Earnings Release • Feb 12, 2019
Earnings Release
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12th February 2018 Richard Godfrey , CEO Rune Skeie, CFO
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Monotherapy and combinations with immune-, targeted and chemotherapies
Biomarker correlation across programme, parallel CDx development
AXL positive patients: 43% ORR in R/R AML/MDS (monotherapy) 40% ORR in 2L NSCLC (KEYTRUDA combo)
Late stage clinical trials to start H2'19
Clinical trial collaborations with Merck and leading academic centres
AXL antibody out licensed to ADC Therapeutics SA
38 staff at two locations: HQ & R&D in Bergen, Norway; Clinical Development in Oxford, UK
Bemcentinib monotherapy & combo in AML/MDS (BGBC003): PoC monotherapy data reported at ASH, combination studies ongoing
Bemcentinib + KEYTRUDA® in NSCLC (BGBC008): Selected as late-breaking abstract for SITC – PoC phase II data (stage 1)
Bemcentinib biomarker programme: Selected for poster discussion at ESMO
Strengthened clinical development team
Post-period updates: BGB149 (AXL antibody) and ADCT-601 (partnered AXL ADC): start phase I trial
ASCO-SITC: Clinical Immuno-Oncology symposium, San Francisco ASCO: American Society of Clinical Oncology, Chicago WCLC: World Conference of Lung Cancer, Toronto ESMO: European Society of Medical Oncology, Munich
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AACR: American Association for Cancer Research, Chicago EHA: European Hematology Association, Stockholm SITC: Society for Immunotherapy of Cancer, DC ASH: American Society for Hematology, San Diego
Drives tumour cell plasticity: non-genetic resistance mechanism
AXL drives features of aggressive cancer:
AXL is an innate immune checkpoint:
very low expression under healthy physiological conditions (ko mouse phenotypically normal)
overexpressed in response to hypoxia, immune reaction, cellular stress / therapy
overexpression correlates with worse prognosis in most cancers
> 350 patients at 50 sites across Europe and USA
| Preclinical | Phase I | Phase II | Phase III | Status | ||
|---|---|---|---|---|---|---|
| Selective AXL kinase inhibitors | ||||||
| Bemcentinib: selective oral small molecule AXL inhibitor | ||||||
| NSCLC + KEYTRUDA (2L, IO naïve) | previously treated advanced adenocarcinoma of the lung | (1) | Stage 1 complete, 40% ORR in AXL+; stage 2 ongoing |
|||
| NSCLC + TARCEVA (1L & 2L) | advanced NSCLC with activating mutation of EGFR | Fully recruited, 1st efficacy endpoint met |
||||
| NSCLC + docetaxel (later line) (2) | previously treated advanced NSCLC | ILS, ongoing – latest update WCLC 2018 |
||||
| AML single agent + low dose chemo (1L & 2L) | AML or previously treated MDS unfit for intensive chemo | Mono: 43% ORR in AXL+ R/R AML/MDS; decitabine combo completed recruitment |
||||
| ILS programme in additional oncology indications (2) | Melanoma, mesothelioma, pancreatic, glioblastoma, MDS | Portfolio of ILS, ongoing & in set-up | ||||
| Fibrosis – preclinical |
IPF, NASH | Pre-clinical work published throughout 2018 | ||||
| BGB149: anti-AXL mAb | ||||||
| Healthy volunteers – phase 1a dose escalation |
Healthy volunteer SAD | |||||
| BGB601: AXL ADC outlicensed | ||||||
| Metastatic cancers | First-in-man solid tumours | Out-licensed | to | |||
| Companion Diagnostics Pipeline | Biomarker Discovery | Biomarker Verification | Validation | |||
| Tissue AXL Soluble AXL Additional soluble markers |
targeted and immunotherapy | Correlation with benefit from monotherapy, combo with | Correlation with efficacy reported |
Associate Professor Dr David Gerber, UTSW Dallas, TC, lead PI BGBIL005
Highly selective, orally bioavailable small molecule, administered once a day, in phase II clinical trials
Blocks AXL signalling, reverses aggressive tumour traits & counteracts immune escape
Clinical PoC in AML and NSCLC as a monotherapy and in combination
Correlation of clinical efficacy with AXL biomarkers observed
Excellent clinical safety profile
Randomised, late stage clinical trials planned to start in H2 2019
Ref. BGBC003 / NCT02488408
Bemcentinib is being evaluated as a monotherapy and in combination with standard of care to treat AML and high-risk MDS
43% ORR in AXL +ve R/R AML and MDS patients chemo combos in 1L ongoing
(pre-leukaemia or smoldering leukaemia)
Occurs when the blood-forming cells in the bone marrow (the soft inner part of certain bones, where new blood cells are made), become abnormal. This leads to low numbers of one or more types of blood cells.
~ 40,000 new cases per year (U.S. only)3
Most diagnoses made in 70s or 80s1
MDS 40% risk of developing into AML.4
Cancer of the myeloid line of blood cells, characterized by rapid growth of abnormal cells that build up in the bone marrow and blood and interfere with normal blood cells
diagnosed and >10,000 deaths (2018, U.S.)2
Most common type of acute leukaemia in adults1
Evidence of immune activation
Chemo combinations ongoing Ø Top line data Q1'19
| Regimen | 0,0 % 10,0 % |
Overall response 20,0 % |
30,0 % 40,0 % |
50,0 % | Patient population |
Mechanism of action |
Administration | Source | |
|---|---|---|---|---|---|---|---|---|---|
| Bemcentinib (Phase II) |
42,8 % | low soluble AXL |
selective AXL inhibitor |
oral, once-daily | Loges et al, ASH 2018 | ||||
| Enasidenib (APPROVED) |
40,3 % | IDH2 mutation | IDH2 inhibitor | oral, once-daily | FDA label, prescribing info |
||||
| Approved, limited pt |
Ivosidenib (APPROVED) |
41,6 % | IDH1 mutation | IDH1 inhibitor | oral, once-daily | FDA label, prescribing info |
|||
| populations only |
Gilteritinib (APPROVED) |
21,0 % | FLT3 mutation | FLT3/AXL inhibitor | oral, once-daily | FDA label, prescribing info |
|||
| Gemtuzumab ozogamicin (APPROVED) |
26,0 % | CD33-positive (reported CR only) |
CD33-directed antibody drug conjugate |
injection, days 1, 4 and 7 | FDA label, prescribing info |
||||
| Emerging | Quizartinib (Phase III) |
48,0 % 19,0 % |
FLT3-ITD-positive | FLT3-ITD inhibitor | oral, once-daily | Cortes J, et al; ASH 2018, Blood |
|||
| therapies in R/R AML |
Venetoclax (Phase II) |
any r/r AML | BCL-2 inhibitor | oral, once-daily | Konopleva M, et al: Cancer Discov 6:1106- 1117, 2016 |
||||
| presented at ASH |
IMGN632 (Phase I) |
33,0 % | CD123-positive | CD123-targeting antibody drug conjugate |
IV infusion, once every 3 weeks |
Daver N, et al; ASH 2018, Blood |
|||
| IMGN779 (Phase I) |
6,9 % | CD33-positive; ≥20% of blasts expressing CD33 by flow cytometry |
next-generation anti-CD33 antibody drug-conjugate (ADC) |
IV infusion, Q2W or QW; premediation with steroids |
Cortes J, et al; ASH 2018, Blood |
||||
| AMG 330 (Phase I) |
11,4 % | any r/r AML |
anti-CD33 bispecific T-cell engager (BiTE) |
IV infusion, 14- or 28-day duration; pretreatment with corticosteroids |
Ravandi et al, ASH 2018, Blood |
||||
| XmAb14045 / SQZ622 (Phase I) |
23,1 % | any r/r AML | CD123-/CD3-targeting bispecific antibody |
IV intermittent infusion, weekly in 28 day cycles |
Ravandi et al, ASH 2018, Blood |
||||
| Flotetuzumab (Phase I/II) |
22,0 % | any r/r AML |
CD123-/CD3-targeting bispecific DART molecule |
IV continuous infusion, 7- day/week |
Uy,G, et al; ASH 2018, Blood |
||||
| CYAD-01 (Phase I) |
42,0 % | any r/r AML |
NKG2D CAR-T therapy | IV infusion, frequency unclear |
Sallman et al, ASH 2018, Blood |
Ref. BGBC008 / NCT03184571
The BGBC008 trial is designed to test whether AXL inhibition can enhance responses to immunotherapy (KEYTRUDA monotherapy showed 8% response rate* in previously treated PD-L1 negative NSCLC), summary of responses:
27% ORR in PD-L1 –ve patients 40% ORR in AXL+ve patients
Clinical collaboration with Merck & Co. (MSD)
* Garon, N Engl J Med 2015: Includes any PD-L1 expression
| Overall Response Rate | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Regimen | 0% | 10% | 20% | 30% | 40% | PFS | Patient details / Biomarker |
Mechanism of action |
Administration | Source | |
| Bemcentinib + pembrolizumab (Phase II) |
n=10 | 40% | 5.9 mo | AXL positive, any PD-L1 (TPS 0- 49% in 70%) |
selective AXL inhibitor | oral, once daily | Krebs, M, et al; SITC 2018 |
||||
| mono | Pembrolizumb (APPROVED) |
n=344 | 18% | 3.9 mo | PD-L1 positive (TPS>1%) | PD-1 inhibitor | IV infusion, once every 3 weeks |
FDA label, prescribing info |
|||
| Atezolizumab (APPROVED) |
n=425 | 14% | 2.8 mo any PD-L1 (55% PD-L1 positive) | PD-L1 inhibitor | IV infusion, once every 3 weeks |
FDA label, prescribing info |
|||||
| Nivolumab (APPROVED) |
n=135 | 20% | 3.5 mo | any PD-L1 (53% PD-L1 positive), squamous |
PD-1 inhibitor | IV infusion, once every 2 weeks |
FDA label, prescribing info |
||||
| Nivolumab (APPROVED) |
n=292 | 19% | 2.3 mo | any PD-L1 (54% PD-L1 positive), non-squamous |
PD-1 inhibitor | IV infusion, once every 2 weeks |
FDA label, prescribing info |
||||
| combo | Epacadostat + pembrolizumab (Phase I/II) |
n=70 | 29% | 4.0 mo | prior treatment w/ CT; IO naive; responses regardless of PD-L1 (no details provided) |
selective inhibitor of IDO1 enzyme |
oral, twice daily | Villaruz, L, et al; WCLC 2018 abstract |
|||
| HBI-8000 + nivolumab (Phase Ib/II) |
n=8 | 38% | not yet available |
includes CPI-naïve and – experienced patients |
HDAC class I & IIb inhibitor |
oral, twice weekly | Khushalani, N, et al; SITC 2018 |
||||
| TSR-042 (Phase I) |
n=32 | 25% | not yet available |
PD-L1 low (TPS 0-49%) | PD-1 inhibitor | IV infusion, once every 3 weeks |
Perez, D, et al; SITC 2018 |
||||
| TSR-022 + TSR-042 (Phase I) |
n=31 | 13% | not yet available |
patients include IO-naive and - experienced; all responses in PD-L1 positive (TPS>1%) |
anti-TIM-3 antibody + anti-PD-1, respectively |
IV infusion, once every 3 weeks |
Davar, D, et al; SITC 2018 |
||||
| Ramucirumab + pembrolizumab (Phase Ia/b) |
n=11 | 18% | 9.7 mo | PD-L1 negative (TPS<1%) | anti-VEGFR2 | IV infusion, once every 3 weeks |
Herbst, R, et al; ASCOPubs 2018, JCO |
27 *emerging therapies presented at SITC, similar patient populations
*seer.com – US only, incidence is 230,000; 70% diagnosed at late stage; 85% NSCLC ** EGFR mutations or ALK rearrangements, (1) Garon Iet al (2015) KEYNOTE 001 study (2) Company estimate based on Q3 2018 worldwide revenues for Opdivo, Keytruda and Tecentriq; half are expected to be in lung cancer
28
27% ORR in PD-L1 -ve patients
Second stage ongoing
Ref. BGB149-101 / NCT03795142
Functionally blocking humanised monoclonal antibody
Binds human AXL, blocks AXL signalling
High affinity (KD: 500pM), Anti-tumour efficacy demonstrated in vivo
Robust manufacturing process established, 18 months stability
First-in-human healthy volunteer Phase I study initiated
First-in-patient trial expected in H2 2019
Out-licensed to ADC Therapeutics (ADCT)
Targets human tumour AXL, induces cell death when internalised
Potent and specific anti-tumour activity demonstrated preclinically1
Based on anti-AXL antibody BGB601 licensed from BerGenBio
* expected
38
ASCO-SITC: Clinical Immuno-Oncology symposium, San Francisco ASCO: American Society of Clinical Oncology, Chicago WCLC: World Conference of Lung Cancer, Toronto ESMO: European Society of Medical Oncology, Munich
AACR: American Association for Cancer Research, Chicago EHA: European Hematology Association, Stockholm SITC: Society for Immunotherapy of Cancer, DC ASH: American Society for Hematology, San Diego
| Strategic priority | Goals | ||
|---|---|---|---|
| Late stage clinical trials with bemcentinib |
H2 2018 H2 2018 H1 2019 H2 2019 H2 2020 |
Clinical PoC monotherapy AML Clinical PoC combo in NSCLC Clinical PoC combo in AML Start late stage clinical programme Interim read-out late stage clinical programme |
✓ ✓ |
| Develop Companion Diagnostics |
H2 2018 H2 2020 H2 2021 |
Identify candidates that correlate with efficacy Validate candidates in late stage clinical programme Clinical assay developed |
✓ |
| BGB149 anti-AXL antibody programme |
H2 2018 H2 2019 H2 2020 |
Initiate first-in-man phase I trial Initiate first-in-patient phase Ib trial Interim readout |
✓ |
| Maximise value for bemcentinib |
H1 2019 | Initiate pipeline opportunities for bemcentinib via ISTs |
✓ |
Rune Skeie CFO
| (NOK million) | Q4 2018 | Q4 2017 | FY 2018 | FY 2017 |
|---|---|---|---|---|
| Operating revenues | 2.3 | 0 | 2.3 | 0 |
| Operating expenses | 53.2 | 47.5 | 196.9 | 183.7 |
| Operating profit (loss) | -50.9 | -47.5 | -194.5 | -183.7 |
| Profit (loss) after tax | -51.1 | -47.6 | -191.7 | -182.2 |
| Q4 Q1 Basic and diluted earnings 2017 2018 |
Q2 2018 |
Q3 2018 |
Q4 2018 |
|
| (loss) per share (NOK) | -0.93 | -0.96 | -3.60 | -4.01 |
| Net cash flow in the period | -37.8 | -28.8 | -9.9 | 208.5 |
| Cash position end of period | 360.4 | 370.3 | 360.4 | 370.3 |
78.1% (YTD 73.8%) of operating expenses in Q4 2018 attributable to Research &
Q4 18 operating loss reflecting level of research and development activities in the quarter
41
• Quarterly cash burn average 2018 at NOK 46.7 million
Strong Phase II PoC clinical data readouts with bemcentinib: All operational milestones met with data presented at international clinical congresses
Data paving the way to late stage clinical trial programme in 2019: Targeting monotherapy and combination opportunities in AML/MDS and NSCLC
Pipeline opportunities pursued to complement key internal programmes: Investigator-led studies broaden oncology applications; rationale in fibrosis
Bemcentinib biomarker programme progressed: Efficacy correlation with AXL reported in clinical trials
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