Polypid Ltd Aktie

Greetings, and welcome to PolyPid's First Quarter 2026 Earnings Conference Call. [Operator Instructions] As a reminder, this call is recorded. And I would now like to introduce your host for today's conference, Yehuda Leibler from ARX Investor Relations. Mr. Leibler, you may begin.

Thank you, operator, and thank you all for joining PolyPid's First Quarter 2026 Earnings Conference Call. Joining me on the call today will be Dikla Czaczkes Akselbrad, Chief Executive Officer of PolyPid; Jonny Missulawin, PolyPid's Chief Financial Officer; and Ori Warshavsky, Chief Operating Officer, U.S. of PolyPid.

Earlier today, PolyPid released its financial results for the 3 months ended March 31, 2026. A copy of the press release is available on the Investors section of the company's website at www.polypid.com. I'd like to remind you that on this call, management will make forward-looking statements within the meaning of the federal securities laws.

For example, management is making forward-looking statements when discussing the company's regulatory strategy, including the expected completion of the rolling New Drug Application or NDA submission for D-PLEX100. Management may also discuss the company's planned engagements with the European Medicines Agency, or EMA, including meetings with the Rapporteur and Co-Rapporteur regarding the planned marketing authorization application, or MAA, and the anticipated timing thereof. In addition, management may discuss the company's ongoing U.S. commercial strategic partnership discussions, its belief that those discussions are in late stages and expected launch plans and timing.

Other forward-looking statements may relate to the potential clinical and economic value proposition of D-PLEX100. The company's preparations for potential commercialization, the potential for 2026 to be a transformative year for PolyPid and the expectation that current cash resources will be sufficient to fund operations into the second half of 2026 and from several significant upcoming potential milestones. Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond the company's control, including the risks described from time to time in the company's Securities and Exchange Commission filings.

Accordingly, you should not place undue reliance on these statements. I encourage you to review the company's filings with the SEC, including the company's annual report on Form 20-F filed on February 25, 2026. PolyPid disclaims any intention or obligation, except as required by law, to update or revise any forward-looking statements. This conference call contains time-sensitive information and speaks only as of the live broadcast today, May 13, 2026. With that, it is my pleasure to turn the call over to Dikla Akselbrad, the CEO of PolyPid. Dikla?

Thank you, Yehuda, and thank you all for joining us today. The first quarter of 2026 was a defining transition for PolyPid. We moved from late-stage clinical development to final NDA regulatory submission, our U.S. commercial strategic partnership discussion advanced to what we believe are their late stages, and we continue to build the foundation for what we expect will be a transformative year. Our focus remains on two priorities: advancing D-PLEX100 towards potential FDA approval and finalizing a U.S. strategic partnership that will execute commercial launch in the first quarter of 2027. Starting with our regulatory progress.

On March 30, 2026, we initiated our NDA submission to the FDA. As a reminder, D-PLEX100 is our lead product candidate for the prevention of surgical site infections, or SSI, in patients undergoing abdominal colorectal surgery. With this initial filing, we submitted the CMC and nonclinical modules as well as other more administrative modules. We expect to submit the remaining components, including the clinical module imminently. This will complete the full NDA submission. Once the FDA accepts our submission and given our Fast Track and breakthrough therapy designation, the product is eligible for priority review. If received, this would shorten the standard review period from 10 months to 6 months.

In parallel, in March 2026, we received a small business waiver from the FDA for the PDUFA fee. This waiver was approximately $4.3 million, and it allows us to focus our resources on commercialization preparation as we move closer to potential approval. Turning to Europe. We have scheduled meetings in this quarter with the Rapporteur and Co-Rapporteur, which are the European regulatory authorities designated to lead the assessment of our planned MAA for D-PLEX100. The purpose of these meetings is to align on the content and structure of the submission. Importantly, the MAA will be submitted to the EMA under the centralized procedure on the basis of the therapeutic innovation. The centralized procedures allows the submission of a single marketing application to the EMA that, if approved, enables the product to be marketed in all EU member states. Subject to the outcome of these meetings, we currently plan to submit the MAA in the third quarter of this year.

On the commercial front, our strategic partnership discussions with potential U.S. partner have continued to progress. We believe they are now in their late stages as the due diligence and evaluation work that defined earlier phases of this discussion is well behind us, and we are currently focused on the active negotiation of definitive agreement terms. Another important area of commercial readiness is our manufacturing and inspection preparations. Once the FDA accepts our NDA submission, the agency is expected to inspect our manufacturing facility. This is a critical step on the path to potential approval, and we are devoting significant resources to these preparations.

We are working closely with experienced external consultants, including industry quality veterans with robust FDA experience who provide us with valuable guidance regarding FDA expectations. We have also conducted multiple mock inspections to ensure our site is ready, the team is prepared and the FDA inspection passes without any major issues. As a reminder, our facility has already passed four consecutive successful GMP inspections, including the most recent one by the Israeli Ministry of Health. We are entering the FDA inspection process from a position of strength, and we are highly focused on getting it right for first time. We have also continued to advance our engagement with the scientific community surrounding the SHIELD II phase III results with two important data presentations this quarter.

In early May 2026, at the 45th Annual Meeting of the Surgical Infection Society, we presented an analysis of SHIELD II Asepsis score data, a clinical measure of wound infection severity. The results showed a 64% relative risk reduction in patients with an asepsis score greater than 20, which is the threshold for clinically significant wound infection. What this tells us is that even among patients in the D-PLEX arm who did experience wound events, severity was meaningfully reduced. Ori will speak in a moment to what this potentially means commercially.

In April 2026, at the European Society of Clinical Microbiology and Infectious Diseases, also known as ESCMID, we presented new pharmacokinetic or PK data providing further evidence that D-PLEX100 delivers sustained controlled release of doxycycline for approximately 30 days. This result in our largest human data set to date support the core mechanistic premise of our technology. With that, I will now turn the call over to Ori Warshavsky, our Chief Operating Officer, U.S. Ori?

Thank you, Dikla. I would like to spend a few minutes on the broader commercial readiness work underway. Alongside the partnership process and manufacturing readiness, we are continuing with our commercial readiness activities across several other fronts. Picking up on the asepsis data Dikla just referenced, those results have meaningful potential commercial implications.

A 64% relative risk reduction with a P value of 0.0103 in severe wound events translates directly to fewer wound complications, less reliance on intravenous antibiotics, the potential for earlier hospital discharge and lower hospital resource utilization. That is exactly the language hospital P&T committees and payers respond to, and we believe that this is central to the health economics work we are now accelerating. Alongside this, we are expanding our presence at major surgical and infectious disease conferences, advancing additional planned scientific publications and continuing to engage leading clinical voices in the field.

As part of these efforts, we hosted a roundtable discussion with KOLs earlier this month at the Surgical Infection Society annual meeting, which was chaired by the president of the society. There were a lot of good insights during that meeting, including an open discussion on the fact that infection rates are often underreported to avoid penalties and that growing obesity rates are impacting infection rates in abdominal surgeries. At the general assembly of the conference, there was a call from the stage to see how the society can, and I quote, "Help move practice forward with a really novel product." Together, these efforts build the awareness and the evidence base that will support a successful launch.

I would also like to briefly address the broader environment in which D-PLEX100 would be launched. Two converging trends are shaping that environment in important ways. The first is the growing focus across U.S. hospital systems on infection prevention, antimicrobial stewardship and reducing the use of systemic antibiotics. The second is the evolving reimbursement landscape. Under Medicare's new Transforming Episode Accountability model known as TEAM, hospitals are now financially accountable for inpatient and outpatient complications occurring throughout the 30 days following certain surgical procedures, including colorectal surgery.

This represents a significant shift as the 30-day window for SSI is no longer just a clinical concern, it is increasingly tied to how hospitals are reimbursed. We believe D-PLEX100 is well-aligned with both trends. By delivering high concentration of broad-spectrum antibiotic directly at the surgical site rather than relying on systemic antibiotic load, D-PLEX100 supports the same antimicrobial stewardship goals hospital systems are increasingly being asked to advance.

Just as important, D-PLEX100 is designed to provide antibiotic protection for approximately 30 days, the same window which hospitals are now financially accountable for. We expect this convergence, clinical data on one side, policy-driven economic incentives on the other to be an increasingly important part of D-PLEX's position with hospital system and payers as we move towards potential commercialization. With that, I will now turn the call over to Jonny to review our financial performance for the quarter. Jonny?

Thank you, Ori. I will now walk through our financial results for the first quarter ended March 31, 2026. Starting with operating expenses, research and development expenses for the first quarter of 2026 were $5.8 million compared to $6.1 million in the first quarter of 2025. This decrease primarily reflects the completion of the SHIELD II phase III trial and our ongoing transition towards regulatory submission and commercial readiness activities. General and administrative expenses for the quarter were $1.6 million compared to $1.2 million for the same period in 2025.

Marketing and business development expenses were $0.4 million compared to $0.3 million in the prior year period. Net loss for the first quarter of 2026 was $7.7 million or $0.35 per share compared to a net loss of $8.3 million or $0.70 per share in the first quarter of 2025. Turning to the balance sheet, as of March 31, 2026, PolyPI'd had $10.9 million in cash -- cash equivalents and short-term deposits compared to $12.9 million on December 31, 2025. The modest decrease approximately $2 million reflects continued operating activities, partially offset by proceeds from warrant exercises during the quarter. Subsequent to quarter end, our balance sheet has been further strengthened by an additional development. In early May 2026, we completed the full repayment of our remaining loan facility originally entered into in April 2022.

As a result, the company has fully repaid its outstanding debt obligations and has no remaining loan-related liabilities as of the date of today's earnings release, further strengthening our balance sheet ahead of potential commercialization. Based on our current plans and assumptions, we believe that our existing cash resources will be sufficient to fund operations into the second half of 2026 and through several significant upcoming potential milestones. With that, we will now open the call for questions. Operator?

[Operator Instructions] We will take our first question and the first question comes from the line of Chase Knickerbocker from Craig-Hallum.

Maybe just to start, a couple on the filing. Just as we kind of think about that CMC module, maybe talk about the work that you've done with consultants internally to kind of submit that module with confidence, I think, particularly around kind of the process validation portions with your differentiated drug product, which obviously also comes with some novel aspects being that it is differentiated, right?

So maybe just speak to kind of the work you've done with consultants and the confidence you've kind of gained there. And then secondly, I'll just ask both upfront. As you think about kind of the inspection readiness, you had several mock audits at this point. Maybe just talk to us a little bit about how those have progressed, how your findings from those have progressed and again, kind of increase your confidence in the positioning of your filing.

Thank you, Chase. So I'll start with the first portion on the CMC. Obviously, there is the aspect of consultants and regulatory consultant. But I think the most reassuring portion here is that we took advantage of -- or we used the Breakthrough Therapy Designation, which allows us to have more frequent communication with the FDA.

And we really communicate prior to submission the NDA with the FDA on different processes on different methods as well as submitting the development report and everything that we thought could be risky, and we wanted the agency feedback ahead of submitting an NDA, we did that. So yes, there is a portion of getting advised and reviews, and we have a very experienced team in the CMC aspect from the development stage up to the actual operational aspect.

But we also used -- communicate with the FDA multiple times to make sure that we are aligned with what they are expecting to see. So that's on the module -- the CMC module. On the preparation for the inspection, there are a couple of things that I think we've done from the start. The first one being the fact that we have built our own manufacturing facility. So it's not a CMO. We have full control of the processes on the method, regulation, all the implementation methods internally, both in terms of our employees as well as our QA.

It's all internal. And that's, I think, a good thing and strengthen our position. The other thing is really working from day one with the eyes to the FDA expectation, always staying up to date to see what is the FDA expectation, what is the most recent expectation -- and this is why we were able to pass this inspection, which are also, by the way, qualified for the European authorities. So that's an ongoing. And now as we get closer to the pre-approval inspection, obviously, we are even tightening those processes, even tightening what is needed, working with very veteran quality person that really been on almost on a weekly basis part of FDA inspection, so we could really know what the FDA is focusing on these days.

Now you were asking about specifically if anything came out of this mock inspection that can put this in danger. I'm very freely, I can say that we don't think so that obviously, there is -- when there is an inspection, there are comments, there are suggestions, there are reviews, but all of it is things that either have already been implemented and corrected or things that are ongoing, but nothing that we viewed as major. And also the -- for the matter of the Israeli Ministry of Health did not see those as major or critical.

Your next question comes from Jason Butler from Citizens JMP.

First one for me. Just can you speak to any dialogue that you've had with FDA since submitting the first modules of the NDA? Have you had any questions or information requests from FDA yet?

So as we showed previously -- again. So not something formal, nothing formal at this stage, but we've not completed the NDA submission. So we don't really expect to get anything. But the NDA submission is -- or the completion is expected imminently. So I'm sure we'll start to get that immediately after.

Great. And then you've spoken in the past about what you're looking for from a commercial partnership or collaboration. Can you just speak to -- as you continue those discussions, have those priorities shifted at all? Or are your goals the same out of any partnership?

So no, they have not shifted. We are still focused and we think that the main objective is to have a partner with good presence in the hospital and capabilities to build and expand on a sales force that is in the hospital. That's what we are looking at. And we're very pleased so far.

Your next question comes from the line of Boobalan Pachaiyappan from ROTH Capital Partners.

A couple from us. Maybe to start with, I was wondering if you could talk about the tariff rate for drugs that are manufactured in Israel and commercialized in the U.S. and other countries. Is it like a flat tariff rate regardless of indications? Any color on that, please?

Ori, do you want to take this one regarding the U.S.?

Yes. So the question -- just so I understand the question is regarding tariffs on products from Israel to the U.S.

Yes, for drug products that are manufactured in Israel and commercialized in the U.S. and other countries.

That's a good question. As far as I know, and we can follow up on this later, there's a flat tariff rate be negotiated between the government of the U.S. and Israel on all incoming goods coming from Israel to the U.S. We can follow up on this with the rates.

All right. That's helpful. And in light of the ongoing conflict in the Middle East area region, can you maybe talk about the time line or the impact of this conflict on the inspection procedure to be conducted by the FDA? How are you thinking about it? And if you expect the inspection time line to be sort of -- is there -- at what point do you think you will have more clarity on whether or not the inspection will take place in second half of '26?

So thank you for this question, Boobalan. Obviously, if we knew this answer, we would have been -- we could use it in many, many other aspects. But seriously, we know that the FDA was inspecting two facilities in Israel this last March. Obviously, since March, they were not here. We do not expect this to have an effect. The FDA has many means to inspect the facility, either from -- COVID was here 2 years almost and drugs were approved. So I think both companies and the agency find ways to get drugs approved.

So we do not expect it to change anything. We are operating in a normal course of business. You can see both in terms of the time line, we were committed to submitting the NDA before the end of the first quarter, which was done. We are now very shortly, we'll finalize this submission. And the team here is fully committed to all of these processes. And on a personal note, I hope that it will come and there won't be any issues.

All right. Maybe one last one. I understand D-PLEX100 will be commercialized by the strategic partner. So just curious, I mean, do you still need to hire some employees to sort of internally track the progress? And can you also talk about the impact of this on G&A spend?

So I'll let Jonny add on that. But specifically on G&A, I don't see any major impact. We do think that there will be some increase later on as we expand the commercialization and sales increase, we'll need more employees on the operational front, obviously. And once we can discuss more clearly on next step, we will also lay out the development plan as we see it.

No, I agree. So for the whole G&A part, we wouldn't expect such a big increase, but there will be some increase. And as Dikla said, the bigger increase will be in the operational part.

[Operator Instructions] We will take our next question, and the question comes from Brandon Folkes from H.C. Wainwright.

Congrats on the progress. Maybe just two for me. Can you talk about how broad of a development pipeline you would consider once you do execute on a commercial transaction? Are you envisioning a singular product development focus going forward? Or could we sort of see a pretty broad pipeline? And then secondly, you remain very disciplined on the SG&A line. So can you just talk about if you envision PolyPid itself doing any market awareness this year ahead of an approval and ahead of a potential partnership?

Thank you. Thank you, Brandon. So I'll start with the first portion of your question. In terms of -- or maybe let's start with the latter. We do see PolyPid doing some prelaunch activities. Everything that was done up until now was done by us, whether it is around packaging names, scientific conference, all of that is done with us, and we'll see some of it also continues. We are hoping to publish the manuscript of the SHIELD I -- the SHIELD II data in a peer-reviewed journal soon.

All of this is the more scientific clinical assets are managed by us and we'll be able to again say more how much of it will be managed by us or the partner. On other geographies, it's to be seen depending on the arrangement that we will get to. But generally, for D-PLEX, we do not see ourselves marketing the product on our own. In terms of our pipeline, this is a very important question. We envision the pipeline, and this is work that is done already and some of those are communicated to investors, but I think once we have a partner that could be even further reassessed and strengthened, we envision three paths.

One is obviously -- and this was discussed quite intensively expanding D-PLEX behind abdominal indication. There is a high need in many other surgeries, and this will be done with the partner. The other is expanding our PLEX platform to other indications. And we also have our younger program in the metabolic health. So I envision and we envision multiple products that some are late stage and some are more early stage.

There seems to be no further questions. I will now hand the call back to Dikla for closing remarks.

Thank you all for joining us today. The first quarter of 2026 marked a critical transition for PolyPid. Our rolling NDA submission is well underway with completion expected imminently. Our U.S. strategic partnership discussions are in their late stages. Our European regulatory strategy is advancing toward an MAA submission later this year, and our balance sheet has been meaningfully strengthened.

Together, these milestones mark what we believe is the most consequential phase in our company's history. We continue to believe that 2026 has the potential to be a transformative year for PolyPid, and we look forward to providing further updates as these milestones unfold. Thank you. Operator, you may now close the call.

This concludes today's conference call. Thank you for participating. You may now disconnect.

Greetings and welcome to PolyPid's Fourth Quarter and Full Year 2025 Conference Call. [Operator Instructions] As a reminder, this call is recorded. And I would now like to introduce your host for today's conference, Yehuda Leibler from ARX Investor Relations. Mr. Leibler, you may begin.

Thank you, operator, and thank you all for joining PolyPid's Fourth Quarter and Full Year 2025 Earnings Conference Call. Joining me on the call today will be Dikla Czaczkes Akselbrad, Chief Executive Officer of PolyPid; Jonny Missulawin, PolyPid's Chief Financial Officer; and Ori Warshavsky, Chief Operating Officer, U.S. of PolyPid.

Earlier today, PolyPid released its financial results for the 3 and 12 months ending December 31, 2025. A copy of the press release is available in the Investors section on the company's website at www.polypid.com. I'd like to remind you that on this call, management will make forward-looking statements within the meaning of the federal securities laws.

For example, management is making forward-looking statements when it discusses the company's regulatory strategy and the anticipated timing and structure of the planned new drug application or NDA submission for D-PLEX100, including the rolling submission, the potential regulatory and commercial pathways for D-PLEX100, the company's ongoing partnership discussions, commercialization readiness, transition from a primarily R&D and clinically focused organization into one that is preparing for commercialization, the potential for 2026 to be a transformative year for the company, benefits and advantages of D-PLEX100 that Kynatrix represents a broader long-term opportunity for PolyPid and the expectation that current cash resources will be sufficient to fund operations into the second half of 2026.

Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond the company's control, including the risks described from time to time in the company's SEC filings. The company's results may differ materially from those projections. These statements involve material risks and uncertainties that could cause actual results or events to materially differ. Accordingly, you should not place undue reliance on these statements.

I encourage you to review the company's filings with the SEC, including, without limitation, the company's annual report on Form 20-F filed on February 26, 2025, which identifies specific factors that may cause actual results or events to differ materially from those described in the forward-looking statements. PolyPid disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise. This conference call contains time-sensitive information and speaks only as of the live broadcast today, February 11, 2026.

With the completion of those prepared remarks, it is my pleasure to turn the call over to Dikla Czaczkes Akselbrad, the CEO of PolyPid. Dikla?

Thank you, Yehuda, and thank you all for joining us today. 2025 was a pivotal year for PolyPid. Over the course of the year, we successfully completed the SHIELD II Phase III trial and announced positive results with D-PLEX100 meeting its primary endpoint and all key secondary endpoints and demonstrating a meaningful reduction in surgical site infection. Building on that momentum, we advanced D-PLEX100 into the final stages of regulatory preparation, marking an important transition point for the company. In parallel, we continue to advance our broader platform efforts, including our long-acting GLP-1 Receptor Agonist program.

As we continue executing against our strategy, our progress is focused on 2 priorities: advancing the regulatory pathway for D-PLEX100 and advancing our commercial U.S. partnership discussions. Starting with regulatory progress. We recently received positive written feedback from the FDA following the pre-NDA meeting communication. Importantly, the agency supported our plan to pursue a rolling NDA review for D-PLEX100. We expect to begin the rolling NDA submission by the end of the first quarter of 2026. The FDA also agreed that the company's existing clinical data package, including results from the Phase III SHIELD II trial appears adequate to support NDA submission and review.

This feedback provides meaningful clarity on the structure and expectations for our submission and further validates the regulatory pathway we have been preparing for. In parallel with our regulatory efforts, we made significant progress on the commercial front. Following our positive Phase III results and the advancement of our regulatory strategy, we have moved into advanced stages of partnership discussions in the United States. These discussions reflect growing recognition of D-PLEX100's strong clinical profile, its differentiated value proposition and the significant unmet need it addresses. I'm glad to share that we are very pleased with the progress we made throughout the quarter in our U.S. partnership discussions.

These conversations have continued to move forward to advanced stages, which Ori will expand on later in the call. During the quarter, we also participated in a virtual key opinion leader webinar featuring Dr. Steven D. Wexner, a globally recognized leader in colorectal surgery. The discussion focused on the real-life clinical and economic burden of surgical site infections and why prevention remains a major unmet need in abdominal colorectal procedures. Importantly, the conversation reinforced what we believe is the core opportunity of D-PLEX100, a differentiated, long-acting localized approach that can significantly reduce infection while fitting naturally into the surgical workflow.

As Dr. Wexner noted, this is truly new. This is a paradigm shift for us. We view this type of external clinical engagement as an important part of building awareness and readiness as we prepare the market for approval and launch. A link to the recording of the webinar is on our website under the Investors section. I invite all of you to listen to Dr. Wexner insights. Looking ahead, we believe 2026 has the potential to be a transformative year for PolyPid. With the rolling NDA submission expected to begin by the end of this quarter, partnership discussions continue to advance and an organization increasingly oriented towards commercial execution, we are entering a new chapter for the company.

I also want to highlight an important corporate update. In December 2025, we appointed Ms. Brooke Story as Chairman of our Board of Directors. Brooke brings extensive leadership experience in medical technology and surgical solutions, including senior executive role at Becton, Dickinson and Medtronic. As we transition toward commercialization and engage with large strategic partners, we believe her background and perspective will be highly valuable in helping guide PolyPid throughout this next chapter. We look forward to providing updates as these developments continue to unfold.

With that, I will now turn the call over to Ori Warshavsky, our Chief Operating Officer, U.S., who will discuss how we are approaching commercialization readiness and partner engagement, our refreshed corporate brand and the introduction of our Kynatrix technology. Ori?

Thank you, Dikla. As Dikla mentioned, we continue to advance discussions during the quarter with potential U.S. commercial partners that have demonstrated experience in hospital-based commercialization and a strong presence within the surgical ecosystem. As these discussions have progressed, they have become increasingly detailed and operational in nature, reflecting both the maturity of the opportunity following our Phase III results and the progress we have made on our regulatory front.

Turning now to our refreshed corporate brand. As you might have noticed in this morning's press release, PolyPid has a new brand look, which aims to reflect that PolyPid as a company looks different today than it did even a year ago. The 3 brands come at a very intentional moment in the company's life cycle as we transition from a primarily R&D and clinically focused organization into one that is preparing for commercialization and engaging more broadly with external stakeholders. Our audience is expanding. In addition to clinician and investigators, we are increasingly engaging with surgeons, pharmacists, hospital administrators, value committee members and potential commercial partners.

The refresh brand is designed to support the more external safety conversations and to clearly communicate who we are as a company at this stage. Importantly, the new visual language is meant to convey precision, intention, reliability and control, core attributes of how our technology is engineered to perform. It reflects a more confident, mature and credible organization as we move closer to potential commercialization. I encourage investors and partners to visit our new website and review our updated corporate material, which reflects this evolution and our long-term vision. Closely related to this evolution is an important update on our technology. Over the past several years, we have significantly expanded our technological capabilities beyond what the original PLEX platform was designed to do.

As a result, we are formally introducing Kynatrix as the name of our next-generation technology. Kynatrix brings together the broader set of controlled release and delivery capabilities along with the growing intellectual property portfolio we have developed over time. While PLEX remains foundational, our technology is no longer limited to local to local delivery of small molecules such as antibiotics. One clear example of these expanded capabilities is our move into metabolic disease, starting with our ultra-long-acting GLP-1 Receptor Agonist program.

This program serves as the first step case for extending our technology beyond localized delivery towards addressing systemic therapeutic needs, and we continue to evaluate additional modalities where these capabilities may be applied. While Kynatrix represents a broad long-term opportunity for PolyPid, it is important to emphasize that D-PLEX100 remains firmly at the center of our near-term execution and commercial focus. Taken together, our continued progress in partnership discussions, our brand evaluation, the formal introduction of the Kynatrix technology and growing engagement with clinical leaders all reflect the company that is actively preparing for its next phase of growth.

With that, I'll now turn the call over to Jonny to review our financial performance for the quarter and the full year. Jonny?

Thank you, Ori. I'll now walk through our financial results for the fourth quarter and full year ended December 31, 2025. Starting with the fourth quarter, research and development expenses were $6.2 million compared to $7 million in the same period last year. This decrease primarily reflects the completion of the SHIELD II Phase III trial and our transition towards regulatory submission and preparation activities. General and administrative expenses for the quarter were $1.8 million compared to $1 million in the fourth quarter of 2024. Marketing and business development expenses were $0.6 million for the quarter compared to $0.2 million in the prior year period.

Net loss for the fourth quarter was $8.5 million or $0.41 per share compared to a net loss of $8.5 million or $1.13 per share in the fourth quarter of 2024. Turning to the full year results. Research and development expenses for 2025 totaled $23.8 million compared to $22.8 million in 2024. The increase was primarily driven by continued activities related to the completion of the SHIELD II Phase III trial as well as regulatory preparation efforts and advancement of our development programs. General and administrative expenses for the full year were $7.2 million compared to $4.3 million in 2024.

This increase was primarily due to noncash expenses relating to the vesting of performance-based options following the successful completion of the SHIELD II Phase III trial. Marketing and business development expenses for the year were $2 million compared to $0.9 million in 2024, reflecting increased business development and commercial preparation efforts as we move closer to potential commercialization. Net loss for the full year ended December 31, 2025, was $34.2 million or $2.09 per share. compared to a net loss of $29 million or $4.91 per share in 2024. From a balance sheet perspective, as of December 31, 2025, PolyPid had $12.9 million in cash, cash equivalents and short-term deposits.

Subsequent to the end of the quarter, several long-time shareholders exercised warrants ahead of their expiration at prices ranging between $3.61 and $4.5 per share, generating $3.7 million in additional gross proceeds, further strengthening our balance sheet. Based on our current plans and assumptions, we believe that our existing cash resources will be sufficient to fund operations into the second half of 2026 and through several significant upcoming milestones.

With that, we will now open the call for questions. Operator?

[Operator Instructions]

We will take our first question -- and the question comes from the line of Chase Knickerbocker from Craig-Hallum.

Maybe just a couple around the pre-NDA minutes that you received in December. Depo, would you be willing to share kind of how those discussions around the scope of the label sort of progressed? And just kind of generally, what your current expectations are as you kind of look to your proposed label as far as what we're thinking around kind of colorectal kind of specific versus a broader kind of abdominal label? And then kind of the same question around what kind of investor expectation should be potentially for some sort of risk factor or size of incision that could be on a proposed label.

Thank you. With regards to label, based on our discussion with the FDA we are targeting an initial label for the prevention of surgical site infections in prevention in patients undergoing abdominal colorectal surgery. This indication is directly supported by the SHIELD II Phase III data and is also our breakthrough therapy designation. We also expect that there may be an opportunity to evaluate potential label expansion into broader abdominal surgical application as we pursue -- as we go through the review process in a parallel. And the main rationale around it is as colorectal is the worst SSI prevalence in abdominal surgery. And obviously, there are other, but that's just as a high level. So that's our baseline assumption.

This is how we built all of our planning and models. We do not expect on that regard anything that will narrow this. We think that this is a very conservative assumption, and this is why this is our baseline assumption. And as you referred to, we also met the FDA towards the end of last year as part of an NDA process, actually had a pre-IND communication with the FDA, where the purpose of this communication was really to align the requirement around the NDA submission, both in terms of time lines as well as in terms of having the FDA agreed that the Phase III data is adequate for NDA submission, both in terms of efficacy and safety.

Got it. Maybe just along those lines, it may be somewhat dependent on kind of partnership discussions as well, but any kind of formal thoughts on kind of plans as far as what may be required for a broader label and/or kind of further expansion opportunities for D-PLEX100 specifically. Maybe a little bit too early for that question, but any additional thoughts?

Yes. Maybe I think what I can say is that we have as part of our planning time frame that we plan to meet with the FDA to discuss this.

Got it. And just maybe last one for me on kind of future applications for the platform. Can you kind of help shape our thinking a little bit for kind of where you may go next? Obviously, you've announced that metabolic program, but -- and how these kind of future formulations may differ from what we've seen you do thus far?

So first, as you rightly referred to, we have the opportunity to expand D-PLEX into other indications, and that's the first and probably the most advanced pipeline expansion that we look, which is specifically on D-PLEX. But with regards to other pipeline, so I'm saying that because it's important for investors to understand that our near-term focus remains firmly on execution, the regulatory and commercialization pathway of D-PLEX. So that is where the vast majority of our intention, our resources are directed. But as we move forward with the NDA submission and approval, we are expanding into specifically, as you all know, around the GLP-1 and metabolic health.

I expect that we will see during this year, we'll get additional data. I would even say around midyear. This program is still at preclinical development but with the underlying technology platform that provides long-term opportunity -- sorry, long-term exposure of 60-plus or around 60 days and the ability to support it in a linear way, this is very lucrative in this area.

The next question comes from Jason Butler at Citizens.

Congrats on the progress. Dikla, can you just talk about the work that you're doing or will be doing this year to get ready for a potential approval of D-PLEX100, both in terms of building awareness as well as getting ready with payers. Just the work that needs to be done before approval.

Sure, sure. So some of it, we've shared with -- in previous calls and some of it is also Ori referred to in our new branding and website. This is all part of getting ready for the commercial stage. Some of it is already out there like the website and the new branding. But also there is work that is done around packaging for D-PLEX, its commercial name that we will obviously expose later on once we are in the approval process.

And in addition to that, we have been doing a lot of work, not just now, but in the last 2 years. And Ori, please feel free to add to that. whether it is in terms of market research of pricing, creating awareness, you'll start to see many more abstracts and article coming from our front during this year, building a KOL network. Just the beginning of it was with our KOL event with doctor -- or well, it was actually our KOL event, but the ROTH Group KOL event with Professor Steven D. Wexner. Ori, do you want to add anything to that?

I would just add that the main work right now is really, like you said, Jason, kind of putting the data out there and making sure that people are aware of the data of the product. So conferences will be a big part of it. publication will be a big part of it. A lot of the health economics piece is something that is kicking off now because, as you said, for market access, this is a driver. But also some of the on the ground kind of boots on the ground market preparation will be dependent on the partner, and we are expecting that the partner will have sufficient time, and we are -- and that's why our conversations are with kind of experienced global partners that will kind of get running immediately after signing can go on and start doing all the prior approval meetings in the hospitals and really get the access piece going almost immediately.

Great. And then just one more for me. On the GLP-1 program, how do you think about strategically when and what data you can generate yourself versus when a partner might make sense to bring on board? And just longer term, how you think about positioning and differentiation in this market?

Sure, sure. So our GLP-1 program leverages our new Kynatrix technology for approximately 60 days of sustained release and we are targeting improved patient compliance. Our vision for this program is to partner at a relatively early stage. What we are building now is more robust preclinical efficacy and [ PK ] sets of data that support this attribute, this sustained release, no spike as you see the burst release that you see -- that is seen with current weekly delivered molecules.

So we are targeting to have this more robust efficacy and PK studies. We are already along the development of this program, have been speaking with different groups, but we believe that once we have this set of data, this could be very interested for partner, especially since we have -- this is coming after a validated program. D-PLEX100 has validated our approach in a very robust way, both in terms of manufacturing, CMC as well as PK and our ability to deliver and develop our technology forward into drugs.

We will take our next question -- your next question comes from the line of Boobalan Pachaiyappan from ROTH Capital Partners.

So first, I wanted to talk about the progress you highlighted in the press release about the potential U.S. partnership. So without getting into the confidential information, is it reasonable to assume the potential partner should also have a presence in ex-U.S. regions? And also assuming the significant interest post-NDA filing, what factors could play a pivotal role in closing in the partnership? And I have some follow-ups.

Great. thank you for that. So I'll start with the first portion. In terms of other geographies. So we are very focused now on U.S. We think that's our highest priority. That said, there might be interest to other geographies as well as part of those discussions and other discussions that we have. But our first priority is U.S. Also, since in terms of the time line, when you look at our NDA submission that is expected by the end of this quarter and European submission is expected later on about a quarter -- around the quarter after we finalize the FDA submission. So it makes more sense. And your second portion was?

So I was asking about what factors might play a role in identifying the final partner.

So Ori, feel free to add to that. But we have been saying for quite some time that the ideal partner and also the partner that we are discussing with are with broad hospital-based capabilities and present in the surgical suite, in the hospital. And this is what's really needed to market a product like D-PLEX100. So I don't see the -- what could go wrong in that respect because I think that the interest and there is an alignment between the interest and the need. Ori, do you want to add to that?

I would just add that we are -- we keep saying we're advancing, but we are advancing from a high-level discussion. The due diligence is going on and becomes more and more in the details. And I think that's a sign that we're heading in the right direction here.

All right. That's helpful. And then you mentioned about the KOL call. Obviously, during my call with Dr. Wexner, she mentioned that the Phase III study was well designed, adequately controlled with balanced characteristics and the patients, they reflect the real-world scenario. So I was wondering if you could comment on whether the FDA took a similar view based on your pre-NDA meeting communications.

I think the fact that the positive -- the feedback was positive and there is an alignment on that and the FDA confirm both the NDA pathway as well as indicated that the existing clinical data package is sufficient to support an NDA submission. I think that's -- it says it all..

All right. Maybe one final question from us. So we have done some research. It looks like there's approximately 900 integrated delivery networks in the U.S., and they manage roughly 6,000 to 7,000 hospitals. So I was wondering, assuming this is indeed the case, what percentage of potential target IDNs would reasonably likely to include D-PLEX on formulary within the first 12 months after approval?

Ori, do you want to take this.

Yes, I can take this. I think the process -- first, I would say that, of course, this would be a mission for the U.S. commercial partner. And this is the reason why we are discussing the commercialization activities with partners that understand the ins and outs of the IDNs that have relationship from the surgeon to the pharmacist to the IDN level to the GPOs to really ensure kind of uptake as fast as we can. Specifically about 1 month, I think it really -- it depends -- it's a hospital-by-hospital or network-by-network decision.

There are a number of steps, and I think we discussed this in the past, there are a number of steps to get the product used in the hospital starts with finding the right champions, which this is a process that will be done even before launch to start educating from a medical perspective, educating the surgeons on the need. Then the product needs to come to a P&T review. And in this P&T review, there will be discussions both on the clinical benefit, the end economic benefits. All of that are topics that we have strong information on and the partners will have all the tools they will need to make the case.

And then likely, the hospital or the IDN will ask for some sort of maybe a small pilot study, a handful of patients just really to see how this product works in the operating room and then an update to the electronic systems within the hospital. So all to say a little bit of a long answer to say that it's -- the uptake will take a little while. It's not a day 1 peak of sales, probably a few months before we'll start seeing a meaningful uptake. But I think the flip side of that is once there is -- once the product is on a formulary and there is usage, it's a relatively sticky process, meaning the products are rarely getting taken off formulary, assuming the product works and there are no issues. So we can see once the product is on formulary, volume growing steadily and usage growing steadily month after month.

We will take our next question -- and the question comes from the line of Brandon Folkes from H.C. Wainwright.

Congrats on all the progress. Maybe just 2 from me. Maybe firstly, any color on when you expect to complete the rolling submission? And then maybe secondly, can you just elaborate on the differences between the Kynatrix platform and D-PLEX technology platform? And just how much early-stage work do you need to do on the Kynatrix platform? Or how much can you leverage from your experience with D-PLEX?'m just thinking about sort of how we should think about timing of moving products forward on the new platform?

Thank you. Thank you, Brandon. So with regards to the time line, as we said, we expect to submit the NDA by the end of the first quarter. We will first submit the CMC and nonclinical module followed by the clinical module. And the gap between those 2 submission is not more than a couple of months. It is very close to one another. From that point, since we have a Fast Track and breakthrough therapy designation that support the use of a rolling submission priority review, we expect that the NDA review will be shortened to 6 months from the regular 10 months. Ori, do you want to give a bit of difference?

Yes, I can take that question. So Brandon, first, I think it's important to understand that it's not that one day we were on PLEX and the next day, it was Kynatrix. Kynatrix really is collecting under one umbrella, a lot of the work that has been done over the past several years that is not -- that was not under PLEX and under the PLEX IP umbrella, meaning to say there's no gap here. The work has been going on for -- as a continuous work.

What you see under Kynatrix is now a way for us to collect some of the IP on peptide release on intratumoral injection on the STING agonist partnership that we had. All these activities coming under this umbrella and helping us build new IP and in a way, allowing us to discuss this more freely without the limitations of PLEX. So it's a new name, but the work in the R&D team and the development has been going on continuously forever. Does that make sense, Brandon?

Yes. Very helpful, I appreciate it and congrats again.

This concludes today's question-and-answer session. I'll now hand the call back for closing remarks.

Thank you all for joining us today. 2025 marked an important turning point for PolyPid, and we enter 2026 with momentum across regulatory, commercial and organizational fronts. With the rolling NDA review expected to begin shortly, continued progress in partnership discussion and a clear strategic vision for the company's future, we believe PolyPid is well positioned for the next phase of growth. We appreciate the continued support of our shareholders, partners and employees, and we look forward to providing further updates as the year progresses. Thank you. And operator, you may now close the call.

This concludes today's conference call. Thank you for participating. You may now disconnect.

All right. Good morning, everyone. My name is Boobalan. I'm a Managing Director and Senior Biotech analyst at ROTH Capital Partners. I specialize in emerging companies in the SMid-cap space, particularly in the pharma and biotech sectors. So I'm delighted to welcome Dr. Steven Wexner to this KOL webinar. So before that, I just wanted to invite PolyPid team as well. Just as a disclosure, PolyPid is a $78 million market cap company. They have a product which is called D-PLEX100, which we'll discuss in detail today.

And then just in case, I cover PolyPid and my recommendation is a buy rating. My 12 months price target is $9 per share. So why don't we start with introductions First, Dr. Wexner, maybe you can give us a high-level introduction. I think you can do better justice to yourself than me.

Sure, sure. So my name is Steve Wexner. I was at the Cleveland Clinic, Florida for 38 years as Chair of the Department of Colorectal Surgery and Director of the Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, past President of the American Society of Colorectal Surgeons, past President of the Society of American Gastrointestinal Endoscopic Surgeons, past Vice Chair of the Board of Regent for the American College of Surgeons and a variety of other things, Editor and Chief of Surgery, one of the most important surgical journals. As of November 1, I'm the Executive Director and System Chief at MedStar Health, Georgetown University Hospital, the 10 hospital system in the Maryland and D.C. area.

Great. Can you also tell us your core practice area and number of patients you treat every year, just to give some idea.

Well, typically, I would be doing about 250 or so major operations annually. That's considering that I'm gone about 1/3 or more of the year traveling, lecturing and teaching, but in the 2/3, I'm there, about 250 major cases, actively participating in research. My main areas of interest in clinical practice and in research are rectal cancer, ulcerative colitis, Crohn's disease.

My practice is largely almost exclusively referral from out of state overseas. And a lot of those patients are for reoperative surgery because they've had other surgeries that haven't, shall we say, had the end result as initially desired. With those operations, I train surgeons from all over the world. I've trained probably a little more than 800 surgeons by now, about 200 from U.S. and about 600 from other countries.

Fantastic. And we also have PolyPid team on the call. So maybe, Dikla and Ori, can you please introduce yourselves?

Sure. So I'm Dikla, Dikla Czaczkes Akselbrad. I'm the company's CEO. I'm with the company now for 11 years in different C-level position, the last 4 as the CFO. Prior to joining PolyPid, I was the CFO of Compugen for many years which is an Israeli cancer immunotherapy company. Ori?

And I'm Ori Warshavsky, Chief Operating Officer. Just about 5 years with PolyPid. Before that, 10 years with Teva Pharmaceuticals. I'm mainly responsible for the U.S. activities for PolyPid, whether it's the commercial side, the investor side and some other activities as well.

All right. Great. Thanks, Dr. Wexner, and thanks, PolyPid for the introduction. So the way we are thinking about this particular event is this will be a fireside style question-and-answer. And obviously, if you have a question you can always submit it in the text box or you can send it to me by e-mail, which is [email protected]. So it's the first letter of my first name and my entire last name at ROTH.com. So all right. Now let's get into the fireside style webinar.

So for the ease of clarity, we have segmented this discussion into 5 broad topics. So first, we wanted to spend some time set this ground for SSI. So people who are not familiar with the topic, they can understand or learn more about this. We'll essentially discuss the symptoms and potential risk factors. And secondly, we will dive deeper into how -- why SSIs are relevant for hospitals, in fact, even for physicians. I think this will be very important because we have an expert in this, and he is going to provide some high-level overview on this.

And thirdly, we will dive deeper into D-PLEX100. This is PolyPid's agent that is designed for the treatment of surgical site infections. So we will spend a little bit time talking about the clinical data generated to date. And we'll also, of course, get some opinion from Dr. Wexner, what he thinks about the data and whether he would be inclined to prescribe these agents, assuming this gets approved.

And fourth, we will speak to PolyPid management. They will guide us in terms of what are the expected next steps, including potential time lines for filing and approval. And finally, we will get some preliminary insights about PolyPid's commercialization plans, particularly in the U.S. and ex-U.S. setting.

So again, if you like to submit your questions, you can submit to my e-mail or provide this in the chat box below. So let's start with topic 1, which is background on SSIs. So Dr. Wexner, can you maybe provide us a high-level overview of what is an SSI and what are some of the signs and symptoms that we are -- you are actually seeing when a patient has SSI? And what risk factors could make this more impactful?

So surgical site infection, which is SSI is a major cause of morbidity prolonged hospitalization, even in some cases, mortality. For what I do for colorectal surgeon, it's particularly high because of working on the bowel, although it can occur with any kind of surgery, including joint replacement surgery and lung surgery and the rest of it, but it's particularly notorious when we're working on the bowel because no matter what we do to try and cleanse the bowel prior to surgery with cathartic laxatives, with oral antibiotics, intravenous antibiotics, it's not -- nothing is infallible.

So we end up with a surgical site infection despite our best efforts. Surgical site infection can cause anywhere from double to an order of magnitude, like 11-fold increase in mortality and is indeed life-threatening. Surgical site infection can be superficial as shown here, where it's a little redness of the incision or maybe there's a little fluid that's seeping out and -- of the incision, the incision opens a little bit. That can cause cosmetic disfiguration later with a wider, broader scar. It can prolong hospitalization, certainly increase cost because of the need to manage that wound.

But when we start getting into the deep incision, the entire wound can open up and the strong connective tissue holding the abdomen closed can open up, which is, of course, a disaster or we get into even deeper infections within the pelvis or within the abdominal cavity, which starts to cost in the U.S. alone, something over $3 billion and increases hospital stay by estimates of up to around 10 days or so and increased cost of admission. It can double the cost of admission.

So one of the major, major Achilles heels of what we do in abdominal surgery and colorectal surgery is surgical site infection, something that we absolutely want to avoid at all costs. And I don't just mean cost of dollar cost, but there's the morbidity. People lose time from work, people go home requiring antibiotics, maybe even intravenous antibiotics at home. That has its own set of complications. Time is lost from work. I'm not sure that's factored in these financial calculations of $3 billion to $10 billion. I think that's health care system cost that doesn't count disability to the patient.

So it is a real, real major problem that we want to avoid. We take precautions, as I say, but there's no panacea, protecting the edges of the wound, all manner of things, irrigating. Until this trial came out, there really was nothing that was paradigm shifting that was moving the needle for us.

Great. Are there certain organs that are more prone to SSI risks or certain surgeries that are more prone to SSI risk versus others? Just curious. For instance, you talked about abdominal surgeries. Of course, there are some cardiac surgeries, there could be some gynecological and all that. So how does this SSI risk varies as you shift from one surgery to the other?

Well, again, I'm limited to colorectal surgery and is very high in colorectal surgery because it's what called clean contaminated surgery. By definition, it's contaminated. So if you had an operation like a joint replacement that is clean surgery, totally clean. There should be absolutely nothing to do with any bacteria. And in fact, if that happens, the patient loses the replace -- can lose the replaced joint. That's a much lower risk of infection.

Gynecology is not quite the same magnitude of colorectal, but it's also concerning because generally, depending what they're doing if the gynecologists are working just on the ovaries, that's intra-abdominal, but if they're taking out the uterus, then they're dividing across the vagina, which also is latent with organisms that can cause problems.

Then there's other abdominal surgery that's a bit cleaner, liver or gallbladder, but all of these operations lend themselves to the potential of infection. So colorectal is really at the top of the list, but that accounts for about 500,000 operations a year, give or take, in the U.S., worldwide, obviously much more. Within colorectal surgery, though, and the other operations, certain patients are at much higher risk, patients with diabetes, patients who've had radiation or recent chemotherapy, patients who are immunocompromised either by an underlying disease or because they're taking medicines to keep them immunocompromised to keep the disease from flaring like arthritis, for example. So there are many, many patients who are even higher risk than the baseline.

Okay. So because you mentioned about colorectal surgery, so maybe I'll restrict my next question, focusing only on colorectal surgery. Can you talk about what's the current standard of care for SSI prevention in colorectal surgery or colorectal setting? And if you can talk about what's the antibiotic you use and what kind of special precautions you take, if you can talk about all of that that would be great.

Yes. So it varies a little bit around the world, and it's kind of like a pendulum that keeps swinging. But where it seems to have settled at least in the U.S. is patients' bowels before surgery, the patient cleanses their bowels with cathartics like somebody would for colonoscopy. Adding to that our oral insoluble antibiotics that deliberately stay in the intestinal tract to try and neutralize the bacteria in the colon.

On top of that, then there's intravenous antibiotics when the patient comes to the hospital, usually a single dose. And it's going to depend what's on formulary at the given hospital, but it's a broad spectrum antibiotic. One of the things I didn't mention in trying to prevent wound infection giving those antibiotics can cause an infection. They can cause antibiotic-induced diarrhea or clostridium difficile, which in and of itself is problematic. It's highly contagious and has a lot of morbidity.

So giving the antibiotics to try to prevent infection can cause infection, ironically enough, at least the way they're typically given intravenously and orally. In addition, what we do to cleanse the bowel may have problems with the joint up healing, the anastomosis healing. And there's a lot of data on the microbiome now from a variety of laboratories around the world, showing that if you really do sterilize the colon, you're also killing the good bacteria, and that's problematic.

So the solutions we have now are not ideal because you're just -- it's taking the shotgun at the fly, if you will, and you're giving all these antibiotics, which risks overly sterilizing the bowel, if you will, possibly having problems with the joint up healing, possibly causing antibiotic-induced diarrhea. We also, during surgery, are very meticulous the way we handle the bowel, and we use wound protectors so that we -- when things are removed or handled, there's no direct contact with the tissue of the patient between the fascia, the strength layer of the abdominal wall closure around the skin.

All right. Great. So with that as a background, let's dive deeper into the impact of SSI on hospitals. So let's just imagine a situation where a patient walks in or gets admitted to the hospital for a colorectal surgery. He gets the surgery done, returns home only to find or he's experiencing SSI. And then he comes back to the hospital. So what are the steps he can take? And how does him coming back impact his own setting? Or how does it impact the hospitals and then we can take things from there.

Yes. So there's the financial impact, which you're showing here, so much so that the DRG may go up because of complications. The hospital is actually getting more money, but then they're being penalized for readmission. In addition, as an individual surgeon, you're having to explain to the patient why the patient has an infection, which is never a pleasant conversation, even though it's part of the informed consent prior to surgery.

On top of that, you're having to present it at the morbidity and mortality conference. So you're having to explain again why the patient got this infection. And depending on the severity of the infection, you may be reoperating on the patient, which the hospital just loses all that money because it's an unanticipated reoperation. So there's a lot of downsides besides the financial CMS penalty, there's a lot of downsides emotionally, psychologically to the surgeon and the patient and physically to the patient.

Okay. So in the interest of time, what I wanted to do is I wanted to spend some time on the middle table that I highlighted, talking about HACRP penalties. So just to get to speed, so this was a retrospective study that was done that analyzed approximately 3,100 hospitals, which participated in the HACRP program. So HACRP stands for Hospital-Acquired Condition Reduction Program. So this analysis identified approximately 25% of hospitals that were included in the study, which is roughly 771, they were penalized by CMS.

The finding that whatever the authors have found out, notably Florida and New York, for instance, they performed poorly, as you can see in the highlighted green box in overall rankings versus other states. And what is even more interesting, if you look at the table on the right side, some of the hospitals that have been known for their excellent service providing capabilities, including those that were chosen by U.S. News's best hospitals on this role, including Weill Cornell and then Stanford, they were also -- were under penalty.

So this scenario, technically, it highlights the needs for U.S. hospitals to increase their service failing to do so, they will be in the bottom 25th percentile, and it will incur approximately, I think, 1% penalty. So with this as a background, I wanted to ask some follow-up questions. So how does SSI impact star rating for the hospitals? What are the implications of a lower rating? If you can maybe elaborate more on that, and then we can take things from there.

Yes. I'm not sure there's a lot more to elaborate beyond that other than we're all pulling in the same direction to limit surgical site infections, which in turn limits morbidity, mortality, readmission, financial penalties, reoperations for patients. And sometimes, quite honestly, permanent long-term adverse sequelae, that's something we've not discussed nor is that information captured in these dollar amounts.

And what I mean specifically is if the patient gets a superficial and certainly a deep surgical site infection involving the fascia, the strong tissue that holds the belly closed at surgery or strong tissue that holds the belly closed without surgery, with fascia, that fascia can open up. And if that fascia opens up or even weakens, the patient ends up with an incisional hernia. And that now may cause problems in the hernia itself.

The patient can get intestine, stuck in that hernia and up with an emergency surgery. Or more likely that's not going to happen, but the hernia grows and is unsightly and the patient ends up having to have the hernia fixed. So now there's another operation that's occurring outside of that immediate 30-day period, maybe outside of the first 12 months, that's additional morbidity potential complications from that surgery. Now maybe the patient has to have mesh implanted at a later date, plus the patients being exposed to the entire gamut of potential complications from a hernia operation. And that's all courtesy of that initial surgical site infection.

Great. And then maybe switching from hospitals to physicians, are surgeons personally impacted by or having -- or reporting high infection rates? How does it impacts the bonuses or ranking, thinking beyond the patient impact here.

Yes. I mean it's going to depend upon the health care system because some surgeons may be working fee-for-service, others may be full-time salaried, some in a hybrid position. But the common denominator is wherever you work, whoever is looking at the data is going to share with you your infection rates. And if your SSI rates are outliers, either good or bad. If it's really good, somebody is going to say, we want to share your best practice. If it's high, somebody is going to say, you need a best practice, what's going on here?

So you're going to be called out for that in a negative way. How the metrics are measured by the various Newsweek and U.S. News & World Report and all the other Castle Connolly and all of these other reporting agencies, it changes all the time. So I'm not exactly sure where in their various algorithms, SSIs are captured. But I can tell you that they do play a role because it's your outcomes, right? It's part of your outcomes. And if the outcomes aren't as good, you're less likely to be cited in the top tier of providers.

Okay. So you mentioned that having an SSI is -- the conversation is not going to be pleasant between a physician and a doctor. In fact, there are some reports saying that patients have legal rights to sue hospitals if they have SSI. So with this as a backdrop, I wanted to ask this question, is every documented SSI qualifies a medical negligence?

I don't personally think so at all. I mean I'm not speaking on behalf of any society or institution, but I think that would be a pretty heavy hand to say that it's somehow malfeasance. It is a recognized problem and that's something that's part of the informed consent in the patient. But I don't believe by any stretch of the imagination, it's what you're potentially suggesting it could be. No, it's not at all. It's an unwanted problem, but it's not an unexpected problem.

Okay. Nicely said. All right. We'll switch gears and talk about D-PLEX100. Maybe I can bring in PolyPid team for this discussion. So maybe Dikla or Ori, can you give us a high-level overview, the genesis of D-PLEX100, because you're -- essentially you're formulating a known drug, which is doxycycline with polymers and lipids. Obviously, doxycycline is known -- it's been in use for more than 50 years. So I'm pretty sure others might have thought about it and maybe they have failed to come up with a formulation similar to yours. So if you can talk about what attracted you about D-PLEX100 the most?

Well, so -- sorry...

Yes, go ahead please.

No, I thought it was for me. Sorry.

We'll come back to you in a minute. Take a minute.

So first, it was very interesting. I must admit, Dr. Wexner, you pointed out some things we, same as you in a way, breathe and -- breathe day and night the aspect of SSI and specifically abdominal SSI, but it was nice to hear your perspective. So thank you. PolyPid has invested over a decade developing our technology, our platform technology that allows for extended prolong coverage of the drug.

And a couple of years ago, probably around 6, 7 years ago, we decided and understood that utilizing the platform into the area of surgical site infection could really make it different, could really bring innovation into area where there is none to very little innovation and not just bring innovation, but potentially bring something that could be transformational in terms of the level of infection that have been accepted for over a decade.

And I agree with Dr. Wexner, and we heard that very often from surgeon that SSI is in a way the cost of doing business. It's not that you could -- whatever you'll do and even we -- although we are getting very close to that, no one will claim that they have 0 infection rate or that they can get infection level to 0 because the bacteria is out there. It's out there every day on a day-to-day basis. But what we are trying to do by covering, draining incision for 30 days, which is in most of the surgery, the way CDC defines surgical site infection.

So CDC defines surgical site infection as infection that occurs within 30 days from the index surgery and covering the incision deep and superficial, including the fascia for 30 days could really make a difference. So time is of essence here. And the other aspect is the way we are presenting the drug to the site. The fact that it is at the open or where the bacteria could go in from the outer to the inner, although with colorectal, we are also bearing the risk from the inner to the higher, this is why we see a much higher infection rate than in other surgeries, allows us to enhance the antibiotics to create local minimal inhibitory concentration that probably cannot be achieved without very significant side effect in a systemic manner.

Dr. Wexner, do you have any thoughts on that? What attracted you the most about D-PLEX100?

Yes. So I had the privilege of chairing the Data Safety Monitoring Board. I was not an investigator, but I was immediately attracted to the concept of eliminating -- potentially eliminating some of the other types of prep that are used. And in fact, the majority of cases, cases were not done in the U.S. and the majority of cases were not done with the triple preparation as we did -- as we do in the U.S. with oral cathartics, oral antibiotics, intravenous antibiotics, which is great news because maybe we're overkilling.

And maybe instead of trying to do things in all different directions, we just focus on the incision itself with this long-acting potential, and we can get rid of some of the potential adverse sequelae of oral antibiotics, of intravenous antibiotics. I mean even bowel prep itself, giving patients cathartics can cause significant dehydration, it can cause kidney dysfunction, acute kidney injury. We'd like to avoid those things, obviously.

And this is a totally novel way to deliver, as was mentioned earlier, an agent that's been around for a very, very long time that we wouldn't typically pick. This wouldn't be a drug we would use for much of anything. But now suddenly, it has a role. So I was very intrigued by this as being something really in my entire career that's new for SSI prevention. This is truly new. This is a paradigm shift for us. It represents a different direction. And that's what attracted me to it.

Also, when I heard the size of the study, that was also very attractive because sometimes people have underpowered studies, and I'm not interested in participating in underpowered studies because they're not going to tell much. But this is a very, very robustly powered study. And I thought that was a second very appealing factor to me. If I'm going to get involved in research, I want it to be meaningful research.

Fantastic. All right. So let's dive deeper into the D-PLEX100 clinical program. Maybe, Dikla, you can just give us a high-level overview. What are some of the goals you have set prior to launching this program? And obviously, you have done Phase I, Phase II and you have done multiple Phase III studies, and it worked for the third time. I think SHIELD II was very -- the lessons you have learned from the past that you kind of like implemented in SHIELD II that led you to success? And then we can talk more about endpoints in a bit.

Sure. So maybe just as an overview, the SHIELD II and all of our abdominal studies were designed to show reduction of infection within 30 days from the surgery. We also follow the patient for additional 30 days for safety, so overall 60 days. Obviously, all the study were prospective, multinational, randomized, controlled double-arm and blinded studies.

With the Phase III studies based on the feedback from the FDA, from the agency, we also added to the primary endpoint measuring mortality rates, as well as reoperation, which is a common problem, specifically in colorectal resection. And this was our primary. SHIELD II was focusing on open colorectal resection, large incision, although in addition to the 800 patients that were the intention to treat population, we also added about 200 patients that had laparoscopy procedure in -- specifically in colorectal resection, those are having still a relatively large incision of 7 centimeters for the portion of the resected colon. So still high risk of infection even in a laparoscopy procedure.

Can you talk about the endpoints of this study? And what would make the study successful at that point when you launched the program?

So this is a very interesting question because we were obviously looking to show a substantial reduction of infection. We wanted to show -- we said we are giving the surgeon another tool to their toolkit, what we believe is a very powerful tool. We would expect to see fewer infection.

But the other thing that we were set to show is that when you evaluate infection versus infection, yes, in the D-PLEX treated arm, there are much less infection versus the standard of care, but we also thought that we should see milder infection. So we were looking for a dual effect in a way to see fewer infection in the treated arm, but also milder. And I think we -- I'm very pleased to say, and we are all very pleased to say that we've been showing that in this Phase III in the most robust way possible.

Okay. Great. And then Dr. Wexner, here's -- I'm showing you the demographics and surgery characteristics. These are from SHIELD II data. So I wonder, obviously, there's a D-PLEX arm, the standard of care arm. Is there anything that is striking out from this slide? Or do you feel the population or the patients that were enrolled in SHIELD II, they're reflective of real-world population. Can you provide some broader thoughts on that?

Firstly, yes, it's everyday practice for most surgeons around the world in terms of distribution of cases. But secondly, very importantly, the groups are well balanced. And again, that has to do with the statistical design of the study. So the stratification was appropriate. We don't end up with morbidly obese patients in one group and aesthetic patients in the other group or one group very heavily weighted towards inflammatory bowel disease where they'd be immunosuppressed. There's small percentages in both groups. So I think it's well -- it's well designed. It's well balanced, and it is representative of standard practice.

All right. Great. So I'm showing you here the primary efficacy endpoint. So Dikla, when you launched this program, what was your expected SSI rate for the placebo or the standard of care, sorry? And what is that you wanted to show in the treatment arm? And how does the results satisfy your expectations?

So we were thinking about a 10% infection rate in the standard of care arm. And we were hoping to show more than 40% reduction in surgical site infection. What we see here is the primary endpoint, which is combined with mortality and reoperation. So you see that the standard of care arm have 18% of the 3 together.

So patient can have a surgical site infection and they can end up having a reoperation to try to treat the surgical site infection, and they can even die at the end of that process. So we have more than one risk factor or major risk factor that is attributed to surgical site infection among other things, and those were the numbers in the standard of care versus 40% reduction with the D-PLEX arm.

If you move on to the next slide on the key secondary endpoint, I think that is really looking just on surgical site infection, where we believe D-PLEX have a major role in reducing the numbers, and we've seen that all along the way. And you can see here, 60% reduction from almost 10% infection rate to less than 4% infection rate with a p-value that is lower than 0.005, so very robust. I must say, and I'm curious to hear Dr. Wexner's opinion on that, from the time that we had this Phase III data, we shared this with [indiscernible] with surgeon.

And we were getting 2 observations, which we all found interesting. The first one, most of them, if not all of them said that the 9.5 is lower than what they see in practice in their clinic for patients with open large incision. And to that, our response was that it makes perfect sense. This is a clinical study. We cannot enroll patients that undergo emergency surgery. It's very hard to have them sign a consent or patients that are very unstable. So it makes perfect sense that this is a bit lower than the 11%, 12% they expect in this patient.

And the other observation was that with D-PLEX in large open colorectal resection, we have less than 4%, 3.9%, which is usually lower than what surgeons see in laparoscopy procedure. So that was something that we've heard quite frequently, and we found quite interesting.

Okay. Can you also talk a little bit about incision length greater than 7 centimeter, because I think this will potentially help you to broaden the label opportunity. So if you can provide some thoughts on that.

Yes. And this was the purpose of having this almost 200 patients, 177 patients to have a broader patient population. This patient population gets the study to close to 1,000. It is over the intention-to-treat population. And you can see that we maintained the same overall level of efficacy close to 40% in the primary endpoint and very robust, again, p-value, which is lower than 0.005.

Okay. Can you also talk about the safety profile of D-PLEX100 from SHIELD II data?

Sure. So -- and maybe Dr. Wexner would want to add to that. From the perspective of the study ongoing, we found the data, first of all, very robust. We have now overall more than 1,000 patients that have been treated with D-PLEX in different studies. We haven't seen anything that could suggest that there are adverse event at a higher rate in the D-PLEX arm, if at all, lower. So we found that the study is very appealing in terms of the safety aspect.

Okay. Maybe I'll turn to Dr. Wexner. Dr. Wexner, what are your thoughts on SHIELD II data? If you can specifically talk about the primary endpoint and the secondary endpoints, including the ASEPSIS score that is shown on this slide, a little bit on safety, that would be helpful.

Well, in terms of safety, I can tell you, again, having the privilege of chairing the Data Safety Monitoring Board is safe. Safety was not a consideration. We had multiple opportunities to stop the trial if there are any concerns, and there were none. And at the end of the day, there are none. So I think it is very safe. And I think even just logically, intuitively, delivering antibiotics directly to the tissue rather than through the mouth or through the vein is going to be a safer way to do it. I mean, without having any PhD in microbiology, anything like that, it just seems a better mousetrap.

Secondly, in terms of the efficacy, so safety is fine, efficacy, I think that I've only participated maybe one -- firstly, just to preface, I have over 1,200 peer-reviewed publications, okay? So I'm an active researcher. I would say once a decade, I participate in a study as an investigator or the study author, in this case, the DSMB, where there's more than a 50% improvement over the control group. Very often, it's as was hoped. You get a marginal improvement and then you're trying to justify, is it worth it.

This is great. I mean this is, again, a rare finding that you have more than a 50% improvement in efficacy. So I think surgeons are going to be very pleased and non-surgeons, too. I mean, probably the infectious disease doctors are going to say, why are you giving all these other antibiotics by mouth and by vein when you can just use something that you put in a surgery in the wound and it's good for 30 days, and we know that it works and it's safe. So I'm impressed. It's rare to see this degree of efficacy in a trial.

Okay. Can you also talk about potential applicability to other surgeries, let's say, gynecology or urology and other surgeries based on the data you've seen in the colorectal surgery setting? I know you are a colorectal surgeon, so you're limited in terms of what you can say.

Well, in terms of what I do, but in terms of what I've supervised in my years, 12 years as Chief of Staff, and I've served as Chief of Surgery and other things. So -- and being, again, editor in chief of one of the major surgical journals, I am familiar with other fields.

I just don't perform surgery in them. It has applicability anywhere an incision is made. I mean there's probably -- I don't know, there may be applicability in oral surgery for dentists, maybe veterinarians. I really don't know, but one would guess that anywhere an incision is made, there is the potential for a market to try to decrease SSIs because they are problematic in every type of surgery. The mouth is another area just off the top of my head.

So I see this going in a couple of directions. I see it broadening. And again, surgeons are just always try and improve outcomes for patients. So something comes out and the label says something and somebody says, well, I'm going to do an investigation and see if I can push the limits and do this in some other areas. So it says 7 centimeters, but I'm going to do a study and look at some other number.

So people are going to start doing creative things is my guess because that's human nature. Secondly, I think there's the entire arena that's not yet explored of laparoscopic and robotic surgery. So you mentioned urology and prostates, that's robotic. Port sites get infected, too. Extraction sites get infected. So I believe that there is going to be an expansion of utilization as people also try to prevent port site infections and infections of these little specimen extraction sites. So that's not anything official because it's not labeled. I'm just telling you what I think.

Okay. This is a highly upbeat view. That's good. All right. So we'll move on to topic 4, which is D-PLEX100 next steps. Obviously, we want PolyPid management to answer some questions. So Dikla, so you had your sort of pre-NDA meeting discussion, but not necessarily an in-person meeting, which is actually a good news. So can you walk us through like what happened from the time you released SHIELD II data until now? And then what are your next steps? What can we expect to see from PolyPid?

Yes. Thank you. So we were very pleased to report a week ago on the outcome of the pre-NDA process. We reached out and we were preparing a pre-NDA package to get to an agreement with the FDA on the NDA, and we are very happy with collaborative and the answer that we got from the preliminary meeting correspondence, which got us to the understanding that we have an agreement with the agency on the NDA submission and that maybe the most important thing is that they found that the SHIELD II data is sufficient for an NDA submission and initiating review.

We plan to submit the NDA early 2026. Everyone in the company is very focused on that. We are preparing for that for a couple of months now, if not more than a couple of months. And the plan is to submit the NDA early next year. The product has breakthrough therapy designation, so -- and 3Q IDPs and Fast Track designation. So we are eligible for the priority review, which is 6 months plus 2 for acceptance. So we expect that towards the end of 2026, early 2027, we should have a PDUFA date.

Along this time, we also expect the FDA to come and do a pre-approval inspection in our manufacturing facility. This is also part of our planning and preparation these days. And in parallel, we are going also to submit with the European authorities with a short gap from the FDA, probably something around a quarter post finalizing the submission to the FDA.

Okay. Great. So there are a lot of questions I wanted to ask, you already answered in advance, so which makes my job a little bit easier. But let's dive into the most important one, potential for advisory committee meeting. Obviously, this is a technology that is -- I don't know whether -- I wouldn't call it necessarily new, but there were some polymer-based or lipid-based products that are approved by the FDA. So what are the chances of having an advisory committee meeting for D-PLEX100? I also wanted to get some thoughts from Dr. Wexner for the same question. So maybe you can go, Dikla first and then we'll have...

Yes. So I think that we -- and this is, again, part of the benefit of having the breakthrough therapy designation, we and our team have been in contact with the FDA along the years, meaning many of the aspects of CMC, of preclinical, whatever we could get to an agreement with the agency prior to the process, this has been already done.

I don't know to tell you specifically about an advisory committee at this stage. I think that there is a process that is in place. We are very confident with our filing and with our NDA and hopeful that this will be something that will go smoothly. In terms of the platform itself, -- at this stage, the way we're looking at it, I mean, we are a 505(b)(2). So the drug is a known drug. And the platform is unique, but in a way that we are using known excipients. So it's hard to say at this stage.

Okay. Dr. Wexner, same question, thoughts on AdCom.

Yes. I think it is paradigm shifting. It is truly innovative revolution. And I personally hope it's going to be fast tracked and I should think it would be. Again, in my almost 40 years of doing this, most of the applications are for something incremental. It's something a little bit slightly different flavor of ice cream or something, but it's not a new substance. This is a totally new delivery method.

And I think the FDA -- remember, the FDA, CMS, these are all government agencies, which have the same view. They want to improve outcomes. They want to decrease the cost of health care. They want to give access to patients for the best possible tools and therapies. And I personally believe this is in that book of definitions. So I'm optimistic and on a personal level, hopeful because I'd like to be using it in my patients.

Okay. So Dikla, let's go back to the filing process again. So you're planning to do it on a rolling basis, and there's 5 modules. And you said the earliest module might go out in the -- the first module might go out in the first quarter '26. So when do you expect to sort of wrap up the filing process? I mean, what's your assumed completion date? Do you think end of '26 is -- I mean, you can still get approval by end of next year? Is it still a chance?

So as I said before, we are targeting early 2026 for submission. We do not expect more than a 2 months gap between the first model and the last one. This is something that we've already discussed with the FDA as part of the pre-NDA process.

Okay. Right. So meaning assuming you get everything done by first quarter of next year, there's still a chance that you could get the approval by fourth quarter of next year?

Yes. So this is why I said that we think that the PDUFA, the approval, we should look at end of 2026, early 2027. I want to be more realistic and...

Are there anything special steps you have to take to make sure you pass the FDA on-site inspection, if you can talk a little bit on your manufacturing capabilities, especially there is this domestic push towards producing everything in the U.S. So if you can talk about some of the challenges because you're based in Israel, any potential challenges, that will be helpful.

Well, I think that the fact that we built our own manufacturing facility 6, 7 years ago to make sure that we have the capability to manufacture these large clinical studies as well as later on for commercial stage gave us the opportunity to build a lot of experience around the manufacture to establish very robust CMC processes. We are as part of the European regulation and the Israeli regulation are regularly audited and reviewed for GMP. So this will not be the first time that we are audited. Having our own manufacturing facility that is dedicated for D-PLEX, the facility does not manufacture anything else. It's not a CMO that has several clients is also in our benefit. So all of that makes this facility very, very focused on D-PLEX, very focused on the GMP processes for D-PLEX. But that said, we don't take this inspection lightly. We are engaging a lot of -- we have a very detailed plan, including several mock inspection to be prepared for the inspection.

Okay. And then maybe Dr. Wexner, I have a question to ask. Assuming D-PLEX100 gets approved, can you maybe talk about any challenges for hospitals or physicians to adopt this product? I mean, do you see the surgeon making the decision? Or do you see any infectious disease specialists in the hospital in this decision-making process, whether or not to adopt D-PLEX100?

I think health care situation and certainly in the U.S., and I believe around the world has changed. It used to be that a surgeon wanted something and said, I want this and it would appear. That's no longer the case. Everything has to go through a formulary committee. Everything is going to be subject to analysis. Is it -- if it's a substitution for something, it's easier than if it's a new product.

Having said that, if it's a product that's going to save money, that's certainly favored. And this one would because it may save readmissions, which are penalized. It will save time in hospital, which is a financial loss to the institution and all the other things we discussed earlier. So it will have to go through that process of a formulary committee, which is often chaired by someone in infectious disease, not always, but it has a variety of people on it. It may have surgeons of different disciplines. It may have internist. It will have administrative people and a decision will be made.

And the case has to be made both to the surgeons and to the administration that it's a cost-effective, efficacious, safe product. But I believe that all of those data exists, and I think it's going to be fairly compelling. In terms of the surgeon then using it, I think once it's in the hospital then it's going to be very easy for people to say. And I think surgeons are going to resoundingly say, yes, I'd like to reduce SSIs in my patients. And since it's on the shelf, I want to use it.

Okay. So do you also see surgeons sort of expanding the label, meaning like even though the first indication would be colorectal surgery or abdominal surgery greater than 20 centimeter, do you see surgeons like using this product for other surgeries where SSI could be a risk because the drug is already on formulary, assuming that?

I mentioned that earlier. I think surgeons are always looking for best outcomes for patients. And if you look at things like aspirin is not labeled per se to reduce myocardial infarctions or to prevent blood clots when you're flying on planes and people use it. And people use all manner of different drugs, vitamin C to try and prevent colon polyps. There's lots of things floating around out there. So the answer is yes. In my opinion, people will try to offer the benefit in a variety of scenarios.

Okay. Maybe in the last 5 minutes or so, I wanted to spend a little bit on commercialization strategy. So Dikla or Ori, maybe you guys can take the question. So obviously, 4.5 million abdominal surgeries in the U.S., roughly 600,000 cases belong to colorectal surgeries. So you -- I mean your partnership discussions are happening. What is that you're looking for in a potential U.S. partner, assuming the drug gets approved on time, how are you planning to expand on the D-PLEX use?

Yes. Maybe I can take that. So the product, because it is a hospital product and because as we just heard, there's specific knowledge that is needed to get the product on the P&T committee, we are looking for partners, and we are advancing our discussions with potential partners for the commercialization of D-PLEX. The partner needs to be a partner that knows the hospital, kind of knows its way through how to get product on P&T committee, how to talk to infectious disease specialists, how to talk to surgeons. So it's a very specific type of partner. We already have a partner in Europe for the product, Advance Pharma, which is responsible for all the commercial activities in Europe. And we are looking to do the same both in the U.S. and in other major markets as well.

I just got a question from audience. It says, does Dr. Wexner anticipate colorectal surgeons would readily replace current triple therapy ABX Prep with D-PLEX? Or is it more likely to be treated as an [indiscernible] intervention?

No. Well, it's a prophylaxis, it's not a treatment. So it's not a rescue agent. It's prophylactic. So I think that it's going to be a mix. I think some people are going to say like belt and braces, I'm going to do everything I'm doing plus add this. But for those people, and there are many of them who think, well, I don't really need the mechanical bowel prep or I don't need the oral antibiotics. I think it will be a substitute instead.

So I think it's going to be a mix. I can't guess the percentages, but it's going to be a mix. For some people, it's going to be another add-on, but others are going to substitute. And I think what's going to happen over time is it's going to become a replacement therapy for the others. I think people are going to realize you really don't need all of these systemic agents because you've got something that works locally. There'll be exceptions. But I think in many cases, it's going to be a replacement therapy.

Okay. And Ori, maybe you can tell us a little bit about the market research study that you have done recently and maybe highlight a couple of high-level takeaways.

Yes. Yes. So this market research is really trying to independent in a way, validate what we just heard from Dr. Wexner. We asked surgeons. We showed them the data on a blinded basis and asked them first, and this is what you see on the left side here is kind of to help us understand what are the patient population that are -- that fit for this product. And they highlighted the risk factors, just as Dr. Wexner mentioned, the obese, the uncontrolled diabetes, the transplant patients, colorectal, of course, because that's where the study is.

And also large open incision, incisions greater than 10 centimeters is almost, by definition, is a risk factor for -- or increases the risk for infection. So that's what was highlighted. And then what you see on the right here, we asked -- if you can just switch back for just 1 second. What you see on the right here is we asked about the willingness to use the product. And we ask if the product -- the yellow boxes, if the product is on formulary and is talked, the surgeons say that -- 80% of them said that they were extremely likely to use the product.

The next slide talks about similar questions, but from the pharmacy director perspective, those who chair and lead the formulary review process. We ask them first, and this is on the left here, what is the -- how the review and acceptance process will happen in the hospital. And as they mentioned, a multidisciplinary team, surgeons, IDs, finance, all looking at the different benefits of -- and risks of D-PLEX.

They would likely ask for a pilot study to really make sure that the product works as we claim it is, and then there will be a formulary decision as well. I will say that once -- it is a long process, but once the product is on formulary, it's a very sticky product. And just like Dr. Wexner said, people will start using it, word to mouth goes around the hospital, so we can see quite a broad use of it.

On the right here, and this is very critical, we ask the pharmacy directors, how likely are you to put this product on formulary. And you can see the 90% here. So 90% of the people asked said they are extremely likely to put it on formulary. And then we added if you get this additional reimbursement from the NTAP program, this number, this 90% actually go as high as 100%, we'll put it because the financial benefits here with the clinical benefits are almost a no-brainer for coverage.

What is the sample size for your market research study?

Yes. So this was a qualitative research. There were 10 surgeons from different disciplines and 10 pharmacy directors. And really, the idea was to get a sense of where the hospitals are.

Okay. We also have a question from audience. I think this is probably the final question. What is the expected pricing for D-PLEX100? Is this something you can talk about?

So we...

Sorry, go ahead.

The pricing. So we -- in the past, we spoke about around $600 per vial. Without going specifically into the details, we tested -- the numbers that you see here, we tested a higher number than $600 per vial. And still, you see the numbers for -- both for usage and for having a formulary is high as you see.

I would just add that the feedback was even higher once the product has NTAP.

All right. So we are running out of time. I think this is a great discussion and Dikla and Ori and Dr. Wexner, great talking to you. Thanks, everybody, for dialing in. Hopefully, we can talk again in some other appropriate time. Bye-bye. Thank you.

Thank you.

Thank you. Thank you very much. Thank you.

Thank you for having us.

Greetings, and welcome to PolyPid's Third Quarter 2025 Conference Call. [Operator Instructions] As a reminder, this call is recorded.

And I would now like to introduce your host for today's conference, Yehuda Leibler from ARC Investor Relations. Mr. Liebler, you may begin.

Thank you all for participating in PolyPid's Third Quarter 202 Earnings Conference Call. Joining me on the call today will be Dikla Czaczkes Akselbrad, Chief Executive Officer of PolyPid; Jonny Missulawin, PolyPid's Chief Financial Officer; and Ori Warshavsky, Chief Operating Officer, U.S. of PolyPid.

Earlier today, PolyPid released its financial results for the 3 months ended September 30, 2025. A copy of the press release is available in the Investors section on the company's website at www.polypid.com. I'd like to remind you that on this call, management will make forward-looking statements within the meaning of the federal securities laws. For example, management is making forward-looking statements when it discusses the anticipated timing of the pre-new drug application or NDA meeting of the U.S. Food and Drug Administration or FDA, the planned NDA submission for D-PLEX100, the expected submission of the European marketing authorization application, the potential regulatory and commercial pathways for D-PLEX100, including leveraging its fast track and breakthrough therapy designations, the company's ongoing partnership discussions, market adoption, reimbursement assumptions, the company's commercial manufacturing readiness, U.S. market access studies and utilization of D-PLEX100, regulatory inspection readiness and the expected cash runway to fund operations well into 2026.

Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond the company's control, including the risks described from time to time in its SEC filings. The company's results may differ materially from those projections. These statements involve material risks and uncertainties that could cause actual results or events to materially differ. Accordingly, you should not place undue reliance on these statements. I encourage you to review the company's filings with the SEC, including, without limitation, the company's annual report on Form 20-F filed on February 26, 2025, which identifies specific factors that may cause actual results or events to differ materially from those described in the forward-looking statements.

PolyPid disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events, or otherwise. This conference call contains time-sensitive information and speaks only as of the live broadcast today, November 12, 2025.

With the completion of those remarks, it is my pleasure to turn the call over to Dikla Czaczkes Akselbrad, CEO of PolyPid. Dikla?

Thank you, Yehuda. On behalf of our team at PolyPid, I would like to welcome everyone to our Third-Quarter 2025 Earnings Conference Call.

The past quarter was significant for PolyPid as we progress with our objective to bring D-PLEX100, our late-stage product candidate for the prevention of surgical site infection, to the market. We are pleased to report that our pre-NDA meeting with the FDA is scheduled for early December and is expected to be held as an in-person meeting at the FDA office. This important meeting is designed to align with the agency on the data package format and requirements for our NDA submission, representing a key milestone in our path to regulatory approval. We remain on track to submit the NDA for D-PLEX100 in early 2026, leveraging both our Fast Track and breakthrough therapy designation.

In parallel, we are preparing for submission of the European marketing authorization application, which is expected to follow the NDA. During the quarter, we successfully completed the Israeli Ministry of Health Good Manufacturing Practice, or GMP inspection, marking our fourth consecutive successful inspection and an important step forward in achieving commercial manufacturing readiness for D-PLEX100.

The successful completion of this inspection ensures we can manufacture commercial products for the European market once D-PLEX100 is approved in Europe, as well as serve as a real-life test of our readiness for an FDA inspection of our facility, which we expect will follow the NDA submission. We continue to advance our strategic discussions with potential U.S. partners with an established hospital sales infrastructure, building also on the strong momentum of our positive Phase III SHIELD II trial results announced in the second quarter. These discussions have progressed during the third quarter.

We also recently completed a new U.S. market access study based on the presentation of the successful SHIELD II results. The study provided important validation of D-PLEX100's commercial potential. The results were very encouraging, confirming strong interest from both surgeons and hospital pharmacy directors. Taken together, the third quarter marked continued progress across all fronts, regulatory, commercial, and manufacturing, as we move steadily towards the next phase of PolyPid's growth, including our innovative pipeline in oncology, obesity, and diabetes.

With that, I will now turn the call over to Ori Warshavsky, our Chief Operating Officer, U.S., who will provide additional insights on the market access study findings and our commercial readiness efforts.

Thank you, Dikla.

As Dikla noted, this quarter was pivotal in strengthening our commercial readiness for D-PLEX100. The completion of the GMP inspection and our ongoing work with hospital stakeholders brings us closer to launch readiness. Last month, our medical team participated and presented data in 2 major U.S. medical conferences, the 2025 American College of Surgeons Clinical Congress, which gathers surgeons from multiple disciplines across the U.S. and internationally; and IDWeek, the key annual conference for infectious disease specialists. The response from both surgeons and infectious disease specialists was remarkably consistent. Both groups expressed the need for innovation and new tools to prevent SSI and were impressed by the SHIELD II trial design and the 58% reduction in surgical site infection demonstrated by D-PLEX100.

As Dikla mentioned, we also recently completed a new U.S. market access study that included both surgeons and hospital pharmacy directors from leading academic and community hospitals who are contributing members or heads of the Pharmacy and Therapeutic Committee, also known as P&T Committee review process at their respective hospitals. The results were very encouraging and in line with our expectations in terms of both clinical perception and commercial potential. I'd like to share a few key highlights from the study.

Among surgeons, D-PLEX100 was viewed as more valuable than currently available SSI prevention measures, primarily due to its strong efficacy, safety profile, and ease of use in the operating room. Most surgeons indicated that their hospitals are likely to add D-PLEX100 to formulary at launch, with 80% saying they are extremely likely to use it for their next eligible patients once available, and an average expected utilization of approximately 6 out of every 10 eligible cases, particularly for high-risk patients undergoing colorectal or abdominal surgeries or those with comorbidities like obesity or diabetes.

Hospital pharmacy directors echo this enthusiasm. Based on the clinical profile, 70% reported a high likelihood to add and stop D-PLEX100. When asked if a new technology add-on payment or NTAP designation, which provides extra reimbursement to hospitals, would change their response, the pharmacy directors anticipated that the formulary coverage would be even higher, and the overall hospital adoption outlook will look even more favorable. D-PLEX100 was widely seen as a promising new SSI prevention agent addressing a significant unmet need. Altogether, we believe these results are a significant vote of confidence and tangible support for both the clinical and economic potential of D-PLEX100.

With that, I will now turn the call over to Jonny Missulawin, our Chief Financial Officer, to review our financial performance.

Thank you, Ori. Turning to our financial results for the third quarter of 2025. Research and development expenses totaled $5.3 million, down from $6.2 million in the second quarter of 2025 and $6 million in the same quarter last year. This decrease reflects the completion of the SHIELD II Phase III trial. General and administrative expenses came in at $1.8 million compared to $1.2 million in the third quarter of 2024, while marketing and business development expenses were $0.4 million, up from $0.2 million in the same period last year.

The net loss for the quarter was $7.5 million or $0.37 per share, an improvement from the net loss of $7.8 million or $1.22 per share in the third quarter of 2024.

Looking at the 9 months ended September 30, 2025, R&D expenses totaled $17.6 million compared to $15.8 million in the prior year period. G&A expenses increased to $5.4 million from $3.3 million last year, and marketing and business development expenses rose to $1.4 million from $0.7 million last year. The increase in G&A and marketing, and business development expenses were primarily due to noncash expenses related to performance-based options or PSUs, following the successful SHIELD II Phase III trial, which triggered the vesting of the PSUs.

Net loss for the 9-month period was $25.7 million or $1.72 per share compared to $20.5 million or $3.82 per share for the same period in 2024. From a balance sheet perspective, as of September 30, 2025, PolyPid had $18.8 million in cash, cash equivalents, and short-term deposits, up from $15.6 million at year-end 2024. We continue to expect that our current cash balance will fund operations well into 2026. Notably, during the quarter, we made significant progress reducing our debt by decreasing current maturities from $6.5 million to $2.4 million. We remain focused on maintaining financial discipline while advancing our key strategic initiatives towards NDA submission and commercial readiness.

With that, we will now open the call to your questions. Operator?

[Operator Instructions] And your first question comes from the line of Chase Knickerbocker from Craig-Hallum.

Maybe just first on the Israeli Ministry of Health's successful inspection. Could you maybe just walk us through any findings that you did see there? And I would just like kind of to get your thoughts on your general confidence heading into that likely FDA inspection next year, now that you've had multiple successful inspections from several regulatory bodies. I mean, just kind of walk us through kind of your confidence in any additional items that you do need to address before the FDA inspection, or anything else that they would look for that wouldn't be a part of these prior inspections?

Thank you. So yes, we've passed this Ministry of Health inspection. Actually, this was the fourth consequence of inspection that we had. The Israeli Ministry of Health is recognized by the European authorities. So this is also served as commercial validation for the European authorities. And once we'll get the approval, we can start selling. As in every GMP inspection, obviously, there are always comments and things that are suggesting for improvement. And this is -- this has been, and this is an ongoing focus of us to always improve our facility, always improve our QC laboratory, and the way that we are managing this process.

There isn't anything that I can point out specific that I can point out that we were -- we got a comment in specific area. It was an ongoing discussion, nothing that is critical, obviously, otherwise, we wouldn't have passed. But we are very confident on our ability to pass. We have here people with overall years of experience working in GMP facilities, in aseptic facilities. But to be honest, having confidence in this aspect [Audio Gap] and from that, there is a list of things that the team is working on to make sure that we pass this at first. And this is a really important effort for us. So we are highly confident, but this is an ongoing effort. We have to maintain this high standard all along, not just for the inspection, but also afterwards for the actual commercial manufacturing.

Maybe just ahead of that FDA, the pre-NDA meeting in December, any specific items that you can call out there, particularly?

Chase, I can hear you. I'm taking the call from a different location. Please ask again, you were asking about the pre-NDA meeting?

Yes, just out of the pre-NDA meeting, anything--

Can you recap your question because we weren't able to hear it? So if you can ask it again, please?

Yes. Just anything specific that you're -- is particularly crucial to reach alignment with the agency ahead of that -- ahead of the NDA filing that you'd call out for investors?

So we expect to review the data package, the submission format, the label scope. And our goal is to get agreement with the current clinical CMC data support NDA filing and clarity on any remaining requests before the rolling submission. A successful meeting will set the stage for an early 2026 submission, obviously, with priority review potential under our designation. So there's nothing specific, but the regular clearance that you would want to get from the FDA for an NDA.

And then just last for me. Now that you've been able to do quite a bit more survey work. and speak with relevant stakeholders in the market. Any additional thoughts on pricing as we look forward?

Yes, I can take that one. So we've done -- over the last month or so, we had quite a lot of touch points with stakeholders, both formally to market research and less formally in the conferences, and really across the board, very strong interest in the product from the point of view that they really -- there's a need. There's a need for innovation. There is a need for something new to reduce the infection rates from where they are. We tested -- as I mentioned before, we tested both the willingness to prescribe, the willingness to put product on formulary, whether it's on formulary and stocked, or not stocked, and the impact on NTAP. And across the board, it sounds like premium pricing is something that we can reach to.

I don't want to give specific numbers because we are in discussion with partners, and this is all kind of part of the activities that are ongoing on the partnership front. But from the prices that we tested before and we've seen, we see now that we can stretch that even higher. There is room and willingness to use this. There's a very strong understanding of the impact of SSI, what it does from just direct cost of length of stay, but also I heard recently of surgeons that have in their annual review and in the kind of the bonus payment infections or reduction in infection as part of it. So there's really a nice driver there, which will allow us to stretch higher the pricing piece.

Your next question comes from the line of Brandon Folkes from H.C. Wainwright.

Congrats on the progress. Maybe just sort of at a high level, post the partnership, how quickly do you expect to grow the PolyPid pipeline with you being -- well with your manufacturing D-PLEX, can you just help us think through the evolution of PolyPid in 2026 and 2027 through being a manufacturing partner, but then also redeploying capital into the pipeline going forward? And maybe just one more for me. In terms of the FDA filing in early 2026, anything that you need or any sort of answers coming out of that -- the pre-NDA meeting that could extend that timeline? Just sort of how are you feeling about that meeting, and sort of anything that may come out of that versus that guidance?

Thank you, Brandon. So I'll start with the -- with your second question. In terms of our readiness for submission and where we stand, so all the modules are ready for submission. The CMC and the nonclinical modules are finalized, and the clinical modules is -- we are integrating SHIELD II and trial data to bring complete -- to being completed. We will incorporate, obviously, any FDA feedback after the December meeting and then start the rolling submission early 2026. Do not expect anything in particular. I can tell you that in the last year or so, we had a handful of correspondents with the FDA on specific aspects that we wanted to clear specific questions that we wanted to make sure that we are on the right path.

But obviously, having the meeting early December and us wanting to submit in early 2026, there will be some things that will need to be incorporated based on the feedback and the meeting, but we do not expect this to be substantial. We will obviously update once we get the FDA minutes that on the actual meeting, whatever we can update at this point. But there's nothing that we expect on that.

As to your question on -- I would even broaden it a little bit our vision for PolyPid and our vision for the PLEX platform. The way we see it, obviously, a U.S. partner on the abdominal indication is very important. But our platform and our SHIELD II is a validation to our approach and to our ability to bring product in that format. We have our younger program, which obviously will need to accelerate on this, and we've already been working on them, whether it's in the oncology space or in the obesity diabetes space. But we also see D-PLEX growing further behind the abdominal indication. And that's also something that is a potential growth.

Your next question comes from the line of Boobalan Pachaiyappan from ROTH Capital.

So firstly, with respect to market research, you just described, it's pretty exciting. And I just need some additional thoughts on that. So firstly, can you talk to us what's the sample size of your market research study? And then in that specifically, what percentage of those who participated in the research, they were involved in the decision-making process? And within that market research question, I also wanted to know whether you had an option to sort of assess the preliminary thoughts on utilizing D-PLEX100 to the gynecology and urology. Yes. And then what pricing point would make them comfortable to utilize D-PEX100 in the U.S. formulary? That's the first question.

Yes. So -- thanks, Boobalan. All good questions. So in terms of the study itself, first, it's a qualitative study. The study was split into 2. There were 10 surgeons, general surgeons, colorectal and gynecology surgeons. That's one. And then there were 10 pharmacy directors, both from a stand-alone hospital and network hospitals. All of them -- everyone participated in the study was either running the PMT process or contributing member to the process. So that was by design. The purpose of the study was to have people who are on formulary. And then you were asking about -- sorry, you're asking about the -- ask the second part again. I lost my thought.

Maybe before that, I would just add that, that this is not our first market access study. We've done several in the past. And besides for the pricing that was -- we saw a higher price in this and a premium and reference to the NTAP, all were much in line. Now it is very detailed. It's actually -- we use the actual data that we saw in SHIELD II. Obviously, everything is blinded. They did not know the actual product, but it was very detailed in terms of referring to the specific product and the specific results that we had in SHIELD II.

And then second, I understand you are advancing your partnership discussions in the U.S., and this may be some sort of hypothetical questions, or sort of I'm just thinking out loud. So I wanted to know, let's just say there's a global firm, they want to commercialize D-PLEX100 in the U.S. as well as in the ex-U.S. regions. And obviously, your an existing arrangement with Advanced Pharma. So I wanted to know if this existing arrangement would, in any way, provide some sort of barriers or impediments for a partnership with a global player? And will there be any sort of like a buyback clause with the Advanced Pharma agreement?

So no, there's nothing in the advanced agreement. Advance is our exclusive partner for Europe, but nothing out of that is part of this arrangement. U.S. Canada, all the rest of the world, it's not covered by this arrangement. If one of the partners, if it's a global partner that would want to include Europe as part of the discussion, we'll need to see if this is feasible. But it's not something that we plan on pursuing at this stage.

And one final question from us. Obviously, D-PLEX100 will be manufactured in Israel. And as you are well aware, there is a push within the U.S. for domestic manufacturing and also its connection with most-favored-nation pricing. So maybe can you talk to us potential challenges or barriers that PolyPid needs to overcome to commercialize D-PLEX100 in the U.S.

So yes, first, I should mention that our current facility, and we've indicated this along the years, is not our end goal facility. This will -- it will not be sufficient for the peak sales. We -- this facility is built in a way that it should be sufficient for the first 5 years of commercial launch -- from commercial launch. And we've already started planning and evaluating what should be our next facility or expanded facility, and we're taking this into consideration. So the trend in the U.S. around local manufacturing is something that we are taking into consideration. We're thinking about the expansion of the facility.

There seems to be no further questions. I will now hand back to Dikla for closing remarks.

Thank you for joining PolyPid's Third Quarter 2025 Earnings Conference Call. This has been a highly productive period as we execute on our regulatory strategy and move closer to our goal of bringing D-PLEX100 to patients and clinicians worldwide. With our pre-NDA meeting scheduled for early December and our NDA submission on track for early 2026, we are confident in our path forward. At the same time, we are making important progress in partnership discussions and commercial partnerships while advancing our manufacturing readiness to support a successful launch upon approval.

We look forward to sharing further updates on our regulatory and commercial milestones in the months ahead. As always, we thank our team members, partners, and shareholders for their ongoing support and commitment to our--

Greetings, and welcome to PolyPid's Second Quarter 2025 Conference Call. [Operator Instructions] As a reminder, this call is recorded. And I would now like to introduce your host for today's conference, Yehuda Leibler from ARX Capital Markets. Mr. Leibler, you may begin.

Thank you all for participating in PolyPid's Second Quarter 2025 Earnings Conference Call. Joining me on the call today will be Dikla Czaczkes Akselbrad, Chief Executive Officer of PolyPid; Jonny Missulawin, PolyPid's Chief Financial Officer; and Ori Warshavsky, Chief Operating Officer, U.S. of PolyPid.

Earlier today, PolyPid released its financial results for the 3 months ended June 30, 2025. A copy of the press release is available in the Investors section on the company's website available at www.polypid.com. I'd like to remind you that on this call, management will make forward-looking statements within the meaning of the federal securities law. For example, management is making forward-looking statements when it discusses D-PLEX100's potential benefits, including its potential to address a significant unmet medical need and to substantially reduce the burden of surgical site infections, improve patient outcomes and generate meaningful health care cost savings, the expected regulatory submissions and their timing, the aim of GLP-1 program and its potential to address significant unmet medical needs in the treatment of metabolic diseases, the company's expected cash runway and the potential partnership opportunities for D-PLEX100.

Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond the company's control, including the risks described from time to time in its SEC filings. The company's results may differ materially from these projections. These statements involve material risks and uncertainties that could cause actual results or events to materially differ. Accordingly, you should not place undue reliance on these statements. I encourage you to review the company's filings with the SEC, including, without limitation, the company's annual report on its Form 20-F filed on February 26, 2025, which identifies specific factors that may cause actual results or events to differ materially from those described in the forward-looking statements.

PolyPid disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise. This conference call contains time-sensitive information and speaks only as of the live broadcast today, August 13, 2025. With the completion of those prepared remarks, it is my pleasure to turn the call over to Dikla Czaczkes Akselbrad, CEO of PolyPid. Dikla?

Thank you, Yehuda. On behalf of our team at PolyPid, I would like to welcome everyone to our second quarter 2025 earnings conference call. The second quarter of 2025 was truly transformational for PolyPid, marked by the successful results of our SHIELD II Phase III trial, which demonstrated significant clinical benefits of D-PLEX100 in preventing surgical site infections, or SSI, in abdominal colorectal surgeries. As announced in June 2025, the study showed a statistically significant reduction of 38% with a p-value below 0.005 in the primary endpoint, which, as a reminder, is the combination of deep and superficial SSI, all-cause mortality and surgical reintervention.

In addition, we demonstrated a robust 58% reduction in the rate of surgical site infections in patients treated with D-PLEX100 versus standard of care with a p-value below 0.005, including a significant reduction in deep surgical site infection with 5 cases of deep SSIs representing approximately 14% out of all SSIs in the standard of care arm versus 0 in D-PLEX100 arm with a p-value below 0.05. Importantly, we also saw in the study a clear and statistically significant 62% reduction of patients with an ASEPSIS score over 20. The ASEPSIS score reflects the severity of the wound infection appearance and the clinical consequences of the infection. So D-PLEX100 not only markedly decreased the rate of superficial and deep SSIs, but even when SSIs occurred in the D-PLEX100 arm, they were less severe and caused less medical burden such as prolonged hospitalization or use of IV antibiotics.

This robust result validated our conviction in D-PLEX100 potential to address a significant unmet medical need and have generated substantial interest from potential commercial partners. We are extremely encouraged by the enthusiastic reception from health care professionals, lead surgeons in different types of surgeries as well as thought leaders in the field of surgical site infections, all recognize D-PLEX100 potential to substantially reduce the burden of surgical site infections, improve patient outcomes and generate meaningful health care cost savings.

In addition, further analysis of the Phase III SHIELD II trial safety data revealed a good safety profile with no difference in serious treatment-emergent adverse events between patients treated with D-PLEX100 versus standard of care. This safety profile further supports the D-PLEX100 potential as a well-tolerated prophylactic treatment option for patients undergoing major abdominal surgeries. Following the positive Phase III data, we are on track with our new drug application or NDA preparation. Our next steps include a pre-NDA meeting with the FDA planned by the end of this year, leveraging our Fast Track and Breakthrough Therapy designations to facilitate regulatory review. We anticipate submitting the NDA to the FDA in early 2026 and marketing authorization application or MAA submission in Europe shortly thereafter.

Shifting gears, we recently made significant progress on our GLP-1 program, which leverages the company's extensive long-term experience. This initiative aims to deliver approximately 60 days no-burst GLP-1 receptor agonist peptide for improved patient compliance and enhanced therapeutic outcomes in the rapidly growing weight loss and diabetes market. We have formally unveiled this program early in the current quarter, and we believe it represents an exciting opportunity to expand our therapeutic footprint into the fast-growing metabolic disease market.

Following the end of the quarter, yesterday, we announced the appointment of Dr. Nurit Tweezer-Zaks, M.D., M.B.A., as Chief Medical Officer of the company, transitioning from her role on PolyPid's Board of Directors. Dr. Tweezer-Zaks brings extensive medical R&D and business development expertise to this executive position, strengthening the company's leadership team as it advances towards NDA submission and commercial preparations following the positive Phase III SHIELD II results. From a financial perspective, we have significantly strengthened our balance sheet through a successful warrant exercise inducement transaction, extending our cash runway well into 2026.

With that, I will now turn the call over to Ori, our COO in U.S., to provide more details on our commercial preparations and partnering efforts for D-PLEX100. Ori?

Thank you, Dikla. Following the successful completion of the Phase III SHIELD II trial positive efficacy data, we have intensified our commercial preparation activities in partnership discussions. We believe that the positive Phase III results have validated the substantial market opportunity for D-PLEX100. To reiterate, based on our [indiscernible] data, we believe the total addressable market for D-PLEX100 in the U.S. is just over 12 million total surgeries annually, with approximately 4.4 million of those being abdominal surgeries and an additional 2.1 million abdominal procedures, principally in gynecology and urology.

The 58% reduction in SSI demonstrated in our Phase III trial is particularly significant when considering the substantial costs associated with SSI. As a reminder, SSIs are estimated to U.S. health care system up to $10 billion annually, extend hospital length of stay by 9.7 days on average and increase hospitalization by more than $20,000 per patient admission. D-PLEX100's potential ability to significantly reduce these infection rates represents a compelling value proposition for health care systems, payers and most importantly, for patients.

With respect to our partnership strategy, we continue to believe that identifying a U.S. partner with a dedicated hospital-focused sales force and significant resources will enable D-PLEX100 to maximize sales potential in the U.S. Following the positive Phase III data announcement, we have seen increased interest from potential partners, and we are currently evaluating opportunities. We will, of course, provide updates on these discussions as appropriate. For the European market, as we mentioned previously, we already have an exclusive licensing agreement in place with Advance Pharma to commercialize D-PLEX100 across European countries. And we are actively working together to plan and implement prelaunch activities to maximize D-PLEX100 and anticipated launch in Europe.

And with that, I will now turn the call over to our CFO, Jonny, to review our financial results. Jonny?

Thank you, Ori. We are pleased to report our financial results for the second quarter of 2025, which reflects our continued investments in advancing our pipeline while maintaining fiscal discipline. Starting with our balance sheet. As of June 30, 2025, the company had cash and cash equivalents of $17.4 million and short-term deposits of $12 million for a total of $29.5 million. This represents a significant improvement from our cash position of $15.6 million as of December 31, 2024. The increase was primarily driven by the successful warrant exercise inducement transaction that Dikla mentioned earlier. We expect that our current cash balance will be sufficient to fund operations well into 2026.

Now turning to our income statement for the 3 months ended June 30, 2025. Research and development expenses were $6.2 million, compared to $4.8 million in the same period of 2024. The increase was primarily due to activities related to the completion of the SHIELD II Phase III trial and preparation for regulatory submissions. General and administrative expenses were $2.5 million, compared to $1.1 million for the same period of 2024. The increase was primarily due to noncash expenses related to performance-based options or PSUs, following the successful SHIELD II Phase III trial, which triggered the vesting of the PSUs.

Marketing and business development expenses were $0.7 million, compared to $0.3 million for the same period of 2024. For the second quarter of 2025, the company had a net loss of $10 million or $0.78 per share, compared to a net loss of $6.3 million or $1.25 per share in the second quarter of 2024. For the 6 months ended June 30, 2025, R&D expenses were $12.3 million, compared to $9.8 million for the same 6-month period of 2024. G&A expenses were $3.7 million, compared to $2.1 million for the same period of 2024. Marketing and business development expenses were $1 million, compared to $0.5 million for the same period of 2024. The company had a net loss of $18.2 million or $1.48 per share, compared to a net loss of $12.7 million or $2.62 per share in the 6-month period ended June 30, 2024.

With that, we will now open the call to your questions. Operator?

[Operator Instructions] The first question comes from the line of Chase Knickerbocker from Craig-Hallum.

Maybe just on the NDA filing. So if I think about what is kind of left to be done between now and 1Q, can you kind of walk us through the larger items? And then particularly, obviously, on the CMC side, can you talk about your preparations as they continue to progress on products, et cetera, preparing for that 1Q filing?

Sure. We are in the finalization stages of the CMC and the clinical module. So those will be the first that we will submit. There are some points that are still being collected. And obviously, the preparation and the finalization of the document is taking time. Documents have already been reviewed by our external FDA consultants as a first [indiscernible]. And we are now preparing, first of all, the CSR and all the package for pre-NDA meeting, meaning that we would like to meet with the FDA before the end of this year for pre-NDA meeting -- agreement while we are prior to submitting the NDA and then early 2026 in the first quarter to submit the NDA.

In parallel to that, obviously, we are in preparation for the [indiscernible] review. This is something that is ongoing. The facility has been reviewed a couple of times already, both by the Israeli Ministry of Health and European QP. But still there is always room to prepare further for an FDA review and get the facility ready for the commercialization stage. So to summarize, we will be submitting in the next few weeks a pre-NDA meeting request, which we expect during the year and early next year, Q1, we will submit the NDA.

Got it. Maybe just one on -- can you talk about kind of the path forward for the GLP-1 program as far as when we might see some data there and kind of early stage plans in that program? And then just second, last for me. If we think about the Advance partnership, when should we expect some potential milestones from that post data? Is that going to be regulatory? Or will there be anything that triggers from the data itself from the Phase III?

Sure. So the GLP-1 is a program that we're very excited, both because of the broader consequences of it of having [indiscernible] injected in a form that support an average of 50 or about 60 days of content and linear, but also this being a field with so much unmet need and patients that still do not benefit from the current and [indiscernible] being quite harsh on this medication.

So what we think is our main benefit from both the prolonged, both the aspect that we can have relatively longer than without the drug and also the aspect of avoiding the [indiscernible] characterizing current regimen to treatment. In terms of the time line, we are now going into more robust preclinical studies where what we would like to show is both [indiscernible] to support the risk profile that we see in cell in PK studies in bloodstream. This is also, I think, very important for potential partners. And at this stage, we see this program semaglutide started with the GLP-1, but this could be extended being pursued into the clinic collaboration with one of the large player in this field.

And then just on the Advance partnership...

I just wanted to some [indiscernible] as we're getting some messages that the line is not great. So please tell us if [Technical Difficulty].

So regarding the partnership, we are in active and -- the partnership is active and continuous both through the clinical stage as well as now in preparation for the submission as part of the relationship with Advance [Technical Difficulty] submission. And the question was where should we expect [Technical Difficulty]. Definitely, there is a milestone that is expected as more than 3 years have passed since we've signed with Advance, both Advance and [Technical Difficulty] there are some adjustments that needs to be assessed, and this is what we are doing now. I don't expect it to take too long. And once there is anything to announce around that we will obviously announce. But as I said before, we are very pleased with the relationship. I think there is a trust that has been built during the years and appreciation and Advance is now starting to put more effort into the prelaunch activities. So both parties have an interest to finalize this.

Your next question comes from the line of Roy Buchanan from Citizens.

Okay. Great. I'm not sure if she's on the call, but I had a couple for Dr. Tweezer-Zaks. So...

Could you repeat the question?

Yes, I'll try to repeat it. So if Dr. Tweezer-Zaks is on, I was going to ask, I guess, the most compelling reason for joining the company as Chief Medical Officer, D-PLEX100 or the broader PLEX platform, if you could just comment on that? And then what she's going to focus on, I guess, most intently for the next 12 to 24 months?

Sure. So I think this is a really nice addition to our management team. And it's nice because Dr. Tweezer-Zaks was on our Board for almost 2 years. So she knows [indiscernible] intimately. She knows the programs intimately. She knows the good and the bad and everything. And obviously, she [Technical Difficulty] other positions, but she decided to join us, and we're very pleased, and I think she is going to be a great addition to the team.

With regards to how we view the CMO position and what is going to be the role going forward, specifically looking at the coming 2 years or so. We are now in a position, we started to do some prelaunch activities, some pre-commercialization activities as well as all the regulatory aspect. We have a great Phase III data that we want to have it all in front of as much surgeons as possible. Data obviously, we'd like to put it in the best review journal [Technical Difficulty] the preparation and maintain a robust clinical advisory to support broadening label as well as post-launch activities. We have a pipeline, which is another point that we would like assistance in directing our team and will allow another doctors and quite the experience that she has to lead this program.

[Technical Difficulty] getting feedback. Heading into the likely approval and launch next year, undoubtedly, you'd like to bolster the balance sheet further. I guess do you just have a preferred -- and maybe you answered this with Advance response, but do you have a preferred way to do that nondilutive via partnering or something else? Can you just comment on that?

[Technical Difficulty] we'll get. What was the second portion of the question?

If you had a preferred way for bolstering the balance sheet beyond that for the launch and all of those extensive things.

So as we said for quite some time, we are also looking to collaborate around that. So a portion, obviously, of the effort will be financed and taken by our partner. And in terms of other activities, again, we do rely on payments that we expect will be coming both from our existing partners as well as new partners.

Apologies. We do seem to be having technical issues. If I could hand back for closing remarks.

Truly apologizing for that. Thank you for joining PolyPid's Second Quarter 2025 Earnings Conference Call. The second quarter of 2025 was a pivotal period for PolyPid. The positive SHIELD II Phase III results represent a significant milestone in our journey to begin D-PLEX -- to bring D-PLEX100 to market. We are now focused on preparing our regulatory submissions, advancing our commercial preparations and exploring partnership opportunities to maximize the value of D-PLEX100. We are also excited about the progress we have made in extending our pipeline with the GLP-1 program, which leverages our extensive long-term experience to address significant unmet need in the treatment of metabolic disease. As always, we are grateful to our team members, shareholders and all external partners for their commitment to our mission. We look forward to speaking with you again on our next conference call. And if anyone wants to further ask questions that were not asked on the call, please reach out to us.

This concludes today's conference call. Thank you for participating. You may now disconnect.

Greetings, and welcome to PolyPid SHIELD II top line results conference call. [Operator Instructions] As a reminder, this call is being recorded. And I would now like to introduce your host for today's conference, Brian Ritchie from LifeSci Advisors. Mr. Ritchie, you may begin.

Thank you all for participating in PolyPid's conference call discussing the top line results of the SHIELD II Phase III trial of D-PLEX100.

Joining me on the call today will be Dikla Czaczkes Akselbrad, Chief Executive Officer of PolyPid; Dalit Hazan, Deputy CEO, Executive Vice President, R&D, Clinical and Regulatory Affairs; Ori Warshavsky, Chief Operating Officer, United States; and Jonny Missulawin, Chief Financial Officer.

Earlier today, PolyPid issued a press release announcing that the Phase III SHIELD II trial successfully met its primary and key secondary endpoints. A copy of the press release is available in the Investors section on the company's website, www.polypid.com.

I'd like to remind you that on this call, management will make forward-looking statements within the meaning of the Federal Securities Laws. For example, management is making forward-looking statements when it discusses the safety, efficacy and benefits of D-PLEX100; the expected submissions of a new drug application, or NDA; to the U.S. Food and Drug Administration, or FDA; any marketing authorization application, or MAA; and the timing thereof and the company's expectation that the data results should be a substantial catalyst for expediting its ongoing global partnership discussions.

Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond our control, including the risks described from time to time in our SEC filings. These statements involve material risks and uncertainties that could cause actual results or events to materially differ. Accordingly, you should not place undue reliance on these statements. I encourage you to review the company's filings with the Securities and Exchange Commission, including, without limitation, the company's annual report on Form 20-F, which identifies specific factors that may cause actual results or events to differ materially from those described in the forward-looking statements. PolyPid disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise.

This conference call contains time-sensitive information and speaks only as of the live broadcast today, June 9, 2025.

With the completion of those prepared remarks, it is my pleasure to turn the call over to Dikla Czaczkes Akselbrad, CEO of PolyPid. Dikla?

Thank you, Brian. Good morning, and welcome, everyone. It is a very proud moment for all of us at PolyPid today as we share the outstanding top line results from the Phase III SHIELD II study.

I'd like to begin by thanking the patients, principal investigators and study staff who made this study possible as well as our team at PolyPid, especially Dalit Hazan, our Deputy CEO, Executive Vice President of R&D, Clinical and Regulatory Affairs, who led the excellent execution of this Phase III trial and whom you will hear from shortly.

Before that, I will take you through the design of SHIELD II and describe the study's patient demographics. Following this, I will review the key outcomes from SHIELD II's primary and all key secondary endpoints and then discuss our view on the significant unmet medical need we believe D-PLEX100 addresses and our planned next steps. At the conclusion of Dalit's remarks, we will open up the call for questions.

With that, let's dive in and review the trial design as seen on Slide 3. SHIELD II is a prospective, multinational, randomized, double-blind Phase III trial designed to assess the efficacy and safety of D-PLEX100 administered in conjunction with standard of care, which includes prophylactic systemic antibiotics compared to the standard of care alone arm in the prevention of surgical site infection in patients undergoing abdominal colorectal surgery with large incisions of at least 20 centimeters.

In the intent to treat our ITT population, a total of 798 patients were included, consisting of 405 subjects in the D-PLEX100 treatment arm and 393 patients in the control arm. Importantly, SHIELD II was designed based on FDA guidance.

Now that we have reviewed the overall trial design, let's talk a little more about the standard of care on the next slide. In SHIELD II, all patients received standard of care, both in treatment and control arms, which included IV antibiotics with or without mechanical bowel prep or with oral antibiotics combined with mechanical bowel prep. And here, you can see the standard of care IV antibiotics that were used given within 60 minutes prior to surgery and discontinued at a maximum of 24 hours post indexed abdominal surgery. Each study site used the same predefined standard of care for all its subject in the SHIELD II study aligned with SSI prevention guidelines.

Moving on to the study population. As seen on Slide 5, demographics and surgery characteristics were well balanced between the 2 treatment groups in SHIELD II. Median age, BMI and other demographics were similar in both groups. With respect to surgical characteristics, there were no significant differences between the D-PLEX100 and the standard of care treatment arms. You will also notice the majority of patients are cancer patients. Overall, the SHIELD II population was quite homogeneous.

With these background details now complete, let's move on to the top line results. We will begin, of course, with the primary efficacy endpoint of SHIELD II, which is the combination of deep and superficial SSI, all-cause mortality and surgical reinterventions at the same target incision of the original index surgery, all measured within 30 days of the index surgery.

On Slide 7, we see that the study successfully met its primary efficacy endpoint. In the ITT population, the surgical site administration of D-PLEX100 plus standard of care resulted in a significant decrease in the primary efficacy endpoint of 38% compared to standard of care alone, which is clinically meaningful and statistically significant with a p-value lower than 0.005, well below the standard 0.05 required p-value.

Let's now move to each of the key secondary endpoints on the next slide. The first key secondary endpoint, the SSI rate in the ITT population showed a substantial reduction of 58% in deep and superficial surgical site infection rates among patients who received D-PLEX100 plus standard of care versus those who received standard of care alone with a statistically significant p-value lower than 0.005. This 58% reduction in surgical site infection rate from 9.5% to 3.8% show D-PLEX100 among the most effective prophylactic interventions for prevention of SSI in abdominal colorectal surgery.

For context, this moves the surgical site infection rate while using D-PLEX100 well below what most surgeons see even in lower-risk procedures. What makes these results particularly compelling is the consistency we are seeing. It isn't just one positive signal. As you will see in our remaining endpoints, we have observed a consistent and comprehensive clinical benefit.

Moving on to the next slide. The second key secondary efficacy endpoint combined SSI mortality and reintervention as evaluated in the primary endpoint in the full set of 975 randomized patients with a surgical incision longer than or equal to 7 centimeters. Meaning it includes an additional 177 patients with smaller incision enrolled prior to the 2023 SHIELD II protocol change. Of note, the vast majority of these additional patients had laparoscopic surgery. So in this full 975 randomized patient population, the D-PLEX100 arm achieved a 36% reduction of the events versus standard of care alone with a p-value lower than 0.005. So this is also statistically significant.

On Slide 10 now, we can see the third and final key secondary endpoint, which is the number of patients with an ASEPSIS score greater than 20. This is a universally accepted clinical tool used to objectively assess surgical wound infection. This score adds further clinical information to the SSI endpoint as it reflects the severity of the wound infection and the consequences of the infection itself in terms of both wound management and hospitalization. We can see a clear reduction of 62% in the D-PLEX100 arm compared to standard of care alone, again, with a statistically significant p-value lower than 0.05.

I'd like to switch gears a bit here and discuss how we view D-PLEX100 addressing the current unmet need in the surgical setting. SSIs represent a significant burden on patient outcomes and hospital systems, which are penalized for hospital-acquired conditions. SSIs are a large part of these conditions, and they are associated with a two- to 11-fold increase in the risk of mortality, depending on the type and location of infections. Moreover, SSIs generally are estimated to cost the U.S. health care system up to $10 billion annually and extend hospital length of stay by 9.7 days on average with the cost of hospitalization increased by more than $20,000 per patient admission.

Decreasing the incidence of SSIs is of critical importance to patients, surgeons, hospitals and payers. Based on its compelling profile and the collective data generated to date, we believe D-PLEX100 can provide a tangible and crucial improvement in infection events following abdominal surgery. Looking ahead on the next slide, our next steps include a pre-NDA meeting with the FDA planned by the end of 2025, followed by an NDA submission in early 2026 and an MAA submission in Europe shortly thereafter. Our regulatory pathway is further strengthened by the D-PLEX100 breakthrough therapy Fast Track and QIDP FDA designations, which combined to position us for priority review eligibility and an additional 5 years of market exclusivity.

Moreover, we expect these clear and compelling Phase III results to be substantial catalysts for expediting our ongoing global partnership discussions for D-PLEX100. In closing, I would like to congratulate and sincerely thank our extremely talented and dedicated team of employees, advisers and consultants on a job well done.

Now I'd like to turn the call over to Dalit. Dalit?

Thank you, Dikla. Today's positive SHIELD II Phase III study results mark a critical inflection point in PolyPid's journey, further validating our drug delivery platform to address unmet medical needs. I would like to sincerely thank all of the patients, investigators, nurses and caregivers as well as our service providers and partners involved in the D-PLEX100 Phase III trial for their continued support.

Let me reiterate that what excites all of us the most, and I'm speaking on behalf of the entire PolyPid team, is the clinical impact of D-PLEX100 and its potential as an effective and transformative therapy for patients undergoing abdominal surgery where the prevention of serious SSIs remains under addressed with current approaches. We are already preparing our comprehensive data set for presentation at major medical conferences where we expect these results to generate significant attention from the surgical community. So please stay tuned.

And with that, I will now ask the operator to begin our Q&A session. Operator?

[Operator Instructions]

And your first question comes from the line of Chase Nicklbaker from Craig-Hallum.

Congrats on the excellent data here and a big day for the company. First, just on the 58% reduction on SSIs, great to see. Is the data available on the other 2 proponents of the composite primary? Or can you just at least confirm whether there was a numerical advantage in favor of D-PLEX in reinterventions and mortality?

Thank you, Chase. So the data will be available. We just received the top line the 3 key secondary endpoints this Friday and as soon as possible, got them out. I can confirm that we saw a numerical reduction both in mortality and reintervention. So yes, it's all -- when we were saying that it's all consistent, this is exactly what we were referring to. It is within the primary, each of the components show numerical reduction. And overall, together, we have a very robust data.

Great. In your upcoming pre-NDA meeting, as you've had a little bit of time to digest the data here, how are you thinking about your guys' positioning as it comes to a potential label? And can you just, I guess, remind us of your most recent thinking and expectations there?

So as we said also in today's release, we plan to meet the FDA for a pre-NDA meeting later this year. And we were strategically waiting to discuss this aspect with the FDA once we have more clinical data. We think that this data position us well to discuss the FDA the potential label, which we think that could definitely be a broader label than just the colorectal, and we are targeting the abdominal. We, by the way, with the European authority already got indication from them that they view the colorectal open resection as severe -- the most severe abdominal in terms of SSI, and they will see this as a way to approve a broader label.

Got it. And under the partnership with Advanz, can you just remind us what this data makes you eligible for in terms of a milestone under that agreement?

Sure. So we did not disclose the breakdown of the development milestone. We did indicate that there is about 25 -- overall $25 million of milestone payment -- development milestone payment. And definitely, part of those -- part of those development milestone is associated with Phase III data.

Your next question comes from the line of Roy Buchanan from Citizens Bank.

Congrats on the success of the trial. Obviously, it was executed really well. So kudos to the clinical team and the whole company. First question, sorry, I missed if Jonny was on, but can you just remind us the warrants exercise provisions? How much is out there, the strike price? And if they're all exercised, how long of a runway that provides? And also, is there a cashless provision for the warrants?

Sure. So first of all, there's no cashless provision for the warrants. There are 6.7 million warrants with a $4 exercise price. They have a 10-day trading until they expire. So next Friday, they do expire. And that cash comes into the company, so such funding will be beyond approval.

Okay. Great. And then just, I guess, any changes in your confidence? What is your level of confidence in the U.S. partnership based on these results? And is there any scenario where you might promote this yourself?

I can take this. So first, we took the strategic decision to find a partner with the understanding that selling into the hospital is a complex selling pathway, and we need a partner that really understands how to operate in the hospital, how to talk to surgeons, how to get products on P&T. So this has not changed. We believe that going with a partner, a well-established partner is the right way to go.

What we know is that there are a number of potential partners that are already in different stages of due diligence. There are others that are -- we're waiting for top line to increase their engagement. So we expect that to shift into gear even more. Next week, Bio International is happening, and we have a full roster of meetings there. So all in all, I think from now on, we'll see even greater engagement in the partnership discussion.

I would just add that from our perspective, the level of engagement that we had prior to data was surprisingly meaningful, and we definitely see the data as supportive of greater and faster. We obviously cannot commit to time line on that because it's not all in our control. But I think what was proven through SHIELD II and the data that D-PLEX demonstrated in this Phase III is the commercial attractiveness of the product.

Okay. All right. That sounds great. Yes, the product definitely looks approvable and I suspect it will sell.

Your next question comes from the line of Brandon Folkes from H.C. Wainwright.

Congratulations on some very good data here. A few for me. Maybe just firstly, coming back to the label. When I look at the incision length above 7 centimeters, the data obviously looks very compelling there as well. So can you firstly just remind us of the discussions you've had to date with the FDA about SHIELD II and how they view SHIELD II data in terms of approvability versus the broader data set, including SHIELD I?

I will let also Dalit add to that. But I think if we review the discussions with the FDA, the most important thing to start with is that SHIELD II was designed with the guidance from the FDA. We consult with the FDA prior to initiating the study in this format, and we got their feedback on that, which was very important for us, including the -- obviously, the FDA is not committing to anything, but also the understanding that this SHIELD II could serve as our pivotal study for approval, and this is reassuring.

In addition to that, the product has received several designations from the FDA, starting from the breakthrough therapy designation to Fast Track and 3 different QIDP, which also gets the agency engaged in this development to a greater degree. With regards to the labeling, we had some discussions looking at it through the QIDP 2 other things, but we strongly believe that the level of efficacy that we have now combined with the 3 key secondary endpoints that all of them are also statistically significant opens the room here for a discussion that will tailor the label for the benefit of patient. Dalit, you want to add to this?

Just to add to that, as we just discussed before, we plan to meet with the FDA in the pre-NDA meeting with this successful top line results of the study. So we will discuss also the broad labeling of the product. So we have these plans, and we will do that, and we will know it in the upcoming months.

Great. And maybe just a follow-up as well on this. In terms of the potential for as broad a label as possible, can you just remind us of the safety database you have, especially in terms of sort of local administration? And maybe just any additional work from a safety perspective or even just broader between now and the filing, any gating factors we should be on the lookout for?

So first, again, I remind everyone, we received the top line and the 3 key secondary endpoints. So we are still on the way for the key -- for all safety data. But all in all, we had, along the study, along the 2 years, several committees reviewing the safety and no safety concerns were raised. I can also say that we see supportive data on that in the mortality. There is a reduction -- numerical reduction in mortality in the treated arm. So we are very comfortable with that.

The overall patient -- number of patients that have been recruited in different clinical studies that were performed with the D-PLEX100 is over 2,200. So we are in a very good position in terms of exposure to patient population.

Great. And sorry, one more, if I may, I apologize, and I'll hop back in the queue.

No, no. We are here for this purpose. Feel free to ask as many questions as you want.

All right. Great. I don't know if you could answer this one. But as I take a step back and look at PolyPid as a whole, obviously, tremendous focus on D-PLEX100, but it's really underpinned by the D-PLEX technology platform. And if we think about what this does, it somewhat validates the platform technology here. How do we think about your timing strategically in terms of how you think about maybe additional partnering on new molecules or sort of internal development?

Obviously, the focus, I'm sure, #1, #2 and #3 right now, is getting D-PLEX100 across the line and getting a partnership there. But when do you -- how should we think about timing on when you may consider additional business development opportunities being sort of companies looking for partners of a technology that is now derisked and validated? That's it for me.

So very thank you for this question. And we have been doing a lot of work in the last few years around the platform and about prioritizing our pipeline. Obviously, we did not want to convey any message that this is a diversity from D-PLEX, but rather build the infrastructure for the point that we are now to have the first product validated in a robust Phase III, which will allow us now to have broader discussion.

We plan to share with investors some of these developments in the next few months. Investors have seen a few months ago, the agreement that we've signed with ImmunoGenesis around the STING agonist, but we have other products that have been developed in our pipeline, that we would want to share with investors in different areas.

I totally agree with you, this was exactly our line of thinking, that having a robust Phase III data with statistically meaningful will be best validation of the approach in the platform.

Great. Congratulations again on the data.

[Operator Instructions] And your next question comes from the line of Boobalan Pachaiyappan from ROTH Capital.

Congrats on the diligently executed SHIELD II study and positive data. This is truly an achievement, and all the great questions from my colleagues. So just a few more from our end. With respect to Slide #8. So SHIELD II was conducted outside the pandemic, while sort of -- and SHIELD I was conducted in the middle of COVID-19. So I'm just curious, did the SSI data in the standard of care arm meet your expectations?

So yes, definitely. And this is a good point to look at. When you conduct a Phase III study, so obviously, it is within a more sterile environment and not in the sense of sterile in the hospital, but there are exclusion-inclusion criteria that are not mimicking the real world. For example, this -- the patient population where elective surgery, there are a number of emergency surgeries within the colorectal resection.

It's very hard to include those surgeries in a clinical trial because it's hard to get consent from patient undergoing an emergency surgery. I would refer everyone to today's press release and the quote that was given by Professor Charles Edmiston, that is from a recent data, indicating that you would expect to see in real world in colorectal, a much higher infection rate overall.

I think that what is most important from the SSI, which is obviously what the product is designed to do, and this is what we were out to do to show over 50% reduction in infection that with D-PLEX, the reduction using D-PLEX with patients, that all patients got standard of care, which has a lot of value for the patient. We are getting the level of SSI below what surgeons are expecting to see in minimal invasive.

This is really the power of what we do. They are out to do a quite complex surgery, open large incision, with patients that are most of them cancer patients, and they end up with lower than what they would expect to see in minimal invasive laparoscopy surgery.

All right. And then are you in a position to discuss SHIELD II efficacy results in high-risk population? These are the patients with high comorbid conditions such as obesity. Is that data available? Or if it is not available, what do you expect to see in this population?

So definitely, there are many additional secondary endpoints that we would want to see and we would want to share with investors, with clinicians and with the scientific community. We are gathering this data, and it will be added in batches to everything that we received up until now. It's one of the things that we are looking for.

In terms of expectation, I expect to see a similar trend, probably even better alpha -- p value, not that I think it could be much better than 0.005. But what we saw along all the clinical studies that the harder the patient is, the harder the procedure is, the higher the level of infection that is expected. This is where the gap or the effect of D-PLEX is best seen.

Great. And then with respect to potential FDA meeting that could occur in fourth quarter of this year, are there modules that are part of the CTD that are in your control that remain pending?

Actually, right now, we will start working on the clinical model because we just received the top line results, and all the others are already in the final studies of completion. So it's more the clinical part that we are starting to work right now on the results.

All right. Okay. And then with respect to your partnership, so you have given some broader thoughts on it. But let's just say, assuming this partnership occurs after your FDA approval, let's just say sometime in second half of '26, how easy or difficult it is to launch the drug in early 2027?

So the process in the hospital is one that takes time. To get traction in the hospital is something that is not similar to a retail product, it takes time. Whether we sign the partnership earlier or later, it's a process that takes time. We have to find the champions in the hospital, product needs to go to P&T. P&T sometimes meets every month, sometimes every quarter. So this is a product -- and this is kind of our expectation. It's somewhere between 6 to 9 months from approval to start seeing traction in the hospital and see minimum sales.

Again, finding a partner that already has the hospital infrastructure, that has teams that call on surgeons, that has the outreach into the P&T will make the process more expedited.

Okay. Maybe one last question. This is with respect to the commercial capabilities of Advanz Pharma. So let's say, as soon as you file your NDA, of course, you'll be beginning your preparations for the EMA. So I wanted to comment on 2 things. So firstly, does SHIELD II positive data satisfy the EMA requirements? That's number one. Number two, how sooner is Advanz Pharma could launch D-PLEX100 in the U.K. and EU?

We believe that SHIELD II should be sufficient for approval with the EMA. We actually align the requirement between the FDA and the EMA along the years, and it is our understanding that this will be sufficient based on all our written communication with them.

In terms of the time line, we expect -- as we said previously, we expect to submit the NDA early next year, early 2026. And shortly after that, we will submit the MAA. The time lines for approval is about a year from the time that we submit with the European authorities. And around that time, they will be able to -- Advanz will be able to launch the product.

I can tell you that all along, since we've signed with Advanz, we have been working together on a bi-weekly time frame to make sure we have all the prelaunch activities aligned. From little things as packaging to other things, Advanz has several -- not similar products, but products that are being sold to the hospital. Some of them are also in the anti-infective space. So they definitely have the capabilities to launch this product in the U.K. and in Europe.

All right. That's it from us. Congratulations and well done.

Thank you. Thank you very much.

There are no further questions. I will now turn the call over to Ms. Czaczkes Akselbrad for her closing remarks.

Thank you again, everyone, for joining us today. We look forward to providing updates on our next conference call, and we truly appreciate your continued support of PolyPid.

Ladies and gentlemen, this concludes today's presentation. Thank you once again for your participation. You may now disconnect.