As we head into Week 24, our portfolio is purposefully concentrated in three biotech catalyst plays, each with an imminent binary event. This “all or nothing” approach was adopted to try to dramatically outperform in the final stretch of the experiment.
Below is a recap of each position’s thesis, recent developments, and game plan, reinforcing why we are holding through their catalysts.
MIST’s novel nasal spray etripamil (brand: CARDAMYST) for treating paroxysmal supraventricular tachycardia (PSVT) is awaiting FDA approval on Dec 13, 2025. Our thesis is that approval is highly likely.
Key points:
- Phase 3 data showed statistically significant conversion to normal rhythm vs placebo
- First at-home, fast-acting therapy for PSVT (patients currently often require ER visits)
- Prior 2021 CRL was due to manufacturing issues, which have since been resolved
- NDA accepted; no AdCom required
- Strong balance sheet: $82M+ cash (Q3) plus a $75M approval milestone, reducing financing risk
- Stock rallied into the high $2s (52-week high $2.77; closed $2.64 on Dec 4)
- Management tone: “optimistic and excited” ahead of PDUFA
- New AHA analyses showed consistent efficacy across subgroups
- Mentioned in updated ACLS guidelines as a potential future tool
- No safety issues or negative FDA signals publicly
- Analyst targets generally in the mid-single digits, well above current price
We are highly confident in a positive outcome. Approval would be the first new PSVT drug in decades, transforming MIST into a commercial-stage company overnight.
- Expected move: $3.50–$4.50 immediately (≈50–70% gain)
- From our $1.75 entry, this implies ~100%+ return
- Aggressive analysts cite $6–$7 over 12 months
- Surprise CRL could drop stock 50–60% toward ~$1
- ~$1.50/share in cash provides a backstop
- Stop-loss at $1.60 limits downside to a small loss (~$0.15/share)
- Hold through FDA decision
- Sell most or all shares into post-approval rally
- If rejected, stop-loss caps losses
Very High. Strong data, clear unmet need, resolved prior issues, and milestone financing suggest high approval odds. This is our top conviction play.
VTGN is awaiting Phase 3 (PALISADE-3) results for fasedienol (PH94B) in Social Anxiety Disorder (SAD).
Key points:
- Trial redesigned to fix placebo issues from prior failed Phase 3
- Uses more realistic public-speaking challenge and stricter enrollment
- Potential first fast-acting, as-needed SAD treatment
- Large unmet market; current options are SSRIs or off-label benzos
- Data expected by end of 2025
- Management confirmed topline data timing and NDA target mid-2026 if successful
- $77.2M cash (as of 9/30/25), sufficient to reach NDA
- Stock up ~20% in two weeks (mid-$3s to ~$4.30–$4.40)
- Rising volume (~1M shares/day vs ~0.6M previously)
- Added board member with FDA approval experience (Paul Edick)
- No safety issues or delays reported
We assign ~50/50 probability. CNS trials are difficult, but the risk/reward is highly asymmetric.
- Potential move to $8–$10/share
- At $8, market cap would still be only ~$350–$400M
- Some analysts could revive teen-level targets
- Plan to sell in stages to capture euphoria and follow-through
- Failure likely drops stock to $2–$3
- Cash value (~$1.95/share) provides partial floor
- Stop-loss at $3.20 limits loss to ~10–15%
- Hold through data
- If positive: sell ~50% on initial surge, trail stop on remainder
- If negative: stop-loss triggers, exit fully
High. While risky, trial redesign and management confidence justify the bet. Upside multiples far outweigh downside.
SLS is our moonshot: Phase 3 REGAL trial of galinpepimut-S (GPS) cancer vaccine in AML second remission.
Key points:
- Cancer vaccines historically have low success rates
- Interim analysis did not stop for futility
- Success would be transformative, validating a platform
- Additional asset: CDK9 inhibitor SLS009
Estimated probability: ~10–20%, but with massive upside.
- Cash position strengthened to ~$73M total
- Virtual R&D Day featured enthusiastic KOL commentary
- Positive Phase 2 data for SLS009 presented at ASH
- Stock rose from ~$1.40 to ~$1.74 with heavy volume
- Increased speculation but also risk of “sell-the-news”
A classic low-probability, high-impact event.
- Success could drive stock to $4–$5+ (2–3x)
- $500–$600M valuation plausible on Phase 3 success
- Plan to sell most shares quickly; possibly retain a small runner
- Failure could drop shares 50%+ to ~$0.70–$0.90
- Stop at $1.10, though gap risk exists
- Absolute loss limited due to small position size
- Hold through readout
- Treat as a lottery-style position
- Exit quickly on success; stop-loss on failure
- No doubling down if trial fails
Moderate. We are realistic about the odds. Encouraging signals exist, but history is against cancer vaccines. Small sizing makes the risk acceptable.
We intentionally pivoted to a concentrated, catalyst-driven strategy to attempt a late-stage catch-up to the S&P 500.
- Catalysts are uncorrelated (cardiology, psychiatry, oncology)
- Binary biotech wins can double or triple overnight
- Risk managed via position sizing and stop-losses
- Needed multi-bagger potential given time constraints
- One win: materially narrows performance gap
- Two wins: potential to outperform the S&P 500
- Three wins: grand slam outcome
- Zero wins: portfolio underperforms, but survives (~$50–$60 end value)
We intentionally avoided hedging to preserve upside, accepting volatility as the cost.
Our portfolio thesis is simple but aggressive:
Concentrate risk into a few uncorrelated, high-impact biotech catalysts, manage downside with stops, and let upside run.
This approach gives us a fighting chance for dramatic outperformance, fully acknowledging the volatility and risk involved.