Slide 1: Unlocking the Potential of PSMA Therapy: A Next Generation Portfolio Approach
Unlocking the Potential of PSMA Therapy: A Next Generation Portfolio Approach Scientific Update April 2026
Slide 2: Forward-looking statements
Forward-looking statements This presentation should be read together with our risk factors, as disclosed in our most recently filed reports with the Australian Securities Exchange (ASX), U.S. Securities and Exchange Commission (SEC), including our Annual Report on Form 20-F filed with the SEC, or on
Slide 3: Presenters and Agenda
Presenters Agenda 1 Telix PSMA Portfolio 2 Experience with TLX597-Tx: OPTIMAL-PSMA David N. Cade, MBBS Group Chief Medical Officer Louise Emmett, MD1 Director of Theranostics and Nuclear Medicine 3 Summary and Q&A Telix Pharmaceuticals St Vincent’s Hospital, Sydney, Australia 1. Prof. Emmett is an i
Slide 4: Telix PSMA Portfolio
Telix PSMA Portfolio Dr. David N. Cade 4
Slide 5: Executive Summary
Executive Summary A next generation portfolio overcomes limitations of first generation RLTs 1. 177Lu-PSMA small molecule radioligand therapy (RLT) is established in advanced prostate cancer (e.g. PSMA-617/I&T) 2. However, use of first generation RLT in early prostate cancer has proven challenging,
Slide 6: Key considerations as PSMA RLT moves into earlier settings
Key considerations as PSMA RLT moves into earlier settings Quality of life and tailored dosing are critical Treatment algorithm for metastatic prostate cancer1 • First generation 177Lu-PSMA-617 / I&T established Estimated U.S. incidence2, 2026 as a treatment for advanced prostate cancer • Emerging c
Slide 7: QOL learnings from 177Lu-PSMA-617 in hormone sensitive setting
QOL learnings from 177Lu-PSMA-617 in hormone sensitive setting Challenges in healthier patients may limit potential clinical utility PSMAddition Ph 3 showed limited improvement … leading to clinicians expressing concern about in QOL with PSMA-6171… utility and level of adoption2 FACT-P Total Score (
Slide 8: What does the "next generation" need to look like to succeed?
What does the “next generation” need to look like to succeed? Moving the needle on PSMA theranostics • Greater consideration around clearance organ dosimetry (hepatic clearance or very low renal imparted dose) • Avoidance of exocrine gland irradiation • Higher tumor retention / residualization, espe
Slide 9: TLX597-Tx (177Lu-DOTA-HYNIC-panPSMA)
TLX597-Tx (177Lu-DOTA-HYNIC-panPSMA) Highly targeted small molecule agent optimized for early prostate cancer Representative images from 2 different patients who achieved ≥85% decrease from baseline PSA level following treatment • Current status: with TLX597-Tx1 o Exploratory Phase 1 investigator-in
Slide 10: Portfolio to address early and late stage prostate cancer
Portfolio to address early and late stage prostate cancer Hormone-sensitive Castration-resistant Metastatic hormone-sensitive Metastatic castration-resistant Palliative TLX090-Tx TLX592-Tx Phase 3 TLX591-Tx TLX597-Tx in PSMA+ mCRPC OPTIMAL-E patients previously Global treated with 1 ARPI Phase 2a in
Slide 11: Experience with TLX597-Tx: OPTIMAL-PSMA
Experience with TLX597-Tx: OPTIMAL-PSMA Prof. Louise Emmett 11
Slide 12: OPTIMAL-PSMA: POC for novel dosing with next gen agent
OPTIMAL-PSMA: POC for novel dosing with next gen agent Phase 2 IIT at St Vincent’s Hospital has dosed over 85 patients with TLX597-Tx • VISION1 and TheraP2 trials demonstrated that 177Lu-PSMA-617 improves QOL, but OS benefit is modest • Evidence suggests underdosing of patients with PSMA therapy o S
Slide 13: TLX597-Tx dosimetry: Favorable profile vs available agents
TLX597-Tx dosimetry: Favorable profile vs available agents Dosimetry enables dose intensification TLX597-Tx SPECT scan, 5 and 120 hr TLX597-Tx PSMA-6172 PSMA-I&T2 Organs (Gy/GBq) (Gy/GBq) (Gy/GBq) (n = 12)1 (n = 297) (n = 153) Kidneys 0.28 0.58 0.71 Lacrimals 0.35 1.58 2.83 Submandibular 0.25 0.74 0
Slide 14: TLX597-Tx uptake profile compared to PSMA-617
TLX597-Tx uptake profile compared to PSMA-617 Long tumor retention even at 120 hours, limited salivary gland and kidney uptake TLX597-Tx SPECT biodistribution1 PSMA-617 SPECT biodistribution2 4hrs 24hrs 120hrs Dosimetry demonstrates low salivary gland and renal doses, high persistence of tumor radia
Slide 15: TLX597-Tx proof-of-concept: Phase 2 OPTIMAL-PSMA study
TLX597-Tx proof-of-concept: Phase 2 OPTIMAL-PSMA study Exploring safety, dosimetry, and efficacy of short-interval dose intensification Aim: To see whether giving 177Lu-PSMA more frequently at the start of treatment can overcome early resistance and improve outcomes. Investigator Initiated Trial (PI
Slide 16: Why is up-front dose intensification effective?
Why is up-front dose intensification effective? Dose 1 induces PSMA expression in tumors, potentially increasing uptake of doses 2 and 3 Day 3 scans show increase in TTV from higher PSMA expressions Patient Case A Patient Case B • 3 doses upfront Dose 1 (Day 1) Dose 2 (Day 3) Dose 1 (Day 1) Dose 2 (
Slide 17: Patient case: TLX597-Tx post-chemo (2 lines), post-ARPI
Patient case: TLX597-Tx post-chemo (2 lines), post-ARPI Dose 1 Dose 2 Dose 3 Dose 4 (Day 1) (Day 3) (Day 15) (Week 10) 71-year-old patient with diffuse bone metastases • Blood platelets lower but stable • Normal kidney function • Substantial shrinkage of lesions • 97% PSA response Day 1 Day 3 Day 15
Slide 18: Early data warrants exploring TLX597-Tx in the mHSPC setting
Early data warrants exploring TLX597-Tx in the mHSPC setting Biodistribution, flexible dosing regimen, favorable safety suggest promising profile Safety profile Pharmacokinetic (PK) profile • Quality of life Low renal and salivary Long tumor retention, high lesion characteristics gland uptake, limit
Slide 19: OPTIMAL-E: TLX597-Tx proof-of-concept in mHSPC (n=20)
OPTIMAL-E: TLX597-Tx proof-of-concept in mHSPC (n=20) Ph 2a exploring adaptive dosing with 3, 5, or 7 doses depending on response 2-week Initial 3 dose, 2- Adaptive dosing of 4 cycles Eligibility TLX597-Tx Dose PSMA receptor week loading phase if disease persists • 3 dose loading Intensification • U
Slide 20: Summary
© Telix Summary
Slide 21: Q&A
© Telix Q&A
Slide 22: Telix Contacts
Crystal structure of prostate-specific membrane antigen Telix Contacts: Kyahn Williamson (Global) SVP Investor Relations and Corporate Communications kyahn.williamson@telixpharma.com Telix Investor Relations (U.S.) Ms. Annie Kasparian Director Investor Relations and Corporate Communications annie.ka