20针对MAGE-A4MRCLS的高级自体工程TCR程序:粘液样/圆形细胞脂肪肉瘤;非小细胞肺癌1.基于美国癌症协会2022年(US)和全球癌症协会(EU4/UK 2020)的死亡率数字2.基于ADAP样本的MAGE-A4表达和≥30%肿瘤细胞≥2+强度的表达截止标准*滑膜肉瘤和MRCLS MAGE-A4的表达基于2020年11月20日的1,043例患者样本的数据截断和所有其他类型肿瘤的表达截止到2021年11月19日的1,543例肿瘤样本。·经临床验证的“干净”目标;癌症睾丸抗原家族成员·经筛查证实在多种实体肿瘤中均有表达·在安全性可接受的早期和晚期临床试验中,迄今为止,在多种实体肿瘤适应症中的反应·跨肿瘤的表达水平在~15%至~70%之间·令人鼓舞的反应:·滑膜肉瘤·卵巢·头颈部·膀胱·胃食道·NSCLC-鳞状·黑色素瘤·MRCLS MAGE-A4靶向首代肿瘤和下一代MAGE-A4(ADP-A2M4CD8)计划验证了MAGE-A4+肿瘤患者(美国和欧盟)年死亡率>82,000的目标
21滑膜肉瘤复发-有效率38.6%,持续50周数据截止2022年8月29日。队列1数据。数据代表了在进展期或手术切除前靶病变直径总和(非结节病变的SLD和结节病变的短轴)与基线的百分比变化。PD,进展性疾病;PR,部分反应;SLD,最大直径之和;SD,稳定期。个别患者·阿帕米-赛尔在经过大量预先治疗的滑膜肉瘤患者中有效·滑膜肉瘤的中位应答持续时间:50.3周(范围:11.7-122.0+)·截至数据截止日,仍在进行的8个应答
22 2023年年中将完成滚动BLA提交临床前模块提交临床模块提交CMC模块提交2022年第四季度2023年年中x模块已提交·FDA同意临床方案支持提交BLA·提交包括更新的先锋-1(关键试验)队列1数据,具有成熟的响应时间·完整的CMC档案支持矢量和T细胞
ADP-A2M4CD8
24ADP-A2M4CD8-超越试验家族*基于2022年美国癌症学会(US)和全球CAN(EU4/UK 2020)MAGE-A4表达的死亡率数字基于ADAP样本和≥30%肿瘤细胞在≥2+强度下的表达截止标准。滑膜肉瘤和MRCLS MAGE-A4的表达基于截至2020年11月20日的1,043例患者样本的数据截断和所有其他肿瘤类型的6,167名患者的1,543例肿瘤样本的表达截止到2021年11月19日的数据截断。X相同的MAGE-A4靶向TcR,并增加了CD8α共受体x,旨在比第一代x更有效地参与更广泛的免疫系统x基于迄今的结果,单剂细胞x专注于卵巢癌、尿路上皮癌和H&N癌x在这三种肿瘤类型中52%的ORR x美国和欧盟每年约15,000名符合条件的患者(这三种肿瘤)表达MAGE-A4和HLAA2*针对MAGE-A4的下一代产品设计为更有效
25结果一致:在超过Ph1试验数据截止时间:2022年11月23日;CR=完全缓解:PR=部分缓解;SD=稳定疾病;PD=自体T细胞输注的进展性疾病周·卵巢癌、尿路上皮癌和头颈癌病灶区域的有效率为52%(13/25)·卵巢癌、尿路上皮癌和头颈癌病灶区域的有效率为75%(9/12)
26超越1期(NCT04044859):ADP-A2M4CD8 TCR T细胞疗法作为单一疗法或联合nivolumab重点治疗尿路上皮癌、头颈部癌、卵巢癌合并食道、食道胃交界处或胃癌、非小细胞肺癌、头颈部癌、卵巢癌、黑色素瘤或子宫内膜癌的患者均可在该篮子试验中接受治疗。
27超越1期(NCT04044859)新的H&N队列:一线ADP-A2M4CD8TCRT细胞联合培布罗珠单抗治疗不能切除的局部晚期或新转移的H&N肿瘤患者,CP≥1 CP,综合阳性评分;H&N,头颈部;SOC,标准护理
28超越1期(NCT04044859)新的尿路上皮肿瘤队列:二线ADP-A2M4CD8 TCR T细胞疗法联合培布罗利珠单抗治疗不能切除、局部晚期或新转移的尿路上皮肿瘤SOC患者的一线顺铂化疗,标准护理
29超越-3期2期(NCT05601752):随机ADP-A2M4CD8 TCR T细胞治疗复发卵巢癌患者的单独或联合应用nivolumab,东部合作肿瘤组
靶向介孔蛋白(MSLN)的tr u C程序
31以间皮蛋白为靶点的自体工程TRU C计划*参考文献:Inaguma 2017,SEER Statistics,Morello 2016,Tozbikian 2014 NSCLC非小细胞肺癌·所有肿瘤的表达水平从~20%到~76%不等,包括:~58%的卵巢癌患者·其他包括:·胰腺·三阴性乳房(TNBC)·结直·间皮瘤·NSCLC·胆管癌间皮蛋白是第一代Gavo-cell和下一代(TC-510)计划的靶点·间皮蛋白(MSLN)是一种高表达的表面蛋白抗原,在广泛的实体瘤中表达·Truc程序的独特特性支持表达MSLN的肿瘤患者的治疗,不受HLA亚型的限制·Truc细胞被设计为快速有效、有效的治疗方案迁移和持久反应验证了每年约215,000名患者死亡率的目标*一个交叉多个目标适应症
32 48 26-4-4-5-5-6-8-8-9-10-10-11-12-13-16-18-20-21-22-25-25-39-49-56-61-64-66-67-80-100-90-80-70-60-50-40-30-20-10 0 10 20 40 50 10 29 30 28 7 27 32 19 34 9 11 21 25 16 12 20 18 31 6 8 13 22 33 14 5 3 15 24基线(%)患者符合肿瘤消退所有Gavo-cel+LD ORR 20%22%MPM ORR 18%21%卵巢ORR 29%29%*DCR=PR或SD持续至少3个月*DL0(5x107/m2)DL1(5x107/m2,+LD)DL2(1x108/m2)DL3(1x108/m2,+LD)DL3.5(3x108/m2,+LD)DL4(5x108/m2)DL5(5x108/m2,+LD)数据截止-2022年9月9日OVA OVA MPM OVA OVA CHO MPM Dl,剂量水平;LD,淋巴衰竭;DCR,疾病控制率;ORR,总有效率;PR,部分有效;SD,根据最佳反应评估,肿瘤体积缩小。ORR:29%(Gavo-cel+LD)PFS:5.8个月OS:8.1个月93%的患者肿瘤消退,疾病控制率77%
33提高Gavocel疗效:联合抗PD1和下一代增强剂(TC-510)PD-1重新激活Truc-T细胞Gavo-cel+anti-PD1增强肿瘤微环境中的Gavo-cel和TIL逆转T细胞衰竭PD-1 CD28 PD1xCD28开关T细胞活性维持PD1xCD28开关增强肿瘤微环境中T细胞活性延迟T细胞衰竭Ph 2试验联合nivolumab治疗卵巢癌和间皮瘤有机会减少细胞TC-510=Gavo-cel加PD1xCD28开关在PH1中的剂量递增多适应症研究
针对PRAME和CD70的临床前计划
35 1.基于美国癌症协会2022年(美国)和全球癌症协会(EU4/UK 2020)的死亡率数字;数据来源的PRAME表达:QIAGEN Oncoland TCGA_B38 NSCLC非小细胞肺癌临床前针对PRAME·临床验证的“清洁”靶点的全自体工程TCR计划;癌症睾丸抗原家族的成员·比其他靶点在更广泛的肿瘤中有独特的机会·2023年将成为临床前开发的第一个基因·考虑下一代方法和与MAGE-A4的潜在协同作用·在广泛的实体肿瘤中高表达,包括:·乳房·非小细胞肺癌·肾脏·胃食道·黑色素瘤·子宫内膜·卵巢·头颈验证靶标,年死亡率>160,000 1例PRAME+肿瘤患者(美国和欧盟)
36靶向CD70的TC-520:寻找有吸引力的靶点的下一代方法x表达于:·血液系统恶性肿瘤:急性髓系白血病、淋巴瘤·实体瘤:肾细胞癌,x在正常细胞中的表达仅限于活化的T细胞、B细胞和树突状细胞x通过膜结合IL-15的第一类自体CD70细胞治疗来增强持久性x临床验证的靶点:在急性髓细胞白血病和αCD70mAb的急性髓系白血病IL-15中显示POC
Appendix
TCR programs Targeting MAGE - A4
afami - cel
20 Advanced autologous engineered TCR program targeting MAGE - A4 MRCLS: myxoid/round cell liposarcoma; NSCLC: non - small cell lung cancer 1. Mortality figures based on American Cancer Society 2022 (US) and Global Can (EU4/UK 2020) 2. MAGE - A4 expression based on ADAP samples and expression cut off criteria of ≥30% tumor cells at ≥2+ intensity * Synovial sarcoma and MRCLS MAGE - A4 expression based on 1,043 patient samples at November 20, 2020 data cut - off and expression of all other tumor types on 6,167 pat ients, 1,543 tumor samples at November 19, 2021 data cut - off. • Clinically validated “clean” target ; member of cancer testis antigen family • Expression across broad range of solid tumors confirmed by screening protocol • In early - and late - phase clinical trials with acceptable safety profile , to date, and responses in multiple solid tumor indications • Expression levels ranging from ~15% to ~70% 2 across tumors • Encouraging responses in: • Synovial sarcoma • Ovarian • Head & neck • Bladder • Gastroesophageal • NSCLC - squamous • Melanoma • MRCLS MAGE - A4 target for both first - gen afami - cel and next - gen (ADP - A2M4CD8) programs Validated target with annual mortality of >82,000 1 patients (US and EU) with MAGE - A4+ tumors
21 Afami - cel in Synovial Sarcoma - Response rate 38.6%, Duration 50 weeks Data cut - off August 29, 2022. Cohort 1 data. Data represent percent changes from baseline in sum of diameters ( SLD for non - nodal lesions and short axis for nodal lesions) in target lesions through progression or prior to surgical resection. PD, progressive disease; PR, partial response; SLD, sum of longest diameters; SD, stable disease. Individual patients • afami - cel is efficacious in heavily pre - treated patients with synovial sarcoma • Median duration of response in synovial sarcoma: 50.3 weeks (range: 11.7 – 122.0+) • 8 responses ongoing as of data cut - off
22 Rolling BLA submission to be completed by mid - 2023 Preclinical Module Submission Clinical Module Submission CMC Module Submission Q4 2022 Q1 2023 Mid 2023 x Module submitted • FDA agreed that the clinical package supports submission of the BLA • Submission to include updated SPEARHEAD - 1 (pivotal trial) Cohort 1 data with mature duration of response • Complete CMC dossier supporting vector and T cell
ADP - A2M4CD8
24 ADP - A2M4CD8 – SURPASS family of trials * Mortality figures based on American Cancer Society 2022 (US) and Global Can (EU4/UK 2020) MAGE - A4 expression based on ADAP samples and expression cut off criteria of ≥30% tumor cells at ≥2+ intensity. Synovial sarcoma and MRCLS MAGE - A4 expression based on 1,043 patient samples at N ovember 20, 2020 data cut - off and expression of all other tumor types on 6,167 patients, 1,543 tumor samples at November 19, 2021 data cut - off . x Same MAGE - A4 targeted TCR as afami - cel with the addition of CD8α co - receptor x Designed to be more potent and to more effectively engage the broader immune system compared to first - gen x Single dose of cells x Based on results to date, focusing on ovarian, urothelial and H&N cancers x ORR of 52% across the three tumor types x ~ 15,000 eligible patients per year (with these three tumors) in the US and EU expressing MAGE - A4 and HLA - A2* Next - gen product targeting MAGE - A4 designed to be more potent
25 Results consistent: 37% response rate in SURPASS Ph 1 trial Data cut - off: Nov. 23, 2022; CR=complete response: PR=partial response; SD=stable disease; PD=progressive disease Weeks from SPEAR T - cell infusion • 52% response rate in focus areas of ovarian, urothelial, and head & neck cancers (13/25) • 75% response rate in focus areas of ovarian, urothelial, and head & neck cancers in patients with 3 or fewer prior lines of therapy (9/12)
26 SURPASS Phase 1 (NCT04044859): ADP - A2M4CD8 TCR T - cell therapy as monotherapy or in combination with nivolumab Focus on patients with urothelial carcinoma, head and neck carcinoma, ovarian carcinoma Patients with esophageal , esophagogastric junction, or gastric carcinoma, non - small cell lung cancer, head and neck carcinoma, ovarian carcinoma, melanoma, or endometrial carcinoma can be treated in this basket trial
27 SURPASS Phase 1 (NCT04044859) new H&N cohort: First - line ADP - A2M4CD8 TCR T - cell therapy in combination with pembrolizumab In patients with unresectable locally advanced or newly metastatic H&N tumors with CPS≥1 CPS, combined positive score; H&N, head and neck; SOC, standard of care
28 SURPASS Phase 1 (NCT04044859) new urothelial cohort: Second - line ADP - A2M4CD8 TCR T - cell therapy in combination with pembrolizumab following first - line cisplatin - based chemotherapy In patients with unresectable, locally advanced, or newly metastatic urothelial tumors SOC, standard of care
29 SURPASS - 3 Phase 2 (NCT05601752): Randomized ADP - A2M4CD8 TCR T - cell therapy alone or in combination with nivolumab In patients with recurrent ovarian carcinoma ECOG, Eastern Cooperative Oncology Group
TR u C programs Targeting Mesothelin (MSLN)
31 Pha autologous engineered TR u C program targeting Mesothelin *Refs: Inaguma 2017, SEER Statistics, Morello 2016, Tozbikian 2014 NSCLC Non - small cell lung cancer • Expression levels ranging from ~20% to ~76% 2 across tumors including: ~ 58% of Ovarian cancer patients • Others include: • Pancreatic • Triple Negative Breast (TNBC) • Colorectal • Mesothelioma • NSCLC • Cholangiocarcinoma Mesothelin is target for both first - gen gavo - cel and next - gen (TC - 510) programs • Mesothelin (MSLN) is a highly expressed surface protein antigen expressed across a broad range of solid tumors • Unique characteristics of TRuC program support treatment of patients with tumors expressing MSLN, no limitations by HLA subtype • TRuC cells are engineered for fast and efficient efficacy, migration and durable responses Validated target with annual mortality of ~215,000 patients* a cross m ultiple t arget i ndications
32 48 26 - 4 - 4 - 5 - 5 - 6 - 8 - 8 - 9 - 10 - 10 - 11 - 12 - 13 - 16 - 18 - 20 - 21 - 22 - 25 - 25 - 39 - 49 - 56 - 61 - 64 - 66 - 67 - 80 -100 -90 -80 -70 -60 -50 -40 -30 -20 -10 0 10 20 30 40 50 10 29 30 28 7 27 32 19 34 9 11 21 25 16 12 20 18 1 31 6 8 13 22 33 14 5 3 15 2 4 Change in Target Lesions from Baseline (%) Patients Consistent tumor regression in patients with gavo - cel Blinded Independent Central Review All gavo - cel + LD ORR 20% 22% MPM ORR 18% 21% Ovarian ORR 29% 29% * DCR = PR or SD lasting at least 3 months * DL0 (5x10 7 /m 2 ) DL1 (5x10 7 /m 2 , + LD) DL2 (1x10 8/ m 2 ) DL3 (1x10 8 /m 2 , + LD) DL3.5 (3x10 8 /m 2 ,+ LD) DL4 (5x10 8/ m 2 ) DL5 (5x10 8/ m 2 , + LD) Data Cutoff – September 9, 2022 MPM OVA MPM OVA MPM MPM MPM MPM MPM MPM OVA MPM MPM MPM MPM MPM MPM MPM OVA OVA MPM MPM MPM OVA OVA CHO MPM MPM MPM MPM DL , Dose Level; LD, Lymphodepletion; DCR, Disease Control Rate; ORR, Overall Response Rate; PR, Partial Response; SD, Stable Di sea se * Tumor volume decrease based on best response assessed Ovarian Cancer Results ORR: 29% ( gavo - cel + LD) PFS: 5.8 months OS: 8.1 months Tumor Regression in 93% of Patients, Disease Control Rate 77 %
33 Improving gavo - cel efficacy: combination with anti - PD1 and next - gen enhancements (TC - 510) PD - 1 Re - invigorate TRuC - T cells gavo - cel + anti - PD1 Enhances gavo - cel and TILs in the tumor microenvironment Reverts T cell exhaustion PD - 1 CD28 PD1xCD28 Maintenance of T cell potency PD1xCD28 Switch Enhances T cell activity in tumor microenvironment Delays T cell exhaustion Ph 2 trial in combination with nivolumab in ovarian cancer and mesothelioma with opportunity for redosing with cells TC - 510 = gavo - cel plus PD1xCD28 switch in dose escalating in Ph1 studies in multiple indications
Preclinical Programs Targeting PRAME and CD70
35 1. Mortality figures based on American Cancer Society 2022 (US) and Global Can (EU4/UK 2020) ; PRAME Expressi on data source: Qiagen Oncoland TCGA_B38 NSCLC Non - small cell lung cancer Preclinical a utologous engineered TCR program targeting PRAME • Clinically validated “clean” target; member of cancer testis antigen family • Unique opportunity in a broader range of tumors than other targets • First - gen in preclinical development to be IND - ready in 2023 • C onsidering next - gen approaches and potential synergy with MAGE - A4 • Highly expressed across a broad range of solid tumors including: • Breast • NSCLC • Kidney • Gastroesophageal • Melanoma • Endometrial • Ovarian • Head & neck Validated target with annual mortality of >160,000 1 patients (US and EU) with PRAME+ tumors
36 TC - 520 targeting CD70: Next - gen approach to attractive target x Versatile target expressed in: • hematological malignancies: acute myeloid leukemia (AML), lymphoma • solid tumors: renal cell carcinoma (RCC), x Expression in normal cells limited to a subset of activated T - cells, B - cells and dendritic cells x Path to first - in - class autologous CD70 cell therapy with membrane bound IL - 15 to enhance persistence x Clinically validated target: POC demonstrated in AML with α CD70 mAb in AML ( argenx ) IL - 15