Cambridge Cognition Share Discussion Threads

[smithie6] 01/7/2021 08:17

directors have been working hard in recent weeks !

[40 fathoms] 01/7/2021 06:50

MM84, todays RNS answers your question about the spin out of Monument Therapeutics.

"Cambridge Cognition Holdings Plc (AIM: COG), which develops and markets digital solutions to assess brain health, is pleased to announce the completion of the spin-out of Monument Therapeutics Limited ("Monument Therapeutics"), a drug development company applying digital phenotyping to central nervous system ("CNS") disorders."

A huge amount of optionality in this announcement, we have @36% of a funded early stage drug development company with a potentially large royalty stream in the event of commercialisation. The initial focus is on POCD (post operative cognitive dysfunction)and cognitive impairment in schizophrenia.

If the royalties are top line and given the size of the addressable markets being targeted the amounts involved could be very significant indeed.

[yus777] 28/6/2021 11:18

barchart all resistence broken so tommorow should be even better day 200p roll on

[yus777] 28/6/2021 10:54

looking very very strong nt to buy at 165p no shares available mms very short 180p very soon

[yus777] 28/6/2021 10:25

zak will be all over this strong finnish today then boom tommorow get in while you can short term target 275p

[yus777] 28/6/2021 10:22

should be 1.75 with that 10,000 buy over ask mms no shares thell have to strike it up

[yus777] 28/6/2021 10:20

discuising reported buys as sells the trolls

[yus777] 28/6/2021 10:16

mms holing it down 10,000 bought over ask at 167.5 next target 1.80-190p

[40 fathoms] 28/6/2021 06:07

New £2.2 million contract for at-home cognitive testing in a virtual clinical trial

This is just the start, the announcements are going to keep coming for about as far as the eye can see.

[40 fathoms] 24/6/2021 13:54

it is game on for big pharma, there will be a lot more.

[40 fathoms] 23/6/2021 11:56

Cerrito,

Thank you, always good to have a bit of luck, not happy with the price, given the potential in that name but booked a very decent profit so should not be too greedy. ATB

If you are prepared to look at drug development companies and I understand these are not everyones cup of tea can I suggest you take a look at IXC AU it is a company called Invex and is listed in Australia. Under the guidance of Professor Alexandra Sinclair the Head of the Metabolic Neurology Research Group at Birmingham University they repurposing Ecenatide, a generic drug for treating diabetes to treat Idiopathic Intracranial Hypertension.

Nothing in drug development is a slam dunk, but this is a close as it gets in my view. You have a generic drug with a very well known and established safety profile, the worlds leading expert in the condition heading the science, a very very strong Phase II trial results and is fully funded through its Phase III which will start in the next 6 to 8 months.

It has a current EV of @ AUD 20 million, this is crazy low in my opinion given its postion. The reason for this is the market has misunderstood its approach to the FDA ( I can DM you all of the details if you have interest).

[40 fathoms] 23/6/2021 11:35

Smithie6, I guess my point is that the current market cap does not even start to capture the growth and profitability they will achieve in clinical trials market over the next 3 years.

In that time, as icing you COULD see say 5 million tests a year from healthcare, the spin out of their digital phenotyping business, when you start to look at their patents and the academic papers they are publishing it is clear they are working on digital biomarkers in a number of areas. If one of those hits the mark or gets picked up as a companion diagnostic, you could see depending on the focus area, significant further royalty streams.

They have leading technology, a leading brand and sit at the nexus of two huge investment trends, the digitisation of clinical trials/healthcare and a return of drug development in CNS conditions. My biggest fear is we get taken out before some of these trends have had a chance to play out.

[cerrito] 23/6/2021 10:42

40
I saw yesterday's news on Voluntis and well done for that and too bad I did not organize myself to follow your example.

[smithie6] 23/6/2021 10:03

thanks for writing that.

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the test creator getting $1.5/test seems quite low, but I guess it depends how many tests that client body is committing to sell/use

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big market for the tests, yes I agree.

[40 fathoms] 22/6/2021 13:36

You will probably be aware that the FDA recently approved Aducanumab, as the first disease modifying drug in Alzheimers. The approval has proved controversial, primarily because at one point the trial was abandoned after a futility analysis by Biogen. Then after many months they said that upon closer analysis if you looked at a subset of patients on higher dosage the trial outcome was in fact positive.

This cherry picking of data after a trial has been completed is broadly viewed as a complete no no. So when it was submitted to the FDA for approval, given the controversy, they took it to an Advisory Committee (Adcom), the FDA does not do this often and although they don't have to they almost always accept the Adcom's view. For Aducamumab, almost to a man, the Adcom said that it could not be concluded that Aducanumab met its primary endpoints and that an addition trial was required to determine if it was an effective treatment. The FDA ignored the Adcom advice and approved the drug but with the requirement that it must carry out a post approval study. It will be many year before the data from the trial is gathered and available and in the meantime Biogen can market the drug without any restrictions.

In protest 3 Adcom pannel members have resigned. It seems principally over the lack of consideration given to the Adcoms views and the perceived lowering of FDA standards. In my previous post I was just highlighting that while it is noble to resign on a point of principal, Mr. Knopman weakens his position by then saying he will prescribe the drug.

Anecdotally, I hear that the phones are ringing of the hook at Neurologist office wanting to know about Aducanumab and their suitability for treatment. In the very near future when you go in to a GP or a Neurologists office and say I am a bit worried about my memory, they are going to sit you down with an IPAD or at a PC and make you take a CANTAB test (Cambridge Cognition) or a Cognigram (Cogstate) and after 10 -15 minutes you will be told that either you are cognitively normal for your age and lets check again in a year, or you are abnormal in certain areas and we need to investigate further. I honestly think that within 10 years we will see hundreds of millions of these tests administered every year and there are are only 2 companies that offer a fully automated, cloudbased, fully validated, digital test for this.

These tests will not just be used in AD diagnosis, we are going these tests or or variants there of to test for everything including concussion, post operative cognitive decline, chemobrain, stroke recovery, Parkinson's, ADHD, developmental issue even possibly non medical areas for example GCHQ is now actively seeking to manage the neurodiversity of its employees. I think this is a trend that will catch on in certain areas where problem solving in teams is a key part of the role.

The deal Cogstate has done with Eisai suggests they well be getting @ US$1.5 per test and gross margins will be in the high 90% area, plus they reattain ownership in the data. For Cogstate and Cambridge Cognition the ownership of the data is their moat as they will be able to make the test more and more sensitive.

[smithie6] 22/6/2021 12:39

Adcom, resignation, noble gesture

???????

if you have the time to spell it out to those of us not so well informed, I would be grateful & phps some others as well.

you seem to be very well informed

[40 fathoms] 22/6/2021 06:57

I tend to think the fall was just market related and profit taking. The volume was very low and it was mirrored in some other small cap stocks that are not AD related.

We are going to see a slew of good news over the next 3 months I strongly suspect before the end of the year we will break GBP 2.

As an aside, I thought it was interesting to note that one of the ADCOM members who resigned was asked if he would prescribe Aducanumab, he said he would still offer the medication to his patients when it becomes available, describing that as a “completely separate issue.” To some extent this seems to undermine his noble gesture.

[hatfullofsky] 22/6/2021 06:03

Controversy over the FDA approval of the Alzheimer's approval last month. Chair under pressure, 3 FFA advisory members quit one quoted as "the worst approval " which was rejected last year. Reported by FT Probably the cause for the fall yesterday

[mm84] 18/6/2021 21:49

Thank you very much for your insights 40.
Let me read and digest them and I'll get back to you.

[40 fathoms] 16/6/2021 10:48

mm84,

1) In AD yes, first you need to win a number of early stage trials as only a few will make it through to stage III, secondly you need to get to the end of stage II and from a starting point that could easily be 5 years, especially if you are assessing a therapy focused on MCI or the early stage of the disease. From where we sit visibility is pretty limited but there are often lots of clues or snippets on the internet.

2) To my knowledge they do not. They mainly just do the software and offer limited trial services.

3) There is plenty on the internet about what an eCOA is, I think you just need to understand that many of Cambridge's solutions are specialist/unique and you are probably better of using their integrated plumbing to knit everything together than using somebody else's.

4) No. Has not been spun out yet. I would need to look at what has happened to bring about the change in ownership you have highlighted. You can search on the companies house website and that should provide some indication.

5) I will leave that one to you. Given that they are already profitable and that margins are high, much of any incremental revenue will fall straight to the bottom line. There is no reason why, with a fair wind, they could not be producing profits of between GBP 8 million and GBP 12 million in 3 to 5 years time. Possibly even much higher if they sign a healthcare deal similar to the one Cogstate signed with Eisai.

[mm84] 16/6/2021 08:45

Thank you for sharing your knowledge 40. I really appreciate it.

Some notes: Yes, I'm comparing COG with Cogstate as Cogstate was the first one I loooked at and I'm obviously biased, but working on it :).

1) Regarding the US office, it has been open since 2015. I understand that these things take time, but 6 years??? And how has Cogstate done it while being headquartered in Australia?

Ok, I understand that the different phases take years (it reminds me of the ENTS in Lord of the Rings)but how much visibility do we have in relation to the trials they've been working on and how likely it is that these will translate into big phase 3 trials?

2) Regarding rater training and recruitment, I thought that COG also offered them. At least the recruitment with CANTAB Recruit. Are you saying that Cogstate has been lucky to perform those for large clinical trials whereas COG hasn't?

3) On eCOA, I must confess my ignorance (as with all the rest). I've tried to understand what it is exactly with little success. The best clue that I have found was a mention by the previous CEO on an interview from where I got the feeling that it was a less important product required by their clients like a "basic questionnaire and scales" (CEO's words).

Now that you've mentioned "CNS specific", "voice" and "wearables" I start to get the feeling that I'm way deep over my head.

4) Haven't they spun out Monument already? On the 2019 Annual Report Cambridge stated a 100% ownership whereas in the 2020 AR, it was down to 20%.

5) Which leads me to valuation. How does one put a number on this company? I know, I know, that's not how it works, but when you say that Monument isn't captured in the current valuation, how should it be captured? First there's the valuation of the core business (which I haven't even dared to calculate as I'm still learning the ropes)and then there's the valuation of a drug development business that no one knows what it is, what it's future will look like, it's funding needs, etc, etc. For all I know, it can be a drag on profitability for many years to come (if it remains 20% owned by the company).

Cheers,

[40 fathoms] 16/6/2021 07:59

In the same AD theme and while i am at it (please DYOR and this is not a recommendation) I would suggest you all take a look at a tiny little French company that could have a potentially huge digital application in the treatment pathway for Alzheimer's. They Company is called Voluntis the ticker is ALVTX FP.

They have an interesting business in providing a sort of digital treatment companion that is pared with specific drugs to help patience keep adherence, understand the significance of certain side effects and to monitor certain aspect of the patients response to treatment. They have 7 or 8 of these treatment companions under varying stages of development and regulatory approval and these are each partnered with a specific drugs from various global pharma names, in areas like oncology, diabetes and immunology. Eisai who is Biogen's partner on the development of Aducanumab and other AD drugs recently signed a deal with them for its oncology platform and took a very small equity stake but significantly when the deal was announced it was also said it would include an exploration of extending the project in to Neurology. It is on youtube and only in French, but during and IR call in May 2021 the company confirmed it would specifically be exploring a digital treatment companion for Alzheimers drugs. For those of you who like to dig a little bit I think this one might be a bit of a hidden gem, the company claim they will be cash flow positive in by the second half of this year.

[40 fathoms] 16/6/2021 00:16

MM84,

I am not sure I agree that they have not landed big contracts, there have been 4 or 5 contracts over GBP 1 million in the last 12 months.

I think you are probably making a comparison to Cogstate when you say this. But I think there is a couple of things you need to keep in mind.

1) It is true that Cogstate have, over time, won a few very large contracts. Most of these very large contracts are for phase III trials and in conditions where the trials are run over an extended time period, such as AD particularly trials focusing on the early stages of the disease. It is only with the opening of the US office that Cambridge has been properly positioned to compete for this type of work. So in essence you are unlikely to get appointed to a large phase III, unless you were providing services in phase II and most likely in phase I as well. So if you factor in the relatively short length of time that Cambridge Cognition has been properly addressing this market and given the multiyear length of most AD trials you will see that Cambridge has not yet worked its way through the system to the point where it is picking up these much larger trials. Although in the next 12 to 18 months I would expect that to change. So for example, I would expect them to win a large phase III trial of Cassava's Oral Simufilam before the end of the year. Across the two arms of the trial this will enroll 1,600 people and follow them for 18 months (I think in light of Cassava's advisory board it is reasonable to assume they are using Cambridge Cognition)

2) You should also keep in mind that Cogstate has historically provided a lot of non cognitive measurement services such as rater training and patient recruitment, which is lower margin work but bulks total ticket size.

As for eCOA, all I would say is barriers seem to be reasonably high and I am not aware of any other eCOA that is CNS specific. The barriers to entry are more related to the ability to be configured and VALIDATED to capture different types of CNS specific data (not just AD). I don't know this for sure but I suspect it to be true, no other eCOA can capture data from voice and wearables or certain very specialised CNS scales/instruments, because no one else has a validated commercial product in these areas. For example Cogstate does not have an eCOA and seem to be partnering with ERT in this regard.

With respect to Monument Therapeutics there is very little information about it. What we do know is that they are looking to spin it out. How significant is it ? It is hard to say for sure but looking at Monument's website( ) it is clear there is a drug development business sitting inside Cambridge Cognition targeting some pretty big therapeutic areas and in no way, shape or form is that captured in the current valuation.