Slide 1: Enhancing the Lives of Patients with Hematologic Malignancies
March 2024 Enhancing the Lives of Patients with Hematologic Malignancies Corporate Presentation Exhibit 99.2
Slide 2: Forward-looking statements
Except for the historical information contained herein, this presentation contains forward-looking statements made pursuant to the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995. Investors are cautioned that such statements, include, without limitation, those regard
Slide 3: Geron is on Target for a Successful Transition to Commercial Company in 2024
*Imetelstat is currently under regulatory review by FDA and EMA for the treatment of transfusion-dependent anemia in adult patients with low- to intermediate-1 risk myelodysplastic syndromes (LR-MDS) who have failed to respond or have lost response to or are ineligible for erythropoiesis-stimulating
Slide 4: Exploring the Broad Potential of Imetelstat and Telomerase Inhibition
TD LR-MDS: transfusion-dependent lower-risk myelodysplastic syndromes; R/R MF: relapsed/refractory myelofibrosis; MF: myelofibrosis; R/R AML: relapsed/refractory acute myeloid leukemia; HR-MDS: higher-risk myelodysplastic syndromes; TI: telomerase inhibitor; PDUFA: Prescription Drug User Fee Act; MA
Slide 5: Imetelstat is a First-in-Class Telomerase Inhibitor Based on Nobel-Prize Winning Science
Murati et al, BMC Cancer 2012; Shih et al, Rev Cancer 2012; Ntziachristos et al, Adv Immunol 2013; Vardiman et al, Blood 2009; Kittur et al, Cancer 2007; Anastasi J Hematol Oncol Clin North Am. 2009; Hiyama et al, J Immunol 1995; Hiyama et al, Br J Cancer 2007; Bruedigam et al, Cell Stem Cell 2014;
Slide 6: Transfusion-Dependent Lower-Risk MDS
Transfusion-Dependent Lower-Risk MDS PDUFA date of June 16, 2024* *Imetelstat is currently under regulatory review in the U.S. and EU for the treatment of transfusion-dependent anemia in adult patients with low- to intermediate-1 risk myelodysplastic syndromes (MDS) who have failed to respond or hav
Slide 7: Lower-Risk MDS Patient Experience
DRG MDS Landscape & Forecast 2022, Mangaonkar, et al., Blood Cancer Journal 2018; Giagounidis, et al. Clinical Cancer Research 2016; Incidence and Outcomes for Low Risk MDS, ASH 2012; Greenberg et al, Blood 2012; Feneaux et al, JCO 2017; Platzbecker et al, Blood 2019; Cogle et al, Curr Hematol Malig
Slide 8: Treatment Landscape for LR-MDS and ~$3.5B TAM in 2031
Continuing unmet need presents significant opportunity for imetelstat; ~$3.5B TAM in 2031 (U.S./EU)^ Treatment Landscape for LR-MDS Lower-Risk MDS (~70%) HR-MDS Symptomatic Anemia (~90%) Second line & later RS+/RS- RS+ (~25%) RS- (~75%) Luspatercept ESAs - preferred Luspatercept – other recommended
Slide 9: Differentiated Imetelstat Profile in IMerge Phase 3
Differentiated Imetelstat Profile in IMerge Phase 3 Robust and Durable Response 1-year median TI duration 2.4-years median TI duration 1.3-years duration Broad Response across MDS Subgroups RS+ and RS- High and very high transfusion burden sEPO level greater than or less than 500 mU/mL Low or interm
Slide 10: Durable Transfusion Independence and Significant Response Rates
8, 16, 24-week data cut off was October 2022; 1-year represents 3 additional months of data (cut off January 2023) P-value is based on Cochran Mantel Haenszel test stratified for prior RBC transfusion burden (≤6 units or >6 units of RBCs/8 weeks) and baseline IPSS risk score (Low or Intermediate-1)
Slide 11: Significant Hemoglobin Rises and Reduction in Transfusions
Significant Hemoglobin Rises and Reduction in Transfusions Observed with Imetelstat 3.6 g/dL median Hgb rise in 8-wk RBC-TI responders ≥4U/8 wks transfusion reduction in ~60% of imetelstat-treated patients P-value is based on a mixed model for repeated measures with change in RBC transfusion as the
Slide 12: Consistent Responses Across MDS Subgroups (8-wk RBC-TI)
Cochran Mantel Haenszel test stratified for prior RBC transfusion burden (≤6 units or >6 units of RBCs/8 weeks) and baseline IPSS risk score (Low or Intermediate-1) ^ One patient on imetelstat arm missing RS category Consistent Responses Observed across MDS Subgroups with Imetelstat (≥ 8-wk RBC-TI R
Slide 13: Consistent Responses Across MDS Subgroups (24-wk RBC-TI)
Cochran Mantel Haenszel test stratified for prior RBC transfusion burden (≤6 units or >6 units of RBCs/8 weeks) and baseline IPSS risk score (Low or Intermediate-1) ^ One patient on imetelstat arm missing RS category Consistent Responses Observed across MDS Subgroups with Imetelstat (≥ 24-wk RBC-TI
Slide 14: Improvement in Patient-Reported Fatigue
Improvement in Patient-Reported Fatigue Associated with Clinical Responses with Imetelstat Significant patient-reported fatigue improvements in 8-wk and 24-wk RBC-TI responders Sustained meaningful improvement in fatigue reported in imetelstat-treated patients Platzbecker, Santini et al. The Lancet
Slide 15: Reductions in Variant Allele Frequency with Imetelstat
Among patients with evaluable mutation data, the maximum reductions in VAF of the SF3B1, TET2, DNMT3A and ASXL1 genes were greater with imetelstat than placebo VAF reduction correlated with longer RBC-TI duration and increases in hemoglobin levels in patients treated with imetelstat Note: Analyses i
Slide 16: Most Common AEs were Manageable, Short-Lived Thrombocytopenia and Neutropenia
The Most Common AEs were Manageable, Short-Lived Thrombocytopenia and Neutropenia Grade 3-4 cytopenias were generally of short duration and reversible Consistent with prior clinical experience, the most common imetelstat AEs were hematologic <2-weeks median duration grade 3-4 thrombocytopenia and ne
Slide 17: Grade 3-4 Cytopenias were Manageable
Grade 3-4 Cytopenias were Manageable with Low Incidence of Clinical Consequences Imetelstat AEs were manageable with supportive care and dose modifications Clinical consequences of grade 3–4 infection and bleeding were low and similar for imetelstat and placebo Most AEs leading to dose modifications
Slide 18: IMerge Phase 3 Data Received Favorably by Surveyed Hematologists
Key attributes of imetelstat resonated strongly with community and academic hematologists IMerge Phase 3 Data Received Favorably by Surveyed Practicing Hematologists Across U.S./EU Key Markets EFFICACY SAFETY Totality of Clinical Benefit Compelling TI rates across RS subgroups, sustained reduction o
Slide 19: Hematologists' Feedback Confirms Imetelstat Opportunity
In ESA R/R patient segment, durability of TI with imetelstat is considered compelling Physicians note that imetelstat demonstrated significant improvements in long-term response (24-week TI) over available options, especially in RS- population; additional clinical experience may increase comfort to
Slide 20: Imetelstat Expected to Become New Standard-of-Care in Second-Line TD LR-MDS
Geron Market Research with U.S. based practicing hematologists (N=50), May 2023; share estimates represent unadjusted physician preference shares across key patient segments and are directional. Utilization percentages were calculated using a weighted average of RS+ and RS- utilization estimates (1/
Slide 21: Imetelstat Expected to Become Important New Option in RS- Subgroup
Geron Market Research with U.S. based practicing hematologists (N=50), May 2023; share estimates represent unadjusted physician preference shares across key patient segments and are directional. Utilization percentages were calculated using a weighted average of RS+ and RS- utilization estimates (1/
Slide 22: Well-Positioned for U.S. Launch upon Potential Approval
Well-Positioned for U.S. Launch upon Potential Approval Prepare Geron Commercial and medical affairs teams fully integrated and preparing for launch Sales force hiring on track for Q1-Q2 2024 Infrastructure development on track Prepare Imetelstat Commercial supply plans, third-party logistics, and s
Slide 23: Imetelstat in Relapsed/Refractory MF
Imetelstat in Relapsed/Refractory MF Evaluating potential improved survival CONFIDENTIAL |
Slide 24: Expected MF Market Evolution and Imetelstat Opportunity
^see slide 33 for more information on TAM and patient numbers Expected MF Market Evolution and Imetelstat Opportunity We expect the future MF market to expand significantly with potential approvals of JAKi-based combination regimens and treatments that address anemia in MF patients. Agents in develo
Slide 25: First and Only Phase 3 Trial in MF with OS as Primary Endpoint
50% enrolled as of Nov. 2023 First and Only Phase 3 Trial in MF with OS as Primary Endpoint Statistically well-powered trial Designed with >85% power to detect a 40% reduction in the risk of death in the imetelstat arm compared to best available therapy (BAT; hazard ratio=0.60; one-sided alpha=0.025
Slide 26: Improvement in Overall Survival in IMbark Phase 2
Improvement in overall survival (OS) observed for JAKi relapsed/refractory MF patients in IMbark Phase 2 14 – 16 mos median OS for historical controls for JAKi relapsed/refractory MF patients 29.9 mos median OS in imetelstat 9.4 mg/kg arm Mascarenhas et al, JCO 2021; Mascarenhas et al, ASH 2018 and
Slide 27: IMbark Phase 2 Compared to Real World Data
27 Kuykendall et al, Annals of Hematol 2021 Acknowledging the limitations of such comparative analyses between RWD and clinical trial data, we believe the favorable overall survival (OS) of imetelstat treatment suggested by these comparative analyses in this very poor prognosis patient population wa
Slide 28: Manageable Imetelstat Safety Results in IMbark Phase 2
28 n (%) 9.4 mg/kg (n=59) All Grades Grade ≥ 3 Hematologic (≥10% in either arm)§ Thrombocytopenia 29 (49) 24 (41) Anemia 26 (44) 23 (39) Neutropenia 21 (36) 19 (32) Non-hematologic (≥20% in either arm) Nausea 20 (34) 2 (3) Diarrhea 18 (31) 0 Fatigue 16 (27) 4 (7) Dyspnea 14 (24) 3 (5) Abdominal Pain
Slide 29: Financials & Summary
_ Financials & Summary
Slide 30: Financial Resources to Support Potential U.S. Commercial Launch
* Based on the Company’s current operating plan and expectations regarding the timing of potential approval of imetelstat in the U.S., the Company expects that its existing cash, cash equivalents, and current and noncurrent marketable securities, together with projected revenues from U.S. sales of i
Slide 31: Geron Positioned for Successful Imetelstat Launch, if Approved
Geron Positioned for Successful Imetelstat Launch, if Approved Underserved TD LR-MDS and R/R MF markets with potential combined TAM >$7B in 2031 (U.S./EU)^ Differentiated first-in-class investigational telomerase inhibitor U.S. commercial preparations on track for expected June 2024 launch People an
Slide 32: Thank you! Contact: Investor Relations
Thank you! Contact: Investor Relations investor@geron.com 32
Slide 33: Appendix: TAM (U.S./EU)
Appendix: TAM (U.S./EU) LR-MDS Patient Numbers: Company projections in 2031, based on DRG MDS Landscape and Forecast syndicated data report 2021 and 2022 and YoY growth rate assumptions for eligible patient populations in LR-MDS in the U.S. and EU. EU4/UK population as % of U.S. population in 2031: