Dr. Joseph Kim, President and CEO of Inovio Pharmaceuticals, discusses Inovio's DNA immunotherapy products and clinical trial progress. Key points include:
1) Inovio's lead product, VGX-3100, met primary and secondary efficacy endpoints in a Phase II cervical dysplasia trial by regressing high-grade lesions and clearing HPV.
2) Phase III development of VGX-3100 for cervical dysplasia is underway, with initiation expected in 2016.
3) Inovio is also developing DNA immunotherapies for HPV-related cancers and expanding VGX-3100's application to additional HPV-associated diseases.
4)
Inovio Pharmaceuticals, Inc. - Revolutionizing the Fight Against Cancers and Infectious Diseases
1. Revolutionizing the Fight Against Cancers and Infectious Diseases
Dr. Joseph Kim President & CEO NASDAQ: INO
2. Forward Looking Statement
Our commentary and responses to your questions may contain forward-looking statements, including comments concerning clinical trials and product development programs, evaluation of potential opportunities, the level of corporate expenditures, the assessment of Inovio’s technology by potential corporate partners, capital market conditions, timing of events, cash consumption and other subjects. Information concerning factors that could cause actual results to differ materially from those set forth in our Annual Report on Form 10-K for the year ended December 31, 2013, our Form 10-Q for the quarter ended September 30, 2014, and other regulatory filings from time to time. 2
3. 3
Inovio: creating the path to an active immunotherapy with broad clinical utility
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Lead DNA immunotherapy product, VGX- 3100, meets phase II efficacy endpoints; technology breakthrough for active immunotherapy field
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First clinically meaningful efficacy from T cells generated EXCLUSIVELY in vivo
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De-risking of pipeline products
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Best T cell responses in published clinical studies
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Favorable safety profile
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Validating partnerships
First-in-Class Efficacy from an Active Immunotherapy
4. Human Papillomavirus
Low Grade Cervical Pre-cancer (CIN 1)
High Grade Cervical Pre-cancer (CIN 2/3)
VGX-3100 Phase II Data: Building New Market Opportunity
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Treat HPV-associated pre-cancers and cancers
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Phase II controlled trial regressed high grade cervical pre-cancer and cleared HPV
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Fulfill unmet need, providing non-surgical alternative for pre-cancerous lesions
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Potential elimination of residual HPV in untreated tissue
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Advance into phase III for cervical pre-cancer (CIN 2/3) in 2016
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Dominate post-HPV infection therapeutic markets
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Advance other HPV-associated pre-cancers (vulvar, vaginal and anogenital neoplasias) and cancers (cervical, head and neck, and anogenital) 4
Disease Progression
Cervical
Cancer
5. Phase II: Study Design
•148 subjects: 19-55 year old females with high-grade cervical dysplasia (CIN2/3)
•HPV 16 and/or 18 positive
•6 mg VGX-3100 or placebo(IM followed by EP)
Placebo-controlled, Randomized, Double Blind
•Regression of CIN2/3 to CIN1 or Normal at six months post third dose (Week 36)
Primary Endpoint
•Regression of CIN2/3 to CIN1 or Normal and
•Clearance of HPV 16 and/or 18 genotype detected during screen
Secondary Endpoint
5
6. 0
10
20
30
40
50
60
Phase II: Efficacy Data Meets Primary and Secondary Endpoints
Histopathologic Regression to CIN1 or Normal
(n=143)
49.5% (53/107)
30.6% (11/36)
Statistically significant difference (p=0.017; strata-adjusted)
Percent
Histopathologic Regression to CIN1 or Normal
AND Virological Clearance (HPV16 or 18) Incidence
(n=143)
0
10
20
30
40
50
60
40.2% (43/107)
14.3% (5/35)
Percent
VGX-3100
Placebo
VGX-3100
Placebo
Statistically significant difference (p=0.001; strata-adjusted)
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Efficacy data meets primary and secondary efficacy endpoints
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High level of complete CIN 2/3 clearance
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Robust HPV-specific T cell responses in majority of treated subjects, as in phase I
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Treatment well-tolerated with only administration site redness
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Data being published
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Expect to initiate phase III trial in 2016
6
7. VGX-3100: Next Steps
EXPANSION OF HPV PROGRAM TO RELATED CANCERS AND PRE-CANCERS
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Cervical cancer (Ph I/IIa initiated)
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Head & neck (Ph I/IIa initiated)
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Anogenital cancers
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VIN, PIN
ANALYSIS OF PHASE II DATA IN PROGRESS
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Immunological analysis to further characterize T cell subsets is also in progress. Phase II data will add to Phase I data which has already been extensively characterized (Bagarazzi, et al. Sci Transl Med 2012)
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Manuscripts are in preparation
PHASE III DEVELOPMENT UNDERWAY
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Clinical and regulatory
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Commercial EP device development
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Quantitative market research
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Supply chain strategy
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Pricing & reimbursement 7
8. T cell Antigen-specific killer T cell
Target cell 8
It’s All About the T Cells
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Inovio immunotherapies display best-in-class T cells in HIV and HPV human studies:
o
Magnitude
o
Durability (memory)
o
“Killing tools”: granzyme and perforin
o
Functional killing effect
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A new paradigm for generating clinically relevant immune responses and efficacy
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Safe and well tolerated
10. Broad Medical and Market Opportunities
Product Name
INTERNALLY FUNDED
Indication
Preclinical
Phase I
Phase II
Vgx-3100
Ino-5150
Ino-1400
EXTERNALLY FUNDED
pennvax®
Ino-3510
Ino-8000
ino-1800
Phase III 10
INO-3112
INO-3112
Hepatitis C
Therapeutic
Hepatitis B
Therapeutic
influenza
Preventive
hiv
Preventive/ Therapeutic
Breast/lung / Pancreatic cancers
Therapeutic
Prostate cancer
Therapeutic
Head & Neck Cancer
Therapeutic
Cervical Cancer
Therapeutic
Cervical dysplasia
Therapeutic
Preventive/ Therapeutic
Ebola
Aerodigestive Cancer
Therapeutic
INO-3106
INO-4200
11. 11
Cervical Dysplasia: Schiffman et al. Arch Pathol Lab Med (2003), Public Health England Cervical Cancer Screening Programme, Stoler et al. Anatomic Path (2011), Castle et al. JNCI (2005), Mayrand et al. NEJM (2007) Cancers: CDC, www.hpvcentre.net, WHO IARC
LOW GRADE CERVICAL DYSPLASIA (CIN1)
US: ~1,400,000
EU5: ~1,300,000
HIGH GRADE CERVICAL DYSPLASIA (CIN2/3)
US: 270,800
EU5: 267,400
CERVICAL CANCER
US: 11,818
EU5: 14,043
OROPHARY- NGEAL CANCER
US: 11,726
EU5: 13,932
Incident cases in the US and EU5:
HPV-Caused Pre-Cancers & Cancers: VGX-3100
12. HPV-Associated Cancer Treatments Already Enrolling
Phase I/IIa’s: INO-3112 (VGX-3100 + IL-12 DNA immune activator); HPV 16/ 18 related disease Cervical Cancer
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20 women with cervical carcinoma
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Safety, tolerability, immunogenicity
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Cervical histology
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Treated after chemoradiation Head & Neck Squamous Cell Carcinoma
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20 men/women
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Safety, tolerability, immunogenicity
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Anti-tumor effects & progression free survival
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Arm #1: treated before/after tumor resection
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Arm #2: treated after chemoradiation 12
13. hTERT-Associated Cancers: INO-1400
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Antigen: human telomerase reverse transcriptase (hTERT), an enzyme associated with cancer cell survival; overexpressed in 85% of cancers - potential “universal” cancer therapy
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(+/- IL-12 DNA immune activator)
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Phase I/IIa: 54 patients with breast, lung, or pancreatic cancers
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Safety, tolerability, immunogenicity
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Anti-tumor effects and progression free survival
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Trial launch: 4Q 2014 13
14. anthrax
Louis Pasteur
Peter Kies CFO • Ernst & Young • Experience with growth companies
Mark L. Bagarazzi, MD CMO • Clinical research experience incl. Merck • Led clinical/regulatory for shingles and rotavirus vaccines; DNA vaccine expert 14
J.Joseph Kim, PhD President & CEO • Decades of biotechnology/ pharma management • Merck: hepatitis A and B vaccines manufacturing; HIV vaccine (Ad5) R&D
Niranjan Y. Sardesai, PhD COO • Extensive biotech management and product development experience • Led diagnostics development for mesothelioma, bladder cancer, and ovarian cancer for Fujirebio Diagnostics
Management
15. anthrax
Louis Pasteur
J.Joseph Kim, PhD • President & CEO, Inovio
Adel Mahmoud, PhD • Professor, Princeton University • Former President, Merck Vaccines • Responsible for Gardasil®, Zostavax®, Proquad® and Rotateq®
Morton Collins, PhD • General Partner, Battelle Ventures and Innovations Valley Partners 15
Simon X. Benito • Former Senior Vice President, Merck Vaccine Division
Angel Cabrera, PhD • President, George Mason University • Former President, Thunderbird School of Global Management
Avtar Dhillon, MD Chairman, BOD • Former President & CEO, Inovio Biomedical
Board of Directors
16. anthrax
Louis Pasteur
Stanley A. Plotkin, MD • Developed rubella and rabies vaccines • Oversaw Sanofi flu vaccine • Emeritus Professor, Wistar Institute & University of Pennsylvania
Philip Greenberg, MD • Expert in T cell immunology • Head, Immunology Program, Fred Hutchinson Cancer Research Center 16
Thomas S. Edgington, MD • Founded multiple biotech companies; extensively published • Emeritus Professor, Scripps Research Institute
Anthony W. Ford-Hutchinson, PhD • Former SVP, Vaccines R&D, Merck • Oversaw development: Singulair®, Januvia®, Gardasil®, Zostavax®, Proquad® and Rotateq®
David B. Weiner, PhD Chairman •“Father of DNA vaccines” • Dept. of Pathology & Laboratory Medicine, University of Pennsylvania
Scientific Advisory Board
17. Financial Information
Cash, cash equivalents & short-term investments2
$ 100.9 M
Debt2
0 M
Cash runway
4Q 2017
Shares outstanding2
60.5 M
Recent share price1
$9.44
Market cap1
$ 571.1 M
NASDAQ: INO
1Nov 19, 2014 2Sep 30, 2014 17
Recent insider buying
$2.75M
18. INTERNALLY FUNDED
EXTERNALLY FUNDED
Ino-5150
1H 2015 Initiate phase I
Prostate cancer
Vgx-3100
2016 Initiate phase III
Cervical dysplasia
INO-3112
2Q 2014 Initiated phase I/IIa
Head & Neck Cancer 18
Value Drivers
INO-3112
2Q 2014 Initiated phase I/IIa
Cervical Cancer
Ino-1400
4Q 2014 Initiate phase I/IIa
Breast/lung/ Pancreatic Cancer
PennVAX®
1Q 2015 Initiate PENNVAX-GP phase I
HIV
Ino-8000
2015 Report interim phase I data
Hepatitis C
Ino-1800
2015 Initiate phase I/IIa
Hepatitis B
Ebola
1H 2015 Initiate phase I
INO-3106
3Q 2014 Initiated phase I
Aerodigestive Cancer
INO-4200
19. Best-in-class T cells to prevent, treat and cure cancers and infectious diseases
Targeting broad range of diseases and numerous billion dollar markets
Breakthrough active immune therapy technology with potential to save lives
Validating partnership with Roche; working toward more deals
Phase II data shows clinically significant efficacy
Investor Highlights
19
21. Strain 1
Strain X
Strain 2
Antigen Y
Antigen Y
Antigen Y
T Cells by Design: Antigen-Specific, Optimized, Best-in-Class 21
Identify gene sequence of selected antigen(s) from chosen strains/variants of the virus/cancer
Synthetically create optimal consensus gene sequence for the selected antigen – PATENTABLE
22. Insert SynCon® gene sequence for selected antigen into DNA plasmid.
SYNCON® DNA
Antigen consensus sequence
DNA Plasmid
Designed to Break Tolerance or Provide Universal Protection 22
SynCon DNA plasmid ready to manufacture.
26. PENNVAX®: Highest CD8+ T Cell Responses for HIV Vaccine
Ref: Kalams et al JID 2013
26
A: 3X vaccination without EP B: 4X vaccination without EP C: 2x vaccination with EP (month 2) D: 3x vaccination with EP (month 4) E: Memory response (month 9)
A B C D E
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Best CD8+ T cell response in HIV clinical studies
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Durable T cell memory responses
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Safe and well tolerated
0 1 2 3 4 5 6 7 8 9
Dosing Schedule (Months)
27. Inovio Beats Previous Gold Standard for T Cell Generation DNA/Electroporation vs Merck Ad5 Viral Vector (Non-Human Primates)
SIV Model: UPenn/Merck/Inovio Assay: Data Co-Published
T Cell ELISpot Assay
T Cell Proliferation Assay
DNA + EP Ad5 DNA + EP Ad5
Ref: Hirao et al. Molecular Therapy, August 2010 Flow Cytometry Assay
27
Ad5 DNA + EP
Ad5 DNA + EP
28. Combined Cohorts
Individual Dose Cohorts
VGX-3100 Induces Robust and Durable T Cell Responses
Bagarazzi, Yan, Morrow et al. Sci Transl Med 4, 155ra138 (2012)
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14/18 (78%) subjects responded to at least one antigen
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13/18 (72%) responded to at least two antigens
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9/18 (50%) responded to all four antigens 28
ELISpot Assay
0 1 2 3 4 5 6 7 8 9
Dosing Schedule (Months)
31. VGX-3100 Flow Cytometry – Functional Killing Assays
Inovio Confidential
Bagarazzi, Yan, Morrow et al. Sci Transl Med 4, 155ra138 (2012)
Quantitative Assay
Qualitative Assay
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Patient pre-VGX-3100 PBMC are targets, post-VGX-3100 PBMC are effectors
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Quantitative - PBMC added irrespective of Ag-specific CD8 frequency
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Qualitative - PBMC normalized to account for Ag-specific CD8 frequency
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Measure granzyme B delivery to targets 31
32. Surgical Standard of Care for CIN2/3: LEEP
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High-voltage electrical arc at 100oC vaporizes a plane through the cervix, then fulguration using a cautery
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Black, particulate “coffee ground” discharge for weeks
IARC monograph 2003:Edited by J.W. Sellors and R. Sankaranarayanan
32
33. INO-1400: Potential Universal Cancer Therapy Targeting hTERT (overexpressed in 85% of cancers)
Yan J et al., Cancer Immunol Res. (2013) 33
Dharmapuri et al., Mol Ther. (2009)
T-cell generation: older generation DNA vaccine and electroporation device
SynCon® T-cell generation with CELLECTRA® electroporation device