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Developing the World’s first Ovarian
Cancer Therapeutic Vaccine
September 2011
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Important Notice
The purpose of the presentation is to provide an update of the business of Prima Biomed Ltd ACN 009
237 889 (ASX:PRR) (Prima). These slides have been prepared as a presentation aid only and the
information they contain may require further explanation and/or clarification. Accordingly, these slides and
the information they contain should be read in conjunction with past and future announcements made by
Prima and should not be relied upon as an independent source of information. Please contact Prima
and/or refer to the Company's website for further information.
The views expressed in this presentation contain information derived from publicly
available sources that have not been independently verified. No representation or warranty
is made as to the accuracy, completeness or reliability of the information.
Any forward looking statements in this presentation have been prepared on the basis of a
number of assumptions which may prove incorrect and the current intentions, plans,
expectations and beliefs about future events are subject to risks, uncertainties and other
factors, many of which are outside Prima Biomed Ltd’s control. Important factors that could
cause actual results to differ materially from assumptions or expectations expressed or
implied in this presentation include known and unknown risks. Because actual results
could differ materially to assumptions made and Prima Biomed’s current intentions, plans,
expectations and beliefs about the future, you are urged to view all forward looking
statements contained in this presentation with caution. This presentation should not be relied on as a
recommendation or forecast by Prima Biomed Limited. Nothing in this presentation should be construed
as either an offer to sell or a solicitation of an offer to buy or sell shares in any jurisdiction.
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About Prima Biomed
Prima BioMed (ASX:PRR) is a biotechnology company
focused on developing new oncology therapies
Ovarian cancer – one of lowest survival rates of all gynaecological cancers
CVac to address huge unmet medical need for treatment of ovarian cancer
Company’s strategy is to commercialise Cvac
Addressable market for CVac could exceed $1 B pa
Other products in development pipeline at earlier stages of development
include
- Oral HPV vaccine created using dense gas technology
- Humanised monoclonal antibody targeting Cripto-1
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Executive Leadership • Mr Martin Rogers CEO
– Extensive business management experience & scientific background
• Mr Ian Bangs CFO
– CFO & company secretary for several ASX companies
• Dr Neil Frazer CMO
– Former Glaxo, 25 years drug development experience including 10
FDA approvals
• Amy Brewer US Project Manager
– Several years pharmaceutical project management at SPRI (contract
research organisation)
• Dr Sharron Gargosky SVP CVac™ Program
– 3 previous successful FDA Orphan Drug approvals
• Mr Matthew Lehman COO
– Experience in execution of over 100 clinical trials
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CVac™ – Lead Program
• CVac™ is autologous, dendritic-cell (DC) based therapy or
cancer vaccine similar to Dendreon’s Provenge
• CVac™ is in the clinic with a third clinical study ongoing
• Phase I & phase IIa trials results were very promising
• Ongoing phase IIb & upcoming CANVAS trial likely to
provide further proof of concept for global registration
• If CVac™ progresses to full commercialisation, CVac™
could capture significant share of multi-billion dollar ovarian
cancer treatment vaccine market, & revalue the sector
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How CVac™ Works
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How CVac™ Works
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Demand for CVac™
• Global market size for ovarian cancer therapy estimated at
US$3.6bn*
• 73,000 women pa diagnosed with ovarian cancer in US,
Europe, Australia, Japan – 318,000 women globally*
• Ovarian cancer generally diagnosed at late stage, only 20-
30% patients with late stage disease survive 5 years*
• Maintenance-style treatment like CVac™ would be first of
its type in market & has potential to achieve 10% market
penetration in first year
• 10% market could = $500m+ sales in developed world
[* Thomson Business Intelligence, Ovarian Cancer Therapeutics Industry Analysis 2007]
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Demand for CVac™
• Median progression free survival after optimal surgery &
chemotherapy is only 22 months
• Non-toxic nature of CVac™ – attractive for oncologist to
prescribe; a no-brainer for doctor & patient
• Analysts reviewing market based on Dendreon Corp
forecasts predict market size could be US$1.5+ B per
indication*
• Subject to outcome of additional clinical trials CVac™ may
have an indication in several additional mucin-1 positive
cancers
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* Morgan Joseph and Roth Capital
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CVac™ – Lead Program
• CVac™ could revolutionise treatment for tumors that over-
express mucin-1
• Ovarian cancer, the first target, has highest mortality of all
gynecological cancers
• Drugs used for ovarian cancer not changed in over a
decade
• CVac™ has potential to alter treatment paradigm by
prolonging periods of ovarian cancer remission with very
low toxicity potential
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Clinical Evidence Demonstrates
Disease Modification
• Phase Ib – CVac™(5th Phase I study, first with DC)
– 14 patients with terminal cancer (3-6 months life expectancy), broad range of adenocarcinomas including renal, breast, ovarian, fallopian tube, colon, lung & oesophageal
– Objectives:
• Primary: assess toxicity
• Secondary: assess anti-tumor efficacy, immune response & procedure feasibility
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– Results:
• First time that every patient had immune responses
• All patients produced desired cellular immune
responses
• No treatment related toxicity
• Patients’ cells successfully cryo-preserved
• Of 9 evaluable patients, 4 had stable disease during
the assessment period of 1 year
• 2 patients received ongoing therapy for >40mths
Clinical Evidence Demonstrates
Disease Modification
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Why target Ovarian cancer? CvacTM targets ovarian cancer, disease with very low 5 year
survival & late stage detection
Example: Stage III ovarian cancer patient • Incurable recurrent disease, diagnosed by elevated CA125 marker
• CVacTM treatment demonstrates stabilisation of CA125 initially for 4mths, then for further 18mths post further injections of CVacTM
Stable disease 4mths 18mths
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Phase IIa Trial Demonstrates Disease
Stabilisation
CVac™ results – 21% patients responded to therapy
• Protocol: Enrolled 28 patients (21 evaluable) with incurable
ovarian cancer (life expectancy at least 6 months), & rising
CA125 levels at least 25% over baseline within 1 month
confirming rapidly progressing disease. Patients had received
multiple courses of chemotherapy/ radiotherapy
• Patients received 3 CVacTM injections over 10 weeks, followed by
4 injections at 10 week intervals
• Objectives:
– Primary:
CA125 response or stabilisation in at least 15% patients
– Secondary:
Disease progression-free survival, immune response & safety
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Phase IIa Trial Demonstrates Disease
Modification
CVac™ results – 21% patients responded to therapy (CA-125
reduction or prolonged stabilisation) & 47% patients had disease
stabilisation (CA-125 stable)
• results
– No Cvac ™ therapy-related toxicity
– Ovarian tumors respond to therapy with CA125 reduction or
stabilisation
– Progression Free Survival averaged 127 days (95%
confidence limits 96-219 days)
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Comparison with Marketed Oncology
Drugs Phase II Results
Phase IIa disease intervention trials, response rates
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Drug Activity Disease
modification
Stable disease
Avastin (Roche,
$7b sales)
VEGF Mab
Colon Cancer
16%
Aromasin
(Pfizer >$1b
sales)
Anti-estrogen
Breast Cancer
36%
Tarceva
(Astellas
>$1.5b sales)
EGFR inhibitor
NSCLC
10-20%
Provenge PAP-GMCSF
autologous cell
19%
CVac Mucin-1
autologous cell
21% 47% For
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Clinical Trial Program
• Phase I and IIa trials indicate CVac™ could be strong
candidate for treating ovarian cancer patients in remission
& for other MUC-1 over-expressing tumors
• Phase IIb trial (60 patients) for ovarian cancer patients
after successful 1st or 2nd line therapy is recruiting patients
in US & Australia to:
– Assure comparability of multiple manufacturing centres
– Confirm safety & tolerability established in earlier trials
– Compare CVac™ to standard of care re progression-
free survival (PFS)
– Confirm host immunologic response to CVac™ therapy
– Recruitment complete in Sep 2011
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CVac™ – CANVAS Study Design
• CANVAS(CANcer VAccine Study) will be multinational,
multi-centre, randomised, double-blinded, placebo-
controlled CVac™ trial as maintenance treatment for
epithelial ovarian, primary peritoneal or fallopian tube
cancer in complete remission
– 800 patients randomised, double-blinded, well-designed
efficacy trial
– Definitively establish survival benefit – progression free
survival (PFS) & overall survival (OS)
– Assess quality of life & pharmacoeconomic parameters
– Will support marketing authorisations globally
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CVac™ – CANVAS Study Design
• CANVAS(CANcer VAccine Study)
– First patients to be enrolled in Aust & Europe Q4 2011
– CANVAS conducted at ~150 centres 22 countries –
Australasia, US & Europe
– Based on expected recruitment rates, full patient
enrolment by ~Q1 2013
– CANVAS is event driven study & actual study timelines
dependent on patient outcomes in trial
• (ie how long patients stay in remission & stay alive) As such
these timelines are indicative only
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Value Drivers – Key Prima Biomed
Attributes
• If proven clinically successful CVac could address a
major global unmet medical need
• Depth/experience in management for drug approval
• Global ovarian cancer treatment market ~US$3.6b in 2010,
& Cvac could revalue the market
• 10% of all ovarian cancer patients pa (7000+) would give
Prima BioMed potential revenues $500+m pa
• FDA accepted Investigational New drug (IND) application
in 2009 & EMA provided SA in Feb 2010
• Phase IIb study (61 patients) recruited first patients Q3
2010
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Value Drivers – Key Program
Attributes
• Trial leadership from prestigious Fred Hutchinson Cancer
Center in Seattle & Stanford Medical Center in US http://www.investorcalendar.com/IC/CEPage.asp?ID=163542
• Progressing clinical studies of world’s first ovarian
cancer vaccine, CVac
• Pursuing global fast-track commercialisation
• CANVAS registration study 150 hospital centres 22
countries – Australasia, US & EU
• Full patient recruitment for CANVAS registration study
expected by Q1 2013
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Value Drivers – Key Program
Attributes
• Highly experienced scientific advisory team including Prof
Ian Frazer, co-inventor of Merck/CSL’s cervical cancer
vaccine Gardasil
• Experienced pharma sector expert Dr Neil Frazer
appointed Chief Medical Officer to oversee CVac trials
• Prima has pipeline of earlier stage oncology products
under investigation
• Company in solid financial position
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Clinical Leader Opinions
Further commentary available from key opinion leaders
• Dr Jonathan Berek MD
– Stanford Medical Center, Head of Women's Cancer Center
http://www.investorcalendar.com/IC/CEPage.asp?ID=163542
• Prof Ian Frazer MD
– Uni of Queensland, Diamantia Centre for Immunology
• Dr Heidi Gray MD
– Fred Hutchinson Cancer Center, Uni of Washington
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Clinical Leader Opinions
• “These results indicate the potential of dendritic cell therapy
and the CVac™ approach to harness the immune system to
intervene in tumour growth, even in patients with advanced
disease. In addition, the targeting of Mucin-1 is again
validated for cancer therapies.”
Prof Bruce Loveland, Burnet Cancer Research Centre
• “Despite the advanced stage of disease this new product
candidate CVac™ clearly showed benefit in a statistically
significant number of these patients.”
Principal Investigator, Prof Paul Mitchell, Director Cancer
Services, Austin Hospital
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Anti-Cripto-1 Mab (early
development) • Prima has raised various murine & human monoclonal antibodies
(Mabs) recognising EGF-CFC family member named Cripto-1
• Human Cripto-1 is Mr 36,000 molecule. Cripto-1 is also oncogenic
growth factor involved in cancer cell proliferation & metastasis
• The Mabs inhibit tumour growth in vitro of most cancers of breast,
colon, lung, stomach & pancreas but only weak reaction with
normal tissues. Effects of cripto-1 Mab were greater in presence of
cytotoxic drugs such as 5-fluorouracil, epirubicin & cisplatin
Plan of Action:
1. Update with Anti-Cripto-1 Mab – 3Q 2011
2. Preclinical studies to support an IND &
human trials – 2013
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Oral HPV Vaccine • Prima partnered with Prof Ian Frazer & Prof Neil Foster to
use dense gas technology to try to formulate oral HPV vaccine
• The technology reformulates large, irregular particles into smaller consistent sizes allowing higher bioavailability at lower doses of a drug & encapsulation for oral dosing
• Studies with Eudragit ® coated lyzosyme completed & feasibility studies with ovalbumin ongoing. Animal studies to evaluate immunogenicity Q3 2011
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Using dense gas technology (lysozyme framework) reduced particle
size 70x & produced much more regular shape
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Newsflow
• Phase IIb randomised phase Feb 2011 (complete)
• Regulatory agreement on phase III (complete)
• Scientific Advice with European Union (complete)
• Potency assay expected to be qualified Q2-Q3
2011(complete)
• Phase IIb enrolment finalised Q3 2011(complete)
• FDA meeting for registration study review Q3
2011(complete)
• European license for manufacturing Q2-Q3 2011
• Oral HPV vaccine progress update Q3-Q4 2011
• Phase III study recruitment commencement Q4 2011
• Update Cripto 1 progress Q4 2011
• Dubai sales update Q4 2011
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Conclusions
• There is major unmet medical need for new
therapies for ovarian cancer
• CVac™ has potential to transform treatment of
ovarian cancer in remission
• Cvac™ may also have potential to treat other
mucin-1 over-expressing tumours eg breast,
colorectal, lung, gastric & pancreatic cancers
• Pivotal study has been designed to seek global
registration in key markets for CVac™
• Prima recruited top tier advisers with track
records of successful commercialisation
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Conclusions
• Solid financial position
• Strong management team
• Pipeline of early stage research with other cancer
treatment technologies
• Success will provide considerable investment
return in foreseeable future
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Corporate Snapshot Issued Capital
ASX Code: PRR (Australian Securities Exchange)
Shares: [1,007.3M]
Listed Options: [58.2M] (Exercisable at $0.02 on or before 31 Dec 2011)
Total Issued Securities:[1065.3M]
Price & Capitalisation Share Price: $0.20 (13/9/11)
2011 high: $0.42 (11/4/11)
Mkt. Cap(diluted) $201.8M
Cash Position: $[57.0M] 30/6/11(est. average cash burn $1.4/month FY12)
Board of Directors Ms Lucy Turnbull AO Chairman
Mr Albert Wong Deputy Chair
Mr Martin Rogers Chief Executive Officer
Dr Neil Frazer Chief Medical Officer
Dr Richard Hammel Non-Executive Director
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• Dendritic cell -White blood cells that instruct the immune cells on what foreign thing (antigen) they should attack. They eat what
they identify to be foreign substances in the blood then process (degrade) antigen into small peptides, place the peptides that
indicate the characteristics of an antigen on their surface, and present the antigen to T cells so as to produce the appropriate
immune system response. The class of cells called antigen presenting cells also includes dendritic cells or dendritic macrophages
• Cancer Vaccine /Autologous - A vaccine that has been developed to target a cancer molecule to either prevent cancer
(prophylactic vaccine) or treat existing cancer (therapeutic vaccine). CVac is a cancer vaccine.
• Immunotherapy – A treatment that seeks to make use of the immune system so as to manage a disease condition.
• CA125 - A tumour marker that is indicative of ovarian cancer.
• CD4+ cells - White blood cells that assist in the body’s immune response by helping B cells create antibodies. CD4+ cells receive
the antigen of foreign cells from the MHC Class II molecules on Antigen Presenting Cells.
• CD8+ cells – White blood cells that assist in the body’s immune response by killing foreign cells, which is why CD8+ cells are also
called Cytotoxic T-Lymphocytes or Killer T-cells. CD8+ cells receive the antigen of foreign cells from the MHC Class I molecules on
Antigen Presenting Cells.
• Cell therapy - The process of introducing new cells into a tissue in order to treat a disease. CVac is a cell therapy in that it
introduces an MFP into the body to generate an anti-cancer immune response.
• Cisplatin – A platinum-containing chemotherapy drug first approved by the FDA in 1978. In conjunction with Taxol, it is the current
standard for ovarian cancer treatment.
• Progression free survival – The period of time in which a patient in a clinical trial for a cancer therapy experiences no worsening
of their cancer after being administered the treatment.
• MUC-1 – A mucin that Cancer Vac’s Mannan Fusion Protein targets. MUC-1 is of interest to cancer researchers because a wide
variety of tumour cells, including those from breast, colon, prostate, pancreatic and lung cancers, not only overproduce mucin, and in
particular MUC-1, but seem to produce a variety that is poorly glycosylated.
• Antigen - The ‘bad guy’ substance that stimulates the immune system to respond to the perceived threat.
• T-cell receptors – Receptors on the surface of Helper T lymphocytes that recognise the combined MHC Class II and peptide
epitope and then pass the word on to create the appropriate B lymphocytes.
• T Lymphocytes – White blood cells that are responsible for killing cells infected by viruses, in the case of ‘Cytotoxic T cells’, and
inducing B lymphocytes to produce antibodies, in the case of ‘Helper T lymphocytes’.
• Phase III – A clinical trial in humans to test efficacy in a large sample. Phase III is used for product registration
• IND – Short for Investigation New Drug, an FDA designation of a drug that has been approved for clinical trials in the US.
• Statistical significance - The probability, measured by the ‘p-value’, that an observed outcome of an experiment or trial is due to
chance alone. Generally p-values below 0.05 are taken as markers of statistical significance
• Event Driven Study - Phase III study where the timing is determinant on the outcome of progression free survival
Glossary F
or p
erso
nal u
se o
nly
Contact
Martin Rogers
Chief Executive Officer
Prima BioMed Ltd
P: +61 2 9276 1242
www.primabiomed.com.au
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