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IMMUTEP LIMITED — AGM Information 2021
Jul 25, 2021
65122_rns_2021-07-25_05d88958-7d9e-4d31-8624-56ef2af39bc4.pdf
AGM Information
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The global leader in developing LAG-3 therapeutics (ASX: IMM, NASDAQ: IMMP) Extraordinary General Meeting CEO Presentation 26 July 2021
Notice: Forward Looking Statements
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The purpose of the presentation is to provide an update of the business of Immutep Limited ACN 009 237 889 (ASX:IMM; NASDAQ:IMMP). These slides have been prepared as a presentation aid only and the information they contain may require further explanation and/or clarification. Accordingly, these slides and the information they contain should be read in conjunction with past and future announcements made by Immutep and should not be relied upon as an independent source of information. Please refer to the Company's website and/or the Company’s filings to the ASX and SEC for further information.
The views expressed in this presentation contain information derived from publicly available sources that have not been independently verified. No representation or warranty is made as to the accuracy, completeness or reliability of the information.
Any forward-looking statements in this presentation have been prepared on the basis of a number of assumptions which may prove incorrect and the current intentions, plans, expectations and beliefs about future events are subject to risks, uncertainties and other factors, many of which are outside Immutep’s control. Important factors that could cause actual results to differ materially from assumptions or expectations expressed or implied in this presentation include known and unknown risks. Because actual results could differ materially to assumptions made and Immutep’s current intentions, plans, expectations and beliefs about the future, you are urged to view all forward-looking statements contained in this presentation with caution.
This presentation should not be relied on as a recommendation or forecast by Immutep. Nothing in this presentation should be construed as either an offer to sell or a solicitation of an offer to buy or sell shares in any jurisdiction.
This presentation is authorised for release by Marc Voigt, CEO of Immutep Limited.
2
Overview
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Immutep
is an innovative biotechnology company developing novel immunotherapies for cancer and autoimmune disease
Collaboration deals executed with industry leaders
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Global leadership position
in LAG-3 with 4 product candidates in immuno-oncology and autoimmune disease
Clinical Potential
Immutep’s product candidates have demonstrated clinical potential in a range of indications with high unmet need
3
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LAG-3 Overview - Landscape-
LAG-3 Acceleration & Validation
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LAG-3 Scientific Publications
LAG-3 is an exciting and promising immune checkpoint for cancer treatment
Accelerating interest in LAG-3:
-
Over 900 scientific publications dealing with LAG-3
-
More than 80 clinical trials evaluating 19 LAG-3 product candidates in development
-
Close to 20,000 patients estimated to be enrolled in clinical trials around the globe
Recent LAG-3 validation:
-
Interaction between LAG-3 and MHC class II was recently validated by pharma company Bristol Myers Squibb with Phase III data
-
Its anti-LAG-3 antibody is helping patients with melanoma to live significantly longer without disease progression (PFS)
Immutep is the leading LAG-3 immunotherapy biotech It is the only company with four LAG-3 related compounds each with a different mechanism of action.
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Source: PubMed
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LAG-3 Clinical Trials
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Source: GlobalData, May 2021
5
Immutep’s LAG-3 Trial Pipeline*
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| Oncology Autoimm. Inf. Dis. |
Program | Preclinical | Phase I | Phase II | Late Stage(5) | Commercial Rights |
Market Size(6) |
|---|---|---|---|---|---|---|---|
| Eftilagimod Alpha (efti or IMP321) APC activating soluble LAG-3 protein |
Metastatic Breast Cancer (C AIPAC |
hemo – IO) | Global Rights | US$29.9 billion | |||
| Head and Neck Squamous TACTI-003 |
Cell Carcinoma (IO – IO)(1b) | US$1.9 billion | |||||
| Head and Neck Squamous TACTI-002 |
Cell Carcinoma (IO – IO)(1) | ||||||
| Non-Small-Cell Lung Carci TACTI-002 |
noma (IO – IO)(1) | US$22.6 billion | |||||
| Solid Tumors (IO – IO)(2), (3 INSIGHT-004 |
a) | ||||||
| Solid Tumors (IO – IO)(2), (3 INSIGHT-005 |
b) | § | |||||
| Solid Tumors (IO – IO – ch INSIGHT-003 |
emo)(2) | ||||||
| Solid Tumors (Cancer Vacc YNP01 / YCP02 / CRESCE |
ine)(4a) NT 1 |
||||||
| Metastatic Breast Cancer (C | hemo – IO)(4b) | § | Chinese Rights | US$2.3 billion | |||
| Efti | COVID-19 disease (Monoth EAT-COVID |
erapy)(7) | ~~§~~ | Global Rights(8) | |||
| IMP761 (Agonist AB) |
~~§~~ | Global Rights | US$149.4 billion (2025) |
||||
Notes
-
Information in pipeline chart current as at June 2021
-
(1) In combination with KEYTRUDA® (pembrolizumab) (1b) Planned new trial for 1[st] line HNSCC patients
-
6 (2) INSIGHT Investigator Initiated Trial (“IIT”) is controlled by lead investigator and therefore Immutep has no control over this clinical trial
-
6 (3) a) In combination with BAVENCIO® (avelumab); b) in combination with Bintrafusp alfa
-
(4) a) Conducted by CYTLIMIC in Japan; b) Conducted by EOC in China. Immutep has no control over either of these trials.
-
Late stage refers to Phase IIb clinical trials or more clinically advanced clinical trials GlobalData Market Size forecast for US, JP, EU5, Urban China and Australia; KBV Research: https://www.kbvresearch.com/autoimmune-disease-therapeutics-market/)
-
(5)
-
(6)
-
(7) IIT conducted by University Hospital Pilsen. Immutep has no control over this trial. (8) Ex China
*** Immutep Out-Licensed LAG-3 Trial Pipeline**
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| Oncology Autoimmune |
Program | Preclinical | Phase I | Phase II | Late Stage(1) | Commercial Rights/Partners |
Updates |
|---|---|---|---|---|---|---|---|
| LAG525 (Antagonist AB) |
Solid Tumors + Blood C | ancer (IO-IO Combo) | Global Rights | Novartis currently has five clinical trials ongoing for LAG525 in multiple cancer indications for over 1,000 patients.(4) |
|||
| Triple Negative Breast | Cancer (Chemo-IO Comb | o) | |||||
| Melanoma (IO-IO-Small | Molecule Combo) | ~~§~~ | |||||
| Solid Tumors (IO-IO Co | mbo) | ||||||
| Triple Negative Breast (Chemo-IO-Small Molec |
Cancer ule Combo) |
||||||
| GSK‘781 (Depleting AB) |
Ulcerative Colitis Ulcerative Colitis(6) |
Global Rights | Two successful Phase I studies, but the Phase II clinical study in up to 242 ulcerative colitis patients was discontinued.(5) |
||||
| Healthy Japanese and C | aucasian Subjects(2) | § | |||||
| Psoriasis(3) |
Notes
7 * Information in pipeline chart current as at June 2021 7 (1) Late stage refers to Phase IIb clinical trials or more clinically advanced clinical trials (2) Reflects completed Phase I study in healthy volunteers
(4)
(5)
https://clinicaltrials.gov/ct2/results?cond=&term=LAG525&cntry=&state=&city=&dist= https://clinicaltrials.gov/ct2/results?cond=&term=GSK2831781&cntry=&state=&city=&dist= and https://www.gsk.com/media/5957/q1-2020-results-slides.pdf Discontinued in Jan 2021
TACTI-002 (Phase II)
Design & Status
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TACTI-002: Two ACTive Immunotherapeutics in NSCLC and HNSCC
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UNSELECTED FOR PD-L1
PART A:
S
1 [ST] LINE MET. NSCLC
C
R
PART B: COMBINED
E
2 [ND] LINE MET. NSCLC, IMMUNOTHERAPY
E
PEMBROLIZUMAB + EFTI FOR 12
N REFRACTORY TO PD-1/PD-L1 MONTHS + 12 MONTHS
TARGETING THERAPY PEMBROLIZUMAB MONO
I
N
PART C:
G
2 [ND] LINE MET. HNSCC AFTER Status Report
PLATINUM THERAPY
✓ Fully approved in all countries
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In collaboration with
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ORR, PFS, OS, PK, biomarker, safety and tolerability
Sites in Europe / US / Australia
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- ✓ Up to 183 patients in three indications
30 mg efti (IMP321) s.c. Treatment 200 mg pembrolizumab (Keytruda[] ) i.v.
-
Part A (N=36) completed; extension (N=74 recruiting)
-
✓ Part C (N=39) completed
-
Part B (N=36); stage 2 recruitment ongoing
Notes:
8
ORR – overall response rate, DCR – disease control rate, PFS – progression free survival, OS – overall survival, QoL – Quality of life
TACTI-002 Results[(1)]
1[st] line NSCLC (Part A)
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• PD-L1 distribution as expected (~70% with < 50% PD-L1 expression) → PD L1 all comer trial
- Patients are typical NSCLC 1[st] line pts
| Baseline parameters | N (%) |
|---|---|
| Age (years), median (range) | 68.5 (53-84) |
| Female Male |
11 (30.6) 25 (69.4) |
| ECOG 0 ECOG 1 |
15 (41.7) 21 (58.3) |
| Current / Ex-smokers Non-smokers |
34 (94.4) 2 (5.6) |
| Squamous pathology Non-squamous pathology |
15 (41.7) 21 (58.3) |
| Patients with liver metastasis | 14 (38.9) |
| Best overall response, iRECIST, N = 36 | Local Read (investigator) N(%) |
Blinded Read (BICR) N(%) |
|---|---|---|
| Complete Response | 2 (5.6) | 2 (5.6) |
| Partial Response | 11 (30.6) | 13 (36.1) |
| Stable Disease | 11 (30.6) | 10 (27.8) |
| Progression | 8 (22.2) | 6 (16.7) |
| Not Evaluable** | 4 (11.1) | 5 (13.9) |
| Disease Control Rate | 24 (66.7) | 25 (69.4) |
| Overall Response Rate [95% CI interval]* |
13 (36.1) [20.8-53.8] |
15 (41.7) [25.5-59.2] |
| Overall Response Rate – Evaluable pts *[95% CI interval] |
13 (40.6) [23.7-59.4] |
15 (48.4) [30.1-60.9] |
-
- All patients stage 1 and 2 (N=36) with ≥ 1 treatment
-
** - dropped off prior to first staging or were not evaluable post-baseline for any reason
-
*** - Evaluable for efficacy meaning ≥ 1 treatment and ≥ 1 post baseline tumor staging
Notes:
(1) Preliminary data, cut-off Apr 16, 2021 9 ECOG… Eastern Cooperative Oncology Group iRECIST… Immune Response Evaluation Criteria In Solid Tumors BICR… Blinded Independent Central Review
TACTI-002 Results[(1)]
1[st] line NSCLC (Part A)
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120 Best response:
iUPD/iCPD 100 Best response:
100
iSD iUPD/iCPD
75
60 iSD
iPR
iPR
40 iCR 50
iCR
20
25
0
0
-20
-25
-40
-60 -50
-80
-75
cut-off 16-Apr 2021; n= 33
-100 N=33; ** LN as target lesion; *** - pt had SD but < 6 wks --> BOR =
NE; NY not yet; NE not evaluable
0 12 24 36 48 60 72 84 96 108 120 -100
PD-L1 TPS
% change compared to baseline
Best % change from baseline
50 % 80 % 50 % 15 % 3 % 15 % 80 % 0 % 50 % 70 % 10 % 10 % 10 % 1 % 100 % 0 % 50 % 75 % 90 % 90 % 75 % 100 % 0 %
25 % 0 % 1 % 2 % 40 % <1 % 0 % <1 % 15 % 35 %
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weeks … patients still under therapy
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Duration of response (DoR)
-
92% responses confirmed
-
58% confirmed responses ongoing with 6+ months
-
42% of confirmed responses progressed after 6.5-13.8 months
-
Responses at all PD-L1 levels including 1 Complete Response with TPS of 0%
-
At data cut-off, 7 pts still under therapy and 1 patient completed the 2 years of therapy
-
Median DoR estimated 13+ months
(1) Preliminary data, cut-off Apr 16, 2021 Graphs represent all patients with at least one post baseline assessment. One patient has no official RECIST assessment as this was done < 6 weeks and this does not qualify according to RECIST. Per local investigator assessment. iRECIST… Immune Response Evaluation Criteria In Solid Tumors
10
TACTI-002 Results[(1)]
2[nd] line HNSCC (Part C)
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-
2[nd] line treatment for patients after platinum therapy. PD-L1 all comer population
-
Doubling the ORR compared to historical pembro mono results with 13.5% Complete Responses
| Baseline parameters (N=39) | N (%) | Best overall response*, iRECIST | Investigator assessment N (%) |
|---|---|---|---|
| Age, median (years) | 62 (37-84) | Complete Response | 5 (13.5) |
| Female Male |
4 (10.3) 35 (89.7) 13 (33.3) 26 (66.7) 33 (84.6) 6 (15.4) 39 (100) 16 (41.0) 19 (48.7) 6 (17.6) |
Partial Response | 6 (16.2) |
| Stable Disease | 3 (8.1) | ||
| ECOG 0 ECOG 1 |
|||
| Progression | 17 (45.9) | ||
| Not Evaluable** | 6 (16.2) | ||
| Current / Ex-smokers Non-smokers |
|||
| Disease Control Rate | 14 (37.8) | ||
| Previous chemotherapy | Overall Response Rate [95% CI interval] |
11 (29.7) [15.9-47.0] |
|
| Previous cetuximab | |||
| Overall Response Rate – Evaluable pts *[95% CI interval] |
11 (35.5) [19.2-54.6] |
||
| Lung lesions Liver lesions |
| Primary tumor location (N=39) | N (%) |
|---|---|
| Oral cavity | 12 (30.8) |
| Oropharynx | 14 (35.9) |
| Hypopharynx | 7 (17.9) |
| Larynx | 6 (15.4) |
-
- All patients (N=37) with ≥ 1 treatment and no death due to COVID-19 prior to first post-baseline staging ** - dropped off prior to first staging or were not evaluable post-baseline for any reason
-
*** - evaluable patients (N=31): ≥ 1 treatment and ≥ 1 post baseline tumor staging
All four pathologies enrolled
Note:
(1) Preliminary data, cut-off 16 Apr 2021
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TACTI-002 Results[(1)] 2[nd] line HNSCC (Part C)
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Best response:
100
iUPD/iCPD
75 iSD
iPR
50
iCR
25
PD-L1 CPS
0
-25
-50
-75
n = 31
-100
- NE - not evaluable; NY - not yet evaluated ** LN as target lesion; *** target
lesion decrease at PD due to NL
8 4 NE NY 1 100 2 7 0 5 5 5 0 7 5 2 5 <5 4 0 4 1 8 5
0 0 0 1 1 1 0 NE 2 8 NY 0 NE 0 4 1 1 NY 0 NY
Best % change from baseline
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100
Best response:
80
iUPD/iCPD
60 iSD
iPR
40
iCR
20
0
-20
-40
-60
-80
-100
0 12 24 36 48 60 72 84 96
cut-off 16-Apr 2021, n=31
weeks
… patients still under therapy
% change compared to start of therapy
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Figure 3: Duration of response (DOR) for confirmed responders
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100
50
DoR HNSCC
N=10
0
0 6 12 18
months
Probability of Survival
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Deep responses with 5 Complete Responses Duration of response (DoR)
-
91% confirmed responses
-
80% confirmed responses ongoing (censoring at 4-20 months)
-
No progression prior to 6 months DOR
-
Median duration of response cannot be estimated yet
Note:
(1) Preliminary data, cut-off 16 Apr 2021 ** >= 1 post baseline tumor staging (N=31)
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TACTI-002 Results[(1)]
2[nd] line HNSCC (Part C)
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Kaplan-Meier Plot PFS*
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100
90
CPS >=1 (n=24)
80
unselected for PD-L1 (n=37)
70
60
50
40
30
20
10
0
0 6 12 18 24
Probability of Survival
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months
Overall population (unselected for PD-L1)
Selected for PD-L1 expression, CPS ≥ 1 *
-
Median PFS 2.1 mths
-
30+% progression free at 6 mths
Median OS (58% events) 12.6 mths Median PFS (71% events) 4.1 mths (45% prog. free at 6 mths) ORR iRECIST (95% CI) 45.8% (25.6-67.2)
Note:
(1) Preliminary data, cut-off 16 Apr 2021 (2) * ≥ 1 treatment and no death due to COVID-19 prior to first post-baseline staging (N=37)
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INSIGHT-004 (Stratum D) Results[(1)]
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Efficacy
-
5/12 (42%) with partial responses in different indications:
-
1st line MSI high colorectal cancer; 1st line pleural mesothelioma; after radiochemo in squamous anal cell; pre-treated squamous cervical cancer (PD-L1 TPS < 1%) carcinoma; 3[rd] line gastroesophageal junction
-
75% (n=9) are still alive → 66.7% (n=4) of cohort 1 and 83.3% (n=5) of cohort 2
Safety
-
Combo of avelumab 800 mg + efti 6 mg or 30 mg efti s.c. is feasible and safe
-
No unexpected AEs
Conclusion
-
Treatment with efti + avelumab safe, with promising signals of efficacy
-
Efti + avelumab seems to be a potent combination for enhancing PD-L1 directed therapy and needs further evaluation in new trials
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Best overall response (RECIST 1.1)
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Note:
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(1) ASCO 2021: J Clin Oncol 39, 2021 (suppl 15; abstr 2518); DOI 10.1200/JCO.2021.39.15_suppl.2518
IMP761 a Potential Game Changer for Autoimmune Diseases
Current autoimmune drugs fight the symptoms, treating general inflammation (corticoids, methotrexate, anti-TNF-α, -IL-6, -IL-17, - IL-23 mAbs)
IMP761 potentially fights the cause, treating the disease process by silencing the few autoimmune memory T cells accumulating at the disease site
Immutep to submit an Investigational New Drug (IND) application with the US FDA to begin clinical trials
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US$153.32 billion market by 2025[1]
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IMP761 has broad potential in targeting auto-reactive memory T cells
15 Notes 15 (1) Source: https://www.researchandmarkets.com/reports/4828880/autoimmune-disease-therapeuticsmarket-by-drug
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New Efti Studies - TACTI-003, INSIGHT-005 & INSIGHT-003 -
Positive data driving expansion of clinical program
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With the ongoing strength of data reported at leading conferences SITC 2020; SABCS 2020; ASCO 2021), : Immutep plans to expand and advance its clinical portfolio[(1)]
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Manufacturing
New Phase III Registration Other Trials
New Phase II Trial
Trial Commence process
Two new investigator-
e.g. Triple therapy: anti-PD1 characterisation and
Metastatic breast cancer initiated trials (IITs) with up
+ chemo + efti combination validation for efti commercial
(based on AIPAC) to 40 pts each
manufacturing (2,000 L scale)
Regulatory
Autoimmune Program Strengthen the team
Ongoing interactions with
IND package for IMP761 and research projects
the FDA and EMA
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Immutep expects a range of clinical trials to have significant data read outs in the coming years
17 Notes 17 (1) Expansion and advancement of clinical portfolio is subject to achieving relevant regulatory approvals.
TACTI-003 Trial in 1[st] line HNSCC
Current Design + Status
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In collaboration with
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Design:
-
Randomised study with ORR as primary endpoint
-
Sites worldwide (AU, US, Europe)
-
Approx. 154 pts: either to be randomized to have sufficient pts. in each group or in an experimental arm
Status:
-
Study start up announced on 6 July 2021, with patient recruitment expected to begin within Q3 of calendar year 2021.
-
Fast Track designation granted by FDA in April 2021
18
INSIGHT Platform Trial in Solid Tumours
INSIGHT-005 study arm (Stratum E): Efti + Bintrafusp Alfa combo
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To evaluate the feasibility and safety of combined treatment with bintrafusp alfa (M7824) and eftilagimod alpha.
In collaboration with:
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Institut für Klinisch-Onkologische Forschung
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Bintrafusp alfa: bifunctional fusion protein that aims to block two immunosuppressive pathways: TGF-β and PD-L1
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Phase I/IIa 12 Open label trial Patients in 3 cohorts
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Efti: LAG-3 fusion protein that activates antigen presenting cells (APCs) via the LAG-3 – MHC II pathway
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12 months Combination treatment
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Two sites Germany
Solid tumors
-
histologically confirmed locally advanced or metastatic
-
received ≤ 4 prior lines of therapy
Q2W for maximum of 12 months
-
bintrafusp alfa 1200 mg i.v.
-
eftilagimod alpha 30 mg s.c.
RP2D, Safety, ORR, PFS, PK, PD
19
INSIGHT Platform Trial in Solid Tumours
New INSIGHT-003 study arm (Stratum C): Efti + anti-PD-1 + chemo
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First evaluation of efti in a triple combination therapy
INSIGHT-003 is a new stratum of the investigator-initiated phase I trial, INSIGHT
-
Expansion into triple combination therapy of efti, standard of care chemotherapy and anti-PD-1 therapy
-
Regulatory and ethical approvals received enabling patient recruitment
-
First patient expected to be enrolled in Q3 of calendar year 2021 and first interim results expected in 2022
-
Results to inform about safety and activity
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Phase I study
Up to 20 patients with various solid tumours
Safety, tolerability & initial activity
One site
Germany
24 weeks
therapy duration
20 20
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Corporate Snapshot & Outlook
Corporate Snapshot
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IMM (ASX)
Ticker symbols
IMMP (NASDAQ)
Securities on issue [(1)]
~ 850.92 million ordinary shares
(post transaction)
Proforma cash balance [(2)]
~ A$114.03 million (US$85.73 million)
(post transaction)
Market Cap [(3)]
~ A$425.46 million (US$311.61 million)
(post transaction)
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Notes:
NB: All above figures are provided on a “post transaction” basis and include new Shares from the completed Share Purchase Plan (SPP) (the details of which were announced to ASX on 21 July 2021) and assumes Tranche 2 Placement Shares are approved by shareholders at today’s EGM.
-
(1) As at 30 Jun 2021, 39.04% of the ordinary shares are represented by ADSs listed on NASDAQ where 1 ADS represents 10 ordinary shares.
-
(2) Pro forma cash balance based on Immutep’s cash balance at 30 June 2021 plus the gross proceeds from the SPP and Tranche 2 share issuance.
-
(3) Market capitalization based on ASX close share price of A$0.50 on 21 July 2021 and basic ordinary shares outstanding on a post transaction basis.
US equivalent of amounts above are based on foreign exchange rate for AUD/USD of 0.7324 for market capitalization, and the US cash & cash equivalents amount was calculated using FX rate of 0.7518.
22
2021/2022 News Flow*
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H1 2021 H2 2021 2022
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-
✓ Fast Track designation granted for efti in 1[st] line HNSCC from US FDA
-
✓ Data from TACTI-002 & final data from INSIGHT004 at ASCO
-
✓ Expansion of existing programs, adding:
-
✓ Second collaboration with MSD for TACTI-003
-
✓ First triple combination therapy with efti in INSIGHT-003
-
✓ New collaboration with Merck KGaA for INSIGHT-005
-
✓ Patent protection strengthened
-
✓ Financial position significantly strengthened
-
✓ Validation of LAG-3/MHC-II interaction through BMS’s Phase III results in melanoma
-
❑ Final data from AIPAC : 2[nd] OS follow up in H2 2021
-
❑ Start & ongoing recruitment of new randomised trial in 1st line HNSCC (TACTI-003) in Q3 2021
-
❑ Recruitment & further data from TACTI-002 in 2021 or early 2022
-
❑ INSIGHT-003 first patient enrolled in Q3 2021 and first interim results in 2022
-
❑ INSIGHT-005 first patient enrolled in H2 2021
-
❑ Manufacturing scale up to 2,000 L
-
❑ Ongoing regulatory engagement
-
❑ Updates from IMP761
-
❑ Updates from partnered programs (e.g. GSK, Novartis, EAT COVID, CYTLIMIC and EOC Pharma)
Notes:
*The actual timing of future data readouts may differ from expected timing shown above. These dates are provided on a calendar year basis. A tick symbol indicates a completed item.
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