company presentation - mologen ag · 2018-12-13 · this presentation is not an offer of securities...
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COMPANY PRESENTATION NOVEMBER 2016
www.mologen.com
Disclaimer
2
Certain statements in this presentation contain formulations or terms referring to the future or future developments, as well as negations of such formulations or terms, or similar terminology. These are described as forward-looking statements. In addition, all information in this presentation regarding planned or future results of business segments, financial classification numbers, developments of the financial situation, or other financial or statistical data contains such forward-looking statements. The company cautions prospective investors not to rely on such forward-looking statements as certain prognoses of actual future events and developments. The company is neither responsible nor liable for these forward-looking statements. It is not responsible for updating such information, which only represents the state of affairs on the day of publication.
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Agenda
3
Business overview and “Next Level“ strategy 4
TLR9 agonist product family: Lefitolimod (MGN1703) 9
Market 14
TLR9 agonist product family: EnanDIM® 17
Key milestones 18
Appendix 19
MOLOGEN summary highlights
4
• New management with clear commercial focus and strong track record of previous successes
• Leading German research player transitioning to global market ready company • Strong value-creative pipeline with lead product lefitolimod in two late-stage
trials & two earlier clinical programs as well as follow-up compounds being qualified for trials in man
Advanced immunotherapy
player
• Lefitolimod has the potential to re-activate the immune system • Monotherapy potential in oncology as well as infectious diseases • Combination therapy potential augmenting other existing effective treatments
Safe & well tolerated lead
product
• mCRC (phase III): sizeable market; immunogenic disease • SCLC (phase II): highly lethal; limited treatment advances; short timelines • Combination treatment in solid tumours (phase I): broad market opportunity
including for collaborations • HIV (phase I): potential to eradicate rather than manage infection
Multi-billion dollar target markets
• Advance clinical development of Lefitolimod • Progress follow-up compounds • Adjust organisation to late stage development needs (esp. manufacturing scale-up) • Propel outlicensing activities
Value-creative milestones ahead
Legend: HIV human immuno-deficiency virus | mCRC metastatic colorectal cancer I SCLC small cell lung cancer
New Executive Board: Clear commercial focus & successful track record
5
Dr. Mariola Söhngen, CEO Walter Miller, CFO
29 years biotech industry and corporate leadership experience as founder and former MOB of Paion
15 key successful out-licensings at Paion across the globe
21 years industry as well as financial expertise from leadership positions at Nuvisan and Santhera Pharmaceuticals AG
Successful IPO of Santhera
• Former MOLOGEN leadership successfully focused on the scientific advancement of the company and its products
• New MOLOGEN management brings long-term experience and is focusing on gearing Mologen towards the commercialisation of its development programs
• Value creating projects are being forcefully pursued and key intellectual capital is being retained
Legend: MOB Member of Board
Next Level Strategy: Transition to commercial enterprise
6
Research driven
Market-facing
History
Focus on basic research • Broad pipeline
comprised of three technology platforms
• Own in-house R&D-scale production (trials fully stocked)
Focus on commercial activities • Pipeline focus on lead
compound & follow-up • Streamlined structure,
operational efficiency • Structured partnering/
licensing activities • US strategy being defined
Harvest lefitolimod potential • Enable commercial-
scale production; transition to CMO
• Focus research on follow-up compounds; transition to CRO
• Reduce headcount while retaining expertise
• Enhance flexibility of cost structure
Today Outlook
“Next Level”
Advanced immunotherapy pipeline: Late-stage lefitolimod & follow-up EnanDIM®
7
Indication(1) PC Ph1 Ph2 Ph3 Timeline(2) Exclusivity(3)
Metastatic colorectal cancer (mCRC)
LPI: ’16/’17 Data: ’19 Filing: ’19/’20
EU: 2030 US: 2028
Small-cell lung cancer (SCLC)
Data: ’17 EU: 2030 US: 2028
Advanced solid malignancies (+ ipilimumab)
LPI: ‘18 Data: ’19
EU: 2036 US: 2036
Human immunodeficiency virus (HIV)
LPI: ‘16 Data: ‘17
EU: 2036 US: 2036
Cancer/ infect. Diseases
Pre-clinical
EU: 2035 US: 2035
Renal cell carcinoma (RCC)
Ph I / II data available On hold
EU: 2036 orphan drug status US: 2038
Lefit
olim
od
Enan
DIM
M
GN
1601
Legend: PC Pre-clinical | PH Phase | LPI last patient in • Notes: (1) Pipeline overview excludes MIDGE platform. | (2) Timeline Denotes latest estimated timeline of upcoming milestones. | (3) Exclusivity Denotes estimated minimum market exclusivity horizon based on patent and data protection
IMPALA (MGN)
IMPULSE (MGN)
TEACH (Aarhus)
MD Anderson
ASET (MGN)
Cancer immunotherapy value proposition: Improve long-term overall survival Traditional chemotherapy Immunotherapy
8 Source: "Immuno-oncology: The new weapon in the war against cancer”, Alistair Campbell; Berenberg Equity Highlights, February 2014. Legend: OS overall survival
Immunotherapy
Control group
time
Patients alive in %
Control group
Chemotherapy
time
Patients alive in %
• Fast effect in many patients • Effect not lasting
• Needs time to be effective • Long-lasting effect in a subgroup
of patients
Immunotherapies target improving OS at the long end of the curve
Safe & well tolerated lead product: “Best in class“ TLR9 agonist
9
• Immunologic activation and good safety profile due to molecular composition
– Safety established in ~400 patients to-date
• High dosing over long periods of time – as required to trigger clinical benefit – possible without major toxic effects
• Clinical strategy optimized for lefitolimod TLR9 activation pattern
Light blue area: Motifs recognized by TLR9 receptor
Lefitolimod is geared to success given its combination of safety & tolerability by design with large potential for clinical benefit
Molecular structure Commentary
Safe & well tolerated lead product: Mechanism of action in oncology
10
• The patient’s immune system generally polices the development of cancer cells − occasionally, cells evade that system, developing into cancer
• Lefitolimod reactivates the patient’s own immune system for anti-cancer surveillance • Lefitolimod can work safely alongside other treatments leveraging the body’s own
immune surveillance system
Legend: mDC myeloid dendritic cell I NK cell natural killer cell I NKT cell natural killer T cell I pDC plasmacytoid dendritic cell
Safe & well tolerated lead product: Mechanism of action in HIV
11
• Patients on ART are cleared from actively infecting HI virus, but T cells keep the virus in its latent stage (no immune response against the virus)
• Lefitolimod as “kick & kill” agent kicks the virus from latency into active infection, and reactivates immune surveillance to kill infected cells by NK cells and CTL
Legend: ART anti-retroviral therapy | HIV human immuno-deficiency virus | pDC plasmacytoid dendritic cell | mDC myeloid dendritic cell | NK cell natural killer cell | CTL cytotoxic T lymphocytes
Safe & well tolerated lead product: Combination therapies represent the next opportunity
12
• Combination treatments aim to combat a disease through various synergistic ways
• Expected to play integral role in future new immunotherapy approaches or breakthrough outcomes
• Increased research – and business development – across the market
• Lefitolimod uniquely positioned as potential “combination partner of choice”
Immunotherapy
Control group
time
Patients alive in %
Combination therapies are the latest advancement in the fight against several global diseases including cancer & HIV
Combination therapies
Combination therapy potential Commentary
Source: "Immuno-oncology: The new weapon in the war against cancer”, Alistair Campbell; Berenberg Equity Highlights, Feb 2014
Multi-billion US$ markets in oncology: Strong fundamentals and significant unmet needs
13
WW Prescription Drugs1 WW Oncology Drugs1
2014 2020
743
987 CAGR +4.8%
2014 2020
79
153 CAGR +11.6%
Colorectal Cancer2 Lung Cancer3 SCLC4
8.3 9.4
2013 2020
CAGR +1.8%
4
13
2010 2020
CAGR +12.5%
0.2
2.3
2014 2024
CAGR +27.7%
• Oncology is expected to be among the largest and fastest growing therapeutic areas worldwide
• Cancer immunotherapies represent a huge market potential: ~US$ 35 bn
Sales in US$ bn
Source: 1EvaluatePharma 2015 | 2ResearchandMarkets Jan 2015 (5 EU, US, Japan & Canada) | 3MarketsandMarkets Nov 2011 (G7 Countries) | 4GlobalData, Jan 2016 (5 EU, US, Japan) | Legend: CAGR Compound Annual Growth Rate
AIDS-related deaths (in million) People living with HIV on ART (in million)
• Better diagnostics • Improved treatment regimens • Price reductions of medicines
• Growing patient population • ART represents no cure • Patients remain infectious
Multi-billion dollar markets in HIV: Increasing number of patients living with HIV
14
<1
17
30
2000 2015 2020
Source: UNAIDS; “Global AIDS Update” (worldwide), 2016 | ART antiretroviral therapy
1.5
1.1
<0.5
2000 2015 2020
• People living with AIDS have opened a market for drugs like Lefitolimod • Eradicating HIV would prevent risks of further transmission and of viremia,
while improving QOL
15
MOLOGEN is developing its lead compound in various directions
Lefitolimod (MGN1703)
• Pivotal multicenter (122) EU (8 countries) study “IMPALA” • Status: started Sep-14 targeting 540 patients • Patient recruitment on track • Aims: to compare OS vs. local gold-standard treatment &
to enable regulatory approval • Targets(1): read-out ~early 2019, filing ~late 2019
mCRC: Phase III
• Multicenter (41) EU (4 countries) study “IMPULSE” • Status: started Mar-14 with recruitment of 100 patients
completed Oct-15 • Aims: to compare OS vs. local gold-standard treatment,
to inform development pathway in SCLC, to further support safety data base
• Target(1): read-out ~early 2017
SCLC: Phase II
• Two-stage single-center (DEN) “TEACH” trial – Aarhus Univ. Hospital
• Status: started Jun-2015 – Stage 1 successfully
completed (15 patients) – Stage 2 first patient Jun-
2016 (target: 15 patients) • Aim: to define value in kick
and kill concept in HIV / infectious diseases
• Target: read out 2017
HIV: Phase I • Single-center (US) proof-of-
concept trial combining lefitolimod with checkpoint inhibitor ipilimumab (Yervoy®) – MD Anderson – 50-60 patients envsiaged
• Status: started Jul 2016 (first patient in)
• Aim: to inform development pathway in combination treatments
• Target: read-out 2019
Solid tumours: Phase I
Multi-billion dollar markets: ongoing clinical trials
Legend: HIV human immune deficiency virus | mCRC metastatic colorectal cancer | SCLC small cell lung cancer Note: (1) Subject to actual overall survival (amongst others).
Legend: EnanDIM® Enantiomeric DNA-based ImmunoModulator | DNA sequence essential for function (so-called “CG motifs”) | new structural feature in EnanDIM providing protection against degradation | phosphorothioate backbone (chemical modification)
Follow-up platform EnanDIM®: Next generation TLR9 agonists
16
• Linear molecules – Simple cost-effective
production • Stability through chemically
modified structure – Usually unfavorable risk /
benefit ratio
Linear DNA-structure
• Stability through closed, dumbbell-shaped structure – Production complexity
• Only natural DNA components – Good safety and
tolerability profile
Lefitolimod EnanDIM®
• Linear molecules; stability through specific feature – Simple cost-effective
production • No chemical modifications
– Good safety and tolerability profile expected
• New family of linear TLR9 agonists, combining safety of molecules containing only natural DNA components with simple production process of linear molecules – Allow drug differentiation on molecular level
• Broad immune activation and anti-tumor effect shown in pre-clinical models • Potential application in cancer and in anti-infective therapies
Near-term Value Inflexion Points: Progress of clinical programs and market readiness
17
Program Inflection point Timeline
mCRC • IMPALA patient recruitment completed ‘16/’17
SCLC • Results of randomized IMPULSE trial ’17
HIV • Results of TEACH trial ’17
Commercial-scale production • Technical transfer of production to third party ’17
Legend: mCRC metastatic colorectal cancer | SCLC Small-cell lung cancer | Timeline Denotes latest estimated timeline of upcoming milestones
Appendix
18
Lefitolimod mechanism of action 20
Lefitolimod ongoing clinical trials overviews 23
Lefitolimod Phase II data mCRC 35
Oncology competitive landscape 40
MGN1601 RCC clinical trial overview 42
Financial information 48
Shareholder structure & IR calendar 50
19
Days Weeks
Innate Cellular
cancer cell
Radiation or Chemotherapy
Adaptive Cellular
B cells
Adaptive Humoral
Weeks to Months
pDC
mDC
monocytes
NK
NKT
ADCC
Lefitolimod (MGN1703)
cytotoxic T lymphocytes
TAA, TSA
Lefitolimod: Oncological mode of action (1/3)
Lefitolimod: Oncological mode of action (2/3) Immune surveillance reactivation (ISR)
20
Lefitolimod: Oncological mode of action (3/3)
21 Legend: ADCC antibody dependent cell-mediated cytotoxicity | BCR B cell receptor | mDC myeloid dendritic cells | MHC Major histocompatibility complex | NK cell natural killer cell | NKT cell natural killer T cell | pDC plasmacytoid dendritic cells | | TAA tumor associated antigens | TCR T cell receptor
mCRC program: phase III (ongoing) pivotal IMPALA study
22
• Primary endpoint overall survival (OS) • Open-label, randomized, controlled, two-arm, multinational phase III trial • 540 patients in around 120 sites in eight European countries, including Top
5 European pharma markets • Biomarkers used as stratification factors: CEA level and NKT activation
PD
Lefitolimod (MGN1703)
Trial Treatment Period
Re-Induction
Induction CT 12–30 weeks
Standard first-line
CT for mCRC
PR/CR Responder
Screening/ Randomization
1:1 Control group PD
Lefitolimod (MGN1703)
with induction CT
Induction CT
PD
Start of 2nd line
PD
Legend: CEA carcinoembryonic antigen - a tumor marker for colorectal cancer | CT chemotherapy | CR complete response | mCRC metastatic colorectal cancer | NKT Natural Killer T cells | PD progressive disease | PR partial response
Maintenance
IMPALA: Inclusion & exclusion criteria
23
PD
Legend: CT computed tomography | ECOG eastern cooperative oncology group | RECIST response evaluation criteria in solid tumors | UICC union for international cancer control
Main inclusion criteria • Histologically confirmed colorectal cancer with unresectable stage IV (UICC) disease (primary
tumor may be present) • Complete or partial response (according to RECIST 1.1), within 12-30 weeks from start of
induction treatment with standard first-line chemotherapy with or without biological agents • ECOG performance status 0 or 1
Main exclusion criteria
• History of other malignant tumors within the last 5 years, except basal cell carcinoma or curatively excised cervical carcinoma in situ
• Known brain metastases (present or treated) • Prior allogenic stem cell transplantation or organ transplantation • Active or uncontrolled infections or undiagnosed febrile condition • Pre-existing autoimmune or antibody mediated diseases or immune deficiency • Inadequate pulmonary function according to the investigator’s judgment, history of interstitial
lung disease e.g. pneumonitis or pulmonary fibrosis or evidence of interstitial lung disease on baseline chest CT scan
IMPALA: Statistical considerations
24 Legend: OS overall survival | w/o without
PD
Median OS comparator
[months]
Median OS treatment [months]
Hazard ratio Events needed [#]
Sample size (w/o drop-
out)
Comments
22 29.5 0.75 365 506 Assumption of 10% drop-out (by month 10 per patient) implies sample size of 540
540 patients planned sample size (270 per arm); 365 events required for analysis • Two-sided stratified log-rank test at a 0.05 significance level • Targeted power for superiority in OS of 1–β = 0.80% with targeted hazard ratio (HR)
of 0.75 Assumptions: • Median OS of 29.5 months from randomization in experimental arm vs. 22 months
from randomization in control group, with the gain in OS deemed clinically relevant • Proportional hazards and exponential distributions • Key variables at α=0.05 and power of 80% (two-sided log-rank) (original protocol
calculation):
IMPALA: Secondary endpoints
25
• Overall survival (OS) from induction start; OS rates • Progression-free survival (PFS) on study treatment, until first
progressive disease (PD), after re-introduction, and after first-line treatment; PFS rates
• Overall response rate (ORR) after randomization • Toxicity and safety profile of lefitolimod (adverse events (AE)) • Quality of Life (QoL) and patient-reported outcomes • Translational research - Immunological analyses of patient samples
during follow-up (e.g. immune cell activation, cytokine levels)
Legend: AE adverse events | ORR overall response rate | OS overall survival | PD oprogressive disease | PFS progression-free survival | QoL quality of life
SCLC program: Phase II (ongoing) randomized IMPULSE study
26
• Primary endpoint overall survival (OS) • Randomized, controlled, two-arm, multinational trial with 100 patients in
Belgium, Austria, Germany and Spain • Biomarkers used as stratification factors: NSE level and NKT activation • Patient enrollment completed
PD
Trial Treatment Period
Maintenance
Induction CT 4 cycles of
platinum-based therapy
Standard first-line CT for extensive disease SCLC
PR/CR Responder
Screening/ Randomization
3:2
Experimental Group: 5th cycle of platinum based CT followed by lefitolimod (MGN1703) maintenance
Control Group: 5th cycle of platinum
based CT followed by local practice
PD
PD
Start of 2nd line
Legend: CR complete response | CT chemotherapy | NKT Natural Killer T cells | NSE neuron specific enolase - a tumor marker for lung cancer | PD progressive disease | PR partial response | SCLC small cell lung cancer
IMPULSE: Main inclusion and exclusion criteria
27 Legend: CR complete response | CT chemotherapy | NKT Natural Killer T cells | NSE neuron specific enolase - a tumor marker for lung cancer | PD progressive disease | PR partial response | SCLC small cell lung cancer | ECOG eastern cooperative oncology group
Main inclusion criteria • Extensive disease SCLC confirmed by a pathologist, on the basis of histology of SCLC
or mixed histology of SCLC, or a cytological diagnosis if histology cannot be obtained • Completion of 4 cycles of first-line therapy with a platinum-based regimen and no other
prior chemotherapy • Documented evidence of tumor response (PR or CR) as assessed by the investigator at
the end of the fourth cycle of platinum-based first-line chemotherapy using CT or magnetic resonance imaging (MRI) scan
• ECOG performance status 0 or 1 Main exclusion criteria • Prior or current other malignancy, except adequately treated superficial bladder cancer,
basal or squamous cell carcinoma of the skin, or other cancer for which the patient has been disease free for more than 3 years
• History of carcinomatous meningitis • Prior or current paraneoplastic syndrome related to SCLC • History of autoimmune disease or immune deficiency
IMPULSE: Secondary endpoints
28
PD
Legend: OS overall survival | PFS progression-free survival | RECIST response evaluation in solid tumors | irRC immune-related response criteria | AEs adverse events
Efficacy • OS from the start of the first cycle of induction chemotherapy (OS1) • Progression-free survival (PFS) from the date of randomization with progression
assessed by response evaluation in solid tumors (RECIST) 1.1 and immune-related response criteria (irRC)
• PFS from the start of the first cycle of induction chemotherapy (PFS1) assessed by RECIST 1.1 and irRC
• Best objective response rate (ORR) with clinical response assessed by RECIST 1.1 and irRC
• Quality of life measured by Lung Cancer Symptom Scale at every staging • Treatment outcome correlation of predefined biomarkers and immune parameters Safety • Safety profile of MGN1703 in terms of the incidence of adverse events (AEs) graded
according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTC Version 4.03)
• Autoimmunity of MGN1703 in terms of antinuclear antibodies
29 Legend: SCLC small cell lung cancer | HR hazard ratio | mOS median overall survival | vs versus
• Patients with extensive disease SCLC after response to platinum-based chemotherapy are expected to have a median OS of about 9 months with currently available treatment options
• 100 patients • The number of events observed after an additional follow-up of 12 months will have the
power to detect a difference between the 2 treatment arms according to the following table (1-sided alpha of 0.025):
IMPULSE: Statistical considerations
Safe & well tolerated lead product: Mode of action in HIV
30
• Patients on ART carry the HI virus which is suppressed by the therapy and invisible to the immune system (latent infected cells)
• Lefitolimod “kick & kill” approach triggers viral particles to “unhide” so they can be eradicated by the immune system which is also activated by lefitolimod
KICK via latency reversal
KILL via anti-retroviral therapy
KILL via activated cells
(NK/CD8)
KICK via immunomodulation (activation of pDC)
Legend: LRA latency-reversal agent | ART anti-retroviral therapy | NK cell natural killer cell I pDC plasmacytoid dendritic cell
31
• Collaboration agreement with Aarhus University Hospital, DK • First trial of lefitolimod (MGN1703) in HIV patients • Aarhus University Hospital conducts the trial; MOLOGEN provides
lefitolimod (MGN1703); funding received from the American Foundation for AIDS research (amFAR)
• Extension phase: More patients to be treated for 6 months based on broad activation of immune system induced by lefitolimod as shown in first phase – Activation of plasmacytoid dendritic cells (pDC), natural killer cells (NK)
and T cells in HIV patients during the antiretroviral therapy (ART) – Lefitolimod (MGN1703) could play a role in “kick &and kill‘‘ concept of
HIV eradications – First patients of extension phase enrolled
• Final results expected in mid-2017
HIV program: Phase I (ongoing)
The HIV program explores potential expansion of applications of lefitolimod (MGN1703)
Legend: ART antiretroviral therapy | HIV human immuno-deficiency virus | NK cells natural killer cells| pDC plasmacytoid dendritic cells
Combination program: Phase I (ongoing) lefitolimod (MGN1703) and ipilimumab (Yervoy®)
32
• Collaboration with MD Anderson Cancer Center, Texas, US • First combination trial of lefitolimod (MGN1703) with checkpoint inhibitor,
commercially available ipilimumab (Yervoy®), manufactured by Bristol-Myers Squibb Co.
• MD Anderson Cancer Center conducts the trial; MOLOGEN provides lefitolimod (MGN1703) and funding for the trial
• Phase I trial in 50-60 patients with advanced solid malignancies, mainly melanoma
The combination program explores further potential expansion of applications of lefitolimod (MGN1703)
Study outline • Open-label, single site, phase I trial • Patients with advanced solid tumors • Primary endpoints: Safety, toxicity, MTD, and DLTs of combination therapy; dose finding for phase 2 • Dose escalation part followed by three expansion cohorts:
• Dose escalation: Six lefitolimod dose levels (3.75 – 120 mg) with up to 6 patients per dose level to find MTD; • Once MTD is determined, patients will be enrolled in three expansion cohorts (5-12 patients each) at this dose to further
define this dose and to help determine biological endpoints. • Expansion Cohorts (Malignancy / Variable): (1) Melanoma / lefitolimod SC; (2) Melanoma / lefitolimod IT; (3) Advanced
malignant diseases / recent radiation to tumor
Treatment Course • Lefitolimod (MGN1703) administered weekly, SC (dose escalation and 2 expansion cohorts) or IT (one expansion cohort) • ipilimumab always administered at 3mg/kg IV every 3 weeks • Patients will receive treatment for 4 cycles – a total of 12 weeks • Treatment will be discontinued in case of disease progression • If patients demonstrate stable disease or a response, they will be eligible to continue to receive lefitolimod for up to a year
33
Combination trial: Lefitolimod (MGN1703) and ipilimumab (Yervoy®)
Legend: MTD maximum tolerated dose | DLT dose limiting toxicities | SC subcutaneous | IT intratumoral | IV intravenous
mCRC program: Phase II (completed) IMPACT study design
34
Trial Treatment Period
*at investigators’ discretion
Maintenance
Induction CT 4.5-6 months
mCRC patients treated first-line with FOLFOX /
XELOX or FOLFIRI +/- bevacizumab*
At least SD
Experimental Group: 60mg lefitolimod (MGN1703)
twice weekly s.c.
No maintenance Placebo
Twice weekly s.c.
Screening / Randomization
2:1
PD**
PD**
** Treatment after PD at investigators’ discretion
• Primary endpoint: progression-free survival • Double-blind, randomized, placebo-controlled, two-arm, multinational phase
II trial with 59 mCRC patients • Start: June 2010 • Primary completion date: February 2013
Legend: CEA carcinoembryonic antigen - a tumor marker for colorectal cancer | CT chemotherapy | mCRC metastatic colorectal cancer | NKT natural killer T cells | PD progressive disease | s.c. subcutaneous injection | SD stable disease
mCRC program: Phase II (completed) primary endpoint suggests efficacy
35
• PFS from start of maintenance (local assessment)
• ~ 10% long-term responders
Legend: CI confidence interval | HR hazard ratio | mPFS median progression-free survival
Final results MARCH 2013
4 progression-free patients still on treatment at end of study
MGN1703 (n=43)
Placebo (n=16)
mPFS [95% CI]
2.8 months [2.8-4.1]
2.6 months [2.5-2.8]
HR=0.55 [95% CI: 0.3-1.0]
mCRC program: Phase II (completed) IMPACT key take-aways (1/2)
36
• Primary endpoint met:
– progression free survival (HR 0.55, p= 0.04)
• Secondary endpoint “Overall Survival“:
– median OS 22.6 months (lefitolimod (MGN1703)) vs. 15.1 months (p=ns),
– in subgroup (relevant patients for phase III: responders (PR, CR) to induction
chemotherapy):
median OS 24.5 months (lefitolimod (MGN1703)) vs. 15.1 months (p=0.069)
• Predictive biomarkers identified:
– tumor reduction by induction therapy
– normalized CEA level
– presence of activated NKTs
Legend: CEA carcinoembryonic antigen - a tumor marker for colorectal cancer | HR Hazard Ratio | NKT Natural Killer T cells | ns not significant
mCRC program: Phase II (completed) IMPACT key take-aways (2/2)
37
• Long-term treatment with lefitolimod
– Follow-up of four patients who continued MGN1703 monotherapy in
compassionate use programs since no relapse at end of study:
• 3 patients progression-free in excess of 58 months as of June 2016
• Excellent safety and tolerability, also when treated long-term
Legend: CEA carcinoembryonic antigen - a tumor marker for colorectal cancer | HR Hazard Ratio | NKT Natural Killer T cells | ns not significant
Findings from subgroup analyses were used to optimize the phase III study design
mCRC program: Phase II (completed) IMPACT sustained efficacy
38
April 2010: Patient 049 – Initial diagnosis • Colon carcinoma with multiple liver metastases December 2010: After induction chemotherapy • 06/2010 - 11/2010: 9 courses of CT (FOLFIRI) +
bevacizumab (biologic) • 12/2010: Response to induction CT: PR*
March 2015: Under maintenance therapy • Since 12/2010: Lefitolimod (MGN1703) maintenance
therapy • New PR(1) after 9 months • Still ongoing PR • Good medical condition, mild local skin reactions, no
further severe toxicities
Legend: CT chemotherapy | PR partial response • Note: (1) Confirmed by two independent radiologists.
Competitive landscape oncology (1)
39 Note: (1) Mostly in mCRC; limited competing developments in SCLC Legend: mCRC metastatic colorectal cancer I SCLC small cell lung cancer I Mab monoclonal antibodies
Today
mCRC SCLC
• Chemotherapy (FOLFOX, FOLFIRI) + biologicals (“Mab”: anti-VGEF or anti-EGFR)
• Chemotherapy
Future
Various approaches in trials (examples)1
• Checkpoint inhibitors (CTLA4, PD1, PD-L1, …)
• TLR agonists • Cell therapies • Vaccines (tumor cell or antigen
based)
Indication-specific competition first-line mCRC & SCLC
Lefitolimod has potential to differentiate by long-term efficacy, good tolerability, and high safety
Competitive landscape oncology (2)
40
Pharmaceutical class competition, TLR9 agonists across indications:
• Lefitolimod is the sole TLR9 agonist in phase III development in oncology
– Dynavax, US: SD-101, phase II NHL & phase II melanoma
– Idera, US: IMO-2125, phase II melanoma
– Oligovax, France: Litenimod, phase II glioblastoma multiforme
– Innate, France: MIS416, phase II MS; oncology indications preclinical
– Checkmate, US: CMP-001, phase I melanoma
• Index, Sweden: Kappaproct, the sole other TLR9 in phase III development across indications, however in ulcerative colitis with no disclosed development in oncology
– BiolineRX, Israel: BL-7040 is in phase II against ulcerative colitis & in phase II
against IBD
Source: EvaluatePharma, company websites, Aug 2016 I NHL non-Hodgking’s lymphoma
MGN1601: Therapeutic cancer vaccine: Shipped off the shelf
41
MGN1601: Cell-based cancer vaccination available off the shelf
42
Either single or small number of tumor antigens as peptides, loaded dendritic cells, or clonally selected cell lines; HLA-restricted response selects against tumors not expressing the antigen(s), and thereby driving immune evasion of the tumor
Introduced tumor antigens may not be processed & presented in a natural way
Long and challenging manufacturing process of autologous approaches, individually for each patient
Only moderately immunogenic vaccines (clonal tumor cells, “loaded” dendritic cells), lacking sufficient co-stimulatory signals, use of weak adjuvants
Improved properties to conventional cell-based cancer vaccination strategies
Not clonally selected, allogeneic tumor cell line presents an abundance of broadly recognized key tumor antigens, thereby preventing immune evasion
Unique, allogeneic tumor cell line with naturally processed and presented antigens
GMP-production process in place, batch production and storage established, off the shelf shipment
First 4-fold gene-modified cell-based vaccine expressing co-stimulators (CD80, CD40L) and cytokines, (GM-CSF, IL-7) to enhance immune recognition, potent TLR9 agonist reactivates immune surveillance
Limitations of previous cell-based cancer vaccines
Solution provided by the MGN1601 tumor vaccine
ASET Trial with MGN1601: Promising data
43
Phase I/II study (12/2010 – 08/2013) • Open-label, proof-of-principle, multi-center phase I/II trail • 19 patients with advanced renal cell carcinoma who failed prior systemic
therapies • Primary endpoint met: Favorable safety and tolerability profile • Promising overall survival data in subgroup of patients • Improved function in patient‘s immune cells • Identification of potential biomarkers
ASET trial with MGN1601: Study design
44
TPP Extension phase
Patients with
advanced renal cell cancer
No standard therapy
available
Trial inclusion
8 applications of MGN1601
in 12 weeks i.d.
DC Max. 5
applications in week 24, 36, 48,
72 and 120
Trial Treatment Period
SD PD**
PD**
** Treatment after PD at investigators discretion 8 applications
of MGN1601 in 12
weeks i.d.
• Primary endpoints met: safety and tolerability • Open-label, proof-of-principle, multi-center phase I/II trial • 19 patients with advanced renal cell carcinoma who failed prior systemic therapies • Orphan drug designation from EMA • Start: December 2010 – primary completion date: August 2013
Legend: SD Stable disease | EMA European Medicines Agency | i.d. intradermal injection | PD progressive disease | TPP Treatment per protocol
ASET trial with MGN1601: Study results (1/2)
45
• Overall survival benefit – ITT group (19 patients): all patients who received at least one vaccination – PP group (10 patients): patients received eight vaccinations within twelve weeks
as planned – Non-PP group (9 patients): patients dropped out before finalizing the 12 weeks
course of treatment
Legend: ITT intent-to-treat | OS overall survival | PP (treatment) per-protocol
46
• Median OS: – 24.8 weeks (ITT group) vs. 115.3 weeks (PP group)
• Potential biomarker identified: – MSKCC Score & NLR may have predictive value for longer overall survival (OS) – First evidence of cytotoxic antitumor immune response after MGN1601
vaccination (in patient subgroup) – Significant improvement of cellular immune function during treatment (in patient
subgroup) • Two patients had no progression after 12 weeks and continued treatment:
– One patient with stable disease progressed after 48 weeks – One patient had sustained partial response for over 120 weeks
ASET trial with MGN1601: Study results (2/2)
Legend: MSKCC Memorial Sloan–Kettering Cancer Center | NLR neutrophil-lymphocyte ratio | OS overall survival
Shares
47
• ISIN DE0006637200 • Shares issued: 33,947,251 • Market capitalization ~ €50 m (November 2016) • Frankfurt Stock Exchange (Prime Standard): MGN I Reuters: MGN.DE
29%
5% 4%
4% 3%
55%
Global Derivative Trading GmbH
Deutsche Balaton Aktiengesellschaft
Baloise Holding AG
Deutscher Ring Krankenversicherungsverein a.G.
IPConcept (Luxemburg) S.A.
Freefloat
IMPULSE Start Primary analyses (OS)
BIO-Europe 2016, Cologne
Upcoming events 2016
48
ESMO IO, Lausanne
Scientific Conferences Financial Reporting Investor Conferences Clinical Trials
EKF, Frankfurt
Q3
SITC US, New Harbour
December
Legend: ICIC SITC Society for Immunotherapy of Cancer | EKF Eigenkapitalforum
November
COMPANY PRESENTATION NOVEMBER 2016
www.mologen.com