ERADICATING INNOVATIVE HPV INFECTION IMMUNOTHERAPIES BEFORE TO IT CAUSES CERVICAL DISEASES CANCER AND CANCER FIGHT INFECTIOUS
MODIFIEZ STYLE DU TITRE CorporateLE Presentation June 2016 1
DISCLAIMER This document has been prepared by Genticel (the "Company") and is for information purposes only. The information and opinions contained in this document are provided as of the date of this document only and may be updated, supplemented, revised, verified or amended, and thus such information may be subject to significant changes. The Company is not under any obligation to update the information or opinions contained herein which are subject to change without prior notice. The information contained in this document has not been subject to independent verification. No representation, warranty or undertaking, express or implied, is made as to the accuracy, completeness or appropriateness of the information and opinions contained in this document. The Company, its subsidiaries, its advisors and representatives accept no responsibility for and shall not be held liable for any loss or damage that may arise from the use of this document or the information or opinions contained herein. This document contains information on the Company’s markets and competitive position, and more specifically, on the size of its markets. This information has been drawn from various sources or from the Company’s own estimates. Investors should not base their investment decision on this information. This document contains certain forward-looking statements. These statements are not guarantees of the Company's future performance. These forward-looking statements relate to the Company's future prospects, developments and marketing strategy and are based on analyses of earnings forecasts and estimates of amounts not yet determinable. Forward-looking statements are
subject to a variety of risks and uncertainties as they relate to future events and are dependent on circumstances that may or may not materialize in the future. Forward-looking statements cannot, under any circumstance, be construed as a guarantee of the Company's future performance and the Company’s actual financial position, results and cash flow, as well as the trends in the sector in which the Company operates, may differ materially from those proposed or reflected in the forward-looking statements contained in this document. Even if the Company’s financial position, results, cashflows and developments in the sector in which the Company operates were to conform to the forward-looking statements contained in this document, such results or developments cannot be construed as a reliable indication of the Company's future results or developments. The Company does not undertake any obligation to update or to confirm projections or estimates made by analysts or to make public any correction to any prospective information in order to reflect an event or circumstance that may occur after the date of this document. This document does not constitute an offer to sell or subscribe or a solicitation to purchase or subscribe for securities in France, the United States or any other jurisdiction. Securities may not be offered or sold in the United States absent registration under the US Securities Act of 1933, as amended, or an exemption from registration thereunder. No public offering of securities may be conducted in France or abroad prior to the delivery by the French Autorité des marchés financiers (Financial Markets Authority) of a visa on a prospectus that complies with the provisions of Directive 2003/71/CE as amended. No offering of securities is contemplated in France or any jurisdiction outside France.
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COMPLEMENTARY AND EXPERIENCED MANAGEMENT TEAM Benedikt Timmerman
PhD, MBA • Founder, CEO
PhD in Molecular Genetics – Ghent University, Belgium & MBA - INSEAD, France. 20 years of experience in Academia & Industry. Management positions in R & D and Business Development in Biotechnology and Life Science companies, including Sandoz and Novartis
Martin Koch
Marie-Christine Bissery PhD, Pharm.D
MD, Gynecologist
PhD, Immunology
• Chief Financial Officer
• Chief Development Officer
• Chief Medical Officer
• Chief Scientific Officer
Sales Director, Oncology Cephalon Pharma France (2006 – 2007) and Controlling and Finance Director functions at Elan & Zeneus Pharma UK (2001 – 2005)
International Director of Oncology (2007 – 2008) and Deputy Head of Oncology (2005- 2007) at Sanofi-Aventis; Sr. Director of Experimental Therapeutics and Translational Research, Aventis Pharma (2000 – 2004)
Pediatrics Scientific Coordinator for the European Medicines Agency (notably vaccines), UK (2009-2014) and Senior Director Women’s Health & Bone Repair, Worldwide Project Leader, Wyeth Clinical Research & Development, USA (20012009) & France (1996 – 2000)
20 years of Research Management at GlaxoSmithKline, notably as Head Chronic Disorder Immunotherapeutic Program (2009- 2015) and as Head Cancer Preclinical Immunotherapeutics and Director, R & D, North America, GSK Biologics, Canada (2006-2009)
MsEng, MBA
Sophie Olivier
Rémi Palmantier
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ADVISED BY INDUSTRY EXPERTS & KEY OPINION LEADERS Supervisory Board
Dr Thierry HERCEND President
Ed. De Rothschild Inv. Partners Raphael WISNIEWSKI
Prof. Pierre Van Damme, MD, PhD University of Antwerp
Bpifrance Investissement Dr Olivier MARTINEZ
Prof. Diane Harper, MD, MPH, MS University of Louisville
Kurma Life Sciences Partners Dr Philippe PELTIER Wellington Partners Dr Rainer STROHMENGER Dr Gerald MOELLER Vice President
Clinical Advisory Board
Dr Didier HOCH Mary TANNER Caroline LAPLANE
Emeritus Prof. Chris Meijer, MD University Medical Center Amsterdam Prof. Anna-Barbara Moscicki, MD University of California, San Francisco Emeritus Prof. Margaret Stanley, BSc, PhD OBE University of Cambridge Dr Xavier Bosch, MD, MPH Catalan Institute of Oncology, Barcelona
Industry experience of the Supervisory Board
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SOLID CASH BALANCE
15,554,666 shares outstanding*
€70.1 million raised since inception,
incl. €34.7 million at IPO (04/2014) Cash balance: € 18.8 million* Corresponding to 2 year of financial visibility (mid-2018)
* As at March 31, 2016 5
AN ANTIGEN DELIVERY VECTOR SUITED TO DEVELOP IMMUNOTHERAPIES IN MULTIPLE INDICATIONS CyaA platform
CyaA,
(adenylate cyclase), a breakthrough vaccine carrier licensed from Institut Pasteur based on Bordetella Pertussis (cause of whooping cough)
Unique mechanism of action that triggers both killer and helper T cells
Binding domain targets an integrin receptor of antigen-presenting cells
X
Chosen antigen Recombinant CyaA protein incorporating the antigen of choice
6
A BREAKTHROUGH ANTIGEN DELIVERY VECTOR WITH DUAL MECHANISM OF ACTION Killer cells eliminate cells that contain the antigen
The recombinant CyaA protein delivers the antigen TO and INTO human immune sentinel cells
Helper T cells
Chosen antigen
CyaA + adjuvant
Killer T cells
Eradication of infected cells Antigen Presenting Cell (APC)
The chosen antigen is incorporated in the CyaA protein
Sentinel cells activate antigenspecific immune killer * T cells and helper T cells * cytotoxic
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GTL001, A “FIRST-IN-CLASS” THERAPEUTIC VACCINE TARGETING THE 2 MOST ONCOGENIC HPV TYPES HPV 16 and 18 together cause 70% of cervical cancer cases GTL001consists of 2 CyaA proteins one carrying the E7 antigen of HPV 16 the other carrying the E7 antigen of HPV 18 CyaA-HPV16-E7 16E7
GTL001 first-in-class first-in-indication therapeutic vaccine
+
CyaA-HPV18-E7 18E7
+
Adjuvant (imiquimod cream 5%)
2 inter-dermal injections 6 weeks apart 2 applications of imiquimod cream 5%, 15 minutes and 24 hours after each injection
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GTL001 PHASE 2 TRIAL (RHEIA-VAC)
HALFWAY THROUGH 24-MONTH PROTOCOL CONDUCT PHASE 2 PROOF OF CONCEPT STUDY 222 HPV16 +/- 18 positive women (25-50) W Europe - 7 countries GER, UK, FIN, SP, FR, BE, NL 39 centers
Last patient in
H1 16
Nov 14
600 µg + imiquimod
Viral clearance at M6 & 12
H1 17 Viral clearance at M15 & 18
Maintenance of viral clearance
< 6 weeks >
Placebo + imiquimod < 6 weeks >
n =111 M12
M18
M24
n =111
STUDY POPULATION
Women 25-50 yrs infected by HPV 16 and/or 18 with NILM, LSIL or ASCUS cytology, exclusion of CIN2+ by colposcopy/histology
EFFICACY ENDPOINTS
Primary endpoint at M12 Efficacy of GTL001 + imiquimod to clear HPV 16 and 18 cervical infection as compared to placebo Main secondary endpoints Sustained clearance at M24 Progression to CIN2+
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18 MONTH INTERIM RESULTS AND CONCLUSIONS OF GTL001 PHASE 2 STUDY IN EUROPE
Interim Conclusions
Good Safety Profile No unexpected safety events
Expectations at 24 months
Reactions are mostly local, as expected All reactions are transient ( $2 billion per year 1
2
Initial revenue received in 2015,
next step H2 16
WHO: Weekly epidemiological record, 85, 2010 (http://www.who.int/wer); Klein et al., New England Journal of Medicine, 367(11), 2012; Koepke, Journal of Infectious Disease, 210, 2014; [2] Cheung et al., Infection and Immunity, 74(12), 2006
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VAXICLASE - MECHANISM OF ACTION IN DEVELOPMENT OF IMMUNOTHERAPIES AND VACCINES VAXICLASE AS ANTIGEN VECTOR USE BY GENTICEL FOR GTL002
Antigen inserted in N-terminal domain
Delivers antigen to sentinal cells of immune system
Activates antigen-specific T Killer1 cells and T Helper cells
Eradicates cells carrying targeted antigen
Safety confirmed by GTL001 of vectors based on CyaA
X
Y A
VAXICLASE AS ACTIVE INGREDIENT (PERTUSSIS ANTIGEN2) USE BY SIIL FOR GTL003
Vaxiclase alone as CyaA recombinant protein with no exogenous antigens.
Vaxiclase induces anti-CyaA antibodies CyaA neutralization of pertussis
Increases production of antibodies against other antigens, e.g., DTaP4
Induces TH1/TH17 cellular response “memory” immune response
Z
Vaxiclase with other antigens 1 2 3 4
Vaxiclase without exogenous antigens Cytotoxic Whooping cough is caused by B. pertussis CyaA = Adenylate Cyclase; DTaP= Diphtheria, Tetanus, acellular Pertussis
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NEXT STEPS 2015
License agreement on Vaxiclase signed with SIIL*
02/15
In vivo results for GTL001 show ability to treat & protect
04/15
In vivo preclinical proof of concept of GTL002
05/15
2016
Agreement with Roche to evaluate the cobas® test for use in GTL001 Phase 3
Q1
GTL001 Phase 2 efficacy data at M12
Q1
GTL001 Additional results at 12 months of phase 2 trial
T2
GTL002 in-vivo immunology data (EUROGIN 2016)
T2
H1
GTL001 Phase 2 efficacy data at M 15 & 18
T2
GTL001 US phase 1 tolerability results
H2
Vaxiclase 1st milestone with SIIL*
H2
GTL001 End of phase 2 at M24
Q1
FDA Clearance for U.S. Phase 1 trial of GTL001
06/15
US patent protecting use of platforms to treat cancer
09/15
1st US patient vaccinated with GTL001
10/15
2017 * Serum Institute of India Ltd
GTL001 Commercialized HPV tests validated Five-year stability demonstrated
Increase business development activities
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STRATEGIC UPDATE FOR 2016 Continue GTL001 phase 2 trial until end at 24 months* (january 2017) and reevaluate program at that point in time.
Cash Preservation Continue reducing expenses to extend Company’s funding beyond mid 2018.
Maintain core assets in immunology and clinical development
Focus on business development activities
Strengthen partnership with Serum Institute of India Ltd Pipeline expansion: gain access to innovative development-stage molecules with a strong market potential.
* Under the condition that DSMB approves continuation during its next scheduled for early July 2016
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APPENDICES ▌ FINANCIALS – 2015 ANNUAL RESULTS ▌ GTL001, CLINICAL DATA ▌ IMIQUIMOD AS VACCINE ADJUVANT
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FINANCIALS (31/12/15)
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INCOME STATEMENT (IFRS) Figures in line with company’s expectation
Audited data in K€ Revenues
Advance on GLT001 phase 2 in EU Initiation of a phase 1 in the U.S.
Non-recurring expenses (€0.7 million)3
Interest earned from investing funds 1
2 3
2014 financial statements have been amended in application of IAS 8 (please refer to half-year 2015 financial statements for detailed information) Research tax credit (crédit d’impôt recherche) in France Onetime recruitment costs, ad-hoc market access studies, Intellectual Property management expenses
20141
2015 -
178
(11,190)
(10,935)
Subsidies (CIR2)
2,904
2,940
G&A expenses
(2,763)
(3,599)
Operating result
(11,049)
(11,417)
105
223
(10,944)
(11,193)
(0.79)
(0.72)
R&D expenses
Financial result Net income Net income per share
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BALANCE SHEET (IFRS) €5.2 million of capitalization contract Incl. €2.9 million of Research Tax Credit 2015 €5.0 million in short time deposits Total cash position of €21,8 million2 in line with pipeline development advances
Audited data in K€
20141
2015
Non current assets
10,303
5,501
3,172
3,706
Current financial assets
12,557
5,022
Cash & equivalents
10,170
11,660
TOTAL ASSETS
36,202
25,889
Shareholders equity
30,217
20,335
380
322
Financial debts
2,158
2,522
Other liabilities
3,447
2,710
36,202
25,889
Current receivables
Employee LT Obligation
Repayable advances for €2.6 million Trade payables for €1.9 million
TOTAL LIABILITIES 1
2014 financial statements have been amended in application of IAS 8 (please refer to half-year 2015 financial statements for detailed information)
2
Total cash position results from €11,7 M in cash & equivalents, €5,1 M in non current assets (capitalization contract) and €5 M in current financial assets (term deposits) in accordance with IFRS standards.
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CASH FLOW STATEMENT (IFRS) Audited data in K€
20141
2015
Cash flow from operating activities
(9,847)
Cash flow from investing activities
(22,573)
12 585
38,752
649
Opening cash & equivalents
3,839
10,170
Variation
6,331
1,490
10,170
11,660
Cash flow from financing activities
Closing cash & equivalents
(11,744)
Breakdown of change in WCR Audited data in K€ Other non-current financial assets
20141
2015
17
(7)
Inventories (net inventory impairment)
(13)
21
Other receivables
588
514
Trade payables and related accounts
(740)
776
Tax & social security liabilities
(192)
(37)
18
(1)
(322)
1,266
Other creditors & miscellaneous liabilities Total change
Growth in WCR (€1.2 million in 2015 versus -€0.3 million in 2014) mainly due to decrease in trade payables between 2014 and 2015 (versus increase between 2013 et 2014)
2014 financial statements have been amended in application of IAS 8 (please refer to half-year 2015 financial statements for detailed information) 1
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GTL001, CLINICAL DATA ▌
PHASE 1
▌
PHASE 2 AT 12 MONTHS
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GTL001, PHASE 1 COHORTS Cohort 1 Open-label N=5 GTL001 100 µg solution + imiquimod
Safety review
Cohort 2 Open-label N=5 GTL001 600 µg solution + imiquimod
Safety review
Published in June 2016 Clinical Cancer Research
Cohort 3 Randomized, double-blind N = 28 2:1:1 randomization
GTL001 GTL001 600 µg solution + 600 µg solution + imiquimod placebo cream
Safety review
Placebo injection + imiquimod
Cohort 4 Open-label N=9 GTL001 600 µg powder + imiquimod
Safety review 23
GTL001, EU PHASE 1 STUDY PC10VAC01 DESIGN
Patients: HPV16 and/or 18-infected women with normal cytology
Study Objectives
Primary: general safety and local tolerance ● Incidence of general and local adverse events ● Changes in cervical cytology and HPV virology
Secondary: cellular and humoral immunogenicity
● Peripheral blood E7-specific T cell response (IFNg ELISPOT) ● Anti-CyaA and anti-E7 antibody responses (ELISA)
2 GTL001 formulations tested
Liquid form (5 x 0.2 ml id) - Powder form (1 x 0.2 ml id)
4 cohorts, including one randomized cohort
NB: not powered for statistical significance, no statistical analysis performed
Viral clearance and clearance maintenance for indicative purposes only
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GTL001, TOLERABILITY IN PHASE 1
Local reactions Mostly erythema, induration, pain Generally mild to moderate and short-lived (less than 7 days) More severe after second injection Severe reactions reported by 5-15% of patients
Systemic reactions Include flu-like symptoms (fever, headache, arthralgia/myalgia, and fatigue) Mostly mild to moderate
No drop-out from the study Minimal concomitant medication due to local or systemic reaction was (1 patient
took one dose of Tylenol)
Vaccines administered i.d., such as BCG or rage vaccines, also report transient
severe local reactions
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GTL001 PHASE 1 STUDY COMPELLING RESULTS
ON 47 HPV 16 AND/OR 18 POSITIVE WOMEN (1) – NILM ONLY RESULTS PUBLISHED IN JUNE 2016 IN CLINICAL CANCER RESEARCH
Demonstrated safety profile
More patients treated with GTL001 eradicated their HPV
No dose-limiting toxicity No treatment-related Serious Adverse Effects (SAE) No patients stopped trial participation (no drop-outs) Reactions are mostly local, generally mild or moderate, as expected
0
n=6
62%
GTL001
n = 18
Placebo
0
20
n=3
40
60
80
100
43% (2)
20
40
60
80
100
More patients treated with GTL001 and followed for > 12 months remained virus free
n=9
17%
74%
Placebo
n=7
All reactions are transient (
n =20
US - 4 centers Diane Harper, MD, lead investigator
H1 16
M3
2 cohorts: 25-50 and 50-65 years of age
STUDY POPULATION
Women 25-65 yrs. infected by HPV 16 and/or 18 with Normal, LSIL or ASCUS cytology, exclusion of CIN2+ by colposcopy/histology
ENDPOINTS
Primary endpoint at M3 Tolerability of GTL001, notably in the age group 50-65 (not studied previously) Secondary endpoint Immune response at M3 Warning: as with any phase 1 study, the study is not designed to provide statistically significant efficacy data.
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Q2 2016: COMPLETION OF TWO MAJOR MILESTONES IN PREPARATION FOR PHASE 3 PROGRAM OF GTL001
1
GLOBAL CLINICAL PROGRAM: NEED FOR A WIDELY AVAILABLE HPV GENOTYPING TEST
cobas® HPV test, only test both EU-labeled and FDA-approved Only test approved in the US as first-line primary screening in women 25 years of age and older instead of cytology Extensively tested in the Athena trial1 (more than 47,000 women) HPV 16/ 18 genotyping (+ 12 other high-risk HPV)
TEST CONFIRMED, ABILITY TO USE CLINICALLY VALIDATED HPV TESTS
2
REGISTRATION STUDIES: NEED FOR SUFFICIENT PRODUCT STABILITY EQUIVALENT TO FUTURE MARKETED PRODUCT. 5 YEAR SHELF LIFE OF GTL001 DEMONSTRATED Wright et al. Dépistage du cancer cervical primaire avec le virus du papillome humain : Fin de résultats de l'étude ATHENA utilisant HPV comme test de dépistage en première ligne , Gynecol Oncol 2015: 136; 189-197
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IMIQUIMOD AS VACCINE ADJUVANT
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IMIQUIMOD CREAM 5% SAFE AND EFFECTIVE TOPICAL ADJUVANT Imiquimod (Aldara Cream) activates TLR7/TLR8 in humans Binds to intracellular TLR7 in Antigen Presenting Cells (APC)
leading to a TH1 cytokine profile promoting an effector T cell response Immune response modifier marketed for topical applications on the skin (i.e., external genital and perianal warts and superficial basal cell carcinomas in adults) Several generic versions available in the US
Application at the site of GTL001 ID injection (upper thigh) Used at doses < to normal approved usage
Acknowledged by FDA as an adjuvant in GTL001 IND submission 31
REFERENCES - IMIQUIMOD AS VACCINE ADJUVANT
Imiquimod, a low molecular weight compound in the imidazoquinoline family, is a toll-like receptor (TLR) agonist that binds TLR7 and TLR8 in humans (Stary et al 2007; Schön and Schön 2008) but only binds to TLR7 in mice. Animal and human studies have previously demonstrated that immune responses to a T cell protein-based vaccine can be enhanced by the topical application of imiquimod (Rechtsteiner et al 2005; Othoro et al 2009; Vasilakos and Tomai 2013; Fehres et al 2014; Adams et al 2008; Firbas et al 2010).
Stary G, Bangert C, Tauber M, et al. Tumoricidal activity of TLR7/8activated inflammatory dendritic cells. J Exp Med. 2007;204(6):1441-51
Schön MP and Schön M. TLR7 and TLR8 as targets in cancer therapy. Oncogene. 2008;27(2):190-9.
Rechtsteiner G, Warger T, Osterloh P, et al. Cutting edge: priming of CTL by transcutaneous peptide immunization with imiquimod. J Immunol. 2005;174(5):2476-80.
Othoro C, Johnston D, Lee R, et al. Enhanced immunogenicity of Plasmodium falciparum peptide vaccines using a topical adjuvant containing a potent synthetic Toll-like receptor 7 agonist, imiquimod. Infect Immun. 2009;77(2):739-48.
Vasilakos JP, Tomai MA. The use of Toll-like receptor 7/8 agonists as vaccine adjuvants. Expert Rev Vaccines. 2013;12(7):809-19.
Fehres CM, Bruijns SC, van Beelen AJ, et al. Topical rather than intradermal application of the TLR7 ligand imiquimod leads to human dermal dendritic cell maturation and CD8+ Tcell crosspriming. Eur J Immunol. 2014;44(8):2415-24.
Adams S, O'Neill DW, Nonaka D, et al. Immunization of malignant melanoma patients with full-length NY-ESO-1 protein using TLR7 agonist imiquimod as vaccine adjuvant. J Immunol 2008;181:776784.
Firbas C, Boehm T, Buerger V, et al. Immunogenicity and safety of different injection routes and schedules of IC41, a Hepatitis C virus (HCV) peptide vaccine. Vaccine. 2010;28(12):2397-407.
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CONTACTS GENTICEL Valerie Leroy
[email protected] +33 (0)1 82 82 00 20
US INVESTORS Brian Ritchie
[email protected] +1 (212) 915 2578
MEDIA Caroline Carmagnol
[email protected] +33 6 64 18 99 59
Copyright Genticel 2016
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