Transforming Science into
Medicine
Corporate Presentation
January 2021
2 Forward-Looking Statements
This presentation contains "forward-looking statements." These statements include words like "may," "expects," "believes," "plans," "scheduled," and "intends," and describe opinions about future events. These forward-looking statements involve known and unknown risks and uncertainties that may cause the actual results, performance or achievements of BioLineRx to be materially different from any future results, performance or achievements expressed or implied by such forward-looking
statements.
3 Our Mission
Our mission is to become a leader in the development of novel
therapeutics for the treatment of cancer
4 Who are We?
Ticker / Exchange | BLRX (NASDAQ) |
Headquarters | Tel Aviv, Israel |
Market cap | ~$65 million (15-Jan-21) |
Shares outstanding | ~23.4 million (American Depositary Shares) |
Cash | ~$20.8 million (as of 30-Sep-20) |
Cash runway | Q1 2022 |
Employees | ~40 (30 in R&D) |
NASDAQ: BLRX
5 Investment Highlights
Singular focus on novel | ➢ Motixafortide (BL-8040) program - in phase 3 for SCM; phase 2 for |
pancreatic cancer and AML | |
oncology compounds | |
➢ AGI-134 program - in phase 1/2a for solid tumors |
Advancing towards
potential registration of
Motixafortide in SCM
Multiple opportunities for
value enhancement
- Positive IA for Phase 3 GENESIS trial in SCM, statistically significant improvement in primary endpoint
- Enrollment completed at 122 patients (instead of 177 originally planned)
- Company moving forward towards NDA submission
- Final phase 2 PDAC data showed improvement in all endpoints; planning next development steps - randomized study under potential collaborations
- Significant data readouts over next 12 months, including Phase 3 full results in SCM expected H1 2021
- ~$65 million market cap (15-Jan-21)
Compelling valuation
- ~$20.8 million cash as of Q3 2020
- Cash runway - Q1 2022
SCM - stem cell mobilization; AML - acute myeloid leukemia
6 Pipeline Targeting Multiple Oncology Indications
PROGRAM
ONCOLOGY
Motixafortide (BL-8040)
AGI-134
OTHER
BL-5010
INDICATION | PRE-CLINICAL | PHASE 1 | PHASE 2 | PHASE 3 | REGULATORY | PARTNERS |
APPROVAL | ||||||
Stem-cell mobilization
Pancreatic cancer *
AML
Solid tumors
Skin lesions
*BioLineRx retains all rights to BL-8040 under a clinical trial collaboration with
Motixafortide (BL-8040): CXCR4 Antagonist
Oncology Combination Platform for Solid and Hematological Indications
8 Motixafortide - Best-in-Class CXCR4 Antagonist for Multiple Indications
- A 14-amino acid synthetic cyclic peptide, high-affinity CXCR4 antagonist with long receptor occupancy (>48 hours)
- CXCR4 is over-expressed in more than 70% of cancers and its high expression levels correlate with disease severity
- CXCR4 and its ligand CXCL12 (SDF-1) play a critical role in trafficking of CXCR4 expressing cells such as HSPCs, immune and cancer cells
Phase 3 | Phase 2 | Phase 2 |
Stem Cell Mobilization for | Cancer Immunotherapy for | Acute Myeloid Leukemia |
Multiple Myeloma | Solid Tumors | |
Robust mobilization of HSPCs for | Mobilization of immune cells to | Mobilization of leukemic cells from |
transplant | peripheral blood; infiltration of | bone-marrow protective niche, |
immune T cells into tumor; | sensitization to anti-cancer | |
reduction of immunosuppression in | treatment and induction of | |
tumor microenvironment | apoptosis |
HSPC - Hematopoietic stem and progenitor cell
Motixafortide in SCM
10 SCM for Patients Undergoing Autologous HSC Transplantation
Patients with hematological malignancies often require HSC transplant after treatment to restore their immune system
Significant unmet medical need in SCM
• Multiple apheresis sessions required
• | 50-70% of patients are poor mobilizers |
10 • | For poor mobilizers, 1-4 daily injections |
of Mozobil on top of G-CSF are required |
HSC - hematopoietic stem cell; SCM - stem cell mobilization
11 Stem Cell Mobilization Opportunity
Rare indication showing significant growth and major unmet need
Growing number of auto-HSCTs in MM
- An estimate of ~45,000 auto-HSCTs were conducted in
EU and US in 2018*
- ~90% of auto-HSCTs are in MM and lymphomas
o Number of MM auto-HSCTs doubled since 2010
- Mozobil's sales shown 40% growth since 2016 (~$235 million in 2019)#
Multiple | 54% | 16% |
Myeloma | ||
Lymphomas | ||
38% | 22% | |
36% | ||
2% 8% | 14% |
10% | First Line mobilization | ||
Other | Poor mobilizers | ||
BL-8040best-in-class CXCR4 antagonist potentially offers a more effective and convenient mobilization option for patients
- Robust HSCT mobilization
- Single administration on top of SoC
- Reduced number of apheresis sessions and hospitalization costs
BL-8040 could become new SoC and expand the
market
- BL-8040could expand beyond poor mobilizers to first line treatment
- Potential expansion in other autologous indications, such as lymphomas and sickle cell anemia
* CIMBTR 2019 Summary Slides (US) - https://www.cibmtr.org// EBMT Transplant Activity Survey 2018 Summary (EU) - https://www.ebmt.org/
# Mozobil WW sales - Source GlobalData
Split of market extrapolated based on EBMT indication split. Poor mobilizer data based on CMS Medicare Analysis of Mozobil Utilization/Qualitative Research 2017
12 BL-8040 GENESIS Phase 3 Study: Autologous SCM in MM Patients
Interim analysis successful; full results expected H1 2021; NCT03246529
Study design
- Part 1: Lead-in period - dose confirmation (n=30)
- Part 2: Randomized placebo-controlled study in combination with G-CSF (n=177)
Primary endpoint
Proportion of subjects mobilizing ≥6 x 106 CD34+ cells/kg following single dose of BL- 8040 in up to 2 apheresis sessions
Part 1: Lead-inperiod results (n=11; DMC recommended early initiation of Part 2 based on 11 patients)
- BL-8040in combination with G-CSF is safe and tolerable
- 82% of patients reached primary endpoint threshold with one administration of BL-8040 and in up to 2 apheresis sessions; 73% reached the threshold in 1 apheresis session; all patients reached threshold in up to 4 apheresis sessions
MM= Multiple Myeloma
13 GENESIS Phase 3 Study Interim Results
Interim analysis successful; full results expected H1 2021; NCT03246529
Successful interim analysis of randomized, placebo-controlled part 2 in Oct 2020
Planned interim analysis on 122 patients of study's primary endpoint was conducted independently by study's Data Monitoring Committee (DMC)
Based on statistically significant evidence favoring treatment with motixafortide in primary endpoint and overall safety profile, DMC recommended immediate halt of study enrollment
According to DMC recommendation, enrollment ceased at 122 patients, instead of 177 as planned
"Given the overall safety profile and the unambiguous efficacy of the experimental compound, the DMC unanimously suggests the study halt enrollment now and complete data collection."
BL-8040 on top of G-CSF may become new standard-of-care in autologous SCM
Motixafortide in Cancer
Immunotherapy - PDAC & Solid
Tumors
2L Pancreatic Cancer Market Represents Significant Opportunity
15 | Cold tumor where IO has no effect; significant market opportunity with high unmet medical need |
PDAC incidence significant and growing: 460K cases WW
in 2018, estimated 815K in 2040
Estimated pancreatic cancer cases # 2018-2040
China
Europe
USA+CA
Japan
Poor outcomes in PDAC:
- 5y survival rate 8-10%, minimal change in last 30y
- Multiple late-stage failures
- >50% PDAC patients diagnosed with (stage IV) disease = COMBAT Cohort 2 population
- 5y survival rate ~3%, mOS of 3-5 months
Lack of efficacious treatment options (in all lines):
- 1L Gem/FOL-based; 2L vice versa
- 2L Onivyde is the only approved regimen
- Immunotherapy has no effect* => need to co-target alternative pathways
2L PDAC represents a multi-billion $ addressable market
- ~85% of patients treated 1L and then 40% 2L
- ~130K 2L pts in major markets#
BL-8040 is the only CXCR4 antagonist in advanced clinical development for PDAC
- Failed trials based on single promising endpoint, while BL- 8040 improves multiple endpoints in homogenous population => better prediction of future success
- Plan to expand beyond PDAC 2L into additional treatment lines and other solid tumors (1L PDAC study initiated^)
GLOBOCAN 2018; graph produced from WHO Cancer Tomorrow website - link
# 2L calculation based on e2025: ~400K Pancreatic cancer pts in major markets (US&CA 68K, Europe 146K, China 146K, JP 47K) - link
* Pembro only approved in MSI-H PDAC (~1% of pts) | ^ BL-8040/PD-1i/Chemotherapy - NCT04543071 |
16 Motixafortide - Addressing Unmet Needs in Cancer Immunotherapy
BL-8040 blockade of CXCR4 regulates immune cell trafficking and rebalances the TME immune cells for IO in solid tumors
Immune-cell trafficking regulator
BL-8040 is a powerful mobilizer of immune cells from the bone marrow and lymph nodes (e.g. T-cells,B-cells, immature DCs and NK cells) into the periphery
Induces T cell infiltration
BL-8040 affects CAFs to disrupt stromal interactions, increasing TILs into tumors, e.g. CTLs, shifting cold to hot tumors
TME modulator
BL-8040re-balances effector and immune suppressor cells (CTLs vs. MDSCs & Tregs) in the TME
* Zheng et al. J. Clin. Med. 2019, 8, 1472; doi:10.3390/jcm8091472
17 COMBAT Phase 2a Study- Cohort 1: Dual Combination
Phase 2a open-label,multi-center study to assess the safety and efficacy of BL-8040 and pembrolizumab in subjects with metastatic pancreatic cancer: NCT02826486 (n=37)
MoA demonstrated by mono / dual combination (in patient biopsies - representative MultiOmyxTM data*):
- Increased activated cytotoxic T cells
- Decreased myeloid derived suppressor cells in tumor microenvironment
- Reduction in tumor cell numbers
End Cycle 2 Screening
In collaboration with | *Representative MultiOmyxTM data taken SD patient and long treatment duration (11 combo |
Bockorny et al., Nat Med (2020) | cycles ~34 weeks). Data shown before treatment vs. after ~7w of treatment (end of cycle 2) |
18 Rationale for Motixafortide Triple Combo in Cohort 2
Tumors with low immune visibility require multi-modal approach to advance treatment beyond SoC limitations
Chemotherapy induces tumor death, reducing tumor burden
Chemotherapy induces immunogenic cell death, leading to activation & expansion of new tumor-reactiveT-cell clones
Chemotherapy
Motixafortide facilitates effector T cell mobilization/ trafficking from BM/LN to periphery and infiltration into TME;
Motixafortide facilitates TME modulation: ↑activated CTLs and ↓MDSCs/Tregs
Motixafortide (BL-8040)
PD1 maintains & restores activity of T cells within tumor
Checkpoint Inhibitor
Adapted from Chen and Mellman
19 Design of Triple Combination - Cohort 2
Triple combination: BL-8040 and pembro on top of SOC in 2L PDAC
Main inclusion/exclusion criteria | Endpoints |
18 years old and above | ORR according to RECIST 1.1 criteria |
Metastatic disease at first diagnosis (Stage IV) | Disease control rate (DCR) |
Progressed after first-linegemcitabine-based treatment | Duration of response |
No previous surgeries for PDAC, no previous locally advanced disease | PFS and OS |
No prior PD-1 or PD-L1 treatment | Safety and tolerability |
Study completed; final results presented in December 2020 *
In collaboration with | Dr Hidalgo, Dec 2020 - KOL Webinar - Link |
Bockorny et al., Nat Med (2020) | * All n=43, evaluable n=38 |
20 Encouraging Response Rates from Triple Combo Cohort 2
Change from Baseline* in Target Lesions
Change from Baseline in Target lesions
No. of | % of Subjects | |
Subjects | ||
ORR (PR) | 8 | 21.2% |
cORR | 5 | 13.2% |
SD | 16 | 42.1% |
DCR | 24 | 63.2% |
PD | 14 | 36.8% |
According to RECIST v 1.1, confirmation of response (cORR) is required for non- randomized trials with response as the primary endpoint
Dr Hidalgo, Dec 2020 - KOL Webinar - Link* Baseline: Day 5 monotherapy
21 Triple Combo Shows Tumor Shrinkage Over Time (SD→PR)
Majority of patients achieved PRs and SDs with triple combo
Change from Baseline in Target lesions
Data shown for subjects treated with the triple combination and have at least one Post Monotherapy D5 (BL) Scan
Dr Hidalgo, Dec 2020 - KOL Webinar - Link
22 Triple Combo mOS and mPFS are 6.5 mos and 4.0 mos, respectively
Overall Survival | Progression Free Survival |
Dr Hidalgo, Dec 2020 - KOL Webinar - Link | *ITT data is similar |
23 Favorable Safety - Low Incidence of Neutropenia and Infections
The triple combination was generally well tolerated
Incidence of AEs is consistent with the profile of each drug, however
The incidence of neutropenia and infections is lower than the expected with chemotherapy alone
COMBAT | NAPOLI1 | |
Neutropenia >=G3 | 7% | 20% |
Infections/infestations - All Grades | 21% | 38% |
Infections/infestations >=G3 | 7% | 17% |
1https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/207793lbl.pdfDr Hidalgo, Dec 2020 - KOL Webinar - Link
24 Stage of Diagnosis Affects Survival Data
COMBAT patients all diagnosed at stage IV - i.e., benchmark is 4.7 mos
Data below from NAPOLI-1 registration trial for Onivyde/Leucovorin/5FU chemo combination - same used in COMBAT study
Macarulla Mercade et al, Pancreas 2020
25 Consistent and Meaningful Improvement Across All Study Endpoints
Demonstrated in hard-to-treat PDAC patients (caveated by limitations of small single-arm study)
COMBAT | HISTORICAL DATA# | |
mOS | 6.5 months | 4.7 months1 |
mPFS | 4.0 months | 2.7-3.1 months2,3 |
cORR | 13.2% | 7.7%3 |
DCR | 63.2% | 29-52%2,4 |
Summary of COMBAT Results
COMBAT 2 data showed improvement across all efficacy parameters compared to best matching population benchmark
Prolonged mOS and mPFS
Improved Confirmed ORR Responses and stable disease were generally durable
Favorable safety compared to Onivyde label
- Based on benchmarking conducted - see KOL WebinarLink
1 Macarulla Mercade et al, Pancreas 2020; 2 Petrelli et al Eu J Cancer 2017; 3 Onivyde SMPC; 4 Wang Gillam Eu J cancer 2019
26 Motixafortide Highlights
A differentiated oncology platform with clinical POC in both solid and hematological indications
Differentiated, next-gen CXCR4 antagonist with high affinity and long receptor occupancy
MOA and clinical efficacy demonstrated in several different indications, including SCM, PDAC and AML Recent positive data in SCM and PDAC
- SCM: Positive Phase 3 IA data - advancing towards final results in H1 2021
- PDAC: Meaningful improvements across allendpoints vs historical data
Fast pathway to registration in SCM for multiple myeloma, with potential for extended LCM in other hematological indications requiring mobilization/transplantation
Significant upside as cancer immunotherapy platform in solid tumors and hematological diseases
AGI-134
Cancer Immunotherapy
Universal Anti-Cancer Vaccine with Unique MoA
28 What is the Alpha-Gal and Anti-Gal Story?
Xenotransplantation experiments in the 1980's-90's found that, when introduced to humans, the alpha-Gal- positive tissue was bound by pre- existing human anti-Gal antibodies, which were the main cause of the rejection of porcine heart valves
AGI-134 coats tumor cells with alpha-Gal to make | AGI-134: a fully synthetic alpha-Gal glycolipid for IT injection | ||||
them look like foreign tissue and harness the pre- | |||||
existing immune machinery, to evoke an immune | |||||
response against the tumor | α-Gal | linker phospholipid | |||
29 AGI-134 - Mechanism of Action
AGI-134 directs pre-existinganti-Gal antibodies to the tumor and induces activation of multiple immune system
effector arms against the patient's own neoantigens
30 AGI-134 Monotherapy - Phase 1/2a Study Design
Part 1 successfully completed
Open-label study to evaluate the safety and tolerability of AGI-134 intratumoral as a monotherapy, in unresectable/metastatic solid tumors (NCT03593226) (n=40)
PART 1 | PART 2 | ||||
AccelerateratedEscalationDose EscalationMonotherapy | MonothDoserapyExpansionsion | ||||
1 | 2 | 1 | 1 | ||
25mg | 50mg | 100mg | 200mg | 3 | 32 |
3 Deep Lesions | Deep & Superficial Lesions |
Endpoints
Safety and tolerability
Determine MTD and RP2D
Pharmacodynamic and biomarker assessments
- Part 1 of study successfully completed - AGI-134 was found to be safe and well tolerated with no dose-limiting toxicities observed
- Part 2 initial results expected H2 2021
Looking Ahead
32 Upcoming Major Clinical Milestones in Next 12 Months
BL-8040 | Phase 3 full results in SCM | H1 2021 |
AGI-134 | Initial results from part 2 of Phase 1/2a trial | H2 2021 |
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BioLineRX Ltd. published this content on 17 January 2021 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 22 January 2021 18:03:07 UTC