proprietary pipeline of dual-angiogenic & io-engaging (4 ...proprietary pipeline of...
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Proprietary Pipeline of Dual-Angiogenic & IO-Engaging (4-1BB) Bispecific Antibodies
TR009 (DLL4/VEGF BsAb) as a SINGLE AGENT Stabilized or Shrank 71% of tumors in 4th
Line+ Metastatic Gastric and Colorectal patientso Specific inhibitor of VEGF and DLL4/Notch1 pathways; MOA targets both tumor angiogenesis
and cancer stem cells (CSCs); overcomes multi-VEGF, EGFR, PD1/PDL1 resistance
o 38% gastric cancer patients had =>20% tumor shrinkage; 1 PR patient (tx ongoing)
o Unique DLL4 epitope binding vs. 2 other agents in class establishes differentiated safety profile
o Flagship Molecule with multiple solid tumor indications (next generation Avastin®)
2 Key TR009 Clinical Data Readouts Expected in 2020 (n=55), Fully Fundedo Phase 1B Monotherapy Expansion and Phase 1B Combination with Chemo/anti-PD1/PDL1
o Plan for FDA Phase 2 Master Protocol Filing (2021E); NMPA China/Japan Phase 2 IND(2021E)
o Plan for 4-1BB/BCMA first in class bispecific (multiple myeloma) to enter clinic H1’2021E
TRIGR Therapeutics was incorporated in April 2018 (Delaware)o $10M seed round financed the execution of 2 Global in-licensing agreements from ABL Bio
o Efficient corporate leadership and advisory structure
TRIGR Therapeutics Summary
Our Mission is to Develop Meaningful Treatments for Cancer Patients Worldwide
2
3 Bispecific Antibodies in the Pipeline(In-Licensed from TRIGR HOLDS GLOBAL DEVELOPMENT & COMMERCIAL RIGHTS*)
Proprietary Bispecific Antibody (BsAb) Platform Binds 2 Different Targets in One Molecule: o Conserves stability attributes of 1st generation mAb structure (IgG, Fc for PK/PD, symmetric tetravalent binding)
o Proprietary clones designed to enhance specificity / overcome toxicities known to other drugs in the class
Immune Cell Engaging BsAb (TRIA001 and TRIA002):
o Tumor Antigen Dependent 4-1BB crosslinking for tumor micro-environment localized immune cell activation
(reducing potential systemic toxicity, CRS – no liver tox seen in vivo with 41BB clone)
Pipeline Target Indication Phase 1A Phase 1B
TR009VEGF/DLL4
(Dual Angiogenic/DLL4
Notch1 Blocker)
Gastric, Colorectal, Ovarian, Pancreatic, NSCLC, GBM, TNBC, HCC
CompletedDose Expansion
&Combination
TRIA001*4-1BB/BCMA
(Immunotherapy)
Multiple MyelomaFirst in Class
INDQ1, 2021E
TRIA0024-1BB/+IO CheckPoint
(Immunotherapy)
Solid TumorsFirst in Class
INDQ4, 2021E
Off-the-shelf Alternative to CAR-T
ABL Bio retains S Korea rights to all compounds; TRIGR holds GLOBAL rights to all compounds, *Excluding Japan & certain Asia Pacific territories.
3
Leadership & Clinical Advisory Board
CORPORATE LEADERSHIP
George Uy (CEO, Founder), 35 yrs biopharma commercial leadership experience
Miranda Toledano (COO, CFO), 20 yrs biopharma / Wall St leadership experience
ACADEMIA
Professor Edward Chu MD, M.M.S. UPMC Hillman Cancer Center, University of Pittsburgh
Professor Yung-Jue Bang, MD, Seoul National University College of Medicine and Hospital
Professor Eric Van Cutsem, MD, PhD University of Leuven
Professor Howard Hochster, MD, Rutgers Robert Wood Johnson Medical School
Professor Jin Li, MD, Tongji University Shanghai East Hospital
Professor Patricia M. LoRusso, DO, Yale Cancer Center
PHARMA EXPERIENCE
Dr. Jean-Pierre Bizzari, MD former EVP and Global Head of Oncology at Celgene, Sanofi-
Aventis, Servier
Dr. Joanna Horobin M.B., Ch.B., former CEO Syndax, CMO (Verastem/ Idera), Sanofi
Dr. Ye Hua, MD, MPH, CEO Bionova, former Clinical Head at Hutchison MediPharm
4
5
TR009(Anti-VEGF/DLL4 BsAb)
Anti-Angiogenesis TherapyA Cornerstone in Oncology Treatment
Source: Company reports; 2011 Sep 15;71(18):6073-83. doi: 10.1158/0008-5472.CAN-11-1704. Epub 2011 Jul 29.
* IMBrave150 ph3 study
6
UNMET MEDICAL NEED
Anti-VEGF
mAbs
USD $7.6 B
Anti-Angiogenic
USD $18 B
Anti-VEGF therapy results in more
INVASIVE and METASTATIC
phenotypes
REGRESSION of VEGF-dependent
tumor blood vessels
FORMATION of normalized VEGF-
independent tumor blood vessels
VEGF ALONE CANNOT DESTROY ALL
TUMOR VESSELS
RESISTANCE TO ANTI-VEGF THERAPY
2018 Sales
USD $6.7 Billion
FDA APPROVED
Colon Cancer
Lung Cancer
Ovarian Cancer
Kidney Cancer
Brain Cancer (GBM)
POSITIVE PH3
Liver Cancer (+Tecentriq)*
2018 Sales
USD $821 Million
FDA APPROVED
Colon Cancer
Gastric Cancer
Lung Cancer
Liver Cancer
POSITIVE PH3
Bladder Cancer (PFS)
2018
FDA APPROVED
Colon Cancer
2018 Sales
USD $108 Million
Validated Target
The Problem
Bispecific Approach
DLL4-mediated NOTCH1 signaling represents an essential pathway for
vascular development of tumors and cancer stem cells, thus an
attractive target for angiogenesis-based cancer therapies
Historical cardiotoxicity attributed to DLL4-targeted monoclonal
antibodies raised serious safety concerns despite decent single agent
activity (Regereron/MedImmune/Celgene/Oncomed)
Efficacy: Dual blockade of VEGF/DLL4 shown to overcome VEGF
Resistance pre-clinically and now across 200 patients (TRIGR, ABBVIE,
OMED/MEREO)
Safety: Blocking both DLL4 and VEGF appears to limit the VEGF-
induced vascular sprouting (cardiox) which occurred with DLL4-mabs;
however, both ABBVIE and OMED/MREO had to significantly expand
their Phase 1a trials due to safety signals
Validated TargetDLL4-mediated NOTCH signaling represents an essential pathway for
vascular development of tumors and cancer stem cells, thus an
attractive target for angiogenesis-based cancer therapies
Historical cardiotoxicity attributed to anti-DLL4 monoclonal antibodies
raised serious safety concerns and curtailed their therapeutic
development despite single agent activity
(Regereron/MedImmune/Celgene/Oncomed)
Why Target DLL4/NOTCH As an Alternate Angiogenic
Mechanism To Overcome Primary VEGF-Resistance?
The Problem
7
3 Dual VEGF/DLL4 Bispecific Antibodies in the Clinic
8
PHASE 1A (MONOTHERAPY)Total Evaluable: 21 patients COLORECTAL/GASTRIC
Stable Disease: 14/21 (66%)
Partial Response: 1/21 (5%)
TETRAVALENT- BINDS TWO VEGF/DLL4
HTN (~50%); pulmonary HTN (1 case, 0.5% and Grade 1); NO DLT as of
12.5mg/kg dose
vs. ABT165: separation of binding sites, less steric hindrance (no cardiotxreported at any dose)
vs. navicixizumab: different DLL4 epitope, superior anti-tumor effect in pre-clinical head to head comparisons (no cardiotxreported at any dose)
PHASE 1A (MONOTHERAPY)Total Treated: 55 patients COLORECTAL/OVARIAN
Stable Disease: 30/55 (55%)Partial Response: 5/55 (11%)
TETRAVALENT- BINDS TWO VEGF/DLL4
HTN (55.6%), proteinuria (9.3%), pulmonary HTN (7.4%), GI perforation (3.7%) and STROKE
(1.9%)DLT/SAE reported as of 2.5mg/kg dose
PHASE 1B COLORECTAL (+FOLFIRI)
PHASE 2 COLORECTAL (+FOLFIRI)Vs AVASTIN+FOLFIRI N=100 pts
Initiated Q1’18 – ACTIVE NOT RECRUITING
Poster at EORTC-NCI-AACR, 2016 *ESMO 2018 Poster
** Historical RR in heavily pre-treated platinum resistant OC <15% Presented ASCO 2016
VEGF Dll4 VEGF
Dll4 Dll4
VEGFTR009
VEGF VEGF
Dll4 Dll4ABT-165
Navicixizumab
PHASE 1A (MONOTHERAPY)Total Treated: 66 patients COLORECTAL /OVARIAN
Stable Disease: 19/66 (29%)
Partial Response: 4/66 (6%)
BIVALENT – BINDS ONE VEGF/DLL4
HTN (58%),Pulmonary HTN (18%), BNP elevation, DLT/SAE concern as of 1mg/kg
PHASE 1B* (+PACLITAXEL) OVARIAN(Platinum resistant, prior Avastin & paclitaxel)
Unconfirmed ORR: 41%mPFS= 7.3 mosPulmonary HTN, peripheral edema, GRADE 1
HEART ATTACK
UNDER STRATEGIC REVIEW
PHASE 1B COMBINATION STUDY
(n=12-15)
▪ TR009 + Irinotecan (Gastric, Colorectal)
▪ TR0009 + Paclitaxel (Gastric, Ovarian)
▪ TR009 + PD-1/PD-L1 (partner
dependent)
Start: March 2020E (data H2’20)
9
Note: TR009 Monotx (single agent) is dosed Q2 weeks (28-day cycle)
*Assuming we finish all dose cohorts and launch combotx arm in Korea
Cohort 10.3mg/kg
Cohort 2(1mg/kg)
Cohort 3 (2.5 mg/kg)
Cohort 4
(5 mg/kg)
Cohort 5(7.5 mg/kg)
Cohort 6(10 mg/kg)
Cohort 7(12.5 mg/kg)
PHASE 1B MONOTHERAPY
EXPANSION STUDY (n=15)
▪ 3 cohorts: 7.5mg/kg – 12.5mg/kg
▪ PK/PD and RP2D
▪ DLL4 IHC at baseline
▪ Gastric, CRC, Other DLL4-driven
indications (Ovarian, HCC, Lung,
Pancreatic)
Start: December 2nd, 2019 (data H1’20)
Patient Population• Age > 19 years• Advanced metatstatic/non-resectable
solid tumors• Progressed on prior treatment• ECOG 0-2
Endpoints• Safety, tolerability, toxicity• MTD• PK/PD• Biomarkers; VEGF, soluble NOTCH 1,
soluble VEGFR-2, etc.
TR009 Phase 1A/1B Program Plan (N=54-60 patients)
Phase 1A Ongoing
Q4 2019E Completion
(n~21-27)
Cohort 8(15 mg/kg)
Cohort 9(17.5 mg/kg)
DOSE
ESCALATION
TR009 Phase 1 Dose Escalation: Clinical Benefit Rate of 71%
10*Unconfirmed
Dose Level Primary MalignancyBest Response /
Tumor Change (%)
Duration of Response
Days Months
0.3 mg/kg Gastric (PT 2) SD / -5% 127 4.2
Cholangiocarcinoma (PT 4) PD / 30% 42 1.4
Gastric (PT 5) PD / 75% 43 1.4
1.0 mg/kg Malignant melanoma (PT 7) PD / -13% 37 1.2
Colorectal (PT 10) SD / 4% 288 9.5
Ovarian (PT 11) SD / 3% 119 3.9
2.5 mg/kg Gastric (PT 12) SD / -17% 65 2.1
GIST (PT 13) SD / 7% 84 2.8
Colorectal (PT 14) PD / 23% 43 1.4
5 mg/kg Colorectal (PT 15) SD / 8% 214 7.0
Colorectal (PT 16) SD / 0% 289 9.5
Colorectal (PT 18) SD / -9% 92 3.0
7.5 mg/kg Colorectal (PT 19) PD / 9% 52 1.7
Gastric (PT 20) SD / -11% 138 4.5
Gastric (PT 21) SD / -20% 170 5.6
10.0 mg/kg Gastric (PT 23) SD / -26% 86 2.8
Colorectal (PT 24) PD / 7.7% 47 1.5
Gastric (PT 25) SD / -5% 169 5.6
12.5 mg/kg Colorectal (PT 26) SD / 15% 136 4.5 (RX ONGOING)
Gastric (PT 27) PR* / -40% 137 4.5 (RX ONGOING)
Colorectal (PT 28) SD / 4.3% 133 4.4 (RX ONGOING)
PR: POSITIVE DLL4 IHC (tumor and blood vessel)
Phase 1A Update
(Unaudited, as of
January 10th, 2020)
11
TR009 SINGLE AGENT ACTIVITY
Inherent Differences in Gastric Patient vs. Colorectal Patient
Response
-/-
NA
-/+
-/-
NA -/- NA -/-NA -/+ -/-
NA
-/- NA-/+
NA-/+
+/+-/-
-/-
+/+
-60.0%
-40.0%
-20.0%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
0.3 0.3 2.5 12.5 7.5 5 10 2.5 12.5 1 1 5 10 0.3 5 7.5 1 2.5 7.5 10 12.5
% C
ha
ng
e in
Tu
mo
r S
ize
Waterfall Plot - All Evaluable Patients (N=21)
PR: 1
SD: 14
DLL4 Status (Tumor/Vessel)Negative –Positive +
Not applicable NA
Colorectal Cancer Gastric CancerOthers
Site of DLL4 Expression May Explain Differences in Clinical
Responses (Tumor Shrinkage vs. Long Disease Stabilization)
12DATA PRESENTED ARE PRELIMINARY & UNAUDITED
Patient Dose
(mg/kg)
MaxChange Tumor
Size (%)
DOR
(Months)
S002 0.3 -5% 127 days (4.2)
S012** 2.5 -17% 65 days (2.2)
S020 7.5 -11% 138 days (4.5)
S021** 7.5 -20% 170 days (5.6)
S023* 10 -26% 86 days (2.8)
S025* 10 -5% 169days (5.6)
S027* 12.5 -40% 137 days (4.5)(Rx Ongoing)
Patient Dose(mg/kg)
MaxChange
Tumor Size (%)DOR
(Months)
S010 1 4% 288 days (9.5)
S015 5 8% 214 days (7.0)
S016 5 0% 289 days (9.5)
S018 5 -9% 92 days (3.0)
S026 12.5 15% 136+days(4,5)(Rx Ongoing)
S028 12.5 4% 133+days(4.4)(Rx Ongoing)
Dll4 Expression48% Cells
22% Stroma
Dll4 Expression 71% Endothelial Cells
(Blood Vessels)
GASTRIC
Evaluable Patients = 8
Partial Response=1
Stable Disease=6
Clinical Benefit= 87.5%
COLORECTAL
Evaluable Patients = 9
Stable Disease=6
Clinical Benefit= 66.7%
Direct Tumor shrinkage may be due to DLL4-high expression
in on cancer cells and stroma
References: Clinical implications of DLL4 expression in gastric cancer. Ishigami, et al. Journal of Experimental & Clinical Cancer Research 201332:46
* PRIOR RAMUCIRUMAB **PRIOR RAMUCIRUMAB+NIVO/PEMRBOALL PATIENTS W PRIOR ANTI-VEGF (AVASTIN, REGORAFENIB, OR CETUXIMAB)
Tumor Growth Stops
Direct Tumor Killing
DLL4 expression contained in blood vessels seems to
halt tumor growth, with long term duration
13
Gastric Patients Prior Treatment Regimens and TR009 Tx DurationMean of Responders (PR + SD): 4.13 months
4.17
1.41
2.14
4.53
5.59
2.83
5.55
4.5
S-1, Cape+Cis,Tax, Irinotecan, FOLFOX, FOLFIRI
S-1, Cape+Cis, Ram+Pac, Irin
TS-1,FOLFIRI, VEGR-2+PAC, NIVO, NIVO+Pac
Cape+Oxaliplatin
HERCEPTIN+Cape+Cis; VEGF-R2 +PAC, Irinotecan, PD-1, Capox
Capox, VEGF-R2 +Paclitaxel
Paclitaxel, VEGF-R2 +Pacllitaxel, Irinotecan
Xelox, VEGF-R2 +Pac, Irinotecan, Oxali PR
SD
SD
SD
SD
SD
SD
PD
(Rx Ongoing)
MONTHS
0.3 MG/KG
0.3 MG/KG
2.5 MG/KG
7.5 MG/KG
7.5 MG/KG
10 MG/KG
10 MG/KG
12.5 MG/KG
0 1 2 3 4 5 6
PT 27, -40%
PT 25, -5%
PT 23, -26%
PT 21, -20%
PT 20, -11%
PT 12, -17%
PT 5, 75%
PT 2, -5%
Note: Mean treatment duration does not account for ongoing patients at higher doses
14
Colorectal Patients Prior Treatment Regimens and TR009 Tx DurationMean of Responders (SD): 7.25 months
9.5
1.4
7
9.5
3
1.7
1.5
4.47
4.37
1.0 MG/KG
2.5 MG/KG
5.0 MG/KG
5.0 MG/KG
5.0 MG/KG
7.5 MG/KG
10 MG/KG
12.5 MG/KG
12.5 MG/KG
AVASTIN+FOLFOX, AVASTIN+FOLFIRI, REGORAFENIB, XELODA
FOLFOX, AVASTIN+FOLFIRI, XELODA, REGORAFENIB, 5FU/LV
CAPE, CCRT+CAPE, XELODA, AVASTIN+FOLFIRI, AVASTIN+FOLFOX, REGORAFENIB, KEYTRUDA
5FU, CAPE, AVASTIN+FOLFIRI, CAPE, REGO
CETUXIMAB+FOLFIRI, AVASTIN+FOLFOX, CAPE, 5FU/LV
CETUXIMAB+FOLFIRI, AVASTIN+FOLFOX, CAPE, CKD516/IRI, SIROLIMUS
FOLFOX, AVASTIN+FOLFIRINOX, AVASTIN+FOLFOX
AVASTIN+FOLFIRI, AVASTIN+FOLFOX, AVELUMAB
AVASTIN+FOLFIRI, AVASTIN+FOLFOX,
SD
SD
SD
SD
SD
SD
PD
PD
PD
MONTHS
(Rx Ongoing)
(Rx Ongoing)
0 1 2 3 4 5 6 7 8 9 10
PT 28, 4%
PT 26, 15%
PT 24, 7%
PT 19, 9.4%
PT 18, -9%
PT 16, 0%
PT 15, 8%
PT 14, 23%
PT 10, 4%
Note: Mean treatment duration does not account for ongoing patients at higher doses
15
G1 G2 G3 G4 G5 Total
No. % No. % No. % No. % No. % No. %
Hypertension 4 16.7 4 16.7 4 16.7 12 50
Anemia 2 8.3 1 4.2 3 12.5
Epigastric Pain 1 4.2 2 8.3 3 12.5
General Weakness 2 8.3 1 4.2 3 12.5
Constipation 2 8.3 1 4.2 3 12.5
Abdominal Pain 2 8.3 2 8.3
Alkaline Phosphatase Elevated 2 8.3 2 8.3
Headache 2 8.3 2 8.3
Hypoalbuminemia 1 4.2 1 4.2 2 8.3
Insomnia 2 8.3 2 8.3
Malignant Neoplasm Progress 1 4.2 1 4.2 2 8.3
Upper Respiratory Infection 1 4.2 1 4.2 2 8.3
Pulmonary Hypertension 1 4.2 1 4.2
Other TEAE Occuring <5% 8 0.3 12 0.5 7 0.3 0 0 0 0 27 113
Treatment-Emergent AE by Grade
TR009 Mono Vs Approved 3+L Gastric Cancer Treatments
16
CYRAMZA®Ramucirumab
Eli Lilly (VEGF-R2 mab)
AITAN®Apatinib
Hengrui China (VEGF-R2 TKI)
TR009Anti-VEGF/DLL4
TRIGR
Clinical Trial Phase 3 REGARD 2:1 vs. placebo
Phase 3(2:1 vs Placebo)
Phase 1a (Single arm)
PatientsN=355 (238 Cyramza vs. 117
placebo); 2L/NO prior VEGFs
N=273 (176 Aptanib, 91 Placebo)
3L/NO prior VEGFs
N=84L+; 88% had Prior VEGF-
R2/Cyramza®, HER-2/Herceptin®, PD-1/PD-1
Treatment IV, MONO ORAL MONO IV MONO
RR 3% 2.8% 13%
SD /DCR 49% 42% 88%
mPFS 2.1 m 2.6mDuration of Tx: 4.13m
(mean)
mOS 5.2m 6.5m NA
GR3/4 Toxicity
16% Hypertension; other no diff from BSC
9% GR 3/4 Hand Foot Syndrome, HPN, Proteinuria,
Neutropenia
NO DLTGr2/3 HPN Gr3 Anemia
17
STIVARGA®Regorafenib
Bayer
LONSURF®Trifluridine/tipiracil
Taiho/Servier
ELUNATE®fruquintinib
Chi-Med
TR009Anti-VEGF/DLL4
TRIGR
Clinical Trial Phase 3(2:1 vs Placebo)
Phase 3(2:1 vs Placebo)
Phase 3(2:1 vs Placebo)
Phase 1a (Single arm)
PatientsN=505 (Stivarga); Multiple
prior tx including Avastin®, Erbitux®
N=534 (Lonsurf); Multiple prior txs
including Avastin®, Erbitux®
N=278 (Elunate)2L+; 60% NO prior anti-
VEGF (Avastin®/anti-EGFR
N=94L+; 100% had Prior Avastin®, Erbitux®,
Stivarga®, PD-1/PD-l1
Treatment Oral, MONO Oral, MONO Oral, MONO IV MONO
RR 1% (PR) 1.6% 5% (1CR) TRIAL ONGOING
SD /DCR 41% 44% 62% 67% (6/9)
mPFS 1.9 m 2m 3.7m SD mean 7.25m
mOS 6.4m 7.1m 9.3m NA
GR3/4 Toxicity
17% HFS, 10% fatigue, 7%HPN, diarrhea
50% Neutropenia GR3 21% HPN; 11% HFS
NO DLTGr2/3 HPN Gr3 Anemia
TR009 Mono Vs Approved 3+L MCRC Therapies
TR009 Key Points to Consider
Preliminary Clinical Activity Seen with TR009 MONOTHERAPY Indicates a Clinical Benefit Rate
(CBR) of 71%
o Blocks VEGF and DLL4/Notch1 pathways targeting tumor angiogenesis and cancer stem cells (CSCs)
o Gastric cancer- 88% CBR (SD + PR); mean treatment duration of 4 months
o Colorectal Cancer - 66% CBR (SD); mean treatment duration of 7.25 months
o Gastric PR patient had POSITIVE DLL4 IHC in both tumor cells and blood vessels
o CBR of 71% > both Abbvie (65%) and Oncomed (35%) reported Phase 1A
Tolerability Profile of TR009 Appears Superior to Both Navicixizumab and ABT-165
o Perhaps driven by unique DLL4 epitope of TR009; enables greater combineability with IO/chemoo No expansion of Phase 1A dose escalation required due to safety concerns
o No DLT or SAE reported as of 12.5mg/kg (No Stroke, Heart Attack, BNP elevation, and 1 case of grade 1
Pulmonary Hypertension)
Phase 1B Monotherapy Expansion Will Prioritize DLL4 Driven Tumors (Gastric, Colorectal,
Ovarian, HCC, Pancreatic, Lung) – open label study, data expected in H1’20
Phase 1B Combination Study Will Explore TR009 in Combination with Standard Chemotherapy
Backbones in Colorectal and Gastric Patients – open label study, data expected in H2’20
FDA pre-IND mtg planned in H2’20 for Phase 2 initiation as master protocol
18
TRIGR
IMMUNE ~ CELL ACTIVATORS
T R I A - 0 0 1
T R I A - 0 0 2
19
AGONISTIC STIMULATION OF 4-1BB CAUSES:
CD8+ T cells: Enhance proliferation, differentiation to memory cells, resistance to apoptosis, IL-2 and IFN-γ production
Dendritic cells (DC): Enhance tumor antigen presentation by upregulation of B7 co-stimulatory molecules (CD80, CD86)
Natural Killer (NK) cells: Enhance ADCC, IL-2 and IFN-γproduction
Regulatory T cells (Treg): Repress Treg function
20
4-1BB (CD137) Mediates Important
Immune Function Within the Tumor
Micro-Environment
4-1BB (CD137) is an inducible co-
stimulatory molecule on CD4+ T cells,
CD8+ T cells, regulatory T cells (Treg) and
NK cells, and DC
URELUMAB/BMS
Clinical Experience
Phase 1&2 (n=346)
o ORR=50% (n=46 Melanoma)
combination with Nivolumab
o Responses seen regardless of PDL1
status
o Significant hepatotoxicity at 1
mg/kg or above.
o Clinical development terminated
However, Significant Liver
Toxicity Was Seen with
Agonistic 4-1BB mAbs
PHASE 1
21
Urelumab
Utomilumab
Antigen Presenting Cell
4-1BBL
4-1BB
Activated T cell
TRIGR’s anti-41BB (1A10) Targets Different Epitope
BMS PFIZER
TRIA anti-41BB
1A10
o TRIGR’s anti-4-1BB antibody (1A10) binds to unique epitope (CRD4) and does not compete with 4-1BBL for binding to 4-1BB receptor
o TRIGR’s anti-41BB are engineered to activate upon cross-linking with target tumor antigens (TAA) within thetumor micro-environment
o Repeated doses of up to 75 mg/kg of 1A10 as anti-PD1/41BB have been administered to cynomolgus monkeys safely. No clinically relevant increases in liver chemistry
CRD: cysteine rich domain
✓ First in Class 4-1BB / BCMA BsAb
✓ 4-1BB selectively activates immune cells (T, NK
cells) in the tumor microenvironment
✓ IP: Proprietary 4-1BB clone targets different epitope
to urelimab or utomilumab
✓ Low cytokine release with high cell lysis; also,
shown to induce memory (CD-4) T cells in tumor
re-challenge in vivo experiment
✓ Repeated doses of up to 75 mg/kg of 1A10 as
BsAb have been safely administered to
cynomolgus monkeys. No clinically relevant
increases in liver chemistry
✓ TRIA-001 offers an off the shelf alternative to CAR-T
for MM
✓ IND Q1’2021E
T Cells NK Cells
4-1BB4-1BB
BCMA BCMA
22
TRIA-001(4-1BB/BCMA)
98% of Multiple Myeloma cells
express the BCMA protein or RNA1
1. Cancer cell (2017) 31,1-15
TRIA001 Treatment Resulted in Tumor Growth Inhibition and Expansion of TIL
Anti-Tumor Activity
0
10
20
30
40
CD45 staining
CD
45 H
PF
Tumor PeriTumor
Tumor PeriTumor
Tumor PeriTumor
Isotype 5D5 BiSP 5A6 BiSP
0
5
10
15
CD8 staining
CD
8 H
PF
Tumor PeriTumor
Tumor PeriTumor
Tumor PeriTumor
Isotype 5D5 BiSP 5A6 BiSP
hIgG
CD45
CD8
Tumor Peritumor
BCMAx4-1BB
(TRIA001)
hIgG
BCMAx4-1BB
hIgG BCMAx4-1BB
(TRIA001)
hIgG
BCMAx4-1BB
HPF : High-power field
TIL: Tumor infiltrated lymphocyte
Tumor removal and weighing
Tumor fix and IHC staining
(CD45, CD8)
Tumor injection
(5x106 S.C.) TRIA001 treatment (BIW, i.p, 7 doses)
BIW 7 doses
hIgG (10 mpk, No purified T cell)
BCMAx4-1BB (10 mpk, purified T cell)
hIgG (10 mpk, purified T cell)
NOG mice engrafted with BCMA+ H929 tumor and human T cells were used
Increased CD45+ and CD8+
cells in tumor
23
BCMA CAR-T vs. BCMA/CD3 BsAb
24
JNJ-4528/LCAR-B38M
(ph1b n=29)
ORR- 100%
(69% CR/sCR, 86%VGPR)
27/29 pts progression free at
6 mos
93% CRS
1 CRS death
86% triple refractory to PI, IMiD, and anti-CD38 antibody
CARTITUDE-1 STUDY Phase 1bASH 2019
BB21217
(ph2, N=140)
ORR- 83%
(33% sCR, 50%, VGPR)
mDOR 11.1 mos
66% CRS
1 GR5 CRS
*95% received prior PI, IMiD, and anti-CD38 antibody, 84% refractory to IMiD, PI, CD38.
ORR/PFS from high dose group cohort
KarMMa STUDY Ph2ASH 2019
CC-93269
(ph1, n=30)
ORR- 89%
(44% CR/sCR, 50%, VGPR)
No sign ds progression at 7 mo+
76% CRS
1 CRS death
*Nearly all pts received prior PI, IMiD, and anti-CD38 antibody, 67% refractory to IMiD, PI, CD38.
ORR/CR for 10 mg dose cohort
CC-93269 STUDY Phase 1ASH 2019
Anti-BCMA BsAB as Active as CAR-T Therapies in
Multiple Myeloma
Immune
Checkpoint
T Cells NK Cells
Immune
Checkpoint
4-1BB4-1BB
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Immune Checkpoint / 4-1BB BsAb
First in Class – BIOMARKER DRIVEN
TAA mediated 4-1BB activation observed
in vitro and induce lysis of target TAA
expressing tumor cells
IND filing Q4’2021E
B7 Homolog Family
Down-regulates the body’s immune
system
Highly over-expressed in Breast,
Lung, Ovarian, and Endometrial
tumors
TRIA-002(4-1BB/Undisclosed Immune Checkpoint)
THANK YOU
George Uy
CEO & FOUNDER
001 949 648 0705
Miranda Toledano
COO & CFO
+972-58-55-88-470
26
APPENDIX
27
Founded in S Korea in 2016, 50+ employees
IPO KOSDAQ (KS 298380): $90M at $680M market cap (2018)
Bispecific Antibody (BsAb), Blood-Brain-Barrier (BBB) Penetrating BsAbs, and Antibody Drug Conjugates (ADC) core tech platforms
Global partnerships with TRIGR Rx, iMab Biopharma, LegoChem, Wuxi Biologics
Oncology and Neurodegenerative Disease Focus
Background on Our R&D Partner: ABL Bio
LICENSE & COLLABORATION FRAMEWORK
Discovery, In vitro/ In vivo, Process
Development
ABL Bio
IND-Enabling Activities
ABL Bio/TRIGR
Clinical and Commercialization TRIGR
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Our symbiotic alliance with ABL BIO enables efficient, low capital-intensive
development of our pipeline