Bioshares Investment Summit Presentation · controlled clinical trial currently recruiting patients...
Transcript of Bioshares Investment Summit Presentation · controlled clinical trial currently recruiting patients...
ABN 16 165 160 841
Suite 401, 35 Lime Street, Sydney 2000, Australia
AU Phone: +61 2 8003 3650 NZ Phone: +64 9 525 0532
Email [email protected]
www.innateimmuno.com
ASX RELEASE 20 JULY 2015
Bioshares Investment Summit Presentation Innate Immunotherapeutics' CEO Mr. Simon Wilkinson gave a presentation (attached) at the 2015 Bioshares Investment Summit on Saturday 18 July 2015. The presentation was part of a session entitled "Focus on CNS Drug Development". - End About Multiple Sclerosis (MS) Multiple Sclerosis (MS) is a chronic disease of the central nervous system, where the body’s immune system attacks the myelin sheath surrounding the nerve fibres. The damaged myelin disrupts the communication mechanism of parts of the central nervous system. This results in a wide range of symptoms, which may include loss of balance and muscle coordination, difficulty walking, slurred speech, tremors, stiffness, cognitive impairment, depression, fatigue and bladder problems.
There are two main forms of MS, an early ‘relapsing-remitting’ stage of disease and, a later, more disabling ‘secondary-progressive’ stage of disease. Worldwide, 30% of all MS sufferers have SPMS and there are currently no approved disease modifying drugs for the safe and effective, ongoing treatment of this highly disabling form of the disease.
About MIS416 The microparticle, MIS416, is a biologically derived novel immune modulator and can target both the regulatory functions and the defensive (pathogenic) functions of the innate immune system. MIS416 targets myeloid cells, a sub-set of innate immune cells not currently targeted by existing or other ‘in-trial’ MS drugs. Myeloid cells have only recently been recognised as a significant potential therapeutic target in SPMS. Myeloid cells have the capacity to remodel the deregulated immune activity which is an important part of the disease process in SPMS. These same cells, remodelled in the correct fashion, can also promote neuro repair pathways critical to slowing or reversing disability in SPMS.
About Compassionate Use
Under the New Zealand Medicines Act, a doctor may prescribe an unapproved experimental medicine providing he or she has signed written consent from the patient and the medicine is manufactured pursuant to a Licence to Manufacture Medicines issued by the NZ Ministry of Health. Using this discretion, several doctors in New Zealand have prescribed MIS416 to treat patients with both SPMS and also the rarer form of progressive MS called primary progressive multiple sclerosis. It is important to note that this "compassionate use" of MIS416 has taken place outside of the strict rules of a formal clinical trial and so any reports (from either patients or doctors) about the effects of such treatment are only anecdotal. Such data cannot be relied upon to predict the likely outcome of strictly monitored, placebo controlled, Phase 2 or Phase 3 efficacy trials. Furthermore, such treatment has taken place in a manner that does not control for any placebo effects that may have been experienced by the patients.
About the Phase 2B Clinical Trial for MIS416
Australian and New Zealand patients with SPMS who would like to find out more about the Company's 12 month placebo controlled clinical trial currently recruiting patients in Perth, Melbourne, Brisbane, Adelaide, and Wellington should visit: http://mstrial.com.au for trial site contact information. Detailed information about the design of the trial, including eligibility criteria, can be found at: https://clinicaltrials.gov/ct2/show/NCT02228213 For further information please contact:
Innate Immunotherapeutics Limited Mr Simon Wilkinson, CEO +64 21 661 850 http://www.innateimmuno.com
For
per
sona
l use
onl
y
Focus on CNS Drug DevelopmentTreating secondary progressive multiple sclerosis
Simon Wilkinson, CEO
For
per
sona
l use
onl
y
Forward Looking Statements
This Presentation (and any financial information that may be provided by InnateImmunotherapeutics Limited - the “Company”) may contain forward looking statementsthat involve risks and uncertainties. Such statements include statements regarding theCompany’s belief or current expectation and are necessarily based on the Company’scurrent understanding of the markets and industries in which it operates. Thatunderstanding could change or could prove to be inconsistent with actual developments.The Company’s actual results could differ materially from the results discussed in thisPresentation, including those anticipated in or implied by any forward looking statements.
2
For
per
sona
l use
onl
y
• The myelin sheathprotecting the nerve fibersinside the CNS isdamaged by a likelycombination of bothautoimmune and neurodegenerative processes
• This triggers inflammatorypathology that causesfurther damage
• In early disease, myelin isfully or partially repaired
• Over time, scar-like plaquebuilds up around damagedaxons inhibiting repair
(Source: MedicineNet, Inc)
What is multiple sclerosis? 3
For
per
sona
l use
onl
y
• Until recently most market discussions about multiple sclerosis havefocused on the early stage relapsing-remitting course of the disease.
• In early MS, relapses are largely mediated by auto-reactive pro-inflammatory adaptive immune cells crossing the blood brain barrier andattacking the myelin sheath – an autoimmune ‘process’ or ‘disease’.
• In spite of drugs designed to block, or sequester, or divert such autoimmuneactivity, within 20 years ~70% of RRMS patients transition to a progressivestage of disease where deficits steadily accumulate in the absence ofrelapses and existing RRMS drugs become ineffective.
Is Multiple Sclerosis and CNS disease?
• Progressive MS is now largely viewed as a neurodegenerative disorder.
• The pathologic role of myeloid derived innate immune cells in neuro-degenerative disorders is well understood. However we now know that bothmacrophages and microglia can also play vital roles limiting inflammation &promoting tissue repair in CNS disorders including progressive MS.
4
For
per
sona
l use
onl
y
• This myeloid cell bi-polar behaviour is essential so that an immune responsecan adapt according to the stage, severity, location, & type of disease.
• Peripherally derived macrophages, and the CNS equivalent microglia cells,can be activated or polarised towards either a “M1” inflammatory phenotypeor a “M2” anti-inflammatory phenotype.
• In addition to being anti-inflammatory within the CNS, M2 macrophagesand microglia have been shown to:
– support myelin repair by clearing myelin debris1.
– secrete important tropic factors that can directly promote neuronalsurvival and axon regeneration2,3,4.
Myeloid cells play an important role in CNS disorders
1. Kotter MR et al. 2006. Myelin impairs CNS remyelination by inhibiting oligodendrocyte precursor cell differentiation.J. Neurosci. 26, 328–332
2. Butovsky O et al., 2006. Microglia activated by IL-4 or IFN-gamma differentially induce neurogenesis and oligodendrogenesis from adultstem/progenitor cells. Molec. Cell. Neurosci. 31, 149–160
3. Rolls A et al., 2008.Two faces of chondroitin sulfate proteoglycan in spinal cord repair: a role in microglia/macrophage activation.PLoS Med. 5, e171.
4. Kuo HS et al., 2011. Acid fibroblast growth factor and peripheral nerve grafts regulate Th2 cytokine expression, macrophage activation,polyamine synthesis, and neurotrophin expression in transected rat spinal cords. J. Neurosci. 31, 4137–4147
5
For
per
sona
l use
onl
y
The Journal of Neuroscience, July 8, 2015 – 35(27):9966-9976
Significance StatementThere is a growing appreciation that macrophages exert diverse functions in theinjured and diseased CNS. Indeed, both macrophage-mediated repair andmacrophage-mediated injury occur, and often these effector functions are elicitedsimultaneously. Understanding the mechanisms governing the reparative andpathological properties of activated macrophages is at the forefront ofneuroscience research.
6
For
per
sona
l use
onl
y
• MIS416 is a highly purified microparticle derivedfrom the naturally occurring bacteria P. acnes
• MIS416 reliably, safely, and uniquely targets myeloid cells
• MIS416 targeted myeloid cells:
– Increase in number
– switch activity from pathogenic to reparative
– traffic into the CNS (past the blood brain barrier)
MIS416
2.0 x 0.5 micron rodshaped microparticle
Introducing MIS416 – a MYELOID targeting immune modulator
• The targeted cells have an anti-inflammatory effect inside theCNS and have also been shown to:
– support myelin repair by clearing myelin debris
– secrete important tropic factors that can directly promote neuronalsurvival and axon regeneration
7
For
per
sona
l use
onl
y
Tolerogenic DC Alternate/non classical/M2macrophage
Bone marrow-derivedmonocyte
IL-10
TGFb
IL-27
sTNFR
sIL-1R
Pro-inflammatorymechanisms
Arginase
IDO
Anti-inflammatory/tolerancemechanisms
IL-12p70IL-1bTNFa
MHC I/IICD80/86
NO
MIS416 effect on cellular and soluble anti-inflammatory pathways
Upregulation following MIS416 treatment:
in Mouse
in Human
under investigation
PDL-1
??
?
8
For
per
sona
l use
onl
y
1 2 3 4 5 6 7 8 9 100
100
200
300
sample number (arbitary)
VE
GF
(pg
/mL
)
Vascular Endothelial Factor
Baseline (pre-treatment)
24 hr post dose
1 2 3 4 5 60
100
200
300
400
500
sample number (arbitary)
IGF
-1(p
g/m
L)
Insulin Growth Factor-1
Baseline (pre-treatment)
24 hr post dose
1 2 3 4 5 6 7 8 9 10 11 120
200
400
600
sample number (arbitary)
HG
F(p
g/m
L)
Hepatocyte Growth Factor
(Baseline) pre-treatment
24 hr post dose
1 2 3 4 5 6 7 8 9 1011 1213 14151617 18 190
2000
4000
6000
8000
20000
40000
sample number (arbitary)
EP
O(p
g/m
L)
Erythropoietinpre-treatment
24 hr post dose A selection ofphase 1B and 2Apatient plasmasamples wereanalysed toscreen for theinduction offactorsassociated withneuroprotection.
Data are shownfrom examplesthat showed aclear responsefor a given factorSamples areassignedarbitrary samplenumbers
MIS416 effect on tropic factors associated with CNS protection/repair
9
For
per
sona
l use
onl
y
Phase 2B trial in SPMS – a clinical “Proof of Platform”
• Double blinded, placebo controlled 12 monthtrial of MIS416 in 90 patients
• 2:1 randomisation, once weekly 500 mcg i.v.injection of MIS416 or saline
• Baseline, quarterly, and end of dosing (EoD)clinical assessments including:
• Hand/arm function & strength, cognition,visual acuity, fatigue, MSFC and EDSS
• Patient reported outcomes: SF-36, pain (BPI),and fatigue (NFI-MS)
• Baseline, month 3 & EoD MRI (whole brainatrophy and magnetization transfer ratio)
• 45 patients (50% of the target 90 patients) arenow enrolled, consented or in washout period (forprevious RRMS drugs) – enrolment is on going
10
For
per
sona
l use
onl
y
MIS416 - A CNS REPAIR “PLATFORM”
• Turning off inflammation, removing tissue debris, supplying repair andprotective factors, are all criterial functions of the innate immune systemrelative to repairing tissue damage inside the CNS, whether the damage iscaused by trauma or certain diseases.
• The presence of inflammation inside the CNS, as a consequence of certainother diseases, can amplify disease damage and/or lessen the effectivenessof disease modifying therapies. Activating the regulatory functions of theinnate immune system to switch off inflammation inside the CNS makessense – especially when anti-inflammatory drugs can’t cross the blood-brainbarrier and access the CNS!
• If MIS416 works in patients with SPMS, a disease where there is both tissuedamage (the myelin) and ongoing inflammation inside the CNS, then MIS416becomes a platform to be used in other conditions or diseases requiringthese critical CNS repair “tools”
Further announcements can be expected within the next 8-12 weeks
11
For
per
sona
l use
onl
y
Post Phase 2B – path to market for SPMS
• There are no effective drugs approved to treat SPMS
• Approval of a drug for SPMS could be reviewed underFDA’s “Expedited Programs for Serious Conditions”
• Pharma with existing drugs for early stage MS (RRMS)are actively seeking drugs to treat SPMS
• Biogen’s RRMS drug Tecfidera sold US$3b in 2014following approval part way through 2013
• Upon completion of Phase 2B (2016) – Innate’sstrategy is to license / sell to large Pharmacompany
PotentialTarget Partners
or Acquirers
12
For
per
sona
l use
onl
y
Post Phase 2B – path to market for SPMS
What does a partnering deal look like in SPMS?
• December 2014: Servier paid US$47 million ‘optionfee’ to fund Phase 2B trial of GeNeuro’s blockingantibody to supposed MS-associated retrovirus
• Received option to the non-US territorial rights tiedto a $408 million package of milestones
N.B. The non-US territory accounts for about ~25%of global MS drug revenues
• Also option buy an equity stake sometime in 2015
See announcement: <http://tinyurl.com/fb141202>
LATE BREAKINGNEWS
• Celgene toacquire Phase 3MS companyReceptos forUS$7.2 billioncash
• Deal has rankedReceptos #1 forthe most valuecreated by anybiotech in thelast 10 years.
13
For
per
sona
l use
onl
y
www.innateimmuno.comAustralian Securities Exchange (ASX) ticker - IIL
Simon Wilkinson, CEO
[email protected] or tel +64 21 661 850
Thank you
Two clinical trial patients talk abouttheir ongoing experience with MIS416:http://youtube/YsH579wcqd0
For
per
sona
l use
onl
y