AI assistant
BerGenBio — Investor Presentation 2019
Feb 12, 2019
3555_rns_2019-02-12_09e1d9c0-4060-4f84-b642-a157d04af0e4.pdf
Investor Presentation
Open in viewerOpens in your device viewer
BerGenBio ASA (OSE: BGBIO) Results Fourth Quarter & FY 2018
12th February 2018 Richard Godfrey , CEO Rune Skeie, CFO
Disclaimer
Certain statements contained in this presentation constitute forward-looking statements. Forward-looking statements are statements that are not historical facts and they can be identified by the use of forward-looking terminology, including the words "anticipate", "believe", "intend", "estimate", "expect", "will", "may", "should" and words of similar meaning. By their nature, forwardlooking statements involve a number of risks, uncertainties and assumptions that could cause actual results or events to differ materially from those expressed or implied by the forward-looking statements. Accordingly, no assurance is given that such forwardlooking statements will prove to have been correct. They speak only as at the date of the presentation and no representation or warranty, expressed or implied, is made by BerGenBio ASA or its affiliates ("BerGenBio"), or by any of their respective members, directors, officers or employees that any of these forward-looking statements
or forecasts will come to pass or that any forecast result will be achieved and you are cautioned not to place any undue influence on any forward-looking statement. BerGenBio is making no representation or warranty, expressed or implied, as to the accuracy, reliability or completeness of this presentation, and neither BerGenBio nor any of its directors, officers or employees will have any liability to you or any other person resulting from the use of this presentation.
Copyright of all published material, including photographs, drawings and images in this presentation remain with BerGenBio and relevant third parties, as appropriate. Consequently, no reproduction in any form of the presentation, or parts thereof, is permitted without the prior written permission, and only with appropriate acknowledgements.
Introduction & recent highlights
BGBIO – Investment Highlights
Ph2 data in AML & NSCLC with selective AXL inhibitor bemcentinib
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
Resourced to deliver significant milestones
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
Cash NOK360m
Agenda
- 1. Introduction and recent highlights
- 2. Bemcentinib: First-in-class highly selective AXL inhibitor in Phase II
- 3. Clinical Development Opportunities
- 4. BGB149 – Anti AXL monoclonal antibody in Phase I
- 5. Finance
- 6. Outlook
Q4 2018 Highlights
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
Increasing profile and recognition of bemcentinib at international clinical congresses in 2018
Key data presented in Q4 supports future strategy for late-stage clinical development of bemcentinib in AML/MDS and NSCLC
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
7
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
AXL drives aggressive cancer
AXL receptor tyrosine kinase drives aggressive disease including therapy resistant, immune-evasive tumours
Drives tumour cell plasticity: non-genetic resistance mechanism
Key suppressor of innate immune response
AXL drives features of aggressive cancer:
- Acquired therapy resistance
- Immune escape
- Metastasis
AXL is an innate immune checkpoint:
- M1 to M2 macrophage polarisation
- Decreased antigen presentation by DCs
- Immunosuppressive cytokine profile
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
Three AXL-targeting drug candidates in clinical development
Clinical development programmes of AXL inhibitors
> 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 |
Summary of Phase II PoC data with bemcentinib (Focus on NSCLC & leukaemia)
Associate Professor Dr David Gerber, UTSW Dallas, TC, lead PI BGBIL005
Bemcentinib PoC data summary: Monotherapy and combinations
Bemcentinib: once-a-day AXL inhibitor
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
Acute Myeloid Leukaemia (AML) & Myelodysplastic Syndrome (MDS)
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
MDS & AML: Disease characteristics
New strategies to treat older & relapsed/ refractory patients is an urgent, unmet need
Myelodysplastic syndromes (MDS)
(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
Acute Myeloid Leukaemia (AML)
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
~ 20,000 new cases
diagnosed and >10,000 deaths (2018, U.S.)2
Most common type of acute leukaemia in adults1
AML & MDS – difficult to treat malignancies, predominantly elderly frail patient population.
AML & MDS – difficult to treat malignancies, predominantly elderly frail patient population.
Phase II trial in AML/high risk MDS: monotherapy and combination with LDCT*
Summary results slide and next steps
Status Jan '19
Summary results Next steps
- Monotherapy cohort complete
- 43% ORR in AXL positive patients
- Excellent safety
-
Evidence of immune activation
-
Chemo combinations ongoing Ø Top line data Q1'19
- Comprehensive analysis anticipated at ASCO/EHA '19
Monotherapy shows promising efficacy in comparison to approved & emerging regimens
| 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
Bemcentinib in combination with KEYTRUDA in 2L NSCLC
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
NSCLC causes more cancer related deaths than breast, colon, pancreas and prostate combined
The largest cancer killer, most patients depend on drug therapy
- Ø 2.09 million new cases of lung cancer diagnosed/yr worldwide, making up 11.6% of all cancer cases1
- Ø 1.76 million lung cancer deaths/yr worldwide1
- Ø In the U.S, 5-year survival rate is approximately 18.6%, and 4.7% in patients with distant metastases2
Non-small cell lung cancer is the most common type of lung cancer, making up 80-85% of lung cancers
Rapidly emerging SoC creates opportunities for novel effective, chemo free regimens
Phase II 2L NSCLC study of bemcentinib with KEYTRUDA
Key objectives
- Evaluate safety of the combination and response to treatment with the combination
- Characterise patients by PD-L1 and AXL status
- Evaluate efficacy of patients by biomarker status, and assess predictive qualities of biomarkers
- Assess survival measures in patients by biomarker status
Response per biomarker expression
Analysis of biomarker expression in the BGBC008 trial revealed:
- ü Appr. half of patients were AXL positive (10 out of 21 analysed for AXL)
- ü The vast majority of patients did not express high levels of PD-L1, the biomarker for KEYTRUDA monotherapy efficacy
Promising efficacy in comparison to approved monotherapy and emerging combinations*
| 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
The majority of NSCLC patients are eligible for CPIs, but only few respond: novel combination agents will drive CPI differentiation & multi-billion market opportunity
*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
Summary results and next steps
Status Jan '19
Summary results Next steps
- 1st efficacy endpoint met
- 40% ORR and 6m PFS in AXL positive patients
-
27% ORR in PD-L1 -ve patients
-
Second stage ongoing
- H1 '19
- Ø Top line OS for stage 1
- Ø Preliminary ORR per biomarker stage 2
- H2 '19
- Ø Final efficacy & biomarkers stage 1 + 2
- Ø PFS
Clinical development opportunities for bemcentinib
Clinical Development opportunities for bemcentinib
Data generated provides strong rationale for late stage clinical trials to start in 2019*
BGB149 – a monoclonal anti-AXL antibody
Ref. BGB149-101 / NCT03795142
BGB149: Anti-AXL monoclonal antibody Phase I clinical trial initiated January 2019
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
- Up to 36 subjects
- Safety, PK/PD
First-in-patient trial expected in H2 2019
ADCT-601 – AXL ADC
Out-licensed to ADC Therapeutics (ADCT)
BGB601/ADCT-601: Anti-AXL ADC Phase 1 in solid tumours started January 2019
Antibody Drug Conjugate (ADC)
Targets human tumour AXL, induces cell death when internalised
Potent and specific anti-tumour activity demonstrated preclinically1
First-in-human Phase I study initiated in Jan 2019
- Solid tumours
- Up to 75 patients
- Safety, PK/PD, preliminary efficacy
Based on anti-AXL antibody BGB601 licensed from BerGenBio
Near term goals and news flow
Anticipated clinical data readouts and operational milestones for 2019
* 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
Upcoming company news flow and value creating catalysts
| 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 |
✓ |
Financial review: Good financial position and cost control
Rune Skeie CFO
Key financial figures
| (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 |
Operating profit (loss) million NOK
Operating expenses Q4 2018
- Effective organisation
-
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
- Revenue NOK 2.3 million, licence revenue triggered by pre-clinical milestone (ADCT-601)
- Stage 2 of NSCLC combination with Keytruda re-opened in Q4 18 and ongoing (mandatory safety review in Q3 18)
41
Cash flow and cash position
• Private placement Q2,18 strengthened cash position - gross funds raised NOK 187.5m
• Quarterly cash burn average 2018 at NOK 46.7 million
- Cash position gives runway to deliver key clinical read outs from ongoing clinical studies
- Cash runway into 2020 based on current burn rate
Full year 2018 highlights
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