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June 2020
Important InformationCautionary Statement Regarding Forward-Looking StatementsVarious statements in this release concerning Rocket's future expectations, plans and prospects, including without limitation, Rocket's expectations regarding its guidance for 2020 in light of COVID-19, the safety, effectiveness and timing of product candidates that Rocket may develop, to treat Fanconi Anemia (FA), Leukocyte Adhesion Deficiency-I (LAD-I), Pyruvate Kinase Deficiency (PKD), Infantile Malignant Osteopetrosis (IMO) and Danon Disease, and the safety, effectiveness and timing of related pre-clinical studies and clinical trials, may constitute forward-looking statements for the purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995 and other federal securities laws and are subject to substantial risks, uncertainties and assumptions. You should not place reliance on these forward-looking statements, which often include words such as "believe," "expect," "anticipate," "intend," "plan," "will give," "estimate," "seek," "will," "may," "suggest" or similar terms, variations of such terms or the negative of those terms. Although Rocket believes that the expectations reflected in the forward-looking statements are reasonable, Rocket cannot guarantee such outcomes. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including, without limitation, Rocket's ability to monitor the impact of COVID-19 on its business operations and take steps to ensure the safety of patients, families and employees, the interest from patients and families for participation in each of Rocket’s ongoing trials, our expectations regarding when clinical trial sites will resume normal business operations, our expectations regarding the delays and impact of COVID-19 on clinical sites, patient enrollment, trial timelines and data readouts, our expectations regarding our drug supply for our ongoing and anticipated trials, actions of regulatory agencies, which may affect the initiation, timing and progress of pre-clinical studies and clinical trials of its product candidates, Rocket's dependence on third parties for development, manufacture, marketing, sales and distribution of product candidates, the outcome of litigation, and unexpected expenditures, as well as those risks more fully discussed in the section entitled "Risk Factors" in Rocket’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2020, filed May 8, 2020 with the SEC. Accordingly, you should not place undue reliance on these forward-looking statements. All such statements speak only as of the date made, and Rocket undertakes no obligation to update or revise publicly any forward-looking statements, whether as a result of new information, future events or otherwise.
3
Gene Therapy: A Multi-Platform Approach
In Vivo (In Body)AAV Gene Therapy
Ex Vivo (Outside Body)Lentiviral Gene Therapy
Remove cells &isolate patient HSCs
Laboratory-produced LV
Laboratory-produced AAV
Direct intravenous injection
Gene-modifyHSCs
Infusion of modified HSCs
TherapeuticLVVTherapeutic
AAV
4
About Rocket Pharma
Multi-Platform Gene Therapy (GTx) Company Targeting Rare Diseases1st-in-class with direct on-target mechanism of action (MOA) and clear clinical endpoints
Ex-vivo Lentiviral vectors (LVV) ❑ Fanconi Anemia (FA)
❑ Leukocyte Adhesion Deficiency-I (LAD-I)
❑ Pyruvate Kinase Deficiency (PKD)
❑ Infantile Malignant Osteopetrosis (IMO)
In-vivo adeno-associated virus (AAV) ❑ Danon Disease
Multiple Near- & Medium-term Company Value Drivers
Near-term Milestones (2020) ❑ All five programs in the clinic (initiation of IMO)
❑ New preliminary data in Danon & PKD; Additional mature data in FA & LAD-I
❑ Two programs in registration-enabling Phase 2 (FA, LAD-I)
Medium-term Milestones (2021-2022) ❑ First global submission (BLA/MAA)
❑ Platform establishment and pipeline expansion
❑ Current programs eligible for Pediatric Priority Review Vouchers
Strong Precedents and World-Class Expertise
Strong Precedents and Sound Strategy ❑ Precedents for LVV- & AAV-based therapies
❑ Clearly-defined product metrics across indications
❑ Experienced company leadership
❑ Leading research and manufacturing partners
5
Rocket’s Leadership Team
Jonathan Schwartz, M.D.
CMO & SVP, Clinical DevelopmentLed multiple biologics approvals
Kinnari Patel, Pharm.D., MBA
COO & EVP, DevelopmentLed Opdivo and six rare disease indication approvals
Kamran Alam, CPA, MBA
SVP, Finance and Principal Financial Officer15+ years in biotech industry, including with AveXis
Gayatri R. Rao, M.D., J.D.
VP, Reg Policy & Patient Advocacy7-Year Former Director of FDA’s Office of Orphan
Products Development
Brian C. Beard, Ph.D.
AVP, CMC Lenti & AAV15+ years cell and gene therapies expertise
Ramji Krishnan, Ph.D.
VP, Manufacturing & Manufacturing Sciences17+ years of product development and life cycle
management expertise
Gaurav Shah, M.D.
President & Chief Executive OfficerSpearheaded Kymriah (CART-19) development at
Novartis towards approval
Raj Prabhakar, MBA
Chief Business Officer & SVP~17 years cell, gene and biotech
business development
Claudine Prowse, Ph.D.
SVP, Strategy & Corporate Dev~20 years capital markets, strategy, corporate
development
6
Discovery Preclinical Phase 1 Phase 2 Designations
Fast Track, Orphan Drug (U.S.)
PRIME, RMAT, ATMP, Fast Track, Rare Pediatric, Orphan Drug (U.S./EU)
ATMP, Fast Track, Rare Pediatric, Orphan Drug (U.S./EU)
Orphan Drug (U.S./EU), Fast Track
Rare Pediatric, Orphan Drug (U.S.)
Rocket’s Expanding Pipeline: Potential for Significant Value Creation Near and Long Term
RP-A501Danon Disease
RP-L102Fanconi Anemia
RP-L201Leukocyte Adhesion
Deficiency-I
RP-L301Pyruvate Kinase
Deficiency
RP-L401Infantile Malignant
Osteopetrosis
AAV LVV
7
RP-L102Fanconi Anemia
• Current available treatments: Allogeneic hematopoietic stem cell transplant associated with 100-day mortality, GVHD, and additional increased cancer risk
• Addressable Market2: Estimated U.S.+EU target population of approximately 4,000 patients, 500 patients/year
• RP-L102: LVV gene therapy that elicits phenotypic correction of blood cells and stabilization of previously declining blood counts
• Regulatory Designations: Fast Track, Regenerative Medicine Advanced Therapy (RMAT) and Rare Pediatric Disease designations in the U.S.; Advance Therapy Medicinal Product (ATMP) classification and PRIority MEdicines (PRIME) in the EU; Orphan Drug designation in the U.S./EU
Fanconi Anemia (FA)
Monogenic DNA-repair disorder
1 Alter Br J Hametol 2010.2 4,000 based on a detailed population analysis of FA genomic variants. 500 per year extrapolated by actual transplants per year plus patients from prevalence
Disease Sequelae:Birth DefectsSkin DiscolorationDevelopmental Issues80% Bone Marrow Failure by Age 10Acute Myeloid Leukemia Head and Neck Cancer1
( risk 30-50x)
RP-L201Leukocyte Adhesion
Deficiency-I
RP-A501Danon Disease
RP-L301Pyruvate Kinase
Deficiency
RP-L401Infantile Malignant
Osteopetrosis
Platelets
RBCs
WBCs
Bone Marrow
FANC-A Gene Mutation
Chromosomal breakage
Overview:DNA
double-strand break
CHEK2
BRCA1
PALB2
BRAC2RAD51
RAD51B-RAD51C-RAD51D-XRCC2
DNA repairedA
E
B
F
GL
MC
Fanconi anemia complex
ATM FANCD2
FANCI
8
Potential to Correct Bone Marrow Defect without Conditioning to Prevent Hematologic Failure
Gene Therapy Value Proposition:
• Potential to correct blood & bone marrow defect without conditioning
• GTx implemented as preventative measure to avert bone marrow failure; BMT is indicated for patients in whom marrow failure has occurred.
REL
ATI
VE
VA
LUE
(%)
Age (months) J.Surralles
Rationale for GTx in FA:
• Somatic mosaicism demonstrates that a modest number of gene-corrected hematopoietic stem cells can repopulate a patient’s blood and bone marrow with
corrected (non-FA) cells.1,2
1 Soulier, J., et al. (2005) Detection of somatic mosaicism and classification of Fanconi anemia patients by analysis of the FA/BRCA pathway.Blood 105: 1329-1336; 2Data on file: Showing a single patient with a spontaneous correction of blood counts, no therapy administered.
9
FA Path to Product Registration
• Clinical trial of ~12 patients with sites at Stanford (U.S.), Niño Jesús Hospital (Spain), and other leading centers in the U.S./EU
• No conditioning required
Rocket-Sponsored
Process B
(Cell enrichment, transduction enhancers, commercial-grade vector
and modified cell processing)
• Interim data (>12-month follow-up) showed durable engraftment, continued improvement in phenotypic markers and stabilization of previously-declining blood counts
• No conditioning required
CIEMAT-Sponsored FANCOLEN 1 Study
Process A
Optimization
BLA/MAA
10
0 .5 1 1 .5 2 4 6 9 1 2 1 5 1 8 2 1 2 4 2 7 3 0 3 3 3 6 3 9
0
2 0
4 0
6 0
8 0
1 0 0
0 .0 0
0 .2 0
0 .4 0
0 .6 0
0 .8 0
1 .0 0
M o n t h s p o s t G e n e T h e r a p y
%
Ge
ne
ma
rk
ed
ce
lls C
op
ies
pe
r g
en
om
e
0 .5 1 1 .5 2 4 6 9 1 2 1 5 1 8 2 1 2 4 2 7 3 0 3 3
0
5
1 0
1 5
2 0
2 5
3 0
0 .0 0
0 .0 5
0 .1 0
0 .1 5
0 .2 0
0 .2 5
0 .3 0
M o n t h s p o s t G e n e T h e r a p y
%
Ge
ne
ma
rk
ed
ce
lls C
op
ie
s p
er
g
en
om
e
N A
Bone Marrow Engraftment: Increasing Blood Cell VCNs Provide Evidence of Survival Advantage of Gene-Corrected FA Cells
First Demonstration of Engraftment Without Conditioning (“Process A”—non-optimized—RP-L102)
HIUNJ Data Presented at ASGCT By CIEMAT May 2020 cCFU = Corrected Colony Forming Units; pVCN: Product VCN *Minimally Acceptable Dose
0 .5 1 1 .5 2 3 4 5 6 9 1 2 1 8 2 4 2 7 3 0 3 3 3 6
0 .0
2 .0
4 .0
6 .0
0 .0 0
0 .0 2
0 .0 4
0 .0 6
M o n th s p o s t G e n e T h e r a p y
%
Ge
ne
ma
rk
ed
ce
lls C
op
ies
pe
r g
en
om
e
Months Post Gene Therapy
Months Post Gene Therapy
Months Post Gene Therapy
Months Post Gene Therapy
% G
ene
mar
ked
ce
lls%
Gen
em
arke
d c
ells
*
Co
pie
s pe
r gen
om
eC
op
ies per gen
om
e
Co
pies p
er geno
me
Co
pies p
er geno
me
*
pVCN: 0.45 pVCN: 0.53
pVCN: 0.23pVCN: 0.17%
Gen
em
arke
d c
ells
% G
ene
mar
ked
ce
lls
*
* This point requires additional validation as the long-term follow-up study is activated
11
1
1 0
1 0 0
MM
C S
ur
viv
al
(%
)
0 6 1 2 0 6 1 2 2 4 0 6
F A -0 2 0 0 2 F A -0 2 0 0 6 F A -0 2 0 0 5 F A - 0 2 0 0 4
m o n t h s P o s t - G T 0 6 1 2 1 22 4 2 43 6 3 6 2 4
0 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0
0
2 0
4 0
6 0
8 0
% C o r r e c t e d C D 3 4+
c e l ls
MM
C r
es
ista
nc
e
Y = 0 .9 3 * X + 2 .6 3
R = 0 .8 3
Functional Correction of Bone Marrow
MMC assay identifies cells resistant to Mitomycin-C (MMC), a DNA damaging agent toxic to (uncorrected) FA blood and bone marrow cells
Progressive Phenotypic Correction of BM Cells (MMC-Resistance)
MM
CSu
rviv
al (
%)
MM
CR
esis
tan
ce
% Corrected CD34+ cells
MonthsPost-GT
HIUNJ Data Presented at ASGCT By CIEMAT May 2020
12
0 3 6 9 1 2 1 5 1 8 2 1 2 4 2 7 3 0 3 3 3 6
0
2 0
4 0
6 0
8 0
1 0 0
F A -0 2 0 0 5
M o n t h s p o s t G e n e T h e r a p y
%
Ab
err
an
t c
ell
s M e d ia n F A
0 3 6 9 1 2 1 5 1 8 2 1 2 4 2 7 3 0 3 3 3 6
0
2 0
4 0
6 0
8 0
1 0 0
F A -0 2 0 0 4
M o n t h s p o s t G e n e T h e r a p y
%
Ab
er
ra
nt
ce
lls M e d ia n F A
0 3 6 9 1 2 1 5 1 8 2 1 2 4 2 7 3 0 3 3 3 6
0
2 0
4 0
6 0
8 0
1 0 0
F A -0 2 0 0 6
M o n t h s p o s t G e n e T h e r a p y
%
Ab
er
ra
nt
ce
lls M e d ia n F A
0 3 6 9 1 2 1 5 1 8 2 1 2 4 2 7 3 0 3 3 3 6 3 9
0
2 0
4 0
6 0
8 0
1 0 0
F A -0 2 0 0 2
M o n t h s p o s t G e n e T h e r a p y
%
Ab
err
an
t c
ell
s M e d ia n F A
Gene Therapy Confers a Phenotype Similar to
Somatic Mosaicism
Months Post Gene Therapy Months Post Gene Therapy
Months Post Gene Therapy Months Post Gene Therapy
% A
ber
ran
t ce
lls%
Ab
erra
nt
cells
% A
ber
ran
t ce
lls%
Ab
erra
nt
cells
HIUNJ Data Presented at ASGCT By CIEMAT May 2020
FA-02002 FA-02006
FA-02004FA-02005
13
-9 0 -6 0 -3 0 0
1
1 0
1 0 0
1 0 0 0
1 0 0 0 0
0 6 1 2 1 8 2 4 3 0 3 6
Le
uk
oc
yt
es
/
l
Months Post Gene Therapy Months Post Gene Therapy
Increases of Corrected Leukocytes Support Restoration of Normal Bone Marrow Function Consistent with Mosaic Phenotype
Kinetics of Corrected and Uncorrected PB Leukocytes Prior to and After Gene Therapy
Uncorrected leukocytes/µL Corrected leukocytes/µL
FA-02002 FA-02006 FA-02005 FA-02004
Months Post Gene Therapy Months Post Gene Therapy
HIUNJ Data Presented at ASGCT By CIEMAT May 2020
-4 0 -2 0 0
1
1 0
1 0 0
1 0 0 0
1 0 0 0 0
0 6 1 2 1 8 2 4 3 0 3 6
Le
uk
oc
yt
es
/
l
-9 0 -6 0 -3 0 0
1
1 0
1 0 0
1 0 0 0
1 0 0 0 0
0 6 1 2 1 8 2 4 3 0 3 6
Le
uk
oc
yt
es
/
l
-6 0 -4 0 -2 0 0
1
1 0
1 0 0
1 0 0 0
1 0 0 0 0
0 6 1 2 1 8 2 4 3 0 3 6
Le
uk
oc
yt
es
/
lLe
uko
cyte
s/µ
l
14HIUNJ Data Presented at ASGCT By CIEMAT May 2020
02002 (Cryo) 2.5x105 cCD34+/Kg
1.7x104 cCFU/Kg
02006 (Fresh)4.0x105 cCD34+/Kg1.6x105 cCFU/Kg
02005 (Fresh)2.3x105 cCD34+/Kg
2.8x103 cCFU/Kg
02004 (Cryo)1.7x105 cCD34+/Kg
6.9x103 cCFU/Kg
Gene Therapy Stabilizes and Improves Previously Declining Blood Counts
BM = Bone Marrow; cCD34+ = Corrected CD34+ cells; cCFU = Corrected Colony Forming Units
Months after gene therapyMonths after gene therapyMonths after gene therapyH
b (
g/d
L)
-6 0 -4 0 -2 0 0
6
8
1 0
1 2
1 4
1 6
0 6 1 2 1 8 2 4 3 0 3 6
Ne
utr
op
hil
s (
x1
00
0/
l)
-6 0 -4 0 -2 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6-6 0 -4 0 -2 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
-9 0 -6 0 -3 0 0
4
6
8
1 0
1 2
1 4
0 6 1 2 1 8 2 4 3 0 3 6
Hb
(g
/dL
)
-9 0 -6 0 -3 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6
Ne
utr
op
hil
s (
x1
00
0/
l)
-9 0 -6 0 -3 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
Hb
(g
/dL
)
-4 0 -3 0 -2 0 -1 0 0
4
6
8
1 0
1 2
1 4
0 6 1 2 1 8 2 4 3 0 3 6
Ne
utr
op
hil
s (
x1
00
0/
l)
-4 0 -3 0 -2 0 -1 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6-4 0 -3 0 -2 0 -1 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
tele
ts (
x1
00
0/
l)
Ne
utr
op
hil
s (
x1
00
0/
l)
-8 0 -6 0 -4 0 -2 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6-8 0 -6 0 -4 0 -2 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
Hb
(g
/dL
)
-8 0 -6 0 -4 0 -2 0 0
6
8
1 0
1 2
1 4
0 6 1 2 1 8 2 4 3 0 3 6
Fe Supplement**
-6 0 -4 0 -2 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
-6 0 -4 0 -2 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
-6 0 -4 0 -2 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
-6 0 -4 0 -2 0 0
0
2 0
4 0
6 0
8 0
1 0 0
0 6 1 2 1 8 2 4 3 0 3 6
1 0 0
2 0 0
3 0 0
Pla
te
lets
(x
10
00
/l)
Ne
utr
op
hil
s (
x1
00
0/
l)
-6 0 -4 0 -2 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6
Ne
utr
op
hil
s (
x1
00
0/
l)
-6 0 -4 0 -2 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6
Ne
utr
op
hil
s (
x1
00
0/
l)
-6 0 -4 0 -2 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6
Ne
utr
op
hil
s (
x1
00
0/
l)
-6 0 -4 0 -2 0 0
0
1
2
3
4
0 6 1 2 1 8 2 4 3 0 3 6
Hb
(g
/dL
)
-6 0 -4 0 -2 0 0
6
8
1 0
1 2
1 4
1 6
0 6 1 2 1 8 2 4 3 0 3 6
Hb
(g
/dL
)
-6 0 -4 0 -2 0 0
6
8
1 0
1 2
1 4
1 6
0 6 1 2 1 8 2 4 3 0 3 6
Hb
(g
/dL
)
-6 0 -4 0 -2 0 0
6
8
1 0
1 2
1 4
1 6
0 6 1 2 1 8 2 4 3 0 3 6
Hb
(g
/dL
)
-6 0 -4 0 -2 0 0
6
8
1 0
1 2
1 4
1 6
0 6 1 2 1 8 2 4 3 0 3 6
*
*
*
* These particular data points require additional validation as the long-term follow-up study is activated ** Iron supplement is not likely to enable Hb increase in the absence of viable and productive HSPCs
15
Key Takeaways From ASGCT 2020
• No SAEs associated with the gene correction of FA HSPCs
• Infusion of corrected CD34+ cells in non-conditioned FA patients:
✓ Progressive repopulation advantage of gene-corrected HSPCs at 1-3 years post-
infusion (6/6 patients who were infused with >100,000 cCD34+ cells/kg)
✓ Oligoclonal reconstitution and gene correction of multipotent HSCs
✓ Progressive phenotypic correction of BM progenitors and PB T cells
✓ At 1-3 years post-infusion, stabilization in PBC counts or overall increase in the
erythroid lineage (two patients infused with the highest doses of corrected CD34+
cells)
Phase 1/2 Study of RP-L102 “Process A”
HIUNJ Data Presented at ASGCT By CIEMAT May 2020
16
RP-L102 “Process B” (FA) Clinical Trial
• To evaluate the safety of the infusion of investigational product RP-L102: autologous CD34+ enriched cells transduced with LV carrying the FANCA gene in FA-A patients
• Clinical response: prevention of bone marrow failure• Engraftment as determined by peripheral blood and bone
marrow vector copy number • Progressive increases are anticipated over time
• Phenotypic correction as evidenced by increased resistance of bone marrow and peripheral blood cells to DNA-damaging agents mitomycin-C and diepoxybutane, respectively
Primary Outcomes
Lucile Packard Children’s Hospital Stanford Data Presented at ASH December 2019
• FA complementation group A • Age 1-12 years• At least 1 parameter (Hb, ANC or Plt) below lower limit of
normal• Bone marrow CD34+ count ≥ 30/µL (from aspirate)• If bone marrow CD34+ of 10-29/µL, then at least 2 of the
following:‣ Hb ≥ 11g/dL ‣ PMN ≥ 900/µL ‣ platelets ≥ 60,000/µL
• Available & eligible HLA-identical sibling donor• Lansky PS ≤ 60%• MDS or leukemia (including associated cytogenetic
abnormalities)• Mosaicism with stable/improved blood counts
Secondary Outcomes
Exclusion Criteria
Inclusion Criteria
RP-L102 Process B - U.S. Phase 1
17
Subject 1001 1002
Age (y) Gender 5 F 6 F
WBC (/µL) 4,000 4,600
PMN (/µL) 1,280 1,340
Hb (g/dL) 11.9 8.9
Plt (/µL) 55,000 38,000
Subject 1001 1002
MCV (fL) 86.9 106.2
BM34+ (/µL) 78 34
FA mutation c.2606A>C, p.(Gln869Pro)
c.2813A>G, p.(Asp944Gly)
c.3703C>G,p.(Gln1235Glu)
c.(? -1)(522+1 523-1) del encompassing exons 1-5
c.(? -1)(283+1 284-1) del encompassing exons 1-3
Subject Nucleated Cells/kg CD34+ Cells/kg^ CFCs/kg^ Mean VCN: Liquid Culture
Mean VCN:CFCs
CFC Survival MMC 10nM (%)
1001 7.8 x 106 2.0 x 105 5.2 x 104 2.08 1.10 33
1002 2.4 x 106 3.7 x 105 5.0 x 104 2.21 0.93* 47
Lucile Packard Children’s Hospital Stanford Data Presented at ASH December 2019
* Mean CFC VCN was assessed from a cryopreserved drug product sample.^ Per NC200 automated count (results in ~50% lower count vs. manual used in FANCOLEN-I).
Subject Characteristics
Investigational Product
RP-L102: Subject Characteristics & Drug Product Metrics
18
0 6
0
2
4
6
8
10
L102-001-1001
Months post-Gene Therapy
MM
C
Re
sis
tan
ce
%
50 nM MMC
Preliminary qPCR results at 4 months post infusion (PBMC):
• Pt 1001: VCN ~0.01 (1% correction)Pt 1002: VCN ~0.01 (1% correction)
• For patients on initial FANCOLEN-I trial who received optimal cell/CFC doses and VCNs (patients 2002 & 2006), PB VCNs at this early timepoint were similar
• In absence of conditioning, early kinetics of engraftment post-gene therapy are highly dependent on patient baseline bone marrow; increases in VCN are anticipated over ≥ 12month timeframe
RP-L102: Preliminary Clinical Data
Resistance to 50nM MMC was demonstrated in 4% of bone marrow progenitors (CFCs) from patient 1001 at 6 months post-infusion. No resistance to this level of MMC was observed at pre-treatment baseline
Bone marrow specimen for patient 1002 insufficient to enable MMC-assay.(Bone marrow evaluations at 12 & 18 months planned)
Vector Copy Number Bone Marrow MMC-resistance
Lucile Packard Children’s Hospital Stanford Data Presented at ASH December 2019
19
Months post gene therapy
Pla
tele
ts (
x1
00
0/
L)
-12 -8 -4 00
50
100
150
0 2 4 6Months post gene therapy
He
mo
glo
bin
(g
/dL
)
-12 -8 -4 00
5
10
15
0 2 4 6
Months post gene therapy
Le
uk
oc
yte
s (
x1
00
0/
L)
-36 -24 -12 00
5
10
15
0 2 4 6
Months post gene therapy
Pla
tele
ts (
x10
00/
L)
-36 -24 -12 00
50
100
150
200
250
300
350
400
450
0 2 4 6
Months post gene therapyH
em
og
lob
in (
g/d
L)
-36 -24 -12 00
5
10
15
0 2 4 6Months post gene therapy
Ne
utr
op
hils
(x
10
00/
l)
-36 -24 -12 00
1
2
3
0 2 4 6
Months post gene therapy
Ne
utr
op
hils
(x
10
00/
L)
-12 -8 -4 00
1
2
3
0 2 4 6
Months post gene therapy
Le
uk
oc
yte
s (
x1
00
0/
L)
-12 -8 -4 00
5
10
15
0 2 4 6
RP-L102: Preliminary Clinical DataP
atie
nt
10
01
Pat
ien
t 1
00
2
• Blood count stability in both patients over 6 months following infusion, with trend increases (patient 1001 months 0⇢6; patient 1002 months 4⇢6)
• Blood count decreases in multiple lineages in both patients prior to infusion (patient 1001 over 36 months pre-Rx; patient 1002 over 9 months pre-RX)
Blood Counts: Before and 6-Months After Receiving Therapy
Lucile Packard Children’s Hospital Stanford Data Presented at ASH December 2019
20
RP-L102: Conclusions—Drug Product
Conclusion 1.1Investigational product metrics show consistency with parameters comparable or favorable relative to earlier processes:
• Liquid culture VCNs >2.0 and CFC VCNs ~1.0
• CFC resistance (10nM MMC) in 30-50% range
• VCNs were 2-3 fold improved while CD34+ and CFC counts were comparable to FANCOLEN-I pts who received optimal product and demonstrated engraftment, phenotypic correction and hematologic stability/improvement over 24-36 months
This US Phase 1 trial confirms the HSPC collection, transduction and viability demonstrated in the FANCOLEN-I clinical study and establishes the safety and feasibility of commercial
Process B vector/cell manufacturing in FA
Lucile Packard Children’s Hospital Stanford Data Presented at ASH December 2019
21
RP-L102: Conclusions—Clinical
Conclusion 1.2
With a demonstrated favorable safety profile and early indication of efficacy, global Phase 2 study is underway: NCT# NCT04069533
• Initial patient received infusion• Registration-enabling study with primary endpoint of bone marrow MMC-resistance at 1-3 years
post-infusion
At 6 months, both patients are clinically stable with early indicators of engraftment in the absence of conditioning:
• Preliminary gene marking (VCN) in PB at 4 months (qPCR)
• Increasing bone marrow MMC-resistance at 6 months
• Blood counts stable (potential increase) at 6 months, in setting of multi-lineage decreases in 9-36 months prior to gene therapy
Lucile Packard Children’s Hospital Stanford Data Presented at ASH December 2019
22
RP-L102 “Process B” (FA) Clinical Trial and Outcome Measures1
Design• Enroll 10 pediatric patients globally
Primary Outcomes• Phenotypic correction of bone marrow colony forming (progenitor) cells
• MMC-resistance ≥10% at baseline 12-36 months post-infusion
Secondary Outcomes• Phenotypic correction of T-lymphocytes in peripheral blood
• DEB-induced chromosomal aberrations decrease from ≥50% at baseline to <50% 12-36 months post-infusion
• Engraftment of gene-corrected hematopoietic cells• At least 0.1 vector copy number/peripheral blood cell observed from 6
months post-infusion to the 3rd year post-infusion• Prevention or rescue of bone marrow failure
• Assessment of the need for treatment of bone marrow failure 6-36 months post-infusion
Non-Randomized
Global Phase 2 Study
1Source: https://clinicaltrials.gov/ct2/show/NCT04069533?term=Rocket&cond=Fanconi+Anemia&rank=2 | https://clinicaltrials.gov/ct2/show/NCT04248439
23
RP-L102Fanconi Anemia
RP-L201Leukocyte Adhesion
Deficiency-I
RP-A501Danon Disease
RP-L301Pyruvate Kinase
Deficiency
RP-L401Infantile Malignant
Osteopetrosis
Danon Disease Monogenic Heart Failure Syndrome
Overview:
• Background: Devastating multisystemic disorder caused by highly penetrant and X-linked dominant LAMP2 mutations
• Currently available treatments: Non-curative heart transplants associated with considerable morbidity and mortality
• Addressable Market: Estimated U.S.+EU prevalence of 15,000-30,000
• RP-A501: AAV9 gene therapy product that elicits improvements in survival, cardiac function, and liver enzymes in preclinical studies
• Regulatory Designations: Orphan Drug & Fast Track designations in the U.S.
24
Danon Disease: An Impairment in Autophagy Caused by LAMP2B Mutations
25
0
2000
4000
6000
8000
10000
dP
/dt
max (
mm
Hg
/s)
WT PBS 1e13 5e13 1e14 2e14
LAMP2 KO
AAV9.LAMP2B
-8000
-6000
-4000
-2000
0
dP
/dt
min
(m
mH
g/s
)WT PBS 1e13 5e13 1e14 2e14
LAMP2 KO
AAV9.LAMP2B
Cardiac Contractility Cardiac Relaxation
P<0.0001P<0.0001
P<0.0001P<0.0001
P=0.0018P=0.0093
P=0.011P=0.045
P=0.005
P=0.005
**
*PBS = Phosphate Buffered Saline (Negative Control)
Lower dP/dt max indicates impaired contractility; Higher (less negative) dP/dt min indicates impaired heart relaxation
RP-A501 Restores Cardiac Function in KO Mice
Dose-Dependent Improvements in Systolic and Diastolic Function in LAMP2 KO Mice
26
RP-A501 Shows Survival Benefit at Higher Doses
Note: All mice were sacrificed at Month 10
27
RNA: RP-A501 Elicits Expression of hLAMP2B mRNA in Cardiac Tissue of KO Mice
*hLAMP2B = Human LAMP2B
hLAMP2B mRNA*
28
Protein: RP-A501 Elicits Durable Expression of LAMP2B Protein and Autophagic Flux in Heart1
LAMP2 Protein Expression
1Data are Mean ± SEM. N=5-8 per group. Untx = Untreated, PBS = Phosphate buffered salineNote: Mouse LAMP2 and Human LAMP2 data are from separate Western blots.
LC3-II Protein Expression
Untx PBS 1e13 5e13 1e14 2e14 0
1
2
3
4
5
LA
MP
2 In
ten
sit
y
(No
rmalized
to
GA
PD
H)
AAV9.LAMP2B
LAMP2 KO
Mouse
LAMP2
Human
LAMP2
WT
P = 0.002
P = 0.0001
P = 0.0001
Untx PBS 1e13 5e13 1e14 2e14 0.0
0.5
1.0
1.5
LC
3-I
I In
ten
sit
y
(N
orm
alized
to
GA
PD
H)
P = 0.033
AAV9.LAMP2B
LAMP2 KO
P = 0.0072P = 0.019
WT
Western Blot
29
Structural: RP-A501 Reduces Autophagic Vacuoles in All Examined Organs
Wild Type KO Control 5e13 vg/kg 1e14 vg/kg 2e14 vg/kg
AAV9.LAMP2B
LAMP2 KO
Heart
Liver
SkeletalMuscle
30
Dose-dependent Widespread LAMP2 Expression in Cardiac Tissue
31
AAV9 Vector Shows Consistent & Strong Cardiac Tropism in Several Studies Across Different Species
Disorder &Vector
Dose Species Results Sponsor Reference
LGMD2AAAV9.hCAPN3
3E+13 vg/kg NHP 8-80-fold higher transduction in cardiac vs. skeletal muscle
Genethon Lostal (ASGCT 2018)
Non-specificAAV9.Luc
3E+12 vg/kg NHP ~ 10-fold higher transduction in cardiacvs. diaphragm; and comparable to other muscle
UNC Tarantal 2016
PompeAAV9.hGAA
1E+11 vg/mouse Mouse ~ 10-fold higher transduction in cardiacvs. diaphragm
U. Florida Falk 2015
DMDAAV9.Dys
1.9 - 6.2E+14 vg/kg
Dog 2-3 fold higher transduction in cardiac vs. skeletal muscle
U. Missouri Yue 2015
SMAAAV9.SMN
3E+14 vg/kg & 1E+13 vg/kg
Mouse & NHP
~ 100-fold higher transduction in cardiacvs. skeletal muscle (mouse)
Nationwide Children’s
Meyer 2014
MPSIIIBAAV9.hNAGLU
1 - 2E+13 vg/kg NHP ≥ 10-fold higher transduction in cardiac vs. skeletal muscle in majority of animals
Nationwide Children’s
Murrey 2014
Non-specificAAV9.Luc
5E+10 vg/mouse Mouse 5-10-fold higher transduction in cardiac vs. skeletal muscle
UNC Pulicherla 2011
PompeAAV9.hGAA
4E+05 - 4E+08 vg/mouse
Mouse ~ 8-12-fold higher transduction in cardiac vs. skeletal muscle or diaphragm
U. Florida Pacak 2006
SMAAAV9.SMN
2E14 vg/kg Human Heart VCN ~3-4, Muscle & CNS ~1 AveXis Kaspar 2019 (ASGCT 2019)
32
VCN in Non-Human Primates at Day 102 High in Cardiac Tissues
Differential distribution of vector genomes was observed, with highest levels seen in liver followed by heart
• 30 mg tissue • 20 ng DNA template • Primer/probe to WPRE
• qPCR (40 cycles)
Tissue Type NHP ID 366 NHP ID 690 NHP ID 2750 NHP ID 4247
Brain Cerebellum 0.12 0.06 0.00 0.00
Brain Frontal 1.65 0.63 0.00 0.00
Brain Hipp. 0.50 0.27 0.00 0.00
Brain Medulla 12.26 1.34 0.00 0.00
Brain Occ. Cortex 0.73 0.09 0.00 0.00
Brain Parietal 0.35 0.50 0.00 0.00
Brain Temporal 0.59 0.48 0.00 0.00
Diaphragm 3.25 1.03 0.00 0.00
EYE 0.03 0.56 0.00 0.00
Heart LA 35.74 58.07 0.00 0.00
Heart LV 8.41 11.90 0.00 0.00
Heart RA 57.57 201.58 0.00 0.00
Heart RV 10.82 19.76 0.00 0.00
Kidney Left 4.71 1.55 0.00 0.00
Kidney Right 5.83 1.70 0.00 0.00
Liver Caudate 2536.51 2373.70 0.02 0.00
Liver Left Lobe 2334.43 1862.57 0.00 0.00
Liver Middle Lobe 2447.59 2010.33 0.00 0.00
Liver Right Lobe 2248.60 2168.30 0.00 0.00
Lung Left 4.82 4.93 0.00 0.00
Lung Right 6.74 5.17 0.00 0.00
Lymph Node Inguinal 19.01 10.01 0.00 0.00
Lymph Node Mand. 8.25 7.60 0.00 0.00
Lymph Node Mesen. 1.91 0.87 0.00 0.00
Muscle Gastroc. 0.07 0.52 0.00 0.00
Muscle Quad. 0.61 0.28 0.00 0.00
Pancreas 1.11 1.69 0.00 0.00
Spleen 2.54 1.96 0.00 0.00
Testes Left 1.16 0.24 0.00 0.00
Testes Right 0.94 0.27 0.00 0.00
Vector Genome Copies per Diploid Nuclei
VCN in NHPs Dosed with 3x1014 vg/kg
33
Protein Expression in Non-Human Primates Highest in Cardiac Tissues
Western Blot Analysis GAPDH (housekeeping gene)
LAMP2
LAMP2 Assessment Based on Total Protein1 Loaded on Gel
• Higher levels of transgenic human LAMP2 protein detected over endogenous NHP LAMP2 in most tissues tested, specifically the heart
1Normalized to total protein instead of GAPDH, as housekeeping protein levels were variable.
Right Left
Diaph
ragm
Muc
le Q
uad.
Mus
cle
GA.
Hea
rt RA
Hea
rt LA
Hea
rt RV
Hea
rt LV
Live
r Middle
Live
r Cau
date
Live
r Right
Live
r Lef
t0.0
0.1
0.2
0.3
ng L
AM
P2 p
er
mg o
f Tota
l Pro
tein
(norm
aliz
ed b
ased o
n B
CA
)
**
**
**
*
Vehicle
RP-A501
*p<0.05, **p<0.01
34
Summary of Preclinical Data
• Shows Phenotypic Improvements as Low as 5e13 vg/kg:
- Survival benefit at higher doses
- Dose-dependent restoration of cardiac function
- Improvement in liver enzymes
• RP-A501 Reduces Autophagic Vacuoles in All Examined Organs: Heart, Liver, Skeletal Muscle
• RP-A501 Elicits dose-dependent increase in LAMP2 mRNA and protein
• RP-A501 Preclinical Safety, Tox and Biodistribution Summary:
- No therapy-related deaths
- No significant hematologic changes
- No significant biochemical changes
- No significant clinical chemistry changes
- Mild and transient ALT elevation that self-resolved after one week in a single NHP
- In both mouse and NHPs, VCN detection in Danon disease organs include high concentrations in heart tissue (for NHP, ~10x higher on average than in skeletal muscle and CNS)
35
RP-A501 (DD) Clinical Trial and Outcome Measures1
Design• Enroll ~12-24 pediatric and young adult male patients• Two dose levels investigated in 4 distinct cohorts (n=3-6 patients)
‐ Cohort 1: Adult and age 15 and older: Low Dose
‐ Cohort 2: Adult and age 15 and older: High Dose
‐ Cohort 3: Pediatric age 8-14: Low Dose
‐ Cohort 4: Pediatric age 8-14: High Dose
Primary Outcomes• Evaluation and assessment of safety at both dose levels• Assessment of target tissue transduction • Assessment of effect on cardiomyocyte histology• Assessment of clinical stabilization or improvement via cardiac imaging,
serology and exercise testing
Status• Moving to Higher Dose Adult Cohort. No DLTs in Cohort 1 (Low Dose)
Non-Randomized
Dose-Escalation
Phase 1 Study
1Source: https://clinicaltrials.gov/ct2/show/NCT03882437?cond=danon&rank=2
36
Danon Disease Prevalence: ~15-30K in the U.S.+EU
U.S.+EU Prevalence: ~15-30,000
Hypertrophic Cardiomyopathy (HCM)● U.S. HCM Prevalence: 600K-1MM+ 1
● 1-4% of HCM patients consistently identified with LAMP2 mutations in multiple studies with >1000 subjects evaluated2
● Danon Disease Patients with HCM3
o 85% of males o 30% of females
Dilated Cardiomyopathy (DCM)● Danon Disease Patients with DCM3
o 15% of maleso 50% of females
Hypertrophic Cardiomyopathy
Dilated Cardiomyopathy
Other
1Source: J Am Coll Cardiol. 2015 Mar 31;65(12):1249-1254. 2Sources: Heart. 2004 Aug;90(8):842-6. N Engl J Med. 2005 Jan 27;352(4):362-72. Genet Med. 2015 Nov;17(11):880-8. Gene. 2016 Feb 15;577(2):227-35. J Cardiovasc Transl Res. 2017 Feb;10(1):35-46 3Sources: Neurology. 2002 Jun 25;58(12):1773-8. Genet Med. 2011 Jun;13(6):563-8. Rev Esp Cardiol (Engl Ed). 2018 Aug 11.
37
Author& Year
Age nHCM
n Danon
%Danon
Note
Charron2004
N.A. 197 2 1.0% Studied LAMP2 mutations in 197 HCM patients at a general hospital in Paris
Arad 2005
12-75 75 2 2.7% Studied glycogen storage diseases in 75 consecutive pts diagnosed with HCM (multicenter U.S./EU). No cases of Pompe or Fabry were detected.
Yang2005
1m-15y 50 2 4.0% Studied LAMP2 mutations in 50 pts with ped./juvenile onset HCM (single U.S. center). Additional DD identified in relatives of the n=2 probands were not included in this analysis.
Cheng 2012
N.A. 50 3 2.3% Studied LAMP2 mutations in 50 consecutive pts diagnosed with concentric LVH at a general hospital in Peking. (Concentric LVH is seen in appx. 38% of HCM). DD incidence higher (3/36) when n=14 w/ cardiac amyloidosis were removed from n=50 cohort.
Charon et al. Heart 2004; 90:842-6. Arad et al. N Engl J Med 2005; 352;362-72.Yang et al. Circulation 2005; 112:1612-17. Cheng et al. Eur Heart J 2012; 33:649-56.
Danon Disease Causes 1-4% of Hypertrophic Cardiomyopathy:Consistent Presence in Multiple Series Published 2004-Present
38
RP-L102Fanconi Anemia
Overview:
• Background: Disorder characterized by recurring and ultimately fatal infections caused by ITGB2 gene mutations
- >50% patients with severe variant: 60-75% mortality by age 2
• Current Available Treatments: Allogeneic hematopoietic stem cell transplant associated with significant GVHD
• Addressable Market: Estimated 25-50 pts treatable per year for severe population; up to 100 for potential expansion into moderate population in the U.S.+EU with effective gene therapy
• RP-L201: Preclinical studies show stable engraftment and phenotypic correction in murine models, with restored neutrophil migration capability
• Regulatory Designations: Fast Track and Rare Pediatric Disease designations in the U.S.; Advance Therapy Medicinal Product (ATMP) classification in EU; Orphan Drug designation in the U.S./EU
Leukocyte Adhesion Deficiency-I (LAD-I)
Monogenic Immunodeficiency Disorder
RP-L201Leukocyte Adhesion
Deficiency-I
RP-A501Danon Disease
RP-L301Pyruvate Kinase
Deficiency
RP-L401Infantile Malignant
Osteopetrosis
Tissue infiltration
Leukocyte
ß2 Integrin
CD11CD18
1
1 Defective expression of ß2 integrin on leukocytes limits their extravasation to inflamed sites.
ß2α
39
LAD-I Program Summary
Ultra-rare Disease = Streamlined Regulatory Approach
Potential design & clinical endpoints Target Patient Population: Severe LAD-I patients (CD18<2%), ~2/3 mortality by 2y
Control: Literature review of ~300 pts. (Rocket/academic collaborative publication1)
Potential Clinical Endpoints: Modest correction of CD18 expression, survival
Efficacy Trials & Registration Status – Ahead of Schedule
Registration & study planning on-schedule ✓ Orphan Drug (U.S./EU) and Pediatric Rare Disease (U.S.) designations granted
✓ IND & Phase 1/2 cleared by FDA✓ Spain IMPD cleared✓ U.S. PI (UCLA Dr. Don Kohn)✓ Recruitment underway from around the globe❑ 3 global sites planned in the U.S./EU
Product/Manufacturing Optimization
Process now optimized ✓ VCN using GMP vector with transduction enhancers consistently ~3 (Target VCN >1)
1Almarza Novoa E, Kasbekar S, Thrasher AJ, Kohn DB, Sevilla J, Nguyen T, Schwartz JD, Bueren JA. Leukocyte adhesion deficiency-I: A comprehensive review of all published cases. J Allergy Clin Immunol Pract. 2018 Jan 20. pii: S2213-2198(17)31026-7. doi: 10.1016/j.jaip.2017.12.008.
40
Rationale for Gene Therapy in LAD-I:
CD18 Expression Correlative to Patient Survival
The grey diamond indicates the 39% survival to age 2 years for 66 evaluable patients with severe LAD-I not receiving HSCT
Natural history studies show the correlation between higher CD18 expression and longer patient survival, supporting gene therapy’s potential in LAD-I patients
Source: Almarza Novoa E et al. J Allergy Clin Immunol Pract. 2018 Jan 20. pii: S2213-2198(17)31026-7. [Epub ahead of print]
Kaplan-Meier Survival Estimates by Neutrophil CD18 Expression-Patients with moderate LAD-I not receiving allogeneic HSCT-
Poster Presentation at ASGCT May 2018
41
LAD-I: Mouse Study Shows LAD-I Correction
• Primary and serially transplanted LAD mice underwent CD18 lenti GTx with different promoters
• Myeloablative conditioning was used
• Rocket chose the Chimeric cFES/CTSG (myeloid-specific) promoter (Post-transplant PB VCN 0.4-0.9)
Leon-Rico D, Aldea M, Sanchez-Baltasar R, Mesa-Nuñez C, Record J, Burns SO, Santilli G, Thrasher AJ, Bueren JA, Almarza E. Hum Gene Ther. 2016 Sep;27(9):668-78. doi: 10.1089/hum.2016.016. Epub 2016 May 5.
42
RP-L201 (LAD-I) Clinical Trial and Outcome Measures1
Design• Enroll 9 pediatric patients globally
• Phase 1: Enroll two patients to assess safety and tolerability • Enrollment Complete
• Phase 2: Overall survival at multiple sites (U.S. and EU)
Primary Outcomes• Phase 1:
• Safety associated with treatment • Phase 2:
• Survival: proportion of patients alive at age 2 and at least 1-year post infusion • Safety associated with treatment
Secondary Outcomes• Percentage of neutrophils expressing at least 10% CD18 • At least 10% of peripheral blood neutrophils carrying the therapeutic lentiviral
vector at 6 months post-infusion• Incidence and severity of infections• Improvement/normalization of neutrophils• Resolution (partial or complete) of any underlying skin rash or periodontal
abnormalities
Non-Randomized
Phase 1/2 Study
1Source: https://clinicaltrials.gov/ct2/show/NCT03812263?cond=Leukocyte+Adhesion+Deficiency&rank=5
43
Pyoderma Gangrenosum
Lower Back (BM Bx site)
Pseudomonas Skin InfectionEcthyma/Pyoderma
Gangrenosum
1 2 3 4 5 6 7 8 9Age (Years)
IV Abx, PO Steroids, Multiple Wound DebridementH
osp
ital
ize
d
IV Abx, IV Steroids, Daily Wound Care, Enbrel
Skin Lesions L-flank & Buttocks
Ho
spit
aliz
ed
IV Abx, Steroids
Ho
spit
aliz
ed
Multiple Abscesses Buttocks
Enbrel, Abx
Ulcer R-Leg
Lesion on Thigh
Humira
Partial Lung Resection, Antifungal, Abx
Aspergilloma(Pulmonary)
Ho
spit
aliz
ed
10
IV Abx, Ustekinumab
Ho
spit
aliz
ed
IV Abx, Ustekinumab
Pyoderma Gangrenosum
Abdomen
Prophylactic Antifungal and Antibiotic Rx
Recurrent URI, UTI, Otitis Media, Asthma
Suspected Nocardia Pneumonia
Severe Anemia
IV Abx, Transfusion
Ho
spit
aliz
ed
Historical patient records collected by UCLA Mattel Children’s Hospital LAD has received CIRM Funding
Medical History of Patient L-201-003-1001
44
RP-L201: Drug Product Metric and Clinical Results
• CD34+ Cell Dose: 4.2 x 106 cells/kg
• Drug Product VCN: 3.8
UCL Gosh Data Presented May 2020LAD has received CIRM Funding
0 1 2 3 4
0
10
20
30
40
50
%CD18 Expression in Peripheral Blood
Months post gene therapy
% C
D18 E
xp
ressio
n
0 1 2 3 4
0
10
20
30
40
50
%CD11b Expression in Peripheral Blood
Months post gene therapy
%C
D11b
Exp
ressio
n
0 1 2 3 4
0
10
20
30
40
50
%CD11a Expression in Peripheral Blood
Months post gene therapy
%C
D11a E
xp
ressio
n
• CD18 Expression in Peripheral Blood: - 3-month CD18 expression post-treatment: 45%- 6-month CD18 expression post-treatment: 47%- Pre-treatment CD18 expression was <1%
Key Drug Product Metrics Clinical Results
0 3 6
0
10
20
30
40
50
0 1 2 3 4
0
10
20
30
40
50
%CD18 Expression in Peripheral Blood
Months post gene therapy
% C
D18 E
xp
ressio
n
0 1 2 3 4
0
10
20
30
40
50
%CD18 Expression in Peripheral Blood
Months post gene therapy
% C
D18 E
xp
ressio
n
0 1 2 3 4
0
10
20
30
40
50
%CD18 Expression in Peripheral Blood
Months post gene therapy
% C
D18 E
xp
ressio
n
0 3 6
0
10
20
30
40
50
45
RP-L201: Flow Cytometry 6-Months Post-Treatment
UCL Gosh Data Presented May 2020LAD has received CIRM Funding
Healthy Donor Control L201-003-1001
Neutrophils Neutrophils
CD18 Expression99%
CD18 Expression47%
46
RP-L201: Visible Improvements Post-Treatment
UCLA Mattel Children’s Hospital Data Presented May 2020LAD has received CIRM Funding
Spontaneous Abdominal Lesion
Baseline (Pre-Treatment) 3-months (Post-Treatment) 6-months (Post-Treatment)
47
Prior to Gene Therapy: BM Bx Site BM Bx Site 2 Days After 3-Month Marrow Bx
UCLA Mattel Children’s Hospital Data Presented May 2020LAD has received CIRM Funding
Lower Back Lesion(after BM aspirate)
Lower Back(after BM aspirate)
RP-L201: Visible Improvements Post-TreatmentNo Infection/Inflammation After 3-Month Bone Marrow Biopsy
48
Pyruvate Kinase Deficiency (PKD)
Monogenic Red Blood Cell Hemolytic Disorder
• Current Available Treatments: Chronic blood transfusions and splenectomy—side effects include iron overload and extensive end-organ damage
• Addressable Market2: ~250-500 patients/year
• RP-L301: Corrects multiple components in a PKD mouse model, including increases in hemoglobin, reduction in reticulocytosis, correction of splenomegaly and reduction in hepatic erythroid clusters and iron deposits
• Regulatory Designations: Fast Track in the U.S. and Orphan Drug designation in the U.S./EU
1One glucose molecule is metabolized into two Phosphoenolpyruvate and ultimately two Pyruvate (pyruvic acid) molecules; this final enzymatic step yields two additional ATPs from each glucose molecule 2Market research indicates the application of gene therapy to broader populations could increase the annual market opportunity from approximately 250 to 500, based on an estimated prevalence in the U.S./EU of approximately 3,000 to 8,000.
RP-L201Leukocyte Adhesion
Deficiency-I
RP-L301Pyruvate Kinase
Deficiency
RP-L401Infantile Malignant
Osteopetrosis
Energy Deficit
Hemolysis
PKLR Mutation
2 ADP
PK
C O
CH3
C
O O-
C-O-PO3H2
CH2
C
O O-
Phosphoenolpyruvate1 Pyruvate1
2ATP
Overview:RP-L102Fanconi Anemia
RP-A501Danon Disease
49
• PKD correction observed when at least 20-30% of bone marrow cells are genetically corrected
• PKD correction was achieved when ≥0.3 copies of the vector were detected in peripheral blood mononuclear cell populations
• Spleen size and weight correlated to vector copy number
Mouse Model Indicates Correlation Between Genetic Correction and Reversal of Hemolytic Phenotype Including Normalization of Splenomegaly
Spleen Size
Spleen Weight
CIEMAT Data Presented at ASGCT May 2019
50
PKD Program Summary
Product/Manufacturing Optimization
Positive outlook for near term optimization PoC • Target engraftment of 20-30%• Optimization of vector manufacturing
+ transduction process• VCN now 2-4 range with TDx Enhancers
Clinical Efficacy/Registration Status
Registration & study planning on-schedule ✓ Registry efforts underway✓ U.S. site identified as Stanford University❑ Plan to treat 2 adults, then 2 older and then 2
younger pediatric patients❑ 18 post-splenectomy, transfusion-dependent
patients pre-identified in EU
51
RP-L301 Addressable Market: Approximately 250-500 Patients per Year
• Published Prevalence:
‐ PKD in non-Hispanic Caucasians calculated to be 51 per million1
‐ Conservative estimates conclude a number from 3,000 to 8,000 in the U.S.+EU combined
• Addressable PKD market estimated to be between 250-500 patients per year in the U.S.+EU
• ~50% non-response rate reported in one targeted therapy in development2
1Source: Blood. 2000 Jun 1;95(11)-3585-8.2https://www.sec.gov/Archives/edgar/data/1439222/000119312517366278/d443156dex991.htm
52
RP-L301 (PKD) Clinical Trial and Outcome Measures1
Design• Enroll 6 patients globally, who have a history of severe transfusion
dependent anemia • Adult cohort (n=2)• Pediatric patients ages 12-17 (n=2)• Pediatric patients ages 8-11 (n=2)
• Pediatric patient dosing to commence after determining safety in adult cohort
Primary Outcomes• Safety associated with treatment
Secondary Outcomes• Multi-lineage gene correction in peripheral blood and bone marrow • Reduction in transfusion dependence and/or transfusion
requirements • Reduction in anemia and hemolysis
Non-Randomized
GlobalPhase 1 Study
1Source: https://clinicaltrials.gov/ct2/show/NCT04105166?term=Rocket&cond=Pyruvate+Kinase+Deficiency&rank=1
53
Infantile Malignant Osteopetrosis (IMO)
Monogenic bone resorption disorder
Overview:• Background: Dysfunctional osteoclast disease
characterized by bone marrow failure, skeletal deformities, and neurologic abnormalities caused by TCIRG1 mutations in >50% of cases1
– Frequent mortality before age 10
• Current Available Treatments: Hematopoietic stem cell transplants associated with GVHD and limited efficacy
• Addressable Market: >50 patients/year2
• RP-L401: In vitro restoration of osteoclast resorptive function observed
• Regulatory Designations: Rare Pediatric Disease and Orphan Drug designations in the U.S.
RP-L201Leukocyte Adhesion
Deficiency-I
RP-L301Pyruvate Kinase
Deficiency
RP-L401Infantile Malignant
Osteopetrosis
1Source: https://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=6672Estimated incidence of one in 200,000 live births; Source: http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=667
RP-L102Fanconi Anemia
RP-A501Danon Disease
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Growing IP Portfolio
Multiple in-licensed patent families for GTx products and related technology platforms
Supporting current pipeline efforts ▪ Four In-licensed pending international patent applications filed under Patent Cooperation Treaty (PCT):▪ FA (2)▪ LAD-I▪ PKD
▪ Multiple patent applications pending:▪ Danon (exclusive world-wide license from UCSD)
▪ Multiple patent families licensed from REGENXBIO:▪ Danon – AAV9 (exclusive world-wide license)▪ Danon – 2 undisclosed capsid serotypes (exclusive
world-wide option to license)▪ Multiple cell and gene therapy platform technologies
licensed for pipeline product improvements
Rocket Proprietary Filed IP
Extensive patent portfolio across multiple platforms
▪ Multiple pending patent applications for ex-vivo LVV programs
▪ Multiple pending patent applications for in-vivo AAV
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World-Class Research and Development Partners
• CIBER
• CIEMAT
• Fred Hutchinson Cancer Research Center
• IIS FJD
• Lund University
• Memorial Sloan Kettering Cancer Center
• REGENXBIO
• Stanford Medical School
• University of California, San Diego
• University of California, Los Angeles
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2019
▪ Secured adequate supply of cGMP AAV9 to commercialization in partnership with CMO▪ Established an agreed path forward with Agency using current process
Expansion into Cranbury, NJ: R&D/CMC Efforts and Eventual cGMP Manufacturing
2020
▪ Continue R&D to further support CMC analytics and internal QC and release testing activities for RP-A501
RCKT Cranbury (NJ)103,720 sq. ft. production facility
▪ 50,000 sq. ft. from this facility will be dedicated to AAV cGMP manufacturing (FDA and EMA compliant)
▪ Planned one-time additional spend of ~$20-30M in 1H’20 dedicated to manufacturing build, and normal spend thereafter
▪ Initiating AAV tech transfer activities, projected GMP clinical product release in 2021
▪ Enables dual-sourcing for Danon commercial capacity
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Near and Long-Term Value Drivers
Potential for Five Gene Therapy Products to be Approved by 2025
2Q2020 3Q2020 4Q2020
✓ Danon: Endorsed to Advance to Next Cohort
✓ LAD-I: Phase 1 Data Update (first patient)
✓ FA: Additional “Process A” Data Update
❑ LAD-I: Phase 1 Data Update
❑ FA: Preliminary “Process B” Data
❑ LAD-I: Initiate Phase 2 Study
❑ PKD: Preliminary Phase 1 Data
❑ IMO: Initiation of Clinical Study
❑ Danon: Preliminary Phase 1 Data
Danon Day: The health and safety of our patients and families is our utmost priority, as a result of COVID-19 Danon Day has been postponed.
❑ Danon: First Patient Treatment in Higher Dose Cohort
❑ PKD: First Patient Treatment