Slide 1: Investor Call NANETS 2024 Presentation
Investor Call NANETS 2024 Presentation November 21, 2024 NYSE AMERICAN: CATX
Slide 2: Forward-looking statements
This presentation contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995. Statements in this presentation that are not statements of historical fact are forward-looking statements. Words such as “may,” “will,” “should,” “expect,”
Slide 3: Radiopharmaceutical Therapy Poised to Revolutionize Oncology Treatment
Despite multiple treatment modalities, cancer remains the 2nd leading cause of death in the US1 Targeted therapies e.g., TKIs, mAbs Surgery Bone marrow transplantation External beam radiation Chemotherapy Immunotherapy Hormone therapy Antibody-drug conjugates Radiopharmaceuticals Physical removal or
Slide 4: Unique Payload Delivery Technology Offers Pan-Cancer Opportunities
Targeting Peptide Engineered for cancer-specific receptors to ensure highly directed uptake Linker Selected to assist peptide binding and optimize clearance from blood and healthy tissues Isotope 203Pb for SPECT imaging Chelator Perspective’s proprietary platform technology enabling stable radiolabe
Slide 5: Designed to Deliver a Potent Payload + Optimized Therapeutic Window
Designed to Deliver a Potent Payload + Optimized Therapeutic Window 1”Pb-Specific Chelator”; 2Mirzadeh et al., Radiochimica Acta, 1993 Perspective’s proprietary technology integrates a chelator optimized for 212/203Pb DOTA TCMC PSC1 Perspective’s PSC Chelator Proprietary Designed specifically for Pb
Slide 6: Preclinical Results: Evidence of a Differentiated Biodistribution Profile
Lee D, Li M, Liu D, et al. Structural modifications toward improved lead-203/lead-212 peptide-based image-guided alpha-particle radiopharmaceutical therapies for neuroendocrine tumors. Eur J Nucl Med Mol Imaging. 2024;51(4):1147-1162. doi:10.1007/s00259-023-06494-9 Preclinical Results: Evidence of a
Slide 7: Broad Proprietary Pipeline
Construct Target Disease Discovery Human Clinical Imaging First in Human Therapy Phase 1/2 Phase 3 VMT-⍺-NET Neuroendocrine tumors Other SSTR2 expressing tumors VMT01/02 Melanoma (MC1R imaging & therapy) PSV359 (FAP) Multiple solid tumors PSV40X (Small Molecule) Prostate (PSMA imaging & therapy) Oth
Slide 8: Neuroendocrine Tumors: VMT-α-NET
Neuroendocrine Tumors: VMT-⍺-NET Targeting the somatostatin receptor to treat rare neuroendocrine-type cancers
Slide 9: VMT-α-NET targeting SSTR2 in neuroendocrine tumors
Image Panel: Whole body SPECT scan of NETs patient imaged with [203Pb]VMT-𝛼-NET Fast Track Designation for first line therapy received October 2022 Therapeutic trial in PRRT naïve setting currently recruiting throughout the US Initiated therapy (2022) investigator led study in India – data on 10…
Slide 10: Mechanism of action of radiopharmaceutical therapy
Abbreviations: APC, antigen-presenting cell; DAMPs, damage-associated molecular patterns; dsDNA, double-stranded DNA; RPT, radiopharmaceutical therapy. RPT injection Targeting peptide 212Pb isotope 1. Targeted cell death RPT binds to receptors on cancer cells and releases α particles, resulting in d
Slide 11: Preclinical Results: Linear Dose-Response
Lee D, Li M, Liu D, et al. Structural modifications toward improved lead-203/lead-212 peptide-based image-guided alpha-particle radiopharmaceutical therapies for neuroendocrine tumors. Eur J Nucl Med Mol Imaging. 2024;51(4):1147-1162. doi:10.1007/s00259-023-06494-9 Liu D, et al. European Association
Slide 12: Preclinical Time to Progression and Survival By Administered Dose
Preclinical Time to Progression and Survival By Administered Dose More than 20% increase to the initial tumor volume has been assumed to be progressive Study plan of 90 days duration Lee D, Li M, Liu D, et al. Structural modifications toward improved lead-203/lead-212 peptide-based image-guided alph
Slide 13: Comparison of NET radioligand therapies
(1) US prescribing information; (2) DOI: 10.1056/NEJMoa1607427; (3) NANETS 2021; (4) DOI: 10.1016/S0140-6736(24)00701-3; (5) ASCO 2024; (6) ASCO 2024; (7) SNMMI 2024. No head-to-head studies between the products have been conducted. Given the different study designs and methods, cross-trial comparis
Slide 14: Preliminary Safety and Efficacy Data of [212Pb]VMT-α-NET in SSTR2 NETs
Preliminary Safety and Efficacy Data of [212Pb]VMT-α-NET in Somatostatin Receptor 2 (SSTR2) Expressing Neuroendocrine tumors (NETs) Richard L Wahl MD, Lowell Anthony MD, Lilja B Solnes MD, Samuel H Mehr MD, Lucia Baratto MD, Alaa Hanna MD, Wenjing Yang PhD, Stephen Keefe MD, Thorvardur R Halfdanarso
Slide 15: Disclosures for Dr. Richard Wahl and FDA Status
Disclosures for Dr. Richard Wahl and FDA Status Abdera: consultant Molecular Targeting Technologies, Inc.: consultant, stock options Siemens Healthineers: consultant Voximetry: consultant, stock options Techspert: consultant Clarity Pharmaceuticals: stockholder Perspective Therapeutics: consultant,
Slide 16: Trial Design: [212Pb]VMT-α-NET mTPI-2 Phase 1/2a
Trial Design: [212Pb]VMT-α-NET mTPI-2 Phase 1/2a For Neuroendocrine Tumors 1 mTPI-2: Modified toxicity probability index | https://clinicaltrials.gov/study/NCT05636618 Expansion phase Expansion into non-NET indications (e.g., SCLC) also possible Expansion Cohort [212Pb]VMT-⍺-NET RP2D mCi x 4 Escalat
Slide 17: Patient Characteristics
Patient Characteristics (all patients as treated) Data cutoff 10/31/24 All Treated (N = 9 ) Time since diagnosis (months) Mean 70 Median 37 Range 12, 181 Number of prior systemic therapies Median 1 Range 0, 2 Prior systemic therapies (patients with each) Somatostatin analogues 7 Capecitabine, temozo
Slide 18: Patient Disposition and Exposure
Patient Disposition and Exposure (all patients as treated) 1 Patient experienced syncope and dose was reduced for cycle 3 and cycle 4 to 2.5 mCi of administered activity Additional notes: (1) 17 patients screened, (2) one patient (102-102) experienced a decline in renal function prior to administrat
Slide 19: Incidence of TEAEs
Incidence of TEAEs [212Pb]-VMT-a-NET 92.5 MBq (2.5 mCi) (N=2) [212Pb-VMT-a-NET 185 MBq (5.0 mCi) (N=7) Total (n=9) Grade Grade 1 Grade 2 Grade 3 Grade 1 Grade 2 Grade 3 Grade 1 Grade 2 Grade 3 AEs by Preferred Term and Grade Reported by Patient [Number patients with AE (% of pts treated per cohort)]
Slide 20: Treatment Emergent Adverse Events (2/2)
Treatment Emergent Adverse Events (Occurring in ≥ 2 patients and/or Grade ≥ 2) (2/2) All patients as treated Data cutoff 10/31/24 Incidence of TEAEs [212Pb]-VMT-a-NET 92.5 MBq (2.5 mCi) (N=2) [212Pb-VMT-a-NET 185 MBq (5.0 mCi) (N=7) Total (n=9) Grade Grade 1 Grade 2 Grade 3 Grade 1 Grade 2 Grade 3 G
Slide 21: Estimated Glomerular Filtration Rate, Most Recent versus Baseline
Estimated Glomerular Filtration Rate (eGFR), Most Recent versus Baseline 212Pb-VMT-a-NET 92.5 MBq (2.5 mCi) 212Pb-VMT-a-NET 185 MBq (5.0 mCi) Data cutoff 10/31/24 eGFR eligibility cut-off eGFR eligibility cut-off
Slide 22: Safety Summary
Safety Summary No DLTs were observed in either cohort No grade 4, grade 5 or serious AEs were observed No decline in renal function was observed Hematologic AEs were few in number and low grade No dysphagia was observed No treatment discontinuations due to AE have occurred Data cutoff 10/31/24
Slide 23: Predicted Tumor to Kidney Activity of [212Pb]VMT-α-NET Over Time
Predicted Tumor to Kidney Activity of [212Pb]VMT-α-NET Over Time (Based on Pre-Treatment [203Pb]VMT-α-NET SPECT Imaging and Dosimetry Analysis) Time activity curves for [212Pb]VMT-α-NET are derived from pre-treatment SPECT imaging using 5-7 mCi [203Pb]VMT-α-NET at 1, 4, and 24 hours (n=6). The bold
Slide 24: Preliminary Response Assessment by RECIST v1.1 by Patient Dose Level
Preliminary Response Assessment by RECIST v1.1 by Patient Dose Level * * * * * The full sets of scans following cycle 4 are not yet available to the study team for five patients. Note: Patient 109-103 experienced progressive disease by unambiguous progression of non-target lesions Data cutoff 10/31/
Slide 25: Kinetics of Treatment Response
Kinetics of Treatment Response * The full sets of scans following cycle 4 are not yet available to the study team for five patients. Notes: Patients had progressive disease prior to enrollment on study, and patient 109-103 experienced progressive disease by unambiguous progression of non-target lesi
Slide 26: Preliminary Assessment of Disease Control Durability
Preliminary Assessment of Disease Control Durability Death Disease Progression RECIST v1.1 Response Cohort Cycle 1 Cycle 2 Cycle 3 Cycle 4 Scan 4 completed Scan 4 completed Scan 4 completed Post final treatment scan pending Post final treatment scan pending Post final treatment scan pending Post fin
Slide 27: Patient 103-104 – 212Pb VMT alpha NET
Patient 103-104 – 212Pb VMT alpha NET Rx 5 mCi x 2, 2.5 mCi x 2 March 2023 Oct 2024 May 2023 June 2023
Slide 28: Patient 103-104 – Pre-Rx and Post Rx
Patient 103-104 – 212Pb VMT alpha NET Rx 5 mCi x 2, 2.5 mCi x 2 Pre-Rx 3/2024 Post Rx 10/2024
Slide 29: Conclusions
Conclusions No DLTs were observed No grade 4, grade 5 AEs or SAEs were observed No decline in renal function was observed Hematologic AEs were low in number and low grade No treatment discontinuations due to AE have occurred [203Pb]VMT-α-NET and [212Pb]VMT-α-NET were well-tolerated 8 of 9 (89%) pati
Slide 30: Acknowledgements
Acknowledgements Multi Center trial thanking all investigators and the patients who participated. Special thanks to Doctors Vikas Prasad and Nikos Trikalinos, Lauren Sandner and the CCTR (Center for Clinical Theranostics Research) staff from Washington University for their major contributions, and a
Slide 31: Next steps and concluding remarks
Next steps and concluding remarks
Slide 32: Trial Design: [212Pb]VMT-α-NET mTPI-2 Phase 1/2a
Trial Design: [212Pb]VMT-α-NET mTPI-2 Phase 1/2a For Neuroendocrine Tumors 1mTPI-2: Modified toxicity probability index | https://clinicaltrials.gov/study/NCT05636618 Trial Parameters Escalation Stage Population Key Study Features Study Endpoints Advanced/unresectable or metastatic NETs Progressive
Slide 33: Deeper RECIST Responses Occur with Higher Administered Activity per Kg Body Weight
Data cutoff 10/31/24 Deeper RECIST Responses Occur with Higher Administered Activity per Kg Body Weight
Slide 34: Key future milestones & expected timelines
1 Investigator led research in India in patients with neuroendocrine tumor and medullary thyroid carcinomas. 2 RP2D = recommended Phase 2 dose; ICI = immune check point inhibitor. Program Target Tumor Types Nominate Candidate IND Filing Initiate Cohort 1 Enrolled Cohort 2 Preliminary Update RP2D2 St
Slide 35: Q & A
Q & A