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® MimiVax, LLC is a spin-out company of Roswell Park Cancer Institute formed to commercialize the SurVaxM vaccine. Michael Ciesielski, PhD Chief Scientific Officer, Immunologist Robert Fenstermaker, MD Chief Medical Officer, Neurosurgeon Scott Friedman General Counsel & Manager, Attorney Out-license, acquisition by larger pharma or investment bank transaction Phase II partnerships to bring SurVaxM through phase III & market Inhibitor of apoptosis protein (IAP) with complex function Expression in tumors associated with poor prognosis Very limited expression in normal cells Present in 95% of glioblastomas (not a sub-population) Present in many other cancers C D 4 SurVaxM C Molecular mimic Enhanced MHC class I binding Cross-reactive to wild type survivin D 8 Long peptide MHC class II binding – helper support Limited HLA restriction Multiple CD8+ T cell epitopes Antibody responses 150% 100% 50% 0% Survivin SurVaxM Mimic greatly enhances MHC-I binding (HLA-A*02) SurVaxM stimulates a potent immune response Immune response cross-reacts to wild type survivin in tumor cells Epitope 5 – A*03 (1) Epitope 4 – A*03 (1) Epitope 3 – A*03 (1) Epitope 1 – A*02 (4) Epitope 2 – A*02 (6) Epitope 6 – A*24 (1) Epitope 7 – A*11 (1) The long survivin peptide contained in SVN5367/M57-KLH is shown with brackets indicating empirically confirmed reactive HLA-A*02, HLAA*03, HLA-A*11 and HLA-A*24 epitopes within it. The position of substitution (mimic) within the peptide is indicated (light gray). • 9 patients with survivin-positive, recurrent malignant gliomas and either HLA-A*02 or HLA-A*03 haplotypes. • 4 subcutaneous injections of 500μg SurVaxM emulsified in Montanide ISA 51 VG with 100μg of sargramostim at 2 week intervals. • Safety & Tolerability • Immune Response (Immunomonitoring) • Radiographic Response (MRI) • SurVaxM was well tolerated with minimal side effects. Binding of MHC-peptide complexes (multimers) to CD8+ T cell receptors in patients measured at 8 weeks through 3 years following first vaccination are shown. 2 7 1 6 3 8 2 7 5 9 3 8 Survivin antibodies produced in response to vaccination as one activity biomarker. Seven evaluable patients produced significant 5levels (>1 O.D.) of 9 survivin-specific IgG. 100 O S : 8 e v e n ts , m e d ia n = 8 6 .6 w e e k s P F S : 8 e v e n ts , m e d ia n = 1 7 .6 w e e k s OS P r o b a b ility 80 3 mo. 6 mo. 12 mo. 24 mo. 36 mo. Median 100% 88.9% 88.9% 37.5% 25% 20.2 mos. 3 mo. 6 mo. 12 mo. 24 mo. 36 mo. Median 50% 37.5% 37.5% 12.5% 12.5% 4.1 mos. 60 PFS 40 20 0 0 6 12 18 24 30 36 42 M o n th s Phase I Clinical Trial: SurVaxM in recurrent glioma Historical control median OS = 7 months; PFS6 = 14% SurVaxM median OS = 20.2 months; PFS6 = 37.5% • Appears to be safe and tolerable – Grade I injection site reactions mainly – Fatigue, myalgia • Immunogenic: CD8+, CD4+ & antibodies • No autoimmunity observed • 7/8 Patients OS > 12 mos. • 2/8 Patients OS > 24 mos. • 1/8 Patients OS > 36 mos. & CR Immunohistochemistry of T and B cell markers (200x) in tissue sections of one patient (#8) with recurrent disease 5.6 months following protocol entry. (A) CD4+ and (B) CD8+ T cells in representative fields of patient’s glioblastoma prior to vaccine treatment, and (C) CD4+, (D) CD8+, (E) CD20+ and (F) PD-L1+ cells within contiguous histologic sections of tumor after vaccine treatment and recurrence. A B C D E F 37 y.o. man with glioblastoma -Surgery, XRT, TMZ Recurrence at 5 months -Re-resection, SurVaxM CR, NED at 36+ mos. 6/12 Recurrence – 5 mo. Post-op #1 8/12 Post-Op #2 9/12 On-study 7/15 34-mo Post-vax 50 patients with newly diagnosed survivin-positive glioblastoma SurVaxM plus standard therapy HLA-A*02, -A*03, -A*11 and -A*24 Primary: PFS6 Historical comparison well defined, 95% of all glioblastoma express survivin Secondary: OS12, imaging, immune responses Currently recruiting at Roswell Park and The Cleveland Clinic and soon to be announced third national center. 18 patients with multiple myeloma receiving maintenance therapy SurVaxM plus lenalidomide HLA-A*02, -A*03, -A*11 and -A*24 Primary: Safety & Tolerability Secondary: Immune response compared with added lenalidomide Tertiary: Therapeutic efficacy, PFS Currently recruiting at Roswell Park 2010 – 17/17 patent claims for cancer allowed by USPTO 2011 - US 7,943,138 patent “Survivin Peptides as Cancer Vaccines” awarded 2013 - patent for cancer use awarded in People’s Republic of China 2013 - patent for autoimmune diseases awarded by USPTO 2013 - patent for cancer use awarded in Japan 2014 - claim for cancer use allowed by European Union; Validated filings: United Kingdom, Germany, France, Sweden, Spain, Italy • 2014 - patent for cancer use awarded Hong Kong 2015 - patent for cancer use awarded Canada 2015 – patent for cancer use awarded South Korea 2007 2008 Discovery 2006 2010 2011 Pre-Clinical 2009 2013 2014 Phase I 2012 • Invention of SurVaxM peptide • National Brain Tumor Foundation Award ($50,000) • Patent Filed • Completion of pre-clinical efficacy studies • Initial meetings with FDA • Completed FDA-mandated GMP API scale-up • Completed GLP toxicity studies • Patent Awarded (US) • First IRB approval granted • IND approved by FDA • American Cancer Society Award ($720,000) • Phase I clinical trial in recurrent glioma patients open • Phase I clinical trial in recurrent glioma completed • Private investment offering ($1.5 Million) 2015 2016 2017 Phase II • Phase II trial in newly diag. glioblastoma patients open • Phase I trial in multiple myeloma open • Option/Partnership or acquisition/transaction ® SurVaxM Immunotherapy Michael Ciesielski, PhD Chief Scientific Officer [email protected] 716-845-8850