue and the pace of each program, including the timing of clinical trials; the time, cost and outcome involved in seeking other regulatory approvals; scientific progress in our research and development programs; the magnitude and scope of our research and development programs; our ability to establish and maintain strategic collaborations or partnerships for research, development, clinical testing, manufacturing and marketing of our product candidates; the cost and timing of establishing sales, marketing and distribution capabilities if we commercialize products independently; the cost of establishing clinical and commercial supplies of our product candidates and any products that we may develop; and general market conditions. |
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We may not be able to raise sufficient additional capital when we need it on favorable terms, or at all. The sale of additional equity in the future may be dilutive to our stockholders. If we are unable to obtain adequate funds on reasonable terms, we may be required to curtail operations significantly or to obtain funds by entering into financing, supply or collaboration agreements on unattractive terms. |