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Investor Presentation. Madi R. Madiyalakan, PhD Chief Executive Officer. November 2013. Quest PharmaTech is a publicly traded Canadian biotechnology company developing a portfolio of product candidates for the treatment of cancer by combining proprietary antibodies with chemotherapy
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Investor Presentation Madi R. Madiyalakan, PhD Chief Executive Officer November 2013
Quest PharmaTech is • a publicly traded Canadian biotechnology company • developing a portfolio of product candidates for the treatment of cancer • by combining proprietary antibodies with • chemotherapy • immuno-stimulants • photodynamic therapy Company Overview
Management Madi R Madiyalakan, Ph.D. CEO, Original Inventor of Quest Technology Cornell University, USA 3 Years Roswell Park Cancer Institute, USA 4 Years Biomira Inc. (Oncothyreon) 7 Years CNRS, France 2 Years AltaRex 4 Years Quest PharmaTech 9 Years
Quest’s Approach to Cancer Treatment • Enlist the body to Fight Cancer (Immunotherapy) • Use monoclonal antibodies (IgG and/or IgE) against tumor associated antigens to induce therapeutic immunity • Monitor Cancer Antigen Specific T Cells (as measured by ELISPOT) as a surrogate for clinical response to guide development • Leverage proprietary insights into immune modifying properties of common cancer agents and other commercial drugs to devise combinatorial immunotherapies (superior to mono-immunotherapy) • Identify ideal combination(s) for optimal clinical response in specific cancer indications
Antibodies as VaccineMechanism Of Action CA125-B43.13 Complex CA125 conjugated with FITC (green) pre-incubated with MAb-B43.13-Cy3 (red) added to day 5 DC for 30 min. before fixation; yellow: co-localized complex • Low dose (about 2 mg), intravenous administration of a xenotypic antibody to TAA • After injection, antibody binds to cancer antigen and forms immune complexes • The complexes are cross processed and presented by dendritic cells to activate T-cells
Lead Product: Oregovomab (MAb-B43.13) for CA125 Associated Cancer • Antigen specificity • CA125 • Isotype • Mouse IgG1κ • Affinity • 1.1x1010 M-1 for CA125 antigen • Immunohistochemistry • Stains specifically ovarian and pancreatic carcinomas expressing CA125 • No direct effects (ADCC, CDC, receptor blockage)
Oregovomab Clinical Development Program Synopsis Through 2008
Oregovomab Clinical Trials Conclusions > 980 Ovarian Cancer Patients Excellent Safety Profile Chemotherapy enhances Immunotherapy * (patented) Correlation between T-cell response and Survival ** (Potential surrogate marker) Substantial clinical development supported by phase III product manufacturing development *Braly et al , J Immunother 2009 ** Gordon et al, 2004
Combinatorial Immunotherapy:The New Frontier Immunotherapy induces minimal toxicity Can act independent of concomitant therapies Can be used in combination with conventional therapies such as chemotherapy, local radiation of tumor, small molecule targeted therapy, photodynamic therapy, etc. Can be used in combination with other immune modulating therapies such as immunoadjuvants, check point inhibitors, T cell adaptive transfer therapy, Danger Signals, etc.
Goal : Identify ideal immunotherapy combination(s) with monoclonal antibodies against tumor associated antigens to get better immune and clinical response in cancer patients. Confirm clinical signals suggested in oregovomab phase II study (Braly et al, 2009) to justify a definitive product registration study (chemo immunotherapy) Expand the product indication for oregovomab by including other CA125 expressing cancer (chemo radioimmunotherapy) Increase the immune and clinical response in ovarian cancer patients by including an immunoadjuvant called Hiltonol, a TRL3 agonist (danger signal combination) Expand the product pipeline by targeting other cancer antigens (e.g. MUC1) or use of 2nd generation antibodies (IgE). Current Clinical Program Objectives
Oregovomab Chemo Enhanced ImmunotherapyOngoing Clinical Study • Objective: • Confirm clinical signals suggested in Pilot Phase II Oregovomab study to justify a definitive phase III study • Design: • Randomized parallel prospective study of standard chemotherapy vs. standard of care chemotherapy plus oregovomab • Patients: • Newly Diagnosed Stage III/IV CA125 associated Epithelial Ovarian Cancer who have been optimally cytoreduced (n=80)
Oregovomab Chemo Enhanced ImmunotherapyOngoing Clinical Study – Clinical Centers * 70 Patients have been enrolled as of Oct 2013
Expanding the Product Indication: Oregovomab in other CA125 expressing cancers
CA125 expressed in about 50% of pancreatic cancer patients Phase II Study: Neoadjuvant Chemotherapy with and without Immunotherapy to CA125 (Oregovomab) followed by Hypofractionated Stereotactic Radiotherapy and Concurrent HIV Protease Inhibitor Nelfinavir in Patients with Locally Advanced Pancreatic Cancer (Chemoradioimmunotherapy) Dr. Chi Lin, University of Nebraska Medical Center Patient enrollment underway Oregovomab in CA125 Expressing Pancreatic Cancer
Improving the Immune and Clinical Response : Addition of TLR3 Agonist, Hiltonol®
Hiltonol in multiple ongoing and recently published cancer vaccines studies • 19 studies currently listed on clinical trials.gov • Is being studied in combination with cancer and infectious disease vaccines including peptide, protein, killed virus and cell therapy approaches • Extensive literature confirming safety and activity of current IM dosage form • GMP Manufacturing in conjunction with Canada Biodefense (Dalton) • Clinical pilot for use with antibody in ovarian cancer patients underway Quest PharmaTech has partnered with Oncovir, Inc for combination with Hiltonol
EXPANDING THE PRODUCT PIPELINE • Antibodies (IgG) against multiple targets • MUC1, Her2/neu, PSA • Second generation antibodies (IgE) against targeted antigens
Anti-MUC1 MAb AR20.5Second Product Under Development • MUC1 is a dominant tumor antigen on most adenocarcinoma • Colon, lung, pancreas, ovary, as well as multiple myeloma and others • Mucinous glycoprotein differentially expressed in malignant tissue • hypoglycosylated in malignancy and expressed on all cell surfaces • a distinct immune target
MAb AR20.5 Clinical Studies: Phase I Objectives: • To determine the safety of MAb AR20.5 administered intravenously on weeks 1, 3, 5, 9, 13, and 17 at 3 defined dose levels • To assess the humoral and cellular immune responses induced by MAb AR20.5 • To assess preliminary anti-tumor responses
MAb AR20.5 Clinical Studies: Phase IImmunological Response Results Summary: HAMA, Ab2, anti-MUC1 antibodies and T-cells were induced in 26-40 % of patients across all dose levels Two patients at the 2 mg dose level experienced a decrease in the CA 15.3 level of 29.5 % and 37.6 % A correlation was found between development of anti-MUC1 antibodies and T-cells with stabilization or decrease of CA15.3 de Bono et al Annals of Oncology 2004; 15:1825-1833
Manufacturing of new lot of clinical grade antibody is in progress First indication: Pancreatic Cancer Combination with chemotherapy in resectable or partially resectable patients End points: Immune response, tumor response, survival IND submission 3Q 2014 MAb AR20.5 Development Plan
Second Generation of Antibody for Immunotherapy Monoclonal IgE to Cancer Antigens (Potential for FDA’s Breakthrough Product Designation)
IgE: Another Class of Antibody Plays an important role in allergy Associated with adaptive defense to parasitic organisms Least abundant circulating blood levels among Igs; shares the common light chain of (λ or Κ) Elicits an immune response by binding to Fc epsilon receptors High binding affinity for its Fc receptors compared to IgG No monoclonal IgE on the market Monoclonal IgE Next generation antibody therapeutics
Why IgE ? Inverse correlation between IgE level/allergic history and selected malignancies Chronic anti-IgE therapy associated with increased risk of malignancy Polyclonal IgE levels correlated with survival in multiple myeloma patients IgE positive cellular infiltrate in H&N cancer Specific serum IgE cytotoxic in Pancreatic CA Daniels et al, “The IgE antibody and its use in cancer immunotherapy” in “Cancer and IgE: Introducing the Concept of AllergoOncology” by Penichet, Manuel L.; Jensen-Jarolim, Erika (Eds.) Springer 2010
Proposed Pathways for IgE : Anti-Cancer Effect Tumor specific IgE cause type I hypersensitivity at tumor site, causes local vasodilation and leakage bringing cytotoxic mediators directly to tumor…The antibody will enhance the effects of standard cancer treatments IgE-tumor antigen immune complexes result in enhanced T cell immunity to the antigen ADCP (antibody dependent cell mediated phagocytosis) and ADCC (antibody dependent cell mediated cytoxicity) via relevant Fc-epsilon bearing effectors (including Monocytes, Dendritic cells, Mast cells, Basophils, Eosinophils) (invoking pathways of parasite host defense to fight cancer)
Anti-PSA IgE licensed from UCLA / AIT Strategies Anti MUC1 IgE licensed from Stanford Anti-Her2/Neu IgE licensed from UCLA and UCSF Preclinical development at University of Nebraska Medical Center by Dr. Hollingsworth One approved patent plus four patents pending Update of latest research to be presented as late breaking abstract at SITC Annual Meeting Nov 2013 Lead product selection 2Q 2014 Potential IgE Product Candidates
Current funding arrangement: Up to $12 Million (in return for 40% Product Net Revenue sharing and 10 M Quest common shares) with Korea based AD Biotech Co. Ltd. Received $2M to date. G & A Burn Rate : $ 1.5 Million per year Financial Overview
Anticipated Clinical Trial/Drug Development Expenditure over the next 3 years Financial Overview (Continued)
Management Team Pierre Vermette, C.A. Chief Financial Officer Thomas Woo, M.Sc. Product Development Chris Nicodemus, MD Clinical & Scientific Affairs Connie Sykes, M.Sc. Regulatory Affairs
Board of Directors Madi R Madiyalakan Chief Executive Officer, Director Lorne Meikle, B.A. Chairman, Director Ian McConnan, FCA Audit Committee Chairman Paul Van Damme, C.A. Corporate Governance Committee Chairman
Clinical Advisory Board Members Dr. Christopher Nicodemus (Chair) President and CSO, AIT Strategies, US Professor William McGuire Medical Director, Inova Fairfax Hospital, US Professor Ignace Vergote Catholic University of Leuven, Belgium Chairman, ENGOT Professor Thomas Ehlen University of British Columbia, Canada
Oregovomab Phase IIb clinical trial interim immunology results Anti MUC1 Antibody for pancreatic cancer Phase II clinical trial initiation IgE lead product candidate selection Spin off technology (cosmetic applications) product revenue Upcoming Milestones (Next 12 Months)
Clinically proven lead product (oregovomab) with excellent safety profile currently undergoing a risk mitigation confirmatory clinical trial that may lead to a product registration trial Diversified product pipeline covering almost all cancers that kill, and a novel target that may qualify for breakthrough designation (IgE) Non-core technology and/or products will bring revenue in near term Current clinical programs are well funded and supported by an experienced management team A Remarkable Value Proposition
Photodynamic Therapy PDT drug is delivered to target site Drug uptake by targeted cells Drug is activated by light to destroy targeted cells Combination therapy with immunotherapeutic agents
Patent Portfolio Perylenequinones For Use As Photosensitizers And Sonosensitizers (Granted in US, Canada, Europe and Australia) Aliphatic Amino-substituted Demethoxylated Hypocrellins and their Synthesis (Granted in US, Europe and Australia) Amino-substituted Hypocrellins For Use As Sonosensitizers(Granted in Europe) PERYLENEQUINONES FOR USE WITH IMMUNOTHERAPY AGENTS(Granted in Europe and Australia) Perylenequinone Derivatives And Uses Thereof(Granted in Europe and Australia) Method And Device For Photodynamic Therapy(Allowed in US) Nanoparticles For Cancer Sonodynamic and Photodynamic Therapy (PCT/US) Polymeric Nanoparticles for Photosensitizers (PCT/US)