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Immunity for Life TM DnB NOR Markets Health Care Summit 2006 Prof. Dr. Jan Raa, Chief Scientific Officer 19 September 2006 A biomedical company Pharmaceutical development program + Cash generating businesses 2 Business structure Biotec Pharmacon ASA (Tromsø/Oslo) Marine bioproducts and bioprospecting (Tromsø) 100% Immunocorp AS (Oslo) • Consumer health products (Immutol, Immuderm) • Animal health products (MacroGard) 100% Immunocorp (Irvine, California) 3 Cash generating businesses High-margin non-pharmaceutical products with good growth potentials, based on immune modulating compounds and DNA-modifying enzymes Consumer health 33,8 MNOK in 2005 Animal health & nutrition 23,8 MNOK in 2005 Biochemicals 11,2 MNOK in 2005 4 The pharmaceutical program 1) Basic R&D (Tromsø, Oslo, USA, Berlin) 2) Clinical trials: A) Treatment of diabetic ulcers – – Phase II study completed (Russia) Phase II study ready to start (England) B) Immunotherapy of cancer – – Phase I/II - Neuroblastoma (New York) Phase I/II - Breast cancer (Oslo) – Phase I/II - Non-Hodgkins lymphoma (Oslo) C) Prevention of oral mucositis – Phase II study completed (England) D) Treatment of burn wounds (Bergen) 5 How it started * Two cutting-edge discoveries (1980-ies) on the effect of beta-glucans on: Glucan treated 15 Tumour diameter (mm) Scientific foundation: Biochemistry and innate immunity Control 10 5 0 2) 0 Cancer: Beta-glucan caused complete disappearance of tumors in mice Resistance to infections: Oral betaglucan enhanced resistance to infections and the efficacy of injected vaccines (first demonstrated with salmon) 7 14 21 Days 100 90 Control 80 % mortality 1) 70 60 50 MacroGard 40 30 20 10 0 0 78 88 98 108 118 Days after onset of feeding with MacroGard 6 The pharmaceutical product candidate SBG – Soluble Beta-Glucan • An ”alarm signal molecule” - present in cell walls of yeast (a beta-1,3/1,6-glucan) - alien to the human body • Mobilizes immune mechanisms involved in: - the body’s own destruction of cancer cells - infection defence - wound healing CH2OH O HO HO O HO CH2OHO HO CH2OH O HO OH O HO OH O n CH2OH O O OH CH2OH O OH CH2OH HO O HO n O HO O HO H2C HO CH2OH O HO O O HO O OH CH2OH O OH m H2C O HO CH2OH O HO OH CH2OH O OH OH H2C HO O O O O O O O OH HO O OH m 7 Biotec Pharmacon’s in-house GMP-production of pharmaceutical grade SBG (approved by Norwegian authorities, SLV) 8 Mode of action SBG binds to specific receptors on macrophages and other white blood cells in the body’s innate front-line defence, resulting in: Receptors Macrophage Enhanced • wound/ulcer healing • anti-cancer mechanisms • infection defence • vaccine efficiency ”There is at bottom only one genuinely scientific treatment for all diseases, and that is to stimulate the phagocytes”. In ”The Doctors Dilemma” by G.B.Shaw, inspired by Metchnikoff’s Nobel Prize adress in 1908. SBG 9 SBG in diabetic ulcers • Wound healing – Wounds will normally heal without complications in individuals with normal immune functions and active macrophages – Macrophages play a key role in regeneration of damaged tissues and in infection defence • Diabetic ulcers – Macrophage activity is impaired in individuals with diabetes - a reason why wounds may develop into chronic ulcers (in particular leg and foot ulcers) – Scientists affiliated with Biotec Pharmacon discovered that beta-glucan reactivates diabetic macrophages and enhances wound healing in animals 10 Proof-of-concept study in humans • Open clinical study with 20 patients: – The results showed extraordinary good effect of SBG compared to best available alternative treatment (control group) – Most of the ulcers treated with SBG had healed in 35 days compared to only two in the control group (Dr. T. Zykova, University Hospital, Archangelsk) 11 Clinical studies (phase II) with SBG on diabetic ulcers • A double-blinded phase II study with diabetic ulcer patients has been completed in Russia • A second phase II study has been approved in the U.K. and is ready for start up • Planning of a phase III study 12 Timeline Diabetic ulcers Timeline 2006 - 2008: Start of trial Phase II, Russia Q2-05 Phase II, UK Q3-06 Q1 2006 Q2 Q3 Q4 Q1 2007 Q2 Q3 Q4 Q1 2008 Q2 Q3 X Partnering = Clinical trial = Partnering X = Trial data = Conclusion of patient treatment and expected results 13 Q4 Diabetic ulcers – market • 70 million people with diabetes in OECD • 3.5 million patients are treated for diabetic foot ulcers annually • Estimated market of USD 3.5 billion growing at 1215% per year • High cost of treatment; wound healing products account for approximately 10% of total cost • Blockbuster potential if proved effective; current treatment cost of Regranex from Johnson & Johnson more than $1,000 14 Immunotherapy of cancer Basic idea The body’s immune system should ”perceive” tumor cells as alien and destroy them like it destroys infectious microorganisms Two strategies: 1) Vaccination with components unique for cells in the tumor 2) Injection of pre-fabricated antibodies (mAbs = monoclonal antibodies) Therapeutic efficiency Not in line with expectations 15 Total sales of mAbs • Currently, 19 different mAbs approved for therapeutic use Global sales of Antibody therapeutics • Revenue in 2004: Excess of $10.5 billion, • Projected sale of mAbs of $30 billion by 2010 (50 % cancer) Cancer mAbs sales in 2005: - Rituxan: US$ 3.3 billion - Herceptin: US$ 1.7 billion - Avastin: US$ 1.3 billion 30 Revenues in USD Bn an increase of 44% from 2003 35 25 20 15 10 5 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2007 2010 YEAR 16 Immunotherapy of cancer 17 Biotec Pharmacon’s concept Oral SBG + injected mAbs: • SBG mobilizes innate immune mechanisms that kill cancer cells ”tagged” by injected mAbs • Proof of concept data from Memorial Sloan-Kettering Cancer Center (MSKCC), New York, in 2003 and 2004 showed that SBG elicits strong antitumour effect of injected mAbs 18 Immunotherapy of cancer • Monoclonal antibodies (mAbs) bind to (”tag”) cancer cells • SBG triggers immune destruction of cancer cells ”tagged” by mAbs mAb SBG + mAb EXAMPLE: Effect of a monoclonal antibody (mAb) alone and in combination with oral SBG on tumour development in mice inoculated with human cancer cells 19 Literature quotation “Moreover, mAbs that have virtually no tumor regression activity when used alone are able to mediate complete regression when given in combination with beta-glucan”. Trends in Immunology, Vol.25 No.3 March 2004 20 Clinical studies (phase I/II) with SBG +mAbs • Memorial Sloan-Kettering Cancer Center, New York: – Neuroblastoma (15 patients) – SBG + mAb 3F8 • Ullevål University Hospital/ Tromsø University Hospital : – Breast cancer (12 patients) – SBG + Herceptin • Rikshospitalet-Radiumhospitalet HF: – Lymphoma (12 patients) – SBG + Rituxan/MabThera 21 Timeline Immunotherapy of cancer Timeline 2006 - 2008: Start of trial Q1 2006 Q2 Q3 Q4 Q1 2007 Q2 Q3 Q4 Q1 2008 Q2 Q3 Immunotherapy of cancer: Phase I/II, MSKCC, New York Q4-05 Phase I/II, Ullevaal, Oslo Q4-06 Phase I/II, Radiumhospitalet, Oslo Q4-06 Partnering, cancer = Clinical trial = Partnering X = Trial data = Conclusion of patient treatment and expected results 22 Q4 Immunotherapy of cancer – market • Approximately 5 million new cancer incidents each year in OECD • Sales of cancer antibodies (mAbs) reached USD 5 billion in 2004; expected to triple by 2010. • Roche and Genentech major players • High cost of treatment with mAbs and modest therapeutic effect • Blockbuster potential if SBG can show improved effect of mAbs; current treatment cost with mAbs $20-$45,000. 23 Perspective and implications If human clinical studies confirm proof-of-concept data with animals, showing that SBG improves the effectiveness of cancer monoclonal antibodies - even to a small degree - SBG represents block-buster potential within cancer treatment! 24 Other clinical trials • Prevention of oral mucositis in cancer patients - A clinical phase II trial completed at the Royal Marsden & The Institute of Cancer Research in London - EMEA has granted Orphan drug designation for SBG used in the prevention of oral mucositis • Burn wounds - A clinical phase I/II trial on patients with burn wounds 25 Business model – pharmaceuticals • Retain ownership and strategic flexibility by completing on-going clinical studies • Partner with international pharmaceutical or biotechnology companies with capabilities in late stage clinical development, regulatory compliance, marketing and sales • Income through up-front licence fees, milestone fees, royalty and sales of SBG to licencees 26 Product pipeline 1) Immunotherapeutic and -prophylactic treatment of influenza 2) New antibiotic principles from marine genes 3) New marine gene products for Life science applications 4) Product formulations preventing and treating gingivitis and periodontitis 27 Share information Listed on Oslo Børs in November 2005 TICKER: BIOTEC Number of shares outstanding: 21.489.010 Own shares: 832.000 (3.9%) Number of shareholders: 475 Market cap (14.09.06): MNOK 902 Share price development since IPO 20 largest shareholders: Paro AS Four Seasons Private Equity AS Ludwig Mack AS Odin Norge Hartvig Wennberg AS Nordea Bank Denmark AS Gunnar Rørstad Jan Raa NorgesInvestor Proto AS Knut Eirik Andersen B Skaugen AS MP Pensjon Anchor Secondary 2 Holding AS VPF Avanse Norden Arne Handeland Holberg Norden Verdi Hilde Raa DnB NOR Norden (III) Cat Invest I Violina AS 17.84% 10.25% 8.92% 8.77% 4.00% 3.78% 3.75% 2.83% 2.38% 2.13% 1.78% 1.63% 1.12% 1.09% 0.94% 0.85% 0.85% 0.69% 0.69% 0.69% 28