amarantus diagnostics -...
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Diagnostic and therapeutic products in the areas of neurology, psychiatry, ophthalmology and regenerative medicine
Amarantus Diagnostics
Biotech Showcase 2015Gerald E. Commissiong
President and CEO
OTCQB: AMBS
This presentation contains “forward-looking statements” within the meaning of the “safe-harbor” provisions of the Private Securities Litigation Reform Act of 1995. Such statements involve known and unknown risks, uncertainties and other factors that could cause the actual results of the Company to differ materially from the results expressed or implied by such statements, including changes from anticipated levels of sales, future international, national or regional economic and competitive conditions, changes in relationships with customers, access to capital, difficulties in developing and marketing new products and services, marketing existing products and services, customer acceptance of existing and new products and services and other factors. Accordingly, although the Company believes that the expectations reflected in such forward-looking statements are reasonable, there can be no assurance that such expectations will prove to be correct. The Company has no obligation to update the forward-looking information contained in this presentation.
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Forward-Looking Statements
Screening expertise in identifying undervalued assets, de-risking and transforming into significant product
opportunities for portfolio expansion
AMBS Core Competence in Uncovering Groundbreaking Opportunities
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LymPro Test®
Eltoprazine
MANF
ESS-W*
* = Upon Exercise of Exclusive Option
MS Precise®
Diagnostics
Therapeutics
Georgetown Assays*
Holding Company Model Yields Four Pillars of Expected Transformational Growth
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Amarantus
Diagnostics
MS Precise
LymPro
Georgetown Assays
Therapeutics
Eltoprazine
MANF
Discovery
PhenoGuard
Regen Med
ESS-W
Corporate infrastructure in place to absorb and advance assets.
Management Team with Proven Track Record
Gerald E. Commissiong, President & CEO, DirectorLed acquisition of diagnostic assets and MANF strategic development Stanford University: Management Science & Engineering
Robert Farrell, JD, Chief Financial OfficerFormer CEO and CFO at Titan PharmaceuticalsFormer CFO, Fresenius
Colin Bier, PhD, Corporate AdvisorPresident & CEO at ABA Research (overseeing Diagnostics development)Former Director at Nymox Corporation
Charlotte Keywood, MD, Chief Medical OfficerFormer CMO at Addex Therapeutics (overseeing Eltoprazine development)Former Medical Director at Vernalis
David A. Lowe, PhD, DirectorPresident & CEO at NeuroAssets, Sarl (overseeing MANF development)Former Head of CNS R&D at Roche, Bayer & Sandoz
John W. Commissiong, Chief Scientific Officer, DirectorFormer CSO at Prescient Neuropharma (overseeing PhenoGuard Development)Former Head of the Neurotrophic Factors Group at NINDS, NIH
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Diagnostic Candidates Clinical Validation Analytical Performance Commercialization
LymPro Test®
MSPrecise®
Georgetown Assays
Alzheimer's Disease
Multiple Sclerosis
Alzheimer’s Disease
Potential for Spin-off in 2015
Robust Pipeline of NeuroDiagnostic Assays
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Therapeutic Candidates Pre-Clinical Phase 1 Phase 2 Phase 3 Commercialization
Eltoprazine
Near Term Catalysts: - IND Submission / Approval; Phase 2b in PD LID; End of Phase 2 meeting in Adult ADHD- Potential partnership in 2016
ESS-W
Near Term Catalysts: - Phase 2 clinical trial initiating in Q2/15- Potential partnership in 2017
MANF
Near Term Catalysts: - Orphan Drug Designation application in 2nd retinal disorder; Initiation of FMP Mnftg- Potential PoC in orphan ocular in 2018
Parkinson’s / Adult ADHD
Intractable Severe Burns
Retinitis Pigmentosa
Robust Pipeline of Therapeutic Candidates
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MSPrecise®
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High
Misdiagnos
is Rate
Criteria for diagnosis repeatedly modified; requires
greater reliance on diagnostic testing
Rx Innovation has Amplified the Need for Dx Innovation
Pre-90sNo MS Rx
1977
B cells found in CNS lesions
Past four yearsNew Rxs have improved efficacy but each carry a quantifiable risk of death (2013: $55k/yr)
1964
OCBs are used as MS Dx markers
Mid–90sInjectable Rxs (~$10k/yr)
Late 90sEarly Rx benefits patients
Normal
OCB
MS MS
<$400M MS Rx Market Size $14B
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MS Early Diagnosis: Key Unmet Medical Need
$48,833
$54,146
$54,500
$54,500
$54,704
$54,750
$56,070
$56,178
$58,650
$58,760
$60,423
Extavia
Rebif (22 mcg)
Aubagio (14 mg)
Aubagio (7 mg)
Avonex
Tecfidera
Copaxone
Betaseron
Tysabri
Rebif (44 mcg)
Gilenya
High Annual MS Treatment Costs
(2013 WAC pricing)
Normal
OCB
MS MS
Each FALSE POSITIVE can cost >$100k/year (not including unnecessary side effects)
Current Std. of Care*:40%-50% FALSE POSITIVES
† NICE (UK) recently agreed to reimburse Lemtrada @ £56,000. Ŧ Nielson, JM et al. Ann Neurol 200;58:781–783. Table 3.
• Tintore et al., Neurology, 2008;70;1079-108.
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Published misdiagnosis rateŦ: 58%
4Neurologists must make a treatment choice QUICKLY to help patients:
“If in doubt, TREAT” is the emerging trend among neurologists:
Early treatment of MS reduces the frequency & severity of new attacks while retarding chronic disability
* Source: DGx Qualitative Market Research
MS Diagnosis Paradigm
Patient’s neurological dysfunction leads to
suspicion of RRMS (MS); do medical history and physical
exam
Neurologist requests an MRI Neurologist collects cerebrospinal fluid (CSF) and sends it to lab for testing
Normal
OCB
MS MS
1 2 3
The test from the 1960s is conducted on CSF
(Oligoclonal Banding Test)
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Rx for MS have Significant Side Effects
Drug Label Warnings
Aubagio® Hair thinning, diarrhea, flu, nausea, abnormal liver tests and unusual numbness or tingling in the hands or feet (paresthesias). Less common: lowered levels of white blood cells, which can increase the risk of infections; increase in blood pressure; severe liver damage
Extavia® Less common: allergic reactions, depression, liver abnormalities
Gilenya® Headache, flu, diarrhea, back pain, liver enzyme elevations and cough. Less common: slowed heart rate following first dose, infections, swelling in the eye
Novantrone® Blue-green urine 24 hours after administration; infections, bone marrow suppression, nausea, hair thinning, bladder infections, mouth sores, serious liver and heart damage
Tecfidera® Flushing (sensation of heat or itching and a blush on the skin), gastrointestinal issues (nausea, diarrhea, abdominal pain), rash, protein in the urine, elevated liver enzymes; reduction in blood lymphocyte (white blood cell) counts
Tysabri® Headache, fatigue, urinary tract infections, depression, respiratory tract infections, joint pain, upset stomach, abdominal discomfort, diarrhea, vaginitis, pain in the arms or legs, rash. Less common: allergic or hypersensitivity reactions within two hours of infusion (dizziness, fever, rash, itching, nausea, flushing, low blood pressure, difficulty breathing, chest pain), PML
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How much does your company care about MS, given its prevalence of ~500,000 patients in the US, and why?Humana & Anthem/Wellpoint:
“[We] care due to escalating costs of medications”
HealthNet
“Relatively prevalent condition with very expensive drug therapy. High importance, as we prior authorize all [MS] drugs”
Approximately where does MS rank in total budget impact to your plan? What are diseases or conditions with comparable budget impact?
Anthem/Wellpoint:
Top 20 [total] in terms of cost, RA & Chron’s
HealthNet
Top 10, RA
Are you seeking to manage or control the costs of MS treatment/management? If so, in what cost area(s) do you see the greatest need for cost control, and why?
Humana:
“[Yes] value proposition is corrupted”
Anthem/Wellpoint
“Drugs are prior authorized, but realistically we have little leverage in this space”
Escalating Costs of MS Healthcare:Payors describe impact of MS on their plans
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if 20% of patients on MS drugs are misdiagnosed, >$2.2B per year could be saved by Payors
Reimbursement of MSPrecise® will be driven by current expense associated with misdiagnosis
Pharmacoeconomic Benefit to Payors
Reduction of 3 FALSE POSITIVES/100 patients tested provides Payor a ROI
Payors should get much
more than a ROI by
supporting MSPrecise®
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Meaningfully reduces the high rate of MS misdiagnosis & its large cost
More accurate than the current standard of care
Validated through large prospective multi-site study
Partnered with the National Multiple Sclerosis (MS) Society
Protected by an issued US patent
First Significant New Lab Test for MS in 50 years
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First-in-class molecular diagnostic
for MS
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Neurologist collects CSFper standard
protocol
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First-In-Class Molecular Diagnostic for MS
Sample is shipped to a CLIA lab and analyzed to measure changes in specific immune
cells
Our report is
delivered to the
neurologist
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Your MSPrecise®
EvaluationMS Migraine NMO PND
DN
A M
uta
tions
Not MS: 0-6Has MS: >8
Score: 1.7
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Objective: Validate NGS assay developed through previousclinical studies
Clinical Truth: Unanimous & independently adjudicated diagnosis on each enrolled subject by a panel (3) of MS Dx Specialists (neurologists with 20+ years specializing in MS healthcare)
Primary Correlate MSPrecise scores derived from CSF Endpoint: with Clinical Truth @ ~80% accuracy with statistical
significance (p≤ 0.05)
Subject Inclusion Subjects being evaluated for a demyelinating disease/MSProfile: and undergoing the current Dx standard of care
Cohort Sizes: Assuming that MSPrecise is 80% Sensitive & 80% Specific: at 90% power and p ≤ 0.05; need toanalyze ~15 RRMS and ~15 OND subjects (30 total)
MSPrecise®Scoring:
Clinical Validation Study Design
NOT RRMS (ONDs) RRMS
6.8-5.0 15.0
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Low-resolution analysis of general Ab proteins
High-resolution analysis of specific molecular changes in Abs
Oligoclonal Banding Next Generation Sequence Analysis
MS is an immune-mediated neurological disease
61-70%OCB
S CSF S CSF S CSF S CSF
Normal Normal MS MS
AGT GGG AGC ACC TAC TAC AAC
Mutations in V
region sequence
can change Ab
specificity
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Sensitivity: 96%
Specificity: 83%
Overall Accuracy: 92%
P<0.001
Neurologists Want Better Information to Make More Confident Diagnoses
Neurologists say MSPrecise® would be a welcome addition to current tests*:
75% of Neurologists surveyed say they would do a more thorough diagnostic evaluation if they had access to more accurate tests
They say a new test, if ~80% accurate, would become a critical part of new diagnostic evaluations
They would re-test up to 20% of their patients currently being treated for MS using MSPrecise® to rule out a misdiagnosis
* Source: Epocrates Market Research of US Neurologists (n=100) November 2012
Neurologists have a high intent to
prescribe MSPrecise®*
7
6
5
4
3
2
1
Intent to prescribe
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Clinical Network of Top KOLs Already in Place
<3,000 US Neurologists
are neuro-immune
focused and want better
testing options> 20 Neurologists in 13 US MS
Clinics have validated MSPrecise®
★★★★★
“Given its clinical performance, I would use MSPrecise® withmy patients and would recommend it to my networkof colleagues.”
KOL at Large NE Medical Center
★★★★★
“Thank you.”
KOL from large
Metropolitan
MS Clinic
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Excellent Market Opportunity
Sources:
Quantitative Research Results; SmartAnalyst, July 2009. (n=103 Neurologists)
National Ambulatory Medical Care Survey 2005 Summary Centers for Disease Control June 29, 2007
IMS, National Disease and Therapeutic Index Reports (update through Q3 2011)
Interviews with EU & US clinicians
Pharmacoeconomic Analysis using 2013 US MS Healthcare costs & discounted cost/test of $4k by Quorum Consulting (see slide 35)
Core market: estimated annual NA MS evaluations
estimated annual EU MS evaluations
estimated annual ROW MS evaluations
Patients
110,000220,000250,000
MSPrecise® Incident Market Size: ~$2.3B
Can expand market opportunity by:
testing existing patients on MS Rx 400,000
MSPrecise® Prevelant Market Size: ~$1.6B
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Opportunity Overview: Compelling Commercial Opportunity
• Highly differentiated and validated lead diagnostic test (CSF) targeting significant unmet need in MS diagnosis & treatment
• Forecasted sales in North America of ~$300M;
• Expected CLIA launch in 2015;
• Compact target audience with ~200 MS clinics allowing for economical selling and marketing support; early-adopters primed and eager to order
• Strong Market Protection with little threat of competition
• Diagnostic standard of care platform supports pipeline of opportunities, including blood test for MS, as well as NGS for other neuro-immune disease
• Payor, patient and clinical support compelling based on cost of misdiagnosis
• Initial CLIA regulatory pathway established, evaluating 510(k) / PMA pathway
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Blood based biomarkers for Alzheimer’s disease
Targeting the Investigational Use Only (IUO)Pharma Tx clinical trial market
w/ Biomarker Services
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A blood test for Alzheimer’s
• Acute need to identify early stage and prodromal AD
for clinical trials
• Needs to be cost effective and widely available
• Accuracy should be superior to clinical identification
of Alzheimer’s at every stage
– Current accuracy ~70%
• Ultimately needed to identify AD for payors to justify
drug therapy in MCI or earlier
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AD-P
AD-C
Biomarkers in Alzheimer’s Progression
25Modified from
R.A. Sperling et al. / Alzheimer’s & Dementia 7 (2011) 280-292.
Huge Unmet Need
• 1 in 9 Americans over 65 has AD
• 5.2 million Americans have AD
• 500,000 new diagnoses per year
• Severely misdiagnosed
• $200B costs in the U.S. health system
• 10% of healthcare budget
• Growing rapidly with aging population
• Key Unmet need: effective early diagnostic
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Patient Selection for AD Trials
• Pre-screening of patients to reduce pharma patient acquisition cost 30-40%
• Data generated will add validity to test while generating revenue
• Mechanisms of fundamental disease biology: Emerging Therapeutic Targets
• $150M IUO market opportunity dominated by PET imaging
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“The scientific community and the FDA believe that it is critical to identify and study patients with very early Alzheimer's disease before there is too much irreversible injury to the brain…It is in this population that most researchers believe that new drugs have the best chance of providing meaningful benefit to patients.”
Russell Katz, MD, Former Director of the Division of Neurology Products in the FDA's Center for Drug Evaluation and Research
Technologies to diagnose Alzheimer’s in the Blood
• Cell Cycle Dysregulation
– Impairment of G1/S checkpoint leading to cytokine up-regulation and intraneuronal ploidy can be evaluated in blood lymphocytes
• Lipidomics
– Elevated plasma concentration levels of certain lipids are predictive of phenotypic conversion from asymptomatic to MCI
• Exosomes
– High levels of amyloid and tau found in exosomes in blood samples are correlated with an Alzheimer’s diagnosis
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LymPro Test®
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Cell Cycle Regulation & Alzheimer’s
• Cell Cycle: brain lacks all machinery
• Cell Cycle Response to life and aging: triggered to re-enter the cell cycle
• Hypothesis: AD patients lack proper cell cycle regulatory machinery, leading to aberrant processing (healthy normal get returned to G0),
• Refined hypothesis: dysfunctional G1/S checkpoint allows process to proceed to S-phase where:
– Modification to APP excess Ab
– Over express kinases hyper pTau
• Potential also as pre-screen for PET
Gap-1
G1
Synthesis
S
Gap-2
G2
Mitosis
M
G0
quiescent
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A, tau and cell cycle events in AD
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Seward, M.E., et al. Amyloid- signals through tau to drive ectopic neuronal cell cycle re-entry in Alzheimer’s disease. J Cell Sci. 2013.
Hypothesis:
Tau is required for neuronal cell cycle re-entry triggered by A1–42 oligomers.
Material & Method:
• Primary mouse neuronal cultures
• Immunofluorescence microscopy, immunoblotting, BrdU incorporation
Cell Cycle and Lymphocytes
• LymPro test measures CD69 in lymphocytes after mitogenic
stimulation
• Mitogen stimulates lymphocytes to initiate cell division and they
express CD69 as early indicator of cell cycle entry
• AD lymphocyte expression of CD69 is down regulated following
stimulation compared to healthy control and other dementia
• Measure CD69 expression in key lymphocyte cell lines with flow
cytometry
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Published Clinical Results for LymPro Test®
• Alzheimer’s disease (AD) subjects have impaired immune response to mitogenic stimulation
• CD69 cell surface marker measures response in different lymphocyte sub-populations
• CD19+
• CD4+
• CD69 expression downregulated in AD subjects
• 2 independent peer-reviewed publications
• Stieler, JT et, Neuroreport 2001; 12(18):3969-3972
– AD vs. Healthy Normal (N)
• Steiler J et al, Neurobio Aging 2012 33: 234-341
– AD vs. N, AD vs. PDD, PDD vs. N
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HC=27AD=45
Stim
ula
tio
n In
de
x (=
CD
69
-sti
m/C
D6
9-u
nst
im)
CD4+ CD19+
Chart Review Study Methods (AAIC)
Original flow data utilized
Monitoring visits performed to clarify data relating to cohort designations
7-year patient record follow-up performed by Dr. Marwan Sabbaugh at Banner
Cohort designations and comparisons generated by L. Kirby, MD
Categorization (corrected)
AD vs. OD + Normal (N)
AD vs. N
AD vs. OD
Analysis methods
Summary info
ROC-AUCs with 95% CIs
Diagnostic performance parameters (sensitivity, specificity, FP rate, FN rate, PLR, NLR, OR) with Wilson Score 95% CIs
Dot/Box plots to compare values for OD versus AD and N
Algorithms developed FIO (circular logic due to low N)
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Summary info
Total N=44
N=18 AD
N=9 Normal
N=17 OD
Patients are males (n=27) and females (n=15) and 2
unknown gender, ranging from 59-89 years
(median=80). All are Caucasian except for one
American Indian.
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AD vs. N
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Parameter Result (95% CI)
AUC 0.852 (0.685-1.000)
Sensitivity 83.3 (60.8-94.2)
Specificity 77.8 (45.3-93.7)
FP Rate 22.2 (2.8-60.0)
FN Rate 16.7 (3.6-41.4)
PLR 3.8 (1.1-13.0)
NLR 0.21 (0.07-0.64)
OR 17.5 (2.4-129.5)
p=0.0034
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
Tru
e p
osit
ive r
ate
(S
en
sit
ivit
y)
False positive rate (1-Specificity)
ROC Plot
No discrimination
3MarkerScore;New AD vs. N
AD vs. OD
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Parameter Result (95% CI)
AUC 0.863 (0.732-0.993)
Sensitivity72.2 (49.1-87.5)
Specificity88.2 (65.7-96.7)
FP Rate 11.8 (1.5-36.4)
FN Rate 27.8 (9.7-53.5)
PLR 6.1 (1.6-23.3)
NLR 0.32 (0.15-0.68)
OR 19.5 (3.2-118.0)
p=0.0002
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1
Tru
e p
osit
ive r
ate
(S
en
sit
ivit
y)
False positive rate (1-Specificity)
ROC Plot
Nodiscrimination
7MarkerScore;New AD vs. OD
AD vs. OD – Cutpoint to increase sensitivity
-4
-3
-2
-1
0
1
2
3
4
0 1
7M
ark
erS
co
re;A
D v
s. O
D
AD
94.4% Sensitivity at 64.7% Specificity
Wilcoxon p=0.0002
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LP-002 Study Design
Primary Study Objective:
Replicate published work that shows separation of Alzheimer’s disease from Healthy Controls with LymPro (Version 1) and evaluate new conditions that may improve separation (Version 2)
• Enrollment: 140 patient – 71 Alzhimer’s and 69 healthy controls
• Entry criteria:
• Alzheimer’s = MMSE ≤ 26 (mild to severe)
• Healthy Control = MMSE ≥ 29
• Exclusion criteria:
• Autoimmune disorders
• Immune medications
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Methods
• Analysis generally followed § 6.2 of study protocol– Distributions of results (presented in Appendix)
– Demographics
– Medical histories and concomitant medications (Files in Box; too many levels to summarize)
– Univariate logistic regression and ROC analysis
• Determination of optimal cutpoint and calculation of performance parameters at that cutpoint (sensitivity, specificity, FP rate, FN rate, Odds Ratio, Positive and Negative Likelihood Ratios [PLR and NLR]) via construction of 2 x 2 contingency tables for those variables that display significant ROC-AUC
– Bivariate analyses as appropriate
– Correlations of continuous LymPro results with MMSE
– Correlations of continuous LymPro results with Total Cell Counts
– CBC distributions overall and individually for AD and HC
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Summary of ROC-AUCs
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NEW MARKER displays good discrimination power
%CD3+CD4+ displays good discrimination power
%CD3+CD8+ displays good discrimination power
%CD19+69+ displays good discrimination power
Variable PHA4 AUC PWM20 AUC PWM4 AUC
NEW MARKER 0.550 0.542 0.503
NEW MARKER 0.686 0.607 0.614
%CD3+ CD4+ 0.657 0.666 0.656
%CD3+4+69+ (as a % of 3+4+) 0.542 0.590 0.551
CD3+4+69+ Mean 0.605 0.551 0.578
%CD3+ CD8+ 0.569 0.569 0.572
%CD3+8+69+ (as a % of 3+8+) 0.606 0.650 0.615
CD3+8+69+ Mean 0.581 0.562 0.593
%CD19+ 0.578 0.568 0.584
%CD19+69+ (as a % of CD19+) 0.671 0.647 0.650
CD19+69+ Mean 0.557 0.670 0.557
% CD45+ CD14+ Monos 0.597 0.608 0.635
%CD14+69+ (as a % of CD14+) 0.554 0.689 0.603
CD14+69+ Mean 0.545 0.518 0.502
AUCs in bold and italic are significantly higher than random chance (0.500)
CD19+ has now replicated across 3 studies
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Highly statistically significant difference
Independent of disease stage
Valuable as a marker for pharmaceutical
clinical evaluation
Findings are independent of clinical stage
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Multivariate Model in process to support CLIA
– New highly significant marker discovered during study• Better understanding of cell cycle biology that is improving
predictive value of the assay
• Appears equally or more robust than CD19+
– Multivariate logistic regression and model building• Use of full N=140 to determine upper estimate of performance
(algorithm derived and applied to the same dataset)
• Training/Test set approach
– Training on 2/3 randomly chosen datasets (Column Shuffling method in JMP)
– Evaluation on remaining 1/3 of dataset
– 4 attempts made of backward selection as a sensitivity analysis to determine variance of performance as an effect of selection of AD and HC subjects in training and evaluation sets
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Fit-for-Purpose Analytical Validation at Icon
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Version 1 Validation at Icon
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Version 2 Validation at Icon
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Key Takeaways
Only diagnostic blood test in the marketplace for cell cycle dysregulation to support pharmaceutical therapeutic development programs: biomarker services
Clinical data published in 2 peer-reviewed journals, and internally confirmed
Distribution channel to support US/EU clinical trials at Icon Central Labs
Initial target market: ~$150M IUO market for pharma trials
Total commercial market opportunity: ~$3B
Upcoming Milestones
• First pharmaceutical biomarker customer sales
• CLIA Certification• CE Mark
• FDA pathway evaluation
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LymPro Test® for Alzheimer’s: Overview
Georgetown Assays
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Georgetown Findings
Received 27 August 2013; accepted 9 January 2014;
published online 9 March 2014;
20: 415-418, 2014; doi:10.1038/nm.3466
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• Defines “at risk” Neuropsychologically Normal Individuals that will Phenoconvert to aMCI/AD within 2-3 years in our study group
• The discovered and validated 10 lipid panel provides up to 90% specificity with a 90% sensitivity in predicting those at risk of developing prodromal or manifest AD
• Plasma lipidomics offers significant advantages in screening for preclinical AD, compared to neuroimaging or cerebrospinal fluid
– Familiar procedure, well tolerated by elderly
– Minimally-invasive
– Not time-consuming
– Less expensive than other current methods
• … not accurate enough for general screening test but possibly accurate enough for enriching subject groups for clinical trials
• Requires additional corroboration and assessments in larger, less homogenous populations (in progress)
Blood-based Approaches to Preclinical AD:GU Panel of 10 Plasma Lipids, therefore
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Our Findings
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• A variety of exosomes are found in blood plasma
• Surface proteins on exosomes allows ID of cell of origin
• NCAM and L1CAM (neuronal membrane markers) antibodies were used to separate “neurally-derived” exosomes from others in plasma and allow assessment of their specific protein cargo via ELISA
• RESULT – “Neurally-derived” exosomes carry many of the altered AD proteins (A, Total tau, tau-181, and tau-396) previously used as criteria for AD via spinal fluid assessments…or on neuroimaging studies…or on brain biopsies…but now without the need for a spinal tap, PET scan, or brain specimen
“Blood-based brain biopsy”
Blood-based Approaches to Preclinical ADNeurally-derived Exosomes
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• What new information can blood-based biomarkers provide regarding how AD develops?
– Dysregulated proteins previously seen in brain and CSF can now be assayed in “neurally-derived” exosomes and used to accurately predict preclinical and clinical AD, differentiate AD from FTD, and allow monitoring of progression AD stages
Blood-based Approaches to Preclinical AD
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• University of Rochester Mark Mapstone William J. Hall Susan G. Fisher Derick R. Peterson James M. Haley Michael D. Nazar Steven A. Rich Anthony Almudevar Eileen Johnson Pamela Bailie
• Georgetown University
Amrita K. Cheema
Rajbir Singh
P. Kaur
Xiaogang Zhong
Ming T. Tan
Timothy R. Mhyre
Linda H. MacArthur
Robert M. Padilla
Ishmeal Conteh
Jamie McCann
Danielle Phelps
Ruth Chia
Michael Orquiza
Yuriy Gusev
Krithika Bhuvaneshwar
Lei Song
Subha Madhavan
Liang Huong
Juan Wang
Xiaomin Su
Li Quingliang
Salim Shah
Carole Roan Gresenz
Kevin FitzGerald
Massimo S. Fiandaca
Howard J. Federoff
Rochester/Irvine/Georgetown Aging Study Collaborative Group
• UC Irvine Claudia H. Kawas Dan J. Berlau Carrie B. Peltz Dana Greenia Mukti Patel Archana Balasubramanian
55Funded by: NIH: R01 AG030753 and DOD: W81XWH-09-1-0107
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Near-term Milestones Expected to Build Significant Momentum
Event Q4/14 -Q1/15 Q2-2015
Strengthen Management Team
Strengthen Board of Directors
MANF: Feed back from FDA on ODD
MANF: File ODD for RP in Europe
MANF: Initiate GMP Manufacturing
LymPro: Fit-For-Purpose assay validation
LymPro: Full Data Set from 140 patients
LymPro: Spinoff
Eltoprazine: IND submission
Eltoprazine: Initiate Phase 2b clinical trials
ESS-W: Initiate Phase 2 clinical trial
Financial Snapshot
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Stock Ticker OTCQB: AMBS
Market Capitalization as of January 14, 2015 $79M
Raise from Series E Financing (Nov 2014) $6M
Funding available from equity financing facility $17M
Preparing for Listing on to NASDAQ
Investment Summary
Diagnostics Division – Mature and ready to become standalone
• MSPrecise for early and accurate diagnosis of MS
• Alzheimer’s blood based biomarker suite: cell cycle, lipids, exosomes
Eltoprazine: Phase 2b-ready small molecule for PD LID
• Over 680 patients dosed to date, with strong safety profile
• Phase 2b initiation in process
ESS-W: Life-saving treatment for severe burns
• Orphan drug designation granted
• Phase 2 initiation in Q2/2015
MANF unique biology for multiple indications
• Positive Data in Retinitis Pigmentosa (Orphan)
• Orphan Drug Designation application in process
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Diagnostic and therapeutic products in the areas of neurology, psychiatry, ophthalmology and regenerative medicine
Amarantus Diagnostics
Biotech Showcase 2015Gerald E. Commissiong
President and CEO
OTCQB: AMBS