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The Global Leader in Liver Cell Therapies Breakthrough immunomodulation & anti-fibrotic treatments for devastating immune-mediated liver diseases Short Briefing January 2017 John Tchelingerian, PhD CEO Promethera at a Glance Pioneering cell therapies to treat a broad range of devastating immune-mediated liver diseases Advances in stem cell therapeutics medicine have opened a novel pathway to treat liver diseases Promethera is building unique cell therapy platforms in this area Proprietary process to harvest stem cells with different immunomodulatory properties from human liver Unique sourcing and supply chain Off-the-shelf allogenic products Clinical stage programs building clinical evidence in immunomodulation and antifibrosis Broad and dominant IP position Pipeline HepaStem: Phase 2 initiated in ACLF, Targeted entry in clinic for NASH in H2, 2017 Multiple mechanisms of action with distinct cells Transatlantic organization Headquarters near Brussels, Belgium Production facility near Durham, NC Around 60 employees Broad investor consortium Established broad shareholder base in Europe and Asia Well positioned to benefit from positive regulatory environment and growing markets in Asia and expanding in EU/US 2 Disease-centrality of the liver will make it a key intervention point for novel treatments Liver is the center of many diseases and at the epicenter of many health problems Important organ to treat due to life-critical function Natural regenerative component is beneficial for cell therapies Liver transplantation still a prominent component in life-saving treatments of devastating liver conditions Risky and expensive procedure Average billed charges for liver transplants in the U.S. are ~$577k * Demand of liver transplants already impossible to meet by healthcare systems/organ shortage Filtering Detoxification Metabolism Blood Clotting *source: https://transplantliving.org/before-the-transplant/financing-a-transplant/the-costs/ 3 Strategic Move into Larger Liver Indications & related Markets Capitalize on historical expertise in orphan pediatric indications & actively building opportunities in NASH, ACLF and other major liver indications Heparesc/ HepaStem Enzyme Replacement Focus UCD • Near term revenues source • Targeting potential marketing approval for Heparesc in Canada in 2018 • Partnering opportunity in Asia and other markets HepaStem Orphan indications other… Transfer • Development and regulatory expertise • Manufacturing process • Safety data of procedure • KOL network Major indications Immunomodulatory Focus ACLF NASH/Fibrosis • High-mortality burden • Market lacks innovation • Pre-clinical proof-ofconcept for immunomodulatory capability of HepaStem • Multi billion market size • HepaStem enables multifactorial intervention in NASH • Combination potential with most advanced drugs in development other… 4 Fully-Formed Supply Chain and Product Platform Mastering the supply chain for an off-the-shelf allogenic cell therapy product 5 Our approach as a concept Cooling down the immune system with a safe cell therapy already in clinical trials Lead product (HepaStem) Cooling immune system CAR-T’s Heating Immune system 6 HepaStem Development Pipeline Phase 2 initiated in ACLF, enter clinic for NASH in 2017 INDICATIONS INDICATIONS HepaStem ACLF HepaStem NASH/Fibrosis Start of clinical development in H2, 2017 Genetically modified HepaStem Hemophilia A/B (FVIII / FIX) Early partnering option R&D PRE-CLINICAL PHASE I/II PHASE II PHASE III MAA ongoing ACLF: Acute-on-Chronic Liver Failure / NASH: Non-alcoholic Steatohepatitis 7 Key Intervention Points in Acquired Immune-mediated Liver Diseases Theoretically a reversible event using the right therapeutic modalities Inflammation NAFLD, NASH LIVER FUNCTION Fibrosis Total market potential estimated at: ACLF > $ multi billion markets* Acute insult/ Second hit Compensated cirrhosis HepaStem Decompensated cirrhosis ACLF Total market potential: estimated at Chronic hepatic decompensation/death HepaStem NASH > $ multi billion markets * DISEASE PROGRESSION *Based on Company estimates as applied to a combination of publically available and third-party sourced data 8 HepaStem Shows Multiple Mechanisms of Action in vitro Immunomodulatory and anti-fibrotic potential builds on regenerative support function • Supports recovery Inhibits lymphocyte proliferation Injury & inflammation Inhibits DC generation Leading to Fibrosis Hepatocyte damage and apoptosis • • HepaStem T-lymphocyte infiltration and release of pro-inflammatory cytokines + activation of dendritic cells • Inhibits HSC activation Leading to Cirrhosis OTHER PROTEINS • • Extracellular matrix degeneration Hepatic stellate cell activation Antibacterial activity Collagen deposition 9 8 ACLF – High-Mortality Condition in Need of Paradigm Shift Acute-on-Chronic Liver Failure is a market underserved by innovative therapies Acute deterioration of liver function, rapidly evolving multi-organ failure Est. 60-90k patients p.a. in the USA/EU/Japan, grade 1 &2* High short-term mortality rate (>50 % in severe forms) Standard of care: High dose steroids, liver transplant in some cases after rescue Phase 2 Study initiated in Q4 2016 Primary endpoint: safety of 2 dose regiments Secondary endpoints: clinical and biological efficacy parameters Safety (Day 28, Month 3, Year 1) *Source: 4 CANONIC study : % of patients with ACLF grade 1 & 2 is +/- 86% Even modest response in tough to treat patient population will add validation to approach Status: ongoing trial 10 HepaStem - Preclinical Proof-of-Concept in NASH/Fibrosis Presented in late-breaking poster session at 2016 AASLD Meeting HepaStem effect on NASH-fibrosis in a STAM preclinical model Data supports pushing HepaStem in NASH clinical trials Vehicle NAS SCORING No effect of immunosuppression alone on collagen deposits With HepaStem: significantly decreased collagen deposition in the pericentral region in a dosedependent manner Reduction in NAS score and visible improvement of disease histology 4,0 + Immunosuppression + Immune Suppression 2,2 HepaStem + Immune Suppression 11 HepaStem’s USP in the NASH Therapeutic Landscape Unique position in the current NASH landscape and complementary to advanced therapies Most advanced competitors are single or bi-factorial approaches Ocaliva received accelerated FDA approval in May 2016 Elafibranor in Phase 3 Broader MoA’s provided by HepaStem To our knowledge no compound in entire NASH field has the tissue repair potential HepaStem or second generation cells might have Tissue repair 12 Tapping Into the Attractive Asian Markets Positive regulatory environment has given Asia a head start in cell therapy Introduction of Western lifestyle expected to cause rise in liver diseases such as NASH Advantageous regulatory environment for regenerative medicine in Japan since 2014 Strategic move towards Japan and South Korea initiated Potentially faster development route to market for HepaStem with positive knowledge and data Other commercial partnering opportunities Currently 13% of Promethera’s shares held by leading Asian Investors; including one strategic investor 14 Financing and Shareholdings Broad investor base supporting move into NASH and ACLF Hopp Family**; 1% Vesalius BioCapital; 16% Others*; 14% - Round A - Round B - Round C 5,3 M€ 17,0 M€ 26,3 M€ Total capital raised 48,6 M€ Non-dilutive funding 24,4 M€ Total amount of proceeds 73,0 M€ Founders; 8% Fund +; 13% Cell Innovation Partners; 2% Mitsubishi UFJ Capital; 3% LifeLiver; 3% MGI Global Fund (Mitsui); 9% SRIW; 12% Shire LLC; 5% Boehringer Ingelheim VF; 9% SMS Investments; 5% * Essentially HNWI and private investors ** up to 11,2% after conversion of receivable in 2018 or earlier 14 Experienced Management Team John Tchelingerian - CEO Etienne Sokal - Founder, Chief Scientific & Innovation Officer Serial entrepreneur, CEO of Promethera since Sep. 2015. Co-founder Neurotech, Key-Obs, Silver Ocean Venture Previously: President & CEO Key Neurosciences; Chairman & CEO TcLand Expression, Chairman & CEO Diatos, Development Director Neurotech Frank Hazevoets - CFO & Head of Corporate Development 20+ years of finance experience in the financial and pharmaceutical industry Previously: ING, InBev and TigeniX Patrick Stragier - VP Operations 25+ years of international operational and managerial experience Previously: Solvay, DSM-Biologics, Genzyme and Lonza Co-founder of MaSTherCell 20 years experience in the field of hepatology and liver transplantation More than 300 peer-reviewed publications Henrik L. Luessen – Chief Business Officer Torsten Hombeck - Chief Commercial & Strategy Officer Nancy Veulemans – VP Clinical & Medical Affairs Decebal Bora – VP Regulatory Affairs Serial entrepreneur, Founder and Managing Director of Tytonis Previously: Symbiotec, Nanomi, Activaero, OctoPlus. 25+ years experience in the biopharma and healthcare industries Previously: TigenX, Bristol Myers Squibb, Pfizer, Charles River Lab. 15+ years of U.S. and European experience with public and private biopharmaceutical companies Previously: Co-CEO and CBO of Cytonet, Co-CEO and CFO of Agennix, CFO of GPC Biotech 20+ years experience in the field of regulatory affairs. Previously: ActoGenX, Baxter, Hoffmann-La Roche, Biogen CONFIDENTIAL 15 Near and Medium Term Strategy and Goals Rapid development in ACLF and NASH to reach longer-term and high value inflection points Pre-clinical / Clinical development Start of Phase 2 trial evaluating HepaStem in ACLF Further pre-clinical work to advance HepaStem in NASH towards the clinic in H2, 2017 Continued improvements of manufacturing capabilities to launch scalability for commercial success preparation Heparesc filing for NDS approval in Canada Commercial / Business Development Active partnering discussions for HepaStem in Hemophilia Pursue partnering discussions for Heparesc Targeting potential marketing approval for Heparesc in Canada in 2018 Follow-on product lines Continued work on HepaStem’s range of applications including gene engineering Continued development of our R&D-stage H2Stem platform and for a follow-on clinical stage platform 2 0 1 7 17 Thank you for your attention John Tchelingerian, PhD – CEO +32 10 39 43 00 [email protected] www.promethera.com Heparesc® is a registered trademark of Promethera Biosciences S.A./N.V