#DDDD $LBPS $LOAC

A thread on the potential near term catalysts behind why I have increased my position in 4d Pharma @4dpharmaplc (LON: #DDDD):

1) NASDAQ listing. This is the most obvious.

The idea behind this is that the huge pool of capital and institutional interest in the NASDAQ will enable a higher per-share valuation for #DDDD than was achievable in the UK.
Comparators to @4dpharmaplc #DDDD (market capitalisation £150m) on the NASDAQ and their market capitalisation:
Seres Therapeutics: $2.33bn = £1.72bn (has had a successful phase 3 C. difficile trial); from my previous research (below) the chance of #DDDD achieving this at least once is at least 90%.

https://t.co/O8Fd9uuR7f
Kaleido Biosciences: $347m = £256m. 4 products under consideration, compared to #DDDD's potential 16. When you view @4dpharmaplc's 1000+ patents and AI-driven MicroRx platform (not to mention their end-to-end manufacturing capability), 4d's undervaluation is clear.
Evelo Biosciences: $496m = £366m. 11 potential treatments under consideration compared to #DDDD's 16. 4d's IP, platform and manufacturing are superior. Very arguable that 4d should be comparably valued. @lramseu's content is excellent for comparisons.
This does not take into account the recent frenzy for IPOs/SPAC offerings, like #DDDD. In fact, however, without DraftKings and Nikola included, SPAC returns are negative - hence the case for 4d rests firmly on fundamentals.

https://t.co/EHvA8xVbep.
2) Potential Blautix Phase 3 trial. The below graphic taken from @AimHardy's excellent research shows #DDDD's Blautix was comparable to existing IBS-C and D offerings.
It offers a far superior safety profile however, making it the potential treatment of choice, especially for the $1.1bn-$1.65bn IBS-M market (patients whose symptoms fluctuate between IBS-C and D).
The fact that c. 60% of phase 3 trials are a success notwithstanding, comparing Blautix with Seres' C.difficile trial shows how selecting for specific biomarkers/genotype can yield a highly successful final stage trial.
Just the initiation of a trial netted Seres $20m from Nestlé Health Science, excluding the revenues from developing a safe live biotherapeutic. The potential for #DDDD to rerate, just based on precedent (Seres jumped c. 500% on their P3 success) is colossal.
It is likely that the announcement of a phase 3 trial and partner would lead to some of this movement being priced in, given the favourable chance of a success. Hence it is a potential near term (3-6 month) catalyst, and if not, a potential long term catalyst.
3) Potential FDA fast track for MRx0518. Interim analysis for the #DDDD treatment on its own yielded the following (from 17 individuals under trial):
"Following MRx0518 treatment, relative increases in cytotoxic cells, CD8+ T cells and other immune subsets associated with anti-tumor activity were observed in paired tumor samples.
Upregulation of key immuno-stimulatory anti-tumor cytokines and chemokines, such as IL-12 and CXCL10, was observed in post-treatment plasma samples."
Gene expression analysis identified significant expression changes in 98 genes (p<0.05) in paired samples as a result of MRx0518 treatment, including upregulation of pathways associated with antigen presentation, costimulatory signaling, cytokine and chemokine signaling, known
…to promote anti-tumor immune activity."

This is for #DDDD's treatment group who had exhausted many previous options and had metastatic cancer.
The fact that #DDDD's treatment is clearly having an effect without significant side effects is extremely important (as patients may forgo treatment due to side effects alone), and certainly presents the opportunity for fast-track approval.
To me, it belongs in this list of 2020 fast track approvals:

https://t.co/GFsF6ZYraA

This is without taking into account #DDDD's trial of MRx0518 with Merck $MRK's Keytruda, which is likely to yield as high if not greater efficacy than MRx0518 alone.
4) Potential Merck takeover. This is more dubious so can be listed as a fringe point.
#DDDD's bacterial vaccine partnership with Merck yields a potential $347.5m in milestone payments, and if other treatments show further efficacy then, given Merck's interest in the MicroRx platform and live biotherapeutics (they own 6% of 4d) they may well consider a takeover,…
…which typically occur at a substantial premium to the current share price. Takoevers of Rebiotix and Epibiome in recent history offer validation of this theory.
The key here is if #DDDD become attractive enough to be taken over, their share price would have likely enjoyed a substantial re rate from today's levels already.
To summarise, I believe #DDDD offers substantial long-term value. However there are a number of potential near term catalysts, chiefly a NASDAQ listing, which have prompted me to increase my position in the short term from its historical average.
I believe a #DDDD rerate (and a subsequent SP multiplying of 2-3x given 4d have cash till Q4) could well happen in the coming 3-6 months, and I have positioned accordingly.

Merry Christmas and Happy Holidays!

#DDDD $LBPS $LOAC

More from Science

@mugecevik is an excellent scientist and a responsible professional. She likely read the paper more carefully than most. She grasped some of its strengths and weaknesses that are not apparent from a cursory glance. Below, I will mention a few points some may have missed.
1/


The paper does NOT evaluate the effect of school closures. Instead it conflates all ‘educational settings' into a single category, which includes universities.
2/

The paper primarily evaluates data from March and April 2020. The article is not particularly clear about this limitation, but the information can be found in the hefty supplementary material.
3/


The authors applied four different regression methods (some fancier than others) to the same data. The outcomes of the different regression models are correlated (enough to reach statistical significance), but they vary a lot. (heat map on the right below).
4/


The effect of individual interventions is extremely difficult to disentangle as the authors stress themselves. There is a very large number of interventions considered and the model was run on 49 countries and 26 US States (and not >200 countries).
5/
JUST ONE PERSON—UK 🇬🇧 scientists think one immunocompromised person who cleared virus slowly & only partially wiped out an infection, leaving behind genetically-hardier viruses that rebound & learn how to survive better. That’s likely how #B117 started. 🧵 https://t.co/bMMjM8Hiuz


2) The leading hypothesis is that the new variant evolved within just one person, chronically infected with the virus for so long it was able to evolve into a new, more infectious form.

same thing happened in Boston in another immunocompromised person that was sick for 155 days.

3) What happened in Boston with one 45 year old man who was highly infectious for 155 days straight before he died... is exactly what scientists think happened in Kent, England that gave rise to #B117.


4) Doctors were shocked to find virus has evolved many different forms inside of this one immunocompromised man. 20 new mutations in one virus, akin to the #B117. This is possibly how #B1351 in South Africa 🇿🇦 and #P1 in Brazil 🇧🇷 also evolved.


5) “On its own, the appearance of a new variant in genomic databases doesn’t tell us much. “That’s just one genome amongst thousands every week. It wouldn’t necessarily stick out,” says Oliver Pybus, a professor of evolution and infectious disease at Oxford.

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https://t.co/UqtS1lpw3n


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