A Leader in Engineered Cell Therapy Treatments
Clinical Platforms Targeting
Cardiovascular Disease and Oncology
C O R P O R A T E P R E S E N T A T I O N S T R I C T L Y C O N F I D E N T I A L
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DISCLAIMERS
This presentation is being made in reliance upon Section 105(c) of the Jumpstart Our Business Startup Act of 2012, and is intended solely for investors that are either qualified institutional buyers or institutions that are accredited investors (as such terms are defined under Securities and Exchange Commission (SEC) rules). This presentation shall not constitute an offer to sell or the solicitation of an offer to buy any securities, nor shall there be any sale of these securities in any state or jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction. Any such offering of securities will only be made by means of a
registration statement (including a prospectus) filed with the SEC, after such registration statement becomes effective. No such registration statement has been filed as of the date of this presentation.
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Forward Looking Statements
These slides and the accompanying oral presentation contain forward‐looking statements and information. The use of words such as “may,” “might,” “will,” “should,” “expect,” “plan,” “anticipate,” “believe,” “estimate,” “project,” “intend,” “future,” “potential,” or “continue,” and other similar expressions are intended to identify forward looking statements. For example, all statements we make regarding timely submission and approval of anticipated regulatory filings; the successful initiation and completion of clinical trials, including Phase III clinical trials for C-Cure® and Phase I clinical trial for CAR-NKG2D, additional clinical results validating the use of adult autologous stem cells to treat heart failure and CAR T-cell autologous therapy to treat cancer; satisfaction of regulatory and other requirements; actions of regulatory bodies and other governmental authorities; obtaining, maintaining and protecting intellectual property, our ability to enforce our patents against infringers and defend our patent portfolio against challenges from third parties, competition from others developing products for similar uses, our ability to manage operating expenses, and our ability to obtain additional funding to support our business activities and establish and maintain strategic business alliances and new business initiatives. All forward‐looking statements are based on estimates and assumptions by our management that, although we believe to be reasonable, are inherently uncertain. All forward‐looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those that we expected. These statements are also subject to a number of material risks and uncertainties that are described in the preliminary prospectus. Any forward‐looking statement
speaks only as of the date on which it was made. We undertake no obligation to publicly update or revise any forward looking statement, whether as a result of new information, future events or otherwise, except as required by law.
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Goal of becoming global leader in cell therapies by building franchises in multiple
indications based on core expertise
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Developing reprogramming technologies invented at Mayo Clinic and Dartmouth College
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C-Cure: Phase III trial in ischemic heart failure in Europe and Israel, CHART-1
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CAR T-cell technology: Enrolling patients in Phase I clinical trial in MM and AML at Dana Farber
Cancer Institute (Harvard Medical School) with lead product candidate, CAR-NKG2D
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IP and product portfolio allowing possible targeting of other indications in cardiovascular
diseases and oncology
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GMP production facilities
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CHART-1 efficacy read-out expected middle of 2016
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Headquarters in Belgium, with subsidiaries in US and Asia
A leader in cell therapy treatments with clinical programs
in cardiovascular disease and oncology
MANAGEMENT AND BOARD
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Executive Management Team
Christian Homsy, representative of LSS Consulting SPRL, acting asChief Executive Officer
Patrick Jeanmart, representative of PaJe SPRL, acting as
Chief Financial Officer Vincent Brichard, representative of
ViaNova SPRL, acting as
VP Immuno-Oncology
Peter De Waele, representative of Advanced Therapies Consulting Ltd., acting as
VP Research & Development
Georges Rawadi VP Business Development Warren Sherman Chief Medical Officer
Board of Directors
Michel Lussier, ChairmanLSS Consulting SPRL, represented by its permanent representative Christian Homsy William Wijns
Serge Goblet
Jean-Marc Heynderickx Danny Wong
R.A.D. Life Sciences BVBA, represented by its permanent representative Rudy Dekeyser Chris de Jonghe
Pienter-Jan BVBA, represented by its permanent representative Chris Buyse
Hanspeter Spek
TOLEFI SA, represented by its permanent representative Serge
Goblet
Scientific and clinical Advisors
Charles Sentman, PhD Prof & Director of Immunology Center, Dartmouth College Milton Packer, MD, PhD UT Southwestern, Columbia
University and Presbyterian Medical Center
Stefan Anker, MD, PhD Charité Berlin, Imperial College London, EMA expert
CAR T-Cell platform
Invented at Dartmouth College,
exclusively licensed to Celyad
An approach to cancer immunotherapy
Technology platforms supported by scientific research
CELYAD PLATFORMS
Cardiopoiesis platform
Invented at Mayo Clinic, exclusively
licensed to Celyad
A technology to treat heart failure
Oncology
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Acute Myeloblastic Lymphoma (AML)
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Multiple Myeloma (MM)
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Other Potential Indications:
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Ovarian
•
…
Cardiovascular
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Ischemic Heart Failure
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Other Potential Indications:
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Congestive Non-Ischemic Heart
Failure
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CELYAD OPPORTUNITIES
C
-Cure
®
Ischemic HF– CHART-1 (Europe and IL)
CA
R
T
-Ce
ll
AML & MM – US
Solid and blood cancers expressing NKG2D ligands
•Full data readout expected: Q2-Q3 2016
• Start of enrollment expected: •2H 2015, pending FDA release of existing clinical hold
•Interim data set expected: various times
•Full data readout expected; Q3-2016
•Start Phase IIb expected: 2016
Product
Pre-clinical
Phase I
Phase II
Phase III
Status / Milestones
Allogeneic
Platform
NKp30
• Start Phase I expected: 2016
B7H6
Ischemic HF– CHART-2 (US and Europe)
• Start Phase I expected: 2016
THE CARDIOPOIESIS
PLATFORM
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Heart failure affects 1 - 2% of the adult population in developed
countries
1•
In 2012, approximately
5.7 million heart failure patients in the U.S.
alone
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5-year survival rate for heart failure patients is 50%
3•
$60 billion estimated in direct costs on heart failure in 2014 in the
U.S.
48
1: McMurray, JJV et al., 2005, The Lancet, 365, pp1877-1889 2: Company estimates
3: Go, A.S. et al., Heart Disease and Stroke Statistics 2013 Update:, 4: Voigt, J., et al. (2014). “A Reevaluation of the Costs of Heart Failure and Its A Report From the American Heart Association Implications for Allocation of Health Resources in the United States.” Clinical Cardiology
THE HEART FAILURE MARKET OPPORTUNITY
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One in five people over the age of 40 will develop heart failure
during his or her life
1C-CURE THERAPY FOR THE TREATMENT OF HEART
FAILURE
Large Market,
Unmet Need
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Cardiovascular diseases are leading cause of death
in the world in 2012
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1 million primary HF-related hospitalizations annually
in U.S.
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C-Cure phase II data published in JACC:
improvement
in Ejection Fraction, ESV, 6-min walk
test
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Ongoing Pivotal Phase III trial
in Europe and Israel
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Futility data disclosed March 2015
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Full data set from European trial in the middle of 2016
Validated
Science
Advanced
Clinical
Medications: ACE inhibitors Angiotensin – 2 receptor blockers Beta blcokers Diuretics + Devices Biventricular Pacemakers & Defibrillators (CRTD) ICD Hemodynamic Support LVAD Immunosupressors Transplantation 10
AVAILABLE THERAPIES
– UNMET NEED TO TREAT
FAILING HEARTS
C-Cure target population is NYHA classes II, III, IV
NYHA Classes I & IIMild HF
NYHA Class III Moderate HF
NYHA Class IV Severe HF
SCIENCE &
RESULTS
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Bone marrow drawn from
the patient
Stem cells are selected and
expanded
Cardiopoietic cells are injected back into the heart using
C-Cathez®
1. Behfar et al., “Cardiopoeitic programming of embryoinic stem cells for tumor-free heart
Introduction of functioning myocytes
to induce repair
Stem cells are differentiated to become cardiopoietic cells, through the use of a proprietary
combination of cytokines and growth factors
BRINGING REPROGRAMED PRECURSOR
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Phase II, multicenter, prospective open-label study with blinded core lab analysis
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Endpoints: safety and feasibility. For efficacy - LVEF
Main Inclusion Criteria:
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NYHA Class II and III
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LVEF: ≥15% and ≤40%
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History of Myocardial Infarction (MI)
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Stable treatment
Phase II
(n = 45)
C-Cure group
Control group
Heart Failure of Ischemic
Origin
1: Bartunek, J., et al., Cardiopoietic stem cell therapy in heart failure The C-CURE multicenter randomized trial with lineage-specified biologics. J Am Coll Cardiol, 2013. 27.8 +/-2 28.0 +/-1.8 27.5 +/-1 34.5 +/-1.1 25 27 29 31 33 35 37 Baseline E je c tion Fra c tion (% ) Cell Therapy Control
*
*
P<0.0001Patients treated with C-Cure showed improved left ventricular ejection fraction
1Treatment
Control
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C-CURE TREATED PATIENTS SHOWED IMPROVED
CARDIAC FUNCTION
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-35 -30 -25 -20 -15 -10 -5 0 End-diastolic volume (EDV) End-systolic volume (ESV) Δ V ol ume (m L) Control Treatment -40 -30 -20 -10 0 10 20 30 Control Treatment L V Ma ss In d e x (g /m 2 )
C-Cure treated patients demonstrated
improved cardiac structure
1C-Cure treated patients demonstrated
a reduction of heart mass
1* P<0.001
C-CURE TREATED PATIENTS SHOWED IMPROVED
CARDIAC STRUCTURE
-40 -20 0 20 40 60 80 100 Control Δ Di sta n ce (m )
Patients treated with C-Cure demonstrated improved walked
distance at 6 month in the 6 minute walk distance test with 77m
1*P<0.01
1: Bartunek, J., et al., Cardiopoietic stem cell therapy in heart failure The C-CURE multicenter randomized trial with lineage-specified biologics. J Am Coll Cardiol, 2013.
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From 394m to 456m; ∆+62m, baseline 394m From 419m to 404m;
∆-15m, baseline 419m
C-CURE TREATED PATIENTS SHOWED
SIGNIFICANTLY IMPROVED EXERCISE CAPACITY
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Statistically and clinically significant increase in cardiac function (ejection fraction)
(p<0.0001)
1•
Statistically and clinically significant improvement in cardiac structure (end systolic
volume (p<0.001)
1•
Statistically and clinically significant improvement in exercise capacity (6 minute walk
distance test) (p<0.01)
1PHASE II DATA DEMONSTRATES IMPROVEMENT OF
HEART FAILURE PATIENTS
C-CURE: PHASE III TRIALS DESIGN
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Phase III cell therapy trial using reprogrammed cells for Heart
Failure patients (CHART-1)
C
-Cure
CHART-1
EMA Approved
NYHA class III and IV
Composite endpoint at 9 month:
Mortality, WHF, 6MWT, QoL,
LVEF, ESV
Currently ongoing in over 30 sites
in Europe and Israel
CHART-2
Pending FDA Clearance
NYHA class III and IV
Clinical enpdoint at 9 month;
6MWT
Anticipate start in second half
2015 in US and Europe, pending
release of FDA clinical hold
End of enrolment
March 2015
Futility analysis
March 2015
MANUFACTURING OF C-CURE
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Manufacturing process, ready for upscale and industrialization
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Pilot manufacturing facility with approximately 250 patient production
capacity, sufficient to meet current C-Cure clinical program needs
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Second manufacturing plant in Rochester, MN to increase production
capacity, provide redundancy and decrease logistical burden
CARDIOPOIESIS PATENT PORTFOLIO
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Seven patent families covering the cardiopoiesis platform issued by
Mayo and Celyad
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Lead product, C-Cure is covered by four granted patents in the U.S.
and New Zealand
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C-Cath
ezis a proprietary intramyocardial
injection catheter
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High local delivered retention compared to
existing devices
1–
Optimal biocompatibility through
decreased sheer stress
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Excellent safety profile
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Celyad invention with worldwide patent
applications
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CE marked since April 2012
C-CATH
EZ
: APPROVED PROPRIETARY CATHETER FOR
CAR T-CELL
PORTFOLIO FOR
ONCOLOGY
HOW DOES CAR T-CELL THERAPY WORK FOR
THE PATIENT
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NKG2D: THE STARTING POINT OF INNOVATION
Cell activation
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NKG2D is a receptor that is expressed on Natural
Killer (NK) cells
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An activating receptor that triggers cell killing by NK
cells against “self”
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Killing activity is dependent on NKG2D ligand
expression
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There are several NKG2D ligands generally
expressed by cells under stress conditions
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Numerous tumor cells express NKG2D ligands:
ovarian, bladder, breast, lung, liver, leukemia and
others
Use NKG2D to construct new CAR for fighting
multiple tumors
Human NKG2D Ligands
DNA damage
Infection, or
Malignancy
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MIC molecules may be induced in association with DNA damage, cell
stress, infection or malignant transformation
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System in which “self” alerts the immune system via upregulation of intrinsic
NKG2D ligands
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Tumor cells may express one or more ligands
MIC-B
Healthy
Cell
Tumor
Cell
ULBP
1-6
Tumor
Cell
Tumor
Cell
Tumor
Cell
MIC-A
NKG2D Ligand Expression in Tumor Cells
Expression of NKG2D ligands
on human tumor cells
Tumor Type Reference
Carcinoma Ovarian (40, 43, 148-151) Bladder (152) Breast (40, 153-155) Lung (40, 156, 157) Hepatocellular (158) Colon (40, 41) Renal (40, 159, 160) Prostate (40, 161) Leukemia AML (39, 162-164) CML (39, 165, 166) CLL (167, 168) Lymphoma (169) Multiple Myeloma (138, 170) Melanoma (42, 171, 172) Ewing Sarcoma (56, 173) Glioma (38, 108) Neuroblastoma (104)
CELYAD'S CAR T-CELL TECHNOLOGY
Classical CAR construct
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One CAR construct targets one tumor
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May not be suitable for repeated injections
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Mostly autologous
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Many potential therapies under development
Our CAR construct
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Uses NK cell receptors
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One CAR construct has the potential to
target multiple tumors
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Suitable for repeated injections
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Autologous and possibly allogeneic
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CAR-NKG2D T-CELLS INDUCE LONG-TERM TUMOR
FREE SURVIVAL IN ANIMAL MODELS
1. Barber, A. et al., J. Immunol (2009) 183(4):2365-72;
2. 2. Barber, A. et al., J. Immunol (2009) 183(11):6939-47;
3. 3. Barber, A. et al., J. Immunol (2008) 180(1):72-8
4. 4. Barber A. et al.,Exp. Hematol. (2008) 36(10):1318-28
100% survival in murine models ovarian cancer
CAR-NKG2D CAR T-Cells showed efficacy in multiple
tumor models, including multiple myeloma (MM), ovarian
cancer, lymphoma
0 50 100 150 200 250 0 50 100 Time P e rc e n t s u rv iv a l WT CH Wild-type NKG2D T-Cells (n=12) CAR-NKG2D T-Cells (n=12)NKG2D CAR T-CELLS INDUCE DURABLE
ANTI-TUMOR IMMUNITY
Survivors were either re-challenged with
5T33MM cells or injected with RMA cells
a different tumor cells; naive used as
control
Survivors showed 100% durable protection
against re-challenge
Treatment with NKG2D CAR T-Cells
lead to long-term survival of mice
injected with 5T33MM tumor cells
(MM model)
Survivors were used to re-challenge
0 2 0 4 0 6 0 8 0 1 0 0 0 5 0 1 0 0 T im e P e r c e n t s u r v iv a l W T ( n = 1 1 ) C H ( n = 1 3 )
Following CAR T-Cell therapy, long-term protection demonstrated
against parental tumor, even if NKG2D ligand negative
Wild-type NKG2D T-Cells (n=12) CAR-NKG2D T-Cells (n=12) 0 2 0 4 0 6 0 8 0 0 5 0 1 0 0 T im e P e r c e n t s u r v iv a l 5 T s u r v iv :R M A - R L 5 T s u r v 5 T 3 3 M M N aïv e :R M A - R L N aïv e :5 T 3 3 M M Naïve - RMA-RL (n=11) Survivor - RMA-RL (n=6) Naïve - 5T33MM-L (n=7) Survivor - 5T33MM-L (n=7)
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CAR-NKG2D T-CELLS PHASE I DESIGN
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Phase I to be performed at Dana Farber Cancer Institute, Boston
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Dose escalation 3+3 design; primary objective: feasibility and safety
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Enrolling refractory/relapsed AML or MM patients
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Safety measures cover conventional risks
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Biomarker measurement to assess efficacy
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Additional 12 patients may be included in dose expansion part of the
trial
ALLOGENEIC T-CELL PLATFORM
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Based on co-expression of CAR molecules and TCR Inhibitory Molecules (TIMs) from
same retrovirus DNA
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TIMs inhibit TCR expression and/or dysfunction TCR signaling, resulting in loss of capacity
of engineered T-cell to recognize allogenic HLAs and to generate GVHD reaction
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Celyad allogeneic platform uses T-Cells from healthy donors and generates “off-the-shelf”
CAR T-Cells to potentially treat numerous cancer patients
STRONG IP POSITION
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Three patent families covering all CAR products pipeline and
allogeneic platform
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Distinguished IP on Celyad CAR constructs utilizing NK receptors
A CAR T-CELL PORTFOLIO FOR CANCER
TREATMENT
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Not another CD19 CAR
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No need for antibody platform because it uses natural NK receptors
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Potential to target variety of tumor types including liquid cancers and
solid tumors
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Multiple product candidates possible; lead product candidate
currently beginning Phase I
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Allogeneic T-cell platform may allow manufacturing of “off-the-shelf”
products
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ANTICIPATED CLINICAL MILESTONES
CAR
T
-Cell
C
-CURE
H1 2015
H2 2015
H1 2016
H2 2016
Futility
Analysis
End of
Enrolment
CHART-1
Expected Readout
CHART-1 full data
set
CAR-NKG2D Phase I – interim readouts after each cohort
Expected Readout
CAR-NKG2D full
data set
Recruitment
of 1
stpatient
Interim data to be reported throughout trial
Expected Initiation
of CHART-2 in
US, pending
release of FDA
clinical hold
SHAREHOLDERS AND FUNDING HISTORY
• $165M (€146M) raised since inception
• Public company since July 2013 (Euronext Brussels & Paris)
28.90% 7.24% 5.10% 5.46% 4.25% 2.69% 1.19% 45.18%
Shareholder structure as per March 2, 2015
Tolefi SA Medisun SRIW PMV
Founders & Mgt
Mayo Foundation for Education and Research
Celdara Others