Presentation of Robert Ang (Bavarian Nordic)

BAVARIAN NORDIC
BIO DEUTSCHLAND PRESENTATION
OCTOBER 2014
CSE/OMX:BAVA, OTC:BVNRY
This presentation includes "forward-looking statements" that involve risks, uncertainties and other
factors, many of which are outside of our control, that could cause actual results to differ
materially from the results discussed in the forward-looking statements. Forward-looking
statements include statements concerning our plans, objectives, goals, future events, performance
and/or other information that is not historical information. We undertake no obligation to publicly
update or revise forward-looking statements to reflect subsequent events or circumstances after
the date made, except as required by law.
PIPELINE
CANCER IMMUNOTHERAPY
Prostate cancer
PROSTVAC®
Colorectal cancer
CV-301 Colon
Bladder cancer
CV-301 Bladder
Breast cancer
CV-301 Breast
Prostate cancer
MVA-BN® PRO
Breast cancer
MVA-BN® HER2
Metastatic Tumors
MVA-BN® Brachyury
Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 3
Market
NEW
NEW
INFECTIOUS DISEASES
Smallpox
IMVANEX®/ IMVAMUNE®
Smallpox
IMVAMUNE® freeze-dried
Anthrax
MVA-BN® Anthrax
Filoviruses
MVA-BN® Filo
Foot-and-mouth disease
MVA-BN® FMDV
RSV
MVA-BN® RSV
* Approved in the EU under the trade name IMVANEX® and in Canada under the trade name IMVAMUNE®. Sold
to government stockpiles under national emergency rules. Phase 3 registration studies ongoing in the U.S.
3
*
RECENT HIGHLIGHTS
Cancer Immunotherapy:
 PROSPECT Phase 3 study on track with recruitment ongoing in all planned countries
 Construction of PROSTVAC manufacturing completed; test batches now in
production
 Pipeline expanded through initiation of new NCI-sponsored Phase 2 study of CV-301
in bladder cancer and Phase 1 study of MVA-BN Brachyury
 New data combining BN’s immunotherapy platform with checkpoint inhibitors
Infectious Diseases:
 US Government exercised option valued at US$118M for continued delivery of
IMVAMUNE smallpox vaccine
 Canada orders IMVAMUNE with option for a total of than 500,000 doses
 Acceleration for Ebola vaccine program with NIAID, including partnering with
Johnson & Johnson’s AdVac® technology; clinical trial anticipated in 2015
4
KEY ADVANTAGES OF OUR ACTIVE IMMUNOTHERAPIES
1. Poxvirus-based vectors
Intrinsic adjuvants, off-the-shelf
subcutaneous administration
2. Prime/boost dosing strategy
Magnifies and focuses immune response
away from vectors and toward antigen
3. TRICOM™ immunostimulators
Set of three co-stimulatory molecules
acting as Signal 2 for T cell activation
4. Antigen epitope optimization
One or more target tumor antigenic
sequences with enhanced HLA haplotype
binding
TRICOM
Antigen/s
5
LFA-3
ICAM-1
B7.1
MULTIPLE TECHNOLOGY PLATFORMS
OPTIMIZING TUMOR-SPECIFIC IMMUNE RESPONSES
Boost doses
Prime dose
TAA(s)
Selection of TAA
gene(s) defines
the cancer target
PROSTVAC
CV-301
MVA-BN-Brachyury
6
ICAM-1
B7.1
TRICOM
PSA
Prostate cancer
CEA
Colorectal, breast, lung, ovarian, gastric,
bladder, liver and renal cancers
MUC-1
MVA-BN-HER2
LFA-3
HER2
Brachyury
Breast cancer
Colorectal, breast, lung, ovarian cancers
EBOLA AND MARBURG VACCINE IN DEVELOPMENT
• BN has ongoing collaboration with U.S. National Institutes of Health (NIH) to
evaluate MVA-BN vaccine candidates for filoviruses (Ebola and Marburg
viruses)
• Recent preclinical studies show 100% protection against Ebola in a setting
with MVA-BN
• NIH is now planning to advance the vaccines into clinical studies, with the
initiation of a Phase 1 study in humans, anticipated in 2015
• Members of BN participated in the World Health Organization’s (WHO)
“Consultation on potential Ebola therapies and vaccines” in Geneva on
September 4 and 5
7
PROSTVAC PHASE 2 RESULTS
PRONOUNCED SURVIVAL EFFECT IN PROSTATE CANCER
Significantly extended
overall survival
100
N
Deaths
Median
OS
Control
40
37
16.6
PROSTVAC
82
65
25.1
80
survival
(% of patients)
25.1
months
60
40
Δ 8.5 months improvement in OS
16.6
months
Hazard ratio
0.56 (95% CI 0.37–0.85)
p=0.0061
20
0
0
12
24
36
48
60
months
Overall Survival Analysis of a Phase II Randomized Controlled Trial of a Poxviral-Based
PSA-Targeted Immunotherapy in Metastatic Castration-Resistant Prostate Cancer
Kantoff et al., Journal of Clinical Oncology, January 2010
8
Pivotal data of approved agents:
Provenge®: ΔOS = 4.1 mo (AS/MS mCRPC)
Zytiga®: ΔOS = 5.2 mo (pre-chemo mCRPC)
Xtandi®: ΔOS = 2.2 mo (pre-chemo mCRPC)
Reference
Package insert Sipuleucel-T, enzalutamide and abiraterone
PROSTVAC ACTIVATES PSA-SPECIFIC T CELLS
p = 0.039
n = 46
IFNγ ELISPOT assay
9
p = 0.98
n = 20
Samples from RDBPC Phase 2 PROSTVAC study
PROSPECT
A RANDOMIZED, DOUBLE-BLIND, GLOBAL PHASE 3 EFFICACY TRIAL OF PROSTVAC IN
METASTATIC CASTRATION-RESISTANT PROSTATE CANCER
• Recruitment on track - full enrollment
anticipated in 2014
• All (15) countries active, 200 sites
recruiting
• Australia, Belgium, Canada, Denmark, Estonia,
France, Germany, Iceland, Israel, Netherlands,
Poland, Russia, Spain, UK & US
• Interim analysis plan
• Pre-specified interim data analyses will
evaluate whether the trial should continue as
planned or potentially be stopped early for
efficacy or futility
• Potential for early data read-out
10
1,200 patients
PROSTVAC + GM-CSF
3 study arms
PROSTVAC
Placebo
Primary endpoint is overall survival
Either one of the treatment arms must be
superior to placebo
Each comparison requires 534 deaths for
the final analysis
Phase 2 results:
Demonstrated hazard ratio 0.56 = 44%
reduction in risk of death
SPA terms for Phase 3:
Required hazard ratio 0.82 or less = 18%
reduction in risk of death
MVA-BN BRACHYURY
NOVEL IMMUNOTHERAPY CANDIDATE WITH BROAD POTENTIAL
• Exciting new pipeline opportunity funded by NCI
• Brachyury is a tumor-associated antigen which is overexpressed in major
solid tumor indications
• Brachyury is reported to play a key role in the metastasis and progression of tumors
• Tumors which overexpress Brachyury are believed to be highly resistant to current
therapies and are associated with decreased survival rates
• A Phase 1 study of MVA-BN Brachyury TRICOM initiated in patients with
advanced cancer
• Open label trial that will enroll patients with advanced cancer into three cohorts (6
patients per dose cohort) with dose escalation of MVA-BN Brachyury
• The objective is to determine the safety and tolerability of escalating doses of
MVA-BN Brachyury and to evaluate immunologic responses as measured by an
increase in Brachyury-specific T cells
11
COMBINATION TREATMENT RATIONALE:
IMMUNE CHECKPOINT INHIBITORS
Immune Checkpoint
Inhibitors
‘Foot off the brakes’
Monotherapy
• Remarkable efficacy, but
only in fraction of
subjects treated
• Unfocused immune
activation
• Dose-related toxicity
concerns
12
BN Active
Immunotherapy
‘Foot on the gas’
Combination
Monotherapy
• Long-term clinical
outcome differences but
limited short-term
response
• Immune activation may be
modulated by checkpoint
system
PROSTVAC + IPILIMUMAB COMBINATION
IMPACT ON MEDIAN OVERALL SURVIVAL
PROSTVAC Phase 2 study
NCI Phase 1 PROSTVAC + Ipilimumab
100
survival
(% of patients)
80
25.1
months
60
40
16.6
months
20
0
0
12
24
36
months
Kantoff et al (2010) J Clin Oncology
Madan et al (2012) Lancet Oncol 13, 501-508
13
48
60
POXVIRUS IMMUNOTHERAPIES WITH CHECKPOINTS
SYNERGY WITH ANTI-PD1 BLOCKADE
**** p<0.0001
MVA-BN-HER2
+ anti-PD1
MVA-BN-HER2
Anti-PD1
Control
CT26-HER2 tumors
endogenously express PD-L1
Mice challenged with CT26-HER2 tumors i.d. were subsequently administered MVA-BN-HER2 immunotherapy
and/or anti-PD1 antibody
14
POXVIRUS IMMUNOTHERAPIES WITH CHECKPOINTS
COMPLETE TUMOR REGRESSION WITH PD-1 AND LAG3 BLOCKADE
MVA-BN-HER2
+ anti-PD1
+ anti-LAG3
anti-PD1 +
anti-LAG3
Control
Mice challenged with CT26-HER2 tumors i.d. were subsequently administered MVA-BNHER2 immunotherapy and/or anti-PD1 + anti-LAG3 antibody
15
MVA-BN-HER2
POXVIRUS IMMUNOTHERAPIES WITH CHECKPOINTS
RETENTION OF EFFICACY WITH CHECKPOINT DOSE REDUCTION
Mice challenged i.v. with metastatic CT26-HER2 tumors were subsequently administered
MVA-BN-HER2 immunotherapy and/or anti-PD1 plus anti-CTLA4 antibodies
Statistical significance was determined against untreated controls by Log-Rank with Bonferroni correction
**p<0.01; ***p<0.001
16
THANK YOU
17