jefferies healthcare conference, london, 16 november 2016 · data presented at aacr 2016 show...
TRANSCRIPT
Developing first-in-class treatments in HaematologyJefferies Healthcare Conference, London, 16 November 2016
Luigi Costa, Chief Executive Officer
Forward-looking statements
2
This presentation may contain certain forward-looking statements and forecasts based on uncertainty, since they relate to events and depend on circumstances that will occur in the future and which, by their nature, will have an impact on Nordic Nanovector’s business, financial condition and results of operations. The terms “anticipates”, “assumes”, “believes”, “can”, “could”, “estimates”, “expects”, “forecasts”, “intends”, “may”, “might”, “plans”, “should”, “projects”, “will”, “would” or, in each case, their negative, or other variations or comparable terminology are used to identify forward-looking statements. There are a number of factors that could cause actual results and developments to differ materially from those expressed or implied in a forward-looking statement or affect the extent to which a particular projection is realised. Factors that could cause these differences include, but are not limited to, implementation of Nordic Nanovector’s strategy and its ability to further grow, risks associated with the development and/or approval of Nordic Nanovector’s products candidates, ongoing clinical trials and expected trial results, the ability to commercialise Betalutin®, technology changes and new products in Nordic Nanovector’s potential market and industry, the ability to develop new products and enhance existing products, the impact of competition, changes in general economy and industry conditions and legislative, regulatory and political factors.
No assurance can be given that such expectations will prove to have been correct. Nordic Nanovector disclaims any obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.
Nordic Nanovector at a glance
3
• Focused on the development of targeted therapies for haematological cancers• Leveraging its proprietary Immuno-Conjugate technology to build a pipeline of candidates
• Pipeline led by Betalutin® for treating non-Hodgkin lymphoma (NHL)• Novel anti-CD37 ARC in Phase 1/2 clinical trials
• Promising efficacy with sustainable duration of response, confirmed favourable safety profile
• Clear plan to bring Betalutin® to market • Designed to enhance Betalutin®’s chances of gaining regulatory approval with a competitive product profile
• Intend to independently commercialise Betalutin® in major markets
• Deep pipeline of targeted therapies for haematological cancers
• Successful IPO in March 2015 (OSE: NANO) raising $70m, strong current cash position (US$74m)*
* As at 30th June 2016
Strong Management Team with international experience
Luigi Costa, Chief Executive Officer (CEO)• More than 20 years of experience in the international pharmaceuticals and biotech industry
• Formerly VP of Europe, Middle East and Africa for Onyx Pharmaceuticals, various management positions with Amgen including head of International Oncology Franchise and general manager of Italy and France and various positions with Eli Lilly
• BSc in Business Administration from the University of Parma and an MBA from SDA Bocconi in Milan
Jostein Dahle, Chief Scientific Officer (CSO)• More than 15 years of experience in cancer research
• Formerly leader of the Radioimmunotherapy group at Institute for Cancer Research at the Norwegian Radium Hospital
• Ph.D. in radiation biology from University of Oslo and a M.Sc. in biophysics from Norwegian University for Science and Technology in Trondheim
• Co-founder of Nordic Nanovector
Rita Dege, Chief Human Resources Officer (CHRO)• Over 15 years of experience from global organizations and international start-ups
• Formerly head of HR with an international environmental advisory firm; senior positions within HR and learning and development with global maritime industry, management consulting and finance.
• Diploma in languages, business and finance from Euro Business and Language School, Germany
Anniken Hagen, Chief Technical and Operations Officer (CTOO)• More than 20 years of experience from the pharmaceutical industry with specialty in
radiopharmacy
• Formerly Head of QA and QP at Norwegian Medical Cyclotron Centre, QC Manager at Algeta and scientist at Pronova Biomedical
• M.Sc. in radiochemistry from the University of Oslo
Tone Kvåle, Chief Financial Officer (CFO)• More than 20 years of experience from the biotech industry. CFO in Nordic
Nanovector since November 2012
• Formerly CFO in NorDiag (public Company), Kavli Holding and Dynal Biotech and senior management positions at Invitrogen/Life Technologies/Thermofischer (US)
• Diploma in Finance and Administration from Harstad University College
Marco Renoldi, MD, Chief Operating Officer (COO)• Strong track record of commercial and financial results over 28 years of industry
experience
• Has developed product lines and businesses, including start-ups, for established and innovative companies such as Novartis, Searle/Pharmacia, Amgen and Shionogi
• Medical degree and post-graduate studies in Child Neuropsychiatry from the University of Milan, and an MBA from Fondazione Istituto Dirigenti Italiani
Lisa Rojkjaer, MD, Chief Medical Officer (CMO)• Board-certified hematologist with more than 15 years of executive global and
regional clinical development and medical affairs expertise within biotech and pharma industry
• Formerly Global Clinical Program Head, Oncology Global Development with Novartis Pharmaceuticals, CMO at Molecular Partners and Vice President, Head of Clinical Development at Morphosys AG
• Medical degree from University of Toronto, and board certified in both internal medicine and hematology
Leveraging expertise to develop a broad pipeline of targeted therapies for haematological cancers
5
ADC: antibody-drug conjugate; ARC: antibody-radionuclide conjugate; ASCT: autologous stem cell transplant; chHH1: chimeric HH1 antibody; DLBCL: diffuse large B-cell lymphoma; FL: follicular lymphoma; NHL: non-Hodgkin lymphoma
Betalutin®
6
Multi-cell kill approach
• Localized tumor cell kill (40-cell radius): even poorly perfused or non-antigen expressing cells suffer from cytotoxic radiation effects
• ARC (a multi-cell kill approach) is expected to deliver better treatment outcomes than anti-CD20 therapies and chemotherapy (single cell kill approach)
• Highly expressed in B-cell population
• Internalization of the antibody anchors the payload to the cancer cells, resulting in a prolonged irradiation of the cancer cell nucleus
• Different target ideally suited to be effective for patients previously treated with CD20-based therapies
• Beta-emitting radionuclide with half-life (6.7 days) matching the circulation time of the antibody
• The mean range of the Lu-177 beta particles is 0.67mm
• Radionuclide payload with properties that are well suited for treating NHL while limiting unnecessary side effects
Design Property Differentiation
Lutetium-177 –ideal therapeutic and safety properties
CD37 –a validated target for B-cell NHL
Betalutin® is specifically designed to treat NHL
NHL market expected to reach ~ USD 12bn by 2018
NHL represents a serious unmet medical need
• A cancer of the white blood cells‒ Two types: B-cell (~85%) and T-cell (~15%)
• 10th most common cancer: estimated 850,000 prevalent patients with B-cell NHL
• 66% of diagnosed patients age 55-74 years
• High mortality rate, despite available treatments
• Incidence expected to grow due to the ageing population (1.5% CAGR)
• Treatment currently dominated by anti-CD20 immunotherapy and chemotherapies
• High medical need for differentiated products
7Sources: DataMonitor Pipeline Insight: Lymphomas, Multiple Myeloma and Myelodysplastic Syndromes DMHC2595/ Published 03/2010, National Cancer Institute at the National Institutes of Health, seer.cancer.gov/, annonc.oxfordjournals.org/content/19/3/570.full , Global Non-Hodgkin Lymphoma Therapeutics Market : 2014-2018 (TechNavio), Roche website Investor Relations 2014 webpage
0
2
4
6
8
10
12
14
2013 2018
BU
SD
Americas EMEA APAC
FL market is expected to grow by 50% over the next 10 years, 2L and 3L segments combined will exceed 2 USD billions
8Decision Resources, 2015
Current Standard of Care:Anti-CD20 Mab (rituximab,
obinutuzumab) plus chemo (CHOP, Bendamustine or CVP)
Current Options:Anti-CD20 Mab plus chemo,
R squared (rituximab -lenalidomide), idelalisib,
ibrutinib,ibritumomab tiuxetan
Current Options:R squared, idelalisib, ibrutinib,
rituximab, ibritumomab tiuxetan
1L FL$1.4B
approx. 14,000 (US) + 10,800 (EU-5) patients
2L FL$1.5B
approx. 9,200 (US) + 7,100 (EU-5) patients
3L FL$0.6B
approx. 5,900 (US) + 4,800 (EU-5) patients
Total: $2.3B (2015) $3.5B (2024)
9
* Dose decision based on safety data and Safety Review Committee’s recommendation
Lymrit 37-01 – Phase 1/2 trial
PARADIGME dose decision: 1Q 2017
First Patient: 2H 2017
Dose TBDN=85
Last Patient: 2H 2018
Regulatory submission: 1H 2019
Pivotal Phase 2 PARADIGME trial
20MBq/kg(+ llo 40mg)
N = 310MBq/kg(- llo + R0)
N = 1
15MBq/kg(+ llo 40mg)
N = 6
10MBq/kg(+ llo 40mg)
N = 3Arm 1
Phase 1
Arm 2
Phase 2
15MBq/kg(+ llo 40mg)
N = 16
15MBq/kg(- llo + R0)
N = 3
15MBq/kg(- llo)N = 2
15MBq/kg(+ Ilo 100mg/m2)
N = 3
10MBq/kg(- llo)N = 1
20MBq/kg(+ Ilo 100mg/m2)
N ≥3
20MBq/kg*(+ llo 100mg/m2)
N >3
Arm 3
Arm 4
MBq = Megabecquerel (radioactivity measurement unit)
llo = lilotomab - CD37 B-cell seeking antibody (previously HH1)
R0 = rituximab predosing on day 0N = number of patients
= completed step (all patients enrolled)
Discontinued for futility
Betalutin’s development plan in FL designed to select optimal dosing regimen
Discontinued
Clinical program progressing at higher dosing regimen based on favourable safety data
10
• Escalate Betalutin® dosing (20 MBq/kg) and lilotomab pre-dosing (100 mg/m2), pending confirmation of safety from Arm 4 and protocol amendment approval
• Generate further safety data at higher regimen
• Proceed at higher dose of Betalutin® (20 MBq/kg) and lilotomab 100 mg/m2
• Patient recruitment underway• Completion of dose-finding study / finalise dose decision for PARADIGME
Arm 1/Phase 2Preparing dose escalation
Arm 3Discontinued
Rationale• Pre-dosing protects bone marrow, minimal effect on tumour uptake• Dose escalation expected to improve clinical profile of Betalutin®
Arm 4Initiating dose escalation
• Discontinued
Efficacy
11
Duration of response
Data presented at AACR 2016 show strong and durable efficacy assingle agent
AACR 2016, Poster version of the Abstract LB-252, Prof. A. Kolstad et al.
DoR exceeds 12 months in most responders in the 15 MBq/kg group followed up for at least 12 months
ORR = Overall response rate, CR = Complete response, PR = Partial response, SD = Stable disease, PD = Progressive disease Tumour response assessed according to Cheson criteria 2007One patient with a transformed lesion has been excluded from the efficacy analysis of the 15MBq/kg group but included the incidence of DLTs
Betalutin® monotherapy holds a significant edge over existing and upcoming competitors in R/R FL
• * Data read-out suggests not very strong results. Infinity is still in touch with FDA to look for future action• All agents are approved based on different phase results as mentioned along with asset• Results from different trials for comparison purpose only and NOT head to head studies
Copanlisib(Phase II)
Betalutin(Phase I)
Ibrutinib(Phase II)3
rdLi
ne
2n
dLi
ne
74%
48%
41%
29%
40%
54%
46%
30%
73%
64%
15%
6%
11%
10%
8%
23%
3%
64%
32%
CR ORR
Nivolumab(Phase I)
Idelalisib(Launched)
Rituximab(Launched)
Ibritumomab tiuxetan(Launched)
Duvelisib*(Phase II)
MOR208(Phase II)
mDOR (months) mPFS (months) mOS (months)
>12m -- --
-- ~12m --
-- ~10m --
~13m ~10m12m – 70%15m – 60%
>12.5m -- ~20.3m
-- -- --
>16m 12m – >40% --
-- -- --
-- ~13m --
~6.5m ~7m --
12
CTL019(Phase II)
Kolstad et al, 2016(21 patients)
Novartis, 2015(11 patients)
Bartlett et al, 2014(40 patients)
Dreyling et al, 2014(33 patients)
Gopal et al, 2014(125 patients)
Lesokhin et al, 2016(10 patients)
Jurczak et al, 2016(45 patients)
Infinity Pharma, 2016(129 patients)
McLaughlin et al, 1998(166 patients)
Witzig et al, 2002(57 patients)
Source
Betalutin®’s unique value proposition in FL is based on important differentiating factors
13
High and durable response*• Significantly higher Complete Response than current and future competitors, as a
single agent
• Duration of Response exceeding 12 months in heavily pre-treated patients
Predictable and manageable toxicity*
• Minimal non haematological toxicity
• Predictable, transient and reversible cytopenias
Convenience for patients and physicians
• One-time therapy: 100% patient compliance and improved convenience vs. oral TKIs
• No repeat visits to cancer center: improved QoL for patient
• Optimized healthcare resource utilization
New target and combination potential
• Potential synergy from combination with anti-CD20 mAb
• New target (CD37) ideal for patients who progress after rituximab-based regimens
*AACR 2016, Poster version of the Abstract LB-252, Prof. A. Kolstad et al
Latest clinical results to be presented at ASH on 3 December 2016
14
• Updated clinical results with Betalutin® in FL‒ Poster will include response rates, DOR and safety data from all evaluable
patients to date
‒ Abstract 1780 reports a 57% ORR, based on patients available until August
• Results from studies of Betalutin® in combination with rituximab in preclinical NHL model ‒ Betalutin® increased binding of rituximab to NHL cells and uptake of rituximab
in NHL tumours
‒ 90-100 % survival for 150 days after combination treatment compared to 10-40 % survival for each treatment alone
Clinical study of Betalutin® in DLBCL initiated
15
10 MBq/kg(+ Intermediate
dose llo)
Lymrit 37-05 – Phase 1
Phase 2 dose decision: 1H 2018
Pivotal Phase 2 trial
First patient: 2H 2018 Dose TBD
Last patient: 2H 2019
Protocol design pending SAB and regulatory validation
10 MBq/kg(+High dose llo)
15 MBq/kg(+ Intermediate or
high dose llo)
20 MBq/kg(+ Intermediate or high
dose llo)
Several combinatorial approaches to be explored
N = ≥3
N = 3-24llo = lilotomab - CD37 B-cell seeking antibodyDay -14: rituximabDay 0: Intermediate dose lloDay 0: High dose lloDay 0: Betalutin*
N = ≥3
N = ≥3
N = ≥3
Increase in rituximab binding after Betalutin® treatment
16
Median survival of a mouse model of NHL
Betalutin® + rituximab increased the survival in a preclinical NHL model1
1. Repetto-Llamazares AHV, et al. Poster presented at ASH 2015.
0
20
40
60
80
100
120
140
Placebo Rituximabonly
Betalutin®only
Betalutin® +Rituximab
Med
ian
su
rviv
al (
day
s)
*p<0.05 vs placebo
Time after seeding (days)0 2 4 6 8 10 12 14
% C
D2
0 U
pre
gula
tio
n
0
100
200
300
400
0.9 MBq/ml 177
Lu-HH1
0.4 MBq/ml 177Lu-HH1
1.5 Gy External Beam Radiation
0.5 Gy External Beam Radiation
0.9 MBq/mlBetalutin
0.4 MBq/ml Betalutin
1.5 Gy External Beam Radiation
0.5 Gy External Beam Radiation
*
*
Important research collaborations to develop new Immuno-Conjugatesfor leukemias
17* CLL: chronic lymphocytic leukaemia, AML: acute myeloid leukaemia
• Develop new ARCs optimised for treating leukaemias, e.g. CLL* and AML*• >50 000 patients relapse every year worldwide• Market estimated to grow to USD 5 billion by 2024
• Supported by grant funding from the Research Council of Norway
• Early stage R&D collaborations with goal to develop new ADCs optimisedfor treating leukaemias
• Market estimated to grow to USD 5 billion by 2020
• Leveraging CD37 targeting and biologics expertise of Nordic Nanovectorand complementary technologies of partners
• New area for Nordic Nanovector using non-radionuclide payloads
0
100
200
300
400
500
600
700
800
Cash 31.12.15 Operating activities Investing &financing activities
FX Cash 30.06.16
(109)743
0.5 (17) 618
MNOK
18
Cash flow
Operating expenses reflect focus on development activities
USD 74M*
* USD/NOK 8.39
USD 88M*
Operating expenses distribution YTD 2016
71 %
29 %
Development* Administration
Current cash resources expected to be sufficient to reach first regulatory submission for Betalutin® in 3L FL in 1H 2019
*Development costs: preclinical, clinical, regulatoryand CMC activites
Key milestones through 2017
19
Nordic Nanovector investment proposition
20
Market Substantial unmet medical need and orphan drug opportunities, a growing market worth over USD 30 bn
Leading Product Betalutin®: first in a new class of Antibody-Radionuclide-Conjugates, designed to deliver better treatment outcomes for NHL patients
Evidence Promising clinical data from Phase 1/2 study indicates the potential for a competitive target product profile
Strategy Well thought-out clinical strategy - unencumbered asset with all options open to maximize shareholder value
Team Management team with extensive industry experience in both development and commercialization of anticancer drugs
Nordic Nanovector ASA
Kjelsåsveien 168 B, 0884 Oslo, Norway
www.nordicnanovector.com
IR contact: [email protected]
Thank you for your attention!
Glossary of terms
1L, 2L, 3L: first, second and third line of treatment
ADC: Antibody-Drug Conjugate
ARC: Antibody-Radionuclide-Conjugate
(A)SCT: (Autologous) stem cell transplant
ASH: American Society of Hematology Annual Meeting
B-cell: A type of lymphocyte (white blood cell) in the humoral immunity of the body’s adaptive immune system. Can be distinguished from other lymphocytes by the presence of a protein on the B-cell’s outer surface known as a B cell receptor (BCR). This specialised receptor protein allows a B-cell to bind to a specific antigen.
CD20: B-lymphocyte antigen CD20 is an activated-glycosylated phosphoprotein expressed in the surface of all B-cells beginning at the pro-B phase and progressively increasing in concentration until maturity
CD37: B-lymphocyte antigen CD-37 is a protein, a member of the transmembrane 4 superfamily, also known as the tetraspaninsuperfamily of cell surface antigens
CR: Complete response
DLBCL: Diffuse Large B-Cell Lymphoma
FL: Follicular Lymphoma
FDA: Food and Drug Administration
Lilotomab: Betalutin® consists of the radionuclide lutetium-177 conjugated to the B-cell seeking anti-CD37 antibody lilotomab(formerly referred to as HH1).
IFRS: International Financial Reporting Standard
IND: Investigational New Drug
IPO: Initial Public Offering
KOL: Key opinion leader
LCM: Lifecycle management
177Lu: Radionuclide lutetium-177
MBq: Megabecquerel (radioactivity measurement unit)
MD: Medical doctor
nASCT: Not eligible for autologous stem cell transplant
NNV003: chimeric anti-CD37 antibody developed by Nordic Nanovector
22
Glossary of terms
23
NHL: non-Hodgkin Lymphoma
OSE: Oslo Stock Exchange
ORR: Overall response rate (the CR and PR, jointly)
PARADIGME: Name of Nordic Nanovector’s pivotal Phase 2 study
PFS: Progression free survival
PR: Partial response
QoL: Quality of life
R: rituximab
RIT: Radioimmunotherapy
SAB: Scientific Advisory Board
SD: Stable disease
T-cell: A type of lymphocyte (white blood cell) that plays a central role in cell-mediated immunity. Can be distinguished from other lymphocytes by the presence of a T-cell receptor (TCR) on the cell surface. They are called T-cells because they mature in the thymus.