Slide 1: We want to save patients with severe cancer and autoimmune diseases
We want to save patients with severe cancer and autoimmune diseases Clinical investigations with our lead antibody CAN04 to our proprietary target Göran Forsberg, CEO NOVEMBER 2020
Slide 2: Safe Harbour Statement
Safe Harbour Statement Statements in the Investor Presentation, including those regarding the possible or assumed future or other performance of the Company or its industry or other trend projections, constitute forward-looking statements. By their nature, forward-looking statements involve known an
Slide 3: I. Introduction
I. INTRODUCTION
Slide 4: Cantargia – Opportunity to save lives and create value
Cantargia – Opportunity to save lives and create value Discovery Preclinical Project phase phase Phase I Phase II Phase III Commercial phase CAN04 ➢ Potentially more effective treatment against novel target in clinically Pancreatic cancer Chemo combinations validated pathway Non-small cell lung canc
Slide 5: Cantargia at a glance
Cantargia at a glance UNIQUE IMMUNOTHERAPY ANTIBODY CAN04 IN PHASE IIA CLINICAL DEVELOPMENT Current owners (30 Sep 2020) • Positive interim data set with response rates higher than historic data PLATFORM WITH MANY POTENTIAL THERAPEUTIC AREAS Swedbank Robur Funds 9.6% • IL1RAP found on most solid tum
Slide 6: Cantargia addresses NSCLC & PDAC
Cantargia addresses [NSCLC & PDAC] 12% Lung Non-Small Cell Lung Cancer Pancreatic cancer Breast 12% Bowel Prostate 43% Stomach Incidence Liver 10% Larynx Cervix 2.1m Annual global incidences 0.5m Annual global incidences 7% Other 3% 3% 5% 6% 12% Fraction of cancer incidence: 3% Fraction of cancer in
Slide 7: II. Lead Antibody CAN04
II. LEAD ANTIBODY CAN04
Slide 8: CAN04 – Broader MoA than other IL-1 blocking approaches
CAN04 – Broader MoA than other IL-1 blocking approaches Company Compound IL-1α IL-1β ADCC Indication/dev phase Cantargia CAN04 • Pancreatic cancer, NSCLC phase IIa ++ ++ ++ Xbiotech/ Xilonix • Autoimmunity, dermatology Janssen ++ – + • Pancreatic cancer, phase I Novartis Canakinumab • Autoimmunity,
Slide 9: CAN04 – Mechanism of action
CAN04 – Mechanism of action Note: ADCC = Antibody-Dependent Cellular Cytotoxicity. CAF = Cancer-Associated Fibroblast. NK = Natural Killer. MCP = Monocyte Chemoattractant Protein. MMP = Matrix Metallopeptidase. IL = Interleukin. 9 VEGF = Vascular Endothelial Growth Factor
Slide 10: Validating study – Counteracting tumor inflammation
Validating study – Counteracting tumor inflammation Cantos trial (n=10,061) Canakinumab phase iii trials • Canakinumab (Novartis) ADJUVANT NSCLC • 1,500 patients • Reduced lung cancer incidence by 67% and death by 77% (CANOPY-A) • After surgery, no mets, placebo control • Reduced non-lung cancer dea
Slide 11: Tumor shrinkage - PDAC combination
Tumor shrinkage - PDAC combination → CAN04 combination with gemcitabine/abraxane in 1st line → 8 out of 20 evaluable patients with metastatic PDAC showed response (40% vs historic data 23%). Two responses durable for 12 months → Two other patients had tumor shrinkage after initial PD, with decreasin
Slide 12: PDAC Tumor shrinkage – after initial disease progression
PDAC Tumor shrinkage – after initial disease progression RECIST 1.1 Patient X CA19-9 Patient X 50 500 → Two patients had tumor shrinkage of 39 and 24% after initial PD RECIST 1.1 (mm) 40 400 CA19-9 (kE/L) 30 300 → CA19-9 decreased by 92 and 71%. CA19-9 is a biomarker for 20 200 tumor burden 10 100 0
Slide 13: Tumor shrinkage – NSCLC combination
Tumor shrinkage – NSCLC combination → Combination CAN04 gemcitabine/cisplatin. 5 patients were Patient second line to pembrolizumab monotherapy, 4 patients first 1 2 3 4 5 6 7 8 9 line 0 Percent tumor reduction → 6 of 9 evaluable patients showed response including 1 complete response (67% vs histori
Slide 14: CAN04 – CANFOUR clinical trial
CAN04 – CANFOUR clinical trial Interim Final Jun-19 Q3/Q4 H1 2021 2020 CANFOUR RESULTS PHASE I – Dose escalation PHASE IIa – Dosage with assessment of therapeutic effect with safety assessment Monotherapy Combination therapy, NSCLC (Dose group X) Recommended Extension phase II dose Combination thera
Slide 15: CAN04 – NSCLC cancer strategy
CAN04 – NSCLC cancer strategy CAN04 + Docetaxel 2nd/3rd LINE CHEMOTHERAPY Keytruda/platinum doublet progressors CAN04 + platinum doublet GEM/CIS COMBINATION 1st LINE CHEMOTHERAPY Keytruda monotherapy (CANFOUR) progressors Targeted therapy progressors PT DOUBLET & 1ST LINE PD1/PDL1 KEYTRUDA + CHEMO K
Slide 16: Targeting IL1RAP allows unique synergistic effects with chemotherapy (AACR 2020)
Targeting IL1RAP allows unique synergistic effects with chemotherapy (AACR 2020) → Upregulation of both forms of IL-1 in PDX-model treated with Gem/Cis → CAN04 increase efficacy of chemotherapy regimes → CAN04 counteract weight loss after chemotherapy SYNERGY WITH CHEMOTHERAPY IN LINE WITH CURRENT D
Slide 17: Chemotherapy resistance
Chemotherapy resistance → Most chemotherapies induce chemoresistance already after a few months of therapy → Chemotherapy can upregulate both IL-1α and IL-1β → Blocking IL-1 signalling counteracts chemoresistance in preclinical models → High blood levels of inflammatory cytokines IL-1 and IL-6 leads
Slide 18: CMC – Long term production strategy
CMC – Long term production strategy TECHNOLOGY TRANSFER → Transfer to Patheon (Groningen, NL) → Processing method → Equipment → Analytical methods SCALE-UP AND FIRST BATCH → Assure GMP compliance AT NEW PRODUCTION SCALE → Product testing to confirm equivalence with previous produced product → Succes
Slide 19: III. CAN04 Oncology Expansion
III. CAN04 ONCOLOGY EXPANSION
Slide 20: IL1RAP in several cancer with high medical need
IL1RAP in several cancer with high medical need IL1RAP % of patients with IL1RAP CANTARGIA • Discovery of IL1RAP on cancer cells FOUNDATION • Antibodies against IL1RAP – antitumor effects 100 • IP on antibody therapy against IL1RAP 90 80 PRIMARY • Non-small cell lung cancer – NSCLC 70 INDICATIONS •
Slide 21: IL1RAP and PD-1 blockade – Rationale for combination study
IL1RAP and PD-1 blockade – Rationale for combination study IMMUNE SUPPRESSIVE → Myeloid suppressive cells, such as tumor-associated macrophages (TAMs) or myeloid-derived CHRONIC TUMOR suppressor cells (MDSCs) are key cells in PD-1 resistance and express IL1RAP and are stimulated INFLAMMATION by IL-1
Slide 22: US phase I clinical trial
US phase I clinical trial → First patient started → Combination with checkpoint inhibitor in patients no longer responding to PD1/PDL-1 therapy → Primary endpoint safety, secondary endpoints include biomarkers and efficacy → Indications include NSCLC, HNSCC, malignant melanoma and bladder cancer (18
Slide 23: IV. Untapped Possibilities in Autoimmune Diseases
IV. UNTAPPED POSSIBILITIES IN AUTOIMMUNE DISEASES
Slide 24: CAN10 – New development project
CAN10 – New development project → IL1RAP binding antibody potently blocking IL-1, IL-33 and IL-36 → Unique anti-inflammatory activity observed in mouse model → Development focusing on unmet medical need in systemic sclerosis and myocarditis. Disease selection in collaboration with experts based on s
Slide 25: CAN10 counteract inflammation in disease model
CAN10 counteract inflammation in disease model Total back score → Mechanistic proof of concept for IL1RAP blockade in Isotype anti-IL-1β mCAN10 Dexamethasone inflammatory driven psoriasis model 5 → Effect not dependent on IL-1β blockade 4 3 Score (0-8) 2 1 0 0 1 2 3 4 5 6 7 Days CAN10 HAS UNIQUE ANT
Slide 26: V. Milestones and Summary
V. MILESTONES AND SUMMARY
Slide 27: Significant value inflection points
Significant value inflection points NEWSFLOW NEXT 6–9 MONTHS CAN04 → Phase IIa combination results PDAC and NSCLC → Next steps combination therapy PDAC and NSCLC → Phase IIa biomarker/biopsy results → New clinical trial in disease/combination outside CANFOUR CAN10 → Preclinical progress → Production
Slide 28: Cantargia at a glance
Cantargia at a glance UNIQUE IMMUNOTHERAPY ANTIBODY CAN04 IN PHASE IIA CLINICAL DEVELOPMENT • Positive interim data set and further phase II milestones during 2020 PLATFORM WITH MANY POTENTIAL THERAPEUTIC AREAS • Cancer and large number of autoimmune/inflammatory diseases VISION OF BECOMING AN IMPOR