Edap Tms Q2 2024 Earnings Call Transcript

Quartr
Provided by Quartr
August 28, 2024

There are 6 speakers on the call.

Operator

Good day, and welcome to the EDAP TMS Second Quarter 20 24 Earnings Conference Call. All participants will be in a listen only mode. After today's presentation, there will be an opportunity to ask questions. Please note this event is being recorded. I would now like to turn the conference over to John Francis of LifeSci Advisors.

Operator

Please go ahead.

Speaker 1

Good morning. Thank you for joining us for the EDAP TMS Q2 2020 financial and operating results conference call. Joining me on today's call are Ryan Rhodes, Chief Executive Officer Ken Mobick, Chief Financial Officer and Francois Dietsch, Chief Accounting Officer. Before we begin, I would like to remind everyone that management's remarks today may contain forward looking statements, which include statements regarding the company's growth and expansion plans. Such statements are based on management's current expectations and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those described in such forward looking statements.

Speaker 1

Factors that may cause such a difference include, but are not limited to, those described in the company's filings with the Securities and Exchange Commission. Now I'd like to turn the call over to EDAP's Chief Executive Officer, Ryan Rhodes.

Speaker 2

Ryan? Thank you, John, and good morning, everyone. In the Q2, we reported total worldwide revenue in U. S. Dollars of 15,800,000 dollars up 10.6% on a year over year basis.

Speaker 2

U. S. Focal 1 HIFU procedure growth remained strong in the 2nd quarter with the number of procedures growing by 63% on a year over year basis. We placed 5 Focal One systems during the Q2, which included placements with the City of Hope, National Medical Center in Los Angeles, Robert Wood Johnson University Hospital in New Jersey, the VA Bronx Healthcare System in New York, El Camino Hospital in Silicon Valley and the Morton Plant Hospital in Florida. City of Hope is a world renowned pioneer in both cancer research and treatment.

Speaker 2

It is also a National Cancer Institute designated comprehensive cancer center and a National Cancer Center Network member institution. Placing Focal One at such a well regarded medical institution speaks not only to the quality of the Focal One technology platform, but also reflects a growing trend among top cancer centers in adopting robotic HIFU as a treatment option for localized prostate cancer. The Robert Wood Johnson University Hospital is also another notable win for us this quarter. As part of the Robert Wood Johnson Barnabas Health System, Focal One will now be utilized in the largest integrated healthcare delivery network in the state of New Jersey, which provides treatments and services to over 3,000,000 patients annually. In partnership with the Rutgers Cancer Institute, the Robert Wood Johnson University Hospital is a leader in robotic based treatment solutions for prostate cancer.

Speaker 2

Like the City of Hope, Robert Wood Johnson University Hospital is also an NCI designated comprehensive cancer center. With these two placements Focal One is now installed in 20 of the 59 NCI designated comprehensive cancer centers across the United States. We also placed a Focal One system with the VA Bronx Healthcare System, which is one of the leading healthcare systems serving veterans in the surrounding New York and New Jersey region. I'm pleased to note that this is the first Focal One system placed within a VA healthcare system and given the patient demographics for these hospitals serving U. S.

Speaker 2

Veterans, we anticipate future placements of Focal One systems as well as ExactVue micro ultrasound systems within the VA network. During the quarter, we also converted 2 previously announced placements at Mount Sinai Union Square and the Cleveland Clinic Abu Dhabi into full cash sales. These conversions to cash further validate Focal One technology as a strategic investment that provides access to our leading robotic HIFU platform technology. In addition, it also highlights the flexibility of our commercial placement strategy enabling us to offer a more flexible lease based acquisition option before our customers purchase the Focal One system. As I mentioned earlier, U.

Speaker 2

S. Focal One HIFU procedure growth remains strong in the Q2 with a number of procedures growing by 63% on a year over year basis. We are pleased with this continued strong growth in adoption and we anticipate these utilization trends will remain strong throughout 2024 and beyond. We also believe that positive results from the Hi Fi will help generate additional demand for Focal 1 as a frontline treatment option for localized prostate cancer patients. As discussed last quarter, the Hi Fi study is the largest and most rigorous clinical trial ever conducted evaluating Focal 1 robotic HIFU as a frontline therapy in localized prostate cancer.

Speaker 2

In addition, this represents the largest prospective trial comparing focal therapy to traditional surgical management. Results from this landmark study were recently presented at this year's European Association of Urology and the American Urology Association Scientific Meetings. The Hi Fi study demonstrates that treatment with robotic HIFU is at least as effective as radical prostatectomy as a frontline treatment for the management of localized prostate cancer, but with the important potential for better functional outcomes with respect to preservation of urinary incontinence and sexual function. We believe the future publication of the Hi Fi study in a highly respected peer reviewed medical journal will be instrumental in helping to accelerate market adoption for the Focal 1 procedure. Such publications can also have a major impact on shaping treatment decision guidelines as well as setting a procedure on a pathway toward becoming a new emerging standard of care.

Speaker 2

As a reminder, HIFU is already predominantly included in the treatment guidelines for prostate cancer patients have already failed radiation therapy or what is referred to as salvage therapy. The American Urological Association recently finalized new guidelines specific to salvage therapy for prostate cancer and these new guidelines were presented in detail at this year's AUA meeting and then published in the Journal of Urology, the official journal of the AUA. The new guidelines now include HIFU among the recommended options for patients with a local recurrence post radiation failure. Based on these new guideline updates HIFU is now listed at the same level as a salvage option alongside the standard of care radical prostatectomy. As noted, this represents a clear validation of the growing acceptance of HIFU amongst urologists and the critical role that HIFU will play for this growing subset of prostate cancer patients.

Speaker 2

As the growth in Focal One continues, we are also increasing our presence at several of the most prominent urology focused scientific meetings. Most recently, the Focal One platform took center stage at the 41st World Congress of Endourology and Urotechnology meeting which was held in Seoul, Korea from August 12 to August 16. We had a notable presence at WCET 2024 which was well attended by a large number of leading urologists from around the world. In addition to providing hands on Focal 1 simulations for urologists in attendance, our Focal One platform was featured in a semi live procedure conducted by Doctor. Tarek Benadir, assistant professor from the University of Florida.

Speaker 2

The procedure demonstrated numerous benefits of the Focal One platform. These included importing pretreatment data with real time fusion using MRI and biopsy maps as well as the precise contouring of the treatment plan delivered with 5 axis robotic submillimeter accuracy. Looking ahead, we will have a major presence at strategically important urology focused scientific meetings in the fall as these meetings provide an opportunity for continuous interaction with leading prostate cancer physicians while increasing the visibility of Focal One Robotic HIFU. I would now like to touch on the recent appointments that we made to further strengthen Focal One senior management and the EDAP Board of Directors. We continue to add world class talent to the Focal One team that will support our growth in key strategic markets.

Speaker 2

In June, we announced the appointments of 2 new senior executives, Damian Desmond and Alexander Frome to further strengthen our commercial operations in our Europe, Middle East and Latin America markets. Damian and Alex each bring a track record of successfully commercializing disruptive capital equipment and robotics in the field of urology and they will each play a key role as we lead the expansion of Focal One in these strategic regions. We also further strengthen our Board of Directors with the appointment of Fran Scholes who brings significant experience advising companies in the healthcare sector across a wide array of critical functions including strategic finance, accounting, tax and U. S. And international regulations.

Speaker 2

As we continue to expand our Focal One presence globally, Fran's extensive experience will provide important strategic insights and guidance as we plan for future growth. On a separate note, on August 27, Marco Zekalski resigned as Chairman of the company's Board of Directors in order to allow him more time to focus on other endeavors. We'd like to thank Mark for his dedication to the company and we wish him luck in his future pursuits. I will now briefly touch on the endometriosis clinical development program. In July, we announced interim results from our Phase 3 study evaluating robotic HIFU technology for the treatment of deep infiltrating endometriosis.

Speaker 2

The results show that robotic HIFU therapy continues to maintain an excellent safety profile confirming earlier results from Phase 1 and Phase 2 studies. MRI data also shows that patients who received robotic HIFU therapy presented greater reductions in endometriosis lesion volumes as compared to patients in the sham arm

Speaker 3

of the

Speaker 2

study. While both arms of the study showed significant improvements in pelvic pain reduction at 3 months from baseline as measured by visual analog scale, the primary endpoint of reduced acute pelvic pain in the HIFU arm compared to the sham arm was not met. Both EDAP and the principal investigator of the study have concluded that the 3 month post procedure follow-up period was likely too short of a time period to clinically show meaningful differences in pain scores between the two arms of the study. A therapeutic benefit favoring robotic KIFU is more likely to be confirmed over a longer period of time post procedure as suggested by the stabilization of pain scores at 6 12 months from our published peer reviewed Phase 2 study. Based on the cumulative safety and efficacy data from our Phase 1, 2 and 3 studies, we believe HIFU therapy is safe, non invasive treatment has a greater significant potential to reduce pain for women suffering from this debilitating condition.

Speaker 2

It is also noteworthy and encouraging to see additional patients from the sham arm of the Phase 3 It is also noteworthy and encouraging to see additional patients from the sham arm of the Phase 3 study crossover and elect to be treated with HIFU therapy as permitted per protocol. We look forward to providing further updates on this program later this year. I will now briefly touch on our clinical development program for the treatment of benign prostatic hyperplasia, BPH and its related symptoms. As noted BPH is an extremely common condition that affects the quality of life in approximately half of men 50 years or older. Globally there were over 94,000,000 prevalent cases of BPH in 2019.

Speaker 2

In the U. S. Alone as many as 14,000,000 men have BPH symptoms. BPH is a large market opportunity and represents a natural extension for the use of our robotic HIFU technology beyond prostate cancer. On July 26, the company received approval from the French National Agency For Medicines and Health Products Safety to initiate a Phase onetwo clinical trial investigating Focal 1 HIFU in the treatment of benign prostatic hyperplasia.

Speaker 2

This company sponsored multicenter study is designed as a 2 phase study. The first phase will take place at 2 leading academic prostate treatment centers in France with a recognized experience in the treatment of BPH as well as in the use of Focal One HIFU technology. This first phase is designed as a HIFU dose escalation protocol aimed at defining the optimal treatment parameters to effectively treat BPH and its related symptoms with minimum side effects. This will build upon our prior single center experience. The second phase of the study will incorporate a larger number of treatment centers in order to validate the safety and efficacy of the parameters defined during the first phase of the study on a substantial number of patients.

Speaker 2

The data from this initial phase will also provide the foundation to expand the study outside of France. The first patients are currently enrolled and the first patients' treatments are expected to be performed in early September. I will now turn the call over to Ken to review our financial results for the Q2. Thank you, Ryan, and good morning, everyone. Please note that all figures except for percentages are in euros.

Speaker 2

For conversion purposes, our average euro to dollar exchange rate was 1.0747 for the Q2 of 2024. Total worldwide revenue for the Q2 of 2024 was a record €15,800,000 an increase of 10.6% as compared to total worldwide revenue of €14,300,000 for the comparable period in 2023. Total worldwide revenue for the first half of twenty twenty four was also a record coming in at €30,700,000 an increase of 5.6 percent compared to the 6 months ended June 30, 2023. Looking at revenue by division, total revenue in the HIFU business for the Q2 of 2024 was €4,800,000 as compared to €4,900,000 for the Q2 of 2023. As Ryan mentioned, we placed 5 Focal 1 systems in the Q2, which included 3 CAS sales.

Speaker 2

2nd quarter worldwide HIFU disposable revenues were up 29.4% on a year over year basis, reflecting strong U. S. Procedure growth. For the first half of twenty twenty four, HIFU revenues were €10,600,000 an increase of 4.5 percent compared to the 6 months ended June 30, 2023. Total revenue in the distribution business for the Q2 of 2024 was €8,700,000 as compared to €7,200,000 for the Q2 of 2023.

Speaker 2

The majority of the increase in distribution revenue was driven primarily by 12 ExactVue units sold during the Q2 as compared to 9 units sold during the Q2 of 2023. Total revenue in the distribution business for the 6 months ended June 30, 2024 was €15,600,000 an 11.4 percent increase compared to the 6 months ended June 30, 2023. Total revenue in the litho business for the Q2 of 2020 4 was €2,300,000 as compared to €2,200,000 for the same period in 2023. The increase in litho revenue was driven by 3 lithotripsy units sold in the 2nd quarter as compared to 2 units sold in the Q2 of 2023. Total revenue in the litho business for the 6 months ended June 30, 2024 was €4,600,000 a decrease of 8.5% compared to the 6 months ended June 30, 2023.

Speaker 2

Gross profit for the Q2 of 2024 was €5,900,000 compared to €5,700,000 for the year ago period. Gross profit margin on net sales was 37.5 percent in the 2nd quarter compared to 39.6% in the year ago period. The decrease in gross profit margin year over year was partly due to a shift in product mix as well as a temporary increase in the acquisition costs of certain ultrasound imaging technology for our HIFU and ESWL product lines. We have engaged a new vendor to secure more favorable pricing that we believe will improve our gross margins. Gross profit for the 6 months ended June 30, 2024 was €12,300,000 compared to €11,700,000 for the year ago period.

Speaker 2

Gross profit margin on net sales was flat at 40.1 percent for the 6 months ended June 30, 2024 versus 40.2 percent for the comparable period in 2023. Operating expenses were €12,100,000 for the Q2 compared to €9,900,000 for the same period in 2023. The operating expenses increased due to investments made to support the expansion of both European U. S. Vocal 1 commercial operations as well as higher R and D expenses as we look to expand into new therapeutic applications in robotic HIFU.

Speaker 2

Operating expenses were €23,300,000 for the 6 months ended June 30, 2024 compared to €22,500,000 for the comparable period in 2023. Operating loss for the Q2 of 2024 was €6,100,000 compared to an operating loss of €4,200,000 in the Q2 of 2023. Operating loss for the 6 months ended June 30, 2024 was €11,000,000 compared to an operating loss of €10,800,000 for the 6 months ended June 30, 2023. Net loss for the Q2 of 2024 was €6,100,000 or €0.16 per diluted share as compared to net loss of €4,700,000 or €0.13 per diluted share in the year ago period. Net loss for the 6 months ended June 30, 2024 was €10,700,000 as compared to a net loss of €12,200,000 for the 6 months ended June 30, 2023.

Speaker 2

Turning to the balance sheet, ending inventory was €18,000,000 in the Q2 of 2024 as compared to €15,100,000 at the end of the Q4 in 2023. The €2,900,000 increase in inventory was due in part to the advanced purchasing of ultrasound technology at higher than expected prices the anticipated buildup of Focal 1 and Exactu inventory in anticipation of expected higher demand in the second half of twenty twenty four and as a result of new medical device requirements under CE Mark multiple ESWL units had to be manufactured in advance of these new requirements becoming effective. Total cash and cash equivalents at the end of the second quarter was €30,200,000 or €32,400,000 in U. S. Dollars as compared to €43,500,000 at the end of the Q4 of 2023.

Speaker 2

The €13,300,000 decrease in cash and cash equivalents on a year to date basis was due to the following. Cash used in operating activities inclusive of the inventory investments that I described above, cash used for capital investments to help grow the HIFU business and cash used to pay down short term borrowings. We are closely monitoring our expenditures to optimize our cash resources as we invest and grow our business in the future. These are our key financial highlights for the Q2 of 2024. And with that, I would like to turn the call back to Ryan.

Speaker 2

Thanks, Ken. As demonstrated by our sustained growth in U. S. Procedure volumes, it is clear that an increasing number of urologists are recognizing Focal 1 as a necessary treatment option for the management of localized prostate cancer. This demand is also being driven by growing awareness among prostate cancer patients who are seeking less invasive tissue sparing treatment options that can address their disease without compromising their quality of life.

Speaker 2

As noted on numerous occasions, we are really just at the beginning of what I believe is a long and sustainable upward demand curve that will establish robotic HIFU as a cornerstone treatment option for localized prostate cancer. We have in place the team, technology and infrastructure to fully support the continual global expansion of the Focal One pipeline as the market demand for our technology continues to build. With that, I will now turn the call back over to the operator for questions. Operator?

Operator

We will now begin the question and answer session. The first question comes from Michael Sarcone from Jefferies. Please go ahead.

Speaker 4

Hey, good morning and thanks for the questions. I guess just to start, 5 Focal One placed in the quarter. Congrats on that. I was hoping you can give us just an update on what the sales funnel looks like and how we should think about placements in 2H versus 1H, just an update there? And then any update on what you're seeing in terms of the CapEx environment in the hospital customers?

Speaker 2

Yes. So thanks, Michael. Yes, pipeline is strong in building. We're actively out obviously talking to a lot of centers. And I think if you think of the sales we made this quarter, I mean these are notable institutions.

Speaker 2

So we continue to talk with hospitals both academic and community, and even some that have a designated focus in treating cancer. And so pipeline remains strong and growing. I would say back half of the year, obviously, Q3 and Q4 tend to be stronger quarters, at least the back half. And I would see that here playing out the rest of 2024. We'll have a stronger back half of the year and that is on our roadmap.

Speaker 2

And then in terms of the other question on your third question.

Speaker 4

Was on CapEx.

Speaker 2

Yes. So on the capital expense environment, I think what we're still seeing is with the hospitals, it's just longer cycle times. I think it's due to a couple of things. It's due I think partly macroeconomically given interest rates. I just think when you get approvals in the hospital, there's a lot more committees to go through and it's just taking longer.

Speaker 2

And as Ryan mentioned, our pipelines remain strong. A lot of these deals at the end of the quarter come down to timing.

Speaker 4

Got it. Thank you. And then just maybe one follow-up on the VA system Focal 1 sale. I guess, can you talk about what logistically that process looks like? Is there kind of one approval process to get through to then basically hunt in the entire VA system?

Speaker 4

Or do you kind of have to go hospital by hospital just trying to get a sense of what that will look like logistically?

Speaker 2

Yes, great question. Typically, a lot of the A hospitals, obviously, they're in major metropolitan markets and commonly associated with large teaching hospitals or a near proximity to university teaching hospitals. So again, if we look at our installed base, we've had a growing pedigree of academic centers, who buy our technology. They look at everything, but they buy our technology. So that gives us a good opportunity to speak to the local VA hospitals in those markets.

Speaker 2

And again, many of the academic faculty will actually have a staff appointment in those VA hospitals. So we continue to look at those hospitals strategically across the country. That is the VA system. And at this time, I think it's a notable win that we're in a new VA hospital and we have others that are interested and we continue to work them into our active pipeline.

Speaker 4

Great. Thank you.

Operator

The next question comes from Joseph Downing from Piper Sandler. Please go ahead.

Speaker 5

Hey, good morning guys and thanks for taking the questions. Starting with gross margin, it finished below what we were looking for in our model and obviously we can understand there was some lumpiness impact from product mix. But just curious what it's going to take for that margin to move significantly higher specifically in the high fee segment? Thanks.

Speaker 2

Yes. Thanks for the question. So when I looked at when we look at gross margins in the Q2, number 1, obviously product mix not just within our HIFU business with lower volumes, but also with regards to our distribution and ESWL. With regards to HIFU though, I think there's 3 key elements here, right? Number 1, we converted 2 operating leases this quarter.

Speaker 2

Remember, when the customer is on an operating lease, they're actually paying us. So when it comes to the buyout and oftentimes, the purchase price might be a little bit lower. Number 2, I mentioned we're transferring vendors, so we're going to see some cost a little bit on the higher side. And then number 3, we had some probe cost as well in the second quarter as well. So those are the three things that have the drag on the HIFU margin for the 2nd quarter.

Speaker 2

And to answer your other question, we're working with a new vendor, right, where we will see improved margins going forward as well as in the second half when HIFU business picks up, right, we'll see accretive gross margins as the volumes grow.

Speaker 5

Great. Thanks. That's helpful. And then just touching on the BPH study that you gave some detail on trial you gave some detail on today. Can you give any more detail or color relating to the enrollment size or timelines or anything of the sort?

Speaker 5

And then relatedly, is there anything we could take away from the endometriosis program with respect to key learnings or things you to improve upon that could help with the execution of this trial? Thanks.

Speaker 2

So as far as the VPH study, again, it's a combined Phase 1 and 2 study. So obviously, we're defining the optimal HIFU treatment parameters, that's part of the Phase 1 component. And then we're looking both at safety and effectiveness, in the Phase 2 component. So combining the study, we're able to kind of look and validate safety and effectiveness and then be able to take that data set and use it to achieve a couple of things. 1, obviously, go after CE Mark and MDR, but importantly also go back to the FDA with the ability to look more specific at BPH as a treatment.

Speaker 2

And so again, we're just getting the study underway and we want to start enrolling patients in September. Now noted, this is not a cancer study. So we've got the best team working on it and we should be able to make notable progress in the many weeks and a few months throughout the rest of the year. So I can't really give you an adjusted timeline. However, we are enrolling patients as soon as the month of September and we're excited about moving forward on this.

Speaker 2

Understanding that we did a Phase 0, 9 patient study, really proof of concept study back last year and we can now really focus in on the effort here and we've got a lot of interested folks that are wanting to participate in this study. In terms of endometriosis, as noted, we continue to follow the patients up from the results of the Phase 3 randomized controlled trial. Again, we're looking at subsets of data. I think the positive news here is a couple of things. One is, we've shown that the treatment described as reducing lesion size is effective.

Speaker 2

It does what it needs to do. And we also noted that there's been a large and or I should say growing number of patients in this crossover effect and meaning that patients that were treated in the sham arm have now requested to be treated with Focal 1 robotic HIFU. So their pain has obviously come back to a level, where they want and seek out a treatment and per protocol they have access to have that treatment. We've treated a number of patients already with more on the docket. And so looking beyond that, we've got additional data analysis we're working through to get back in front of the FDA and we want to be able to do that here in the next say, 60 days, 90 days in that timeframe.

Speaker 2

So we're excited for some of the progress we're making and we continue to follow-up on these patients accordingly.

Speaker 5

Great. Appreciate that.

Operator

The next question comes from RK Ramakanth from H. C. Wainwright. Please go ahead.

Speaker 3

Thank you. Good morning, Ryan and Ken. In terms of the top tier cancer centers, I'd just like to have an idea of what percentage of that top tier cancer center market has a focal one? And of that market, what's really accessible for you guys?

Speaker 2

Well, RK, that's a great question. I mean, if you look at the hospitals we're in and if you look at kind of some data points, we're in 7 out of the 10 U. S. News World Report best ranked hospitals. So we're not 10 out of 10 yet, we're 7 out of 10.

Speaker 2

But that's on a 70% basis, that's good progress. The SUO, Society of Urologic Oncology Fellowship Hospitals, we're in 17 out of 35. And then as noted, with these 2 recent sales we've made, placement sales, we're now upping our position in these what we call National Comprehensive Cancer Network participating hospitals. We're over 42% now. And so there's still more market opportunity.

Speaker 2

And I think that the takeaway story is that we show progress, routine progress in growing this install base with some of the top centers in the world. And we continue to put more of them in our active pipeline. So, I would look out and say, we should be the dominant therapy or focal therapy in these prestigious academic centers or regional cancer centers. And we continue to focus on that in light of the other focus, which is in community hospitals. We continue to sell actively in community hospitals.

Speaker 2

So, I still think there's a lot of more opportunity there and we are highly focused on penetrating more of those accounts as we look forward.

Speaker 3

Thank you for that. And then in terms of ex U. S. Geographies, you talked about EMEAI and also other European countries where you place couple of senior commercial management folks. So in your thinking, how long would it take for these geographies to start contributing meaningfully?

Speaker 3

And also what are you trying to telegraph with this new

Speaker 2

appointments? Yes. So we're blessed to have both Damian and Alex join our teams. They worked at Intuitive Surgical with me. And they're exceptional individuals that can lead the efforts in these key markets.

Speaker 2

And what I see is, first a couple of things. We received reimbursement in Switzerland back in July. And so if you go back and look in time where we've been, we've been making progress there. We sold the system in that market and we'll continue to focus on that market as part of the DASK region, the German, Austria, Switzerland region. The other thing that as we know, the Hi Fi study has been presented in 2 notable scientific meetings and will come out in a peer reviewed journal.

Speaker 2

So we're waiting for that. Ideally, 60, 90 days somewhere in that timeframe is what we hear today. But that data will be very, very important because the precedence of this study was based on the French government and the Association of French Urology to drive a reimbursement for HIFU in patients diagnosed with prostate cancer. So that would lead you to believe obviously a reimbursement awarded for HIFU for prostate cancer. When will that come?

Speaker 2

Potentially end of the year, but more likely maybe in Q1. So again, the HiFi study data will come out and we'll hear more back in terms of a response in terms of reward of reimbursement. So Damian as noted is French and lives in France. We have a strong leader looking over that market in driving our business and we will continue to build the team out in a very precise prescriptive way to be able to capitalize on any changes forthcoming in reimbursement.

Speaker 3

Okay. And my last question is on the BPH indication. At what point would you start adding centers in the U. S. And the rest of the European Union as we understand this is actually this is a very large indication?

Speaker 3

And the other question within that is, does this require any retooling of Focal

Speaker 2

1? So as far as adding centers, again, the trial design and the studies we're doing really are to be able to get back in front of receiving CE Mark MDR in Europe. And so we want that obviously. And the other is, if you remember on our FDA labeling, we have the ability to ablate prostate tissue. And here this would give us the ability to go back to the FDA at some near future date with data with the anticipation of being called out specifically for a BPH as a treatment.

Speaker 2

Now we've got work to do in this study. And if we look outward, I'm very encouraged that some of the results we saw from our Phase 0 study leads us where we're going now with a combined Phase 1, Phase 2 study. So I can't give you a specific necessarily timeline there, but arguably we are working very hard. We've got the right people focused on this. And it's a real effort within the company to move this forward on a fast track.

Speaker 2

Additionally, you mentioned changes of the system. Yes, we're looking at dose escalation in the protocol and really that's really looking at the right treatment parameters. So we have that right to get the best outcomes in the right subset of men diagnosed with BPH. So that is written into the protocol. And again, we're always looking at improving our products, and whether it's hardware, software or other.

Speaker 2

And so that is built into the study itself. As we look at dose escalation, the ability to vary dose accordingly for treating BPH effectively.

Speaker 3

Thank you. Thanks for taking all my questions.

Speaker 2

Thank you, RK. Operator?

Operator

This concludes our question and answer session. I would like to turn the conference over to Ryan Rhodes for closing remarks.

Speaker 2

I want to thank everyone for joining us on today's call. And we look forward to seeing you at the upcoming H. C. Wainwright Healthcare Conference in New York in September. Thank you.

Operator

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

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