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Transforming Immuno-Oncology Using Next-Generation Immune Cell Engagers
Corporate PresentationAugust 2017
Forward-looking statements / safe harbor
This presentation and the accompanying oral commentary contain “forward-looking” statements that involve substantial risks and uncertainties. All statements other than statements of historical facts contained in this presentation and the accompanying oral commentary, including statements regarding our future financial condition, business strategy and plans and objectives ofmanagement for future operations, are forward-looking statements. In some cases, you can identify forward-looking statements by terminology such as “believe,” “will,” “may,” “estimate,” “continue,” “anticipate,” “intend,” “should,” “plan,”“might,” “approximately,” “expect,” “predict,” “could,” “potentially” or the negative of these terms or other similar expressions. Forward-looking statements appear in a number of places throughout this presentation and the accompanying oral commentary and include statements regarding our intentions, beliefs, projections, outlook, analyses and current expectations concerning, among other things, our ongoing and planned preclinical development and clinical trials, our collaborations and development of our products in combination with other therapies, the timing of and our ability to make regulatory filings and obtain and maintain regulatory approvals for our product candidates our intellectual property position, our collaboration activities, our ability to develop commercial functions, expectations regarding clinical trial data, our results of operations, cash needs, financial condition, liquidity, prospects, future transactions, growth and strategies, the industry in which we operate, the trends that may affect the industry or us and the risks uncertainties and other factors described underthe heading “Risk Factors” in Affimed’s filings with the Securities and Exchange Commission.
Forward-looking statements involve known and unknown risks, uncertainties, assumptions and other factors that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements.
Forward-looking statements represent our management’s beliefs and assumptions only as of the date of this presentation. Except as required by law, we assume no obligation to update these forward-looking statements publicly, or to update the reasons why actual results could differ materially from those anticipated in the forward-looking statements, even if new information becomes available in the future.
2
Overview
Approach
• Eliminating tumor cells by engaging NK cells or T cells
Pipeline
• Clinical and preclinical assets based on tetravalent bi- and trispecific antibody formats
Leader in NK cell engagement
• AFM13 is the most advanced NK cell engager in clinical development, with solid Phase 1 data
• Rationale for combination of NK cell engagers with CPIs, adoptive NK cell transfer or cytokines
Well-differentiated T cell-based approach
• Addresses limitations of other drugs, such as potency at low T cell numbers, elimination of malignant cells with low target expression, etc.
Partnerships with industry, academia, and advocacy groups
• Merck (MSD), MD Anderson Cancer Center (MDACC), Leukemia & Lymphoma Society (LLS)
3
Affimed’s pipeline and programs
4
Q2/17 updates (1)
5
NK cell engager programs
• AFM13 (CD30/CD16A) Phase 1b combination study with Keytruda in r/r HL has completed dose escalation phase and initiated expansion phase
• AFM13 Phase 2 monotherapy in r/r HL (sponsored by the German Hodgkin Study Group) is open to recruit under new study design
• Columbia University initiated AFM13 translational Phase 1b/2a study in CD30+ lymphoma
• MDACC collaboration to evaluate AFM13 with MDACC’s NK cell product is ongoing
• Differentiating data on AFM24 (EGFR/CD16A) and AFM26 (BCMA/CD16A) were presented at AACR, ASCO and at EACR-AACR-SIC
Q2/17 updates (2)
6
T cell engager programs
• Phase 1 dose-escalation trials of AFM11 (CD19/CD3) in ALL and in NHL
• Ongoing and recruiting
• AFM11 overall well-tolerated, no DLTs observed to date under revised study protocol
• AFM11 in r/r ALL
• Patients currently being recruited into the 4th dose cohort
• 12 sites in the Czech Republic, Poland, Russia, Austria and Israel open and recruiting
• AFM11 in r/r NHL
• Patients currently being recruited into the 3rd dose cohort
• 10 sites in the Czech Republic, Poland, Germany, and the U.S. open and recruiting
• Amphivena Phase 1 study in AML with AMV564 ongoing
Affimed’s tetravalent bispecific antibody formats
7
Most competitorsBivalent, T cell focus
Avidity, high specificity, tailored PK
Antibody binding domains
AFMDTetravalent, NK and T cells
Tumor cell
CD16ACD3
Tumor antigen
NK-cell
Tumor cell
Tumor antigen
CD3
Immune cell
Immune cell
NK cells are becoming a cornerstone of cancer immunotherapy
8*Sconocchia et al, 2011; Imai et al, 2000 ** Romee at al. Sci. Transl. Med 2016
• There is a positive correlation between NK cell infiltration and clinical outcome in patients (low cytotoxicity associated with higher incidence of cancer*)
• Recent clinical data show improved anti-tumor responses of ex vivo expanded and activated NK cell populations**
• NK cell-based approaches show a favorable safety profile
• NK cell-based immunotherapy has recently advanced with different treatment approaches: Engagers, checkpoint modulators, cytokines, adoptive cellular transfer
Opportunity for:
NK cell redirection to address lack of recognition of cancer cells
Combination of NK cells with other approaches to enhance efficacy
CD16A – a unique activating receptor on NK cells
9
*Bryceson, et al., Blood 114:2657-2666, 2009 Bryceson, et al., Immunol. Rev. 214:73-91, 2006
Koch & Tesar, accepted for publication
CD16A is the only activating receptor triggering the cytotoxic activity of naïve human NK cells even in the absence of co-stimulatory signals.*
High affinity binding of tetravalent bispecific immune cell engagers restore NK cell killing and tumor immune control
IgG-based approach shows significant limitations to address immune cell re-direction in oncology
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Koch & Tesar, accepted for publication
Affimed‘s CD16A platform confers superior engager features
Specificity
• Specific for CD16A
• No binding to CD16B on neutrophils
• Independent of 158 V/F polymorphisms
• Virtually no competition with plasma IgG
Affinity
• >1000x higher than mAbs
Increased potency and efficacy
11
Koch & Tesar, accepted for publication
AFM13 – A first-in-class CD16A-targeting NK cell engager suitable for mono- and combination therapy
Phase 1: Safety and clinical activity demonstrated in heavily pre-treated HL patients
• Favorable safety profile determined
• Tumor shrinkage in 62% and PRs in 23% of patients at doses of at least 1.5 mg/kg
Phase 2a monotherapy in r/r HL (IST by GHSG, ongoing)
• Evidence of AFM13 single agent activity in patients which failed standard treatments including B.V. (2/7 evaluable patients with PR)
Phase 1b in r/r HL in combination with Merck’s Keytruda® (ongoing)
• Dose escalation (3 cohorts) completed; dose expansion cohort initiated at highest dose explored during dose escalation
Phase 1b/2a study in r/r CD30+ lymphoma (IST by Columbia University, initiated)
• Translational study in patients with cutaneous manifestation enabling serial biopsies
• FPI July 2017
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13
Koch & Tesar, accepted for publication
Combination of NK cell-engaging bispecifics with adoptive NK cell transfer (MDACC collaboration)
• Develop combination of Affimed’s NK cell platform and MDACC’s cord blood-derived NK cells
• Initially focused on AFM13 in HL
• Collaboration may pave way for combinations in further indications, e.g. multiple myeloma
14
AFM24 – Designed to overcome limitations of conventional therapies
Medical need for a novel approach to treat EGFR+ solid tumors
• Side-effects such as skin toxicity may impact physicians‘ willingness to prescribe EGFR inhibitors
• Patients with RAS mutation cannot be treated with EGFR-blocking antibodies
AFM24
• Tetravalent bispecific NK cell engager molecules targeting EGFR and CD16A
• Improved potency and more favorable safety profile vs. cetuximab/panitumumab
• Potential to overcome intrinsic or acquired resistance
• Potent NK cell engagers may shift the validated target EGFR towards IO
• Development candidates identified and progressed to cell line generation
• IND-enabling studies initiated for several candidates
15
AFM24 – Differentiated through efficacy
• In vitro: Highly potent tumor cell killing independent of RAS mutational status
• In vivo: Efficacy demonstrated in EGFR+ tumors, incl. tumors resistant to EGFR-targeting agents
tum
or
volu
me
(mm
3)
time after inoculation (days)
A431
Cetuximab-resistant RAS mutant model: Better efficacy
Cetuximab-sensitive tumor model: Comparable efficacy
a n tib o d y c o n c e n tr a t io n [p M ]
% s
pe
cif
ic l
ys
is
1 0 -2 1 0 -1 1 0 0 1 0 1 1 0 2 1 0 3 1 0 4 1 0 5
0
2 0
4 0
6 0
8 0
1 0 0
1 2 0
w /o
A F M 2 4
w /o a n tib o d y
c e tu x im a b
H C T -1 1 6
% s
pe
cif
iccell
lysis
vehicle control
AFM24
cetuximab
16
AFM24 – Differentiated through safety
• Pilot toxicity studies in cynomolgus monkeys completed with no major safety findings
• Dosed up to 93.75 mg/kg in dose range-finder and up to 30 mg/kg in 4 weeks repeated dose studies
• No AFM24-related macro- or microscopic changes in tissues incl. vital organs, skin, injection site
• No evidence of skin toxicity in both studies
• No signs of delayed toxicity in repeated dose study recovery animals
• In vitro toxicology: no cytokine release or NK cell proliferation in the absence of target cells
AFM26 – Urgent need for a novel approach to treat multiple myeloma
17
• Medical need to achieve minimal residual disease (MRD) negativity in 1st line treatment
• MRD positivity is associated with a poorer prognosis
• Persistent MRD can predict unsustained CR*
• MM characterized by high M-protein serum levels (up to 170mg/mL)
• Competition by serum IgG is known to strongly impair ADCC activity of mAbs
New therapies have significantly improved outcomes but cure remains elusive and the majority of patients eventually relapse
*Paiva et al., Blood, 2012
AFM26 – Designed to overcome limitations of conventional therapies
18
• NK cell engagement offers potential to achieve MRD-negativity
• NK cell binding largely unaffected by circulating IgG potential NK cell activation in presence of M-protein
• High affinity to both target and NK cells leads to prolonged cell retention
• High cytotoxic activity towards high and low BCMA-expressing myeloma cell lines
• Potentially safer than T cell-based approaches, allowing for faster development timelines
• Potential positioning in 1st line as monotherapy after ASCT, as combination therapy with adoptive NK cell transfer during ASCT or in salvage setting
19
• BCMA (B cell maturation antigen) is an antigen ubiquitously expressed on malignant plasma cells
• Expression in healthy tissues limited to plasma cells and pDCs
Binding to primary NK cells Cell surface retention on primary NK cells
AFM26 – Binding BCMA, an ideal target for immunotherapy of multiple myeloma
20
A n tib o d y c o n c e n tra t io n [p M ]
Sp
ec
ific
ly
sis
[%
]
1 0 - 2 1 0 0 1 0 2 1 0 4 1 0 6
0
2 0
4 0
6 0
8 0
1 0 0
A F M 26
a n ti-C D 3 8 Ig G 1
a n ti-C S 1 Ig G 1
C e tu x im a b
A n tib o d y c o n c e n tra t io n [p M ]
Sp
ec
ific
ly
sis
[%
]
1 0 - 2 1 0 0 1 0 2 1 0 4 1 0 6
0
2 0
4 0
6 0
8 0
1 0 0
MM.1S NCI-H929
1 0- 2
1 0- 1
1 00
1 01
1 02
1 03
0
2 0
4 0
6 0
8 0
A n t i b o d y c o n c e n t r a t i o n [ n M ]
MF
I
c t r l .
1 0 µ g / m L m A b a n t i - B C M A ( A N C 3 B 1 )
2 . 5 µ g / m L m A b a n t i - C D 3 8 ( H B 7 )
2 . 5 µ g / m L m A b a n t i - C R A C C / S L A M F 7 ( 2 3 5 6 1 4 )
1 0- 2
1 0- 1
1 00
1 01
1 02
1 03
0
1 0
2 0
3 0
4 0
A n t i b o d y c o n c e n t r a t i o n [ n M ]
MF
I
c t r l .
Cytotoxicity
BCMA-binding
AFM26 – Differentiated through target cell binding and potent tumor cell lysis
21
EC50: 23.5pM
EC50: 18.3pM
Potential superior safety profile compared with T cell engagement
No NK cell activation in the absence of target cells
Antibody-induced target cell lysis in vitro
Cytokine release induced in human PBMC cultures in the presence of BCMA+ target cells
AFM26 – Differentiated through safety
0,00
500,00
1000,00
1500,00
500
00,0
01
0000
,00
200
0,00
400
,00
80,
00
16,
00
3,2
0
0,6
4
0,1
3
0,0
3
500
00,0
0
100
00,0
0
200
0,00
400
,00
80,
00
16,
00
3,2
0
0,6
4
0,1
3
0,0
3
AFM26
BiTE
IL-4
IL-2
IL-10
IL-6
TNFa
IFN-g
AFM26 BiTE ng/mL
pg/mL
22
Q2 2017 Cash Flow statement
• Raised €16.4m net proceeds in follow-on financing in Q1/2017 and from second loan tranche of €2.5m in Q2/2017
• Runway at least until YE/2018
In thousands of € H1 2017
Cash and Cash equivalents at the beginning of the period 35,407
FX related changes to Cash and Cash equivalents (947)
Net cash used in operating activities (13,083)
Cash Flow from investing activities 4,200
Cash Flow from financing activities 18,909
Cash and Cash equivalents at the end of the period 44,486
* short-term deposits
Cash and cash equivalents and financial assets*end of period
48,867
Path forward: Maximize value from pipeline and technologies
Expand NK cell engagement leadership
• Develop AFM13 (CD30/CD16A) in combination with Keytruda® and as monotherapy in r/r HL and in CD30+ lymphoma
• Advance AFM24 (EGFRwt/CD16A) in solid tumors (incl. lung, head and neck, and colon cancer) and AFM26 (BCMA/CD16A) in multiple myeloma
• Combine NK cell engagers with adoptive NK cell therapy (MDACC) or cytokines (e.g. IL-15)
Focus on DLBCL, MCL and ALL in T cell engagement
• Generate PoC for T cell engagers with AFM11 (CD19/CD3)
• Additional PoC through AMV564 (CD33/CD3) in AML
Expand platforms (multiple formats, targeting MHC-peptide complexes)
Use pipeline and technologies to create value through both next-generation products and partnership opportunities
23