EX-99.1 2 d214596dex991.htm EX-99.1 EX-99.1

Exhibit 99.1 SITC 2021 Results: Management Update GLOBAL WEBCAST Date & Time: 8.00 am AEDT (Sydney) Wednesday 17 November 2021 4.00 pm EST (New York) Tuesday 16 November 2021 10.00 pm CET (Berlin) Tuesday 16 November 2021 Register: https://fnn.webex.com/fnn/onstage/g.php?MTID=ef12af93633b5d17a2e4e176fcac2f070 A replay of the webcast will also be available at www.immutep.com (ASX: IMM, NASDAQ: IMMP)


Notice: Forward Looking Statements The purpose of the presentation is to provide an update of the business of Immutep Limited ACN 009 237 889 (ASX:IMM; NASDAQ:IMMP). These slides have been prepared as a presentation aid only and the information they contain may require further explanation and/or clarification. Accordingly, these slides and the information they contain should be read in conjunction with past and future announcements made by Immutep and should not be relied upon as an independent source of information. Please refer to the Company's website and/or the Company’s filings to the ASX and SEC for further information. The views expressed in this presentation contain information derived from publicly available sources that have not been independently verified. No representation or warranty is made as to the accuracy, completeness or reliability of the information. Any forward looking statements in this presentation have been prepared on the basis of a number of assumptions which may prove incorrect and the current intentions, plans, expectations and beliefs about future events are subject to risks, uncertainties and other factors, many of which are outside Immutep’s control. Important factors that could cause actual results to differ materially from assumptions or expectations expressed or implied in this presentation include known and unknown risks. Because actual results could differ materially to assumptions made and Immutep’s current intentions, plans, expectations and beliefs about the future, you are urged to view all forward looking statements contained in this presentation with caution. This presentation should not be relied on as a recommendation or forecast by Immutep. Nothing in this presentation should be construed as either an offer to sell or a solicitation of an offer to buy or sell shares in any jurisdiction. This presentation is authorised for release by the CEO of Immutep Limited. 2


Overview Immutep Collaborating with industry is an innovative biotechnology leaders company developing novel immunotherapies for cancer and autoimmune disease Globally active Leadership position in LAG-3 with 4 product candidates in immuno-oncology and autoimmune disease Clinical Potential LAG-3 Pioneer Immutep’s product candidates have French immunologist demonstrated clinical potential in a Prof. Frédéric Triebel, Immutep range of indications with high unmet CMO & CSO need 3


LAG-3 Overview & Product Candidates 4


LAG-3 Therapeutic Landscape Overview Company Program Preclinical Phase I Phase II Phase III Total Trials Patients Eftilagimod 10 4 14 967 (5) Alpha (6) 7 32 2 BMS Relatlimab 41 9,775 Merck & Co. Inc. Favezelimab 1 5 6 1066 PDUFA goal date March 19, 2022 Ieramilimab 1 4 5 952 Macrogenics Tebotelimab 3 3 6 1422 1 2 H-L Roche RO7247669 3 538 4 1 B.I. BI754111 5 649 (1) Regeneron Fianlimab 1 1 2 836 Innovent IBI110 1 1 2 328 (3) Tesaro TSR-033 1 1 2 139 1 Incyte INCAGN02385 1 2 74 (2) 3 Symphogen SYM022 3 169 F-star FS-118 2 2 102 1 Xencor XmAb-22841 1 242 IMP761 -- -- (4) GSK2831781 2 3 207 1 (IMP731) Sources: GlobalData, Company websites, clinicaltrials.gov, and sec.gov, as of 25th October 2021. The green bars above represent programs conducted by Immutep &/or its partners. Total trials includes all active, completed &/or inactive trials. Patient totals are based on estimated total enrolled &/or to be enrolled. Not a complete list of currently existing LAG-3 products. 1) As of January 7, 2019 Regeneron is in full control of program and continuing development 4) Includes two completed Phase I studies and one discontinued Phase 2 study (https://www.sec.gov/Archives/edgar/data/872589/000110465919000977/a19-1325_18k.htm) 5) Including IITs, one planned trials (MBC trial by EOC) 2) On 3 Apr. 2020 Les Laboratoires Servier acquired Symphogen 6) RELATIVITY-047 (https://investors.bms.com/iframes/press-releases/press-release-details/2021/Bristol-Myers-Squibb-Announces-RELATIVITY- 5 047-a-Trial-Evaluating-Anti-LAG-3-Antibody-Relatlimab-and-Opdivo-nivolumab-in-Patients-with-Previously-Untreated-Metastatic-or-Unresectable- 3) Tesaro was acquired by and is now part of GSK (www.gsk.com/en-gb/media/press-releases/gsk-completes-acquisition-of- Melanoma-Meets-Primary-Endpoint-of-Progression-Free-Survival/default.aspx) tesaro-an-oncology-focused-biopharmaceutical-company/ ) Autoimmune Oncology Depleting Agonist Antagonist Agonist AB


Eftilagimod Alpha Bringing APC Activation into Oncology Eftilagimod alpha ~ Efti ~ IMP321 6


Efti: an Innovative LAG-3 I-O Product Candidate • Efti is a soluble LAG-3 protein targeting a subset of MHC class II on APC • Potentially synergistic with other therapeutic agents, e.g. Immuno-Oncology (I-O) agents or chemotherapies “PUSHING THE ACCELERATOR ON IMMUNE RESPONSES” “RELEASING THE BRAKE ON THE T CELL” Efti is an MHC II agonist: LAG-3 antagonist, or blocking, antibodies: APC activator Immune checkpoint inhibitor + • boost and sustain the CD8 T cell responses • increase cytotoxicity of the pre-existing CD8 • activate multiple immune cell subsets T cell response Notes: 7 * APC: antigen presenting cell


Clinical Development Efti: Main Trials* Commercial (5) Program Preclinical Phase I Phase II Late Stage Rights (1) Metastatic Breast Cancer (Chemo – IO) AIPAC-003 Metastatic Breast Cancer (Chemo – IO) AIPAC (2) Head and Neck Squamous Cell Carcinoma (IO – IO) TACTI-003 (2) Head and Neck Squamous Cell Carcinoma (IO – IO) TACTI-002 (2) Non-Small-Cell Lung Carcinoma (IO – IO) Eftilagimod Alpha TACTI-002 (Efti or IMP321) Global Rights (3) Solid Tumors (IO – IO – Chemo) APC activating INSIGHT-003 § soluble LAG-3 (3), (4a) Solid Tumors (IO – IO) Protein INSIGHT-004 (1), (3), (4b) Solid Tumors (IO – IO) INSIGHT-005 (2) Melanoma (IO – IO) TACTI-mel (5a) Solid Tumors (Cancer Vaccine) YNP01 / YCP02 / CRESCENT 1 Chinese Rights (5b) Metastatic Breast Cancer (Chemo – IO) § Notes: * Information in pipeline chart current as at November 2021. AIPAC-003 and INSIGHT-005 trial initiation are subject to further approvals. (4) a) In combination with BAVENCIO® (avelumab); b) in combination with Bintrafusp alfa (1) Planned trial (5) a) Conducted by CYTLIMIC in Japan; b) Conducted by EOC in China. Immutep has no control over either of these trials. 8 (2) In combination with KEYTRUDA® (pembrolizumab) (6) Late stage refers to Phase IIb clinical trials or more clinically advanced clinical trials (3) INSIGHT Investigator Initiated Trial (“IIT”) is controlled by lead investigator and therefore Immutep has no control over this clinical trial Oncology


Clinical Development Operational Update TACTI-002 ✓ Recruitment into Part A (1st line NSCLC) is expected to be completed ahead of time, due to great interest from sites. ✓ 70+ of 74 patients for part A extension already enrolled. TACTI-003 ✓ Full CTA approvals received in 5 of 8 countries → no roadblocks or any major comments received from authorities. ✓ Recruitment initiated, first patients randomized. INSIGHT ✓ INSIGHT-003 (efti+SoC (e.g. doublet chemo + PD-1) in e.g. 1st line NSCLC) has enrolled already 5 patients. ✓ Preparation for INSIGHT-005 collaboration with Merck KGaA are ongoing, but under review due to bintrafusp alfa performance. AIPAC-003 ✓ Positive feedback from EMA received. ✓ FDA discussion ongoing as planned. 9


Efti + Chemo Combination AIPAC trial Final OS results presented at SITC, 10-14 November 2021 10


Goal: Improving OS while maintaining QoL in + – HR /HER2 MBC patients Epidemiology: • Breast cancer (BC) is the most frequently diagnosed cancer. More than 2 million breast cancer (thereof ~70% + -- HR /HER2 ) diagnoses per annum worldwide. • Up to 550,000 patients in total and app. 350,000 patients younger than 65 develop metastatic disease and are (1) (2) eligible to receive chemotherapy ~10% ~35% Lack of Innovation Weekly paclitaxel well ~55% established SOC Notes (1) Source: WHO Global Cancer Observatory 2020 and Informa Intelligence October 2020 11 (2) Wang et al. BMC Cancer (2019) 19:1091 MBC – metastatic breast cancer; BC – Breast Cancer


Efti: AIPAC (Phase IIb) design – + AIPAC: Active Immunotherapy PAClitaxel in HER2 / HR metastatic breast cancer (MBC) Fact sheet Hypothesis-Generating Study ( )✓ Conducted in 7 EU countries Primary endpoint * (presented Mar. 2020) included: ✓ Local and blinded independent central read • Assessment of Progression-Free Survival (PFS) ( ) ✓ Last Patient In enrolled Jun. 2019 Secondary endpoints * (presented Dec. 2020) included: • Overall Survival (OS) ✓ Primary analysis PFS (immature OS) Mar. 2020 • Safety and tolerability ✓ Follow-up 1 analysis OS Sep. 2020 (SABCS • Overall Response Rate (ORR) and other efficacy parameters Dec. 2020) – ~60% OS events • Biomarker and Immune Monitoring ✓ Final OS analysis at SITC 2021 Notes: * No hypothesis testing 12 ORR – overall response rate, DCR – disease control rate, PFS – progression free survival, OS – overall survival, QoL – Quality of life


AIPAC Phase IIb Clinical Results Baseline Characteristics ➢ Well balanced treatment groups. ➢ Difficult to treat patient population: ▪ Very late stage disease: 92% with visceral disease and 69% with elevated LDH ▪ Heavily pre-treated subjects: 84% endocrine resistant; 44% received prior CDK 4/6; median of 2 prior systemic anticancer regimens. + – ▪ HR /HER2 tumor is traditionally not considered immunogenic. ➢ 227 patients were randomized to efti (N=114) or to placebo (N=113) between January 2017- July 2019. All except one patient received at least 1 dose of study medication and were included in the full analysis and safety populations. Notes: ¶ Central assessment performed on available and evaluable primary or metastatic tissues (n=169). Classified using PgR and Ki67 index 1 according to St Gallen International Expert Consensus guidelines . 13 Δ 2 Defined according to ESMO Internal Consensus Guidelines (Advanced Breast Cancer 4) . 1. Goldhirsch A, Winer EP, Coates AS, et al. 2013;24(9):2206–2223. doi:10.1093/annonc/mdt303


AIPAC Phase IIb Clinical Results Outstanding Safety Profile Most common (≥15%) TEAEs in any arm • No fatal TEAE related to efti Summary of treatment-emergent Efti + Paclitaxel Placebo + Paclitaxel ¶ adverse events (TEAEs) N=114, n (%) N=112, n (%) • 3 pts discontinued due to hypersenstivity reactions ≥1 TEAE 113 (99.1) 112 (100) developing after efti injections and 4 pts due to paclitaxel-induced hypersensitivity, respectively ≥1 TEAE leading to death 2 (1.8) 3 (2.7) ≥1 TEAE leading to efti/placebo • Most common efti related adverse event was any kind 6 (5.3) 7 (6.3) discontinuation of local injection site reaction up to grade 3 reported in 75 (65.8%) pts in the efti arm ≥1 Grade ≥3 TEAE 78 (68.4) 73 (65.2) Notes: 14 ORR – overall response rate, DCR – disease control rate, PFS – progression free survival, OS – overall survival, QoL – Quality of life


Overall Unselected Population* Improving OS with better QoL Global Health Status / QoL QLQC30-B23 * • Increase in OS: +2.9 months from median of 17.5 (95% CI: 12.9- • Preserving QoL in the efti arm, while significant deterioration 21.9) in placebo to 20.4 (95% CI: 14.3 -25.1) in the efti group. of QoL (QLQ-C30-B23) observed in the placebo group at 6 months. • Post-study treatment similar: 86 % (efti) vs. 90 %(placebo); majority received chemotherapy 70.2% (efti) vs. 76.8% (placebo) • Note: Paclitaxel treatment intensity was similar between groups Notes: * These results were presented at SITC 2021. Database cut-off date was May 14, 2021 (73% of events) with minimum follow up of 22 months 15


AIPAC Phase IIb Clinical Results Immune Monitoring on Fresh Blood (up to 70 patients) Significant Increase of CD8+ T Cell Count Significant Correlation: + Minimal Residual Effect: samples taken just before next treatment OS and cytotoxic CD8 T cell count Placebo Rho= -0.2; p= 0.5 30 mg efti Rho= 0.6; p= 0.007 1000 500 300 100 10 20 30 40 50 Overall survival (months) Proof of Concept Proof of Principle Increased number of cytotoxic CD8+ T cells Number of T cells increased in efti group, correlated with improved OS in the efti arm especially cytotoxic CD8+ T cells Notes: * These results were presented at SITC 2021. Database cut-off date was May 14, 2021 16 CD8 T cell count at 6 months 6 (10 /L of blood)


Prespecified Subgroups* Exploratory Analysis Exploratory multivariate analyses → Prior CDK 4/6 treatment is an independent poor prognostic factor with a 37% increase in risk for death. • Prior CDK 4/6 has a negative impact on OS in placebo group (median reduced from 20.4 to 14.9 months), but not in the efti group (median OS 21.9 vs. 20.2 months). • CDK4/6 treatment are now standard, and most patients will have received it → favorable for efti. • Prespecified (prior to unblinding) exploratory univariate analysis showed that younger patients (<65 years), those with low baseline monocytes (<0.25/nL) or breast cancer subtype luminal B had significant and clinical meaningful improvement in median OS compared to placebo. • In a post-hoc multivariate analysis “no prior taxanes” were found to be an additional predictive marker Notes: * These results were presented at SITC 2021. Database cut-off date was May 14, 2021 (73% of events) with minimum follow up of 22 months 17


Prespecified Subgroup <65 years* Clinically meaningful improvement for OS, PFS and ORR mOS mPFS ORR +7.5 months median OS (HR 0.66; p=0.017) Benefit +7.5 months +2.0 months +8% HR 0.66 (p=0.02) HR 0.77 (p=0.07) (46% vs. 38%) Effect of age on OS • Prespecified subgroup showed significant (p=0.017, one-sided) • HR point estimates for different age groups. improvement in OS with a HR of 0.66 (95% CI: 0.45-0.97). • ESMO scale of magnitude** = level 4/5 (would be very • Age had an almost linear effect on HR for OS. supportive for reimbursement). Notes: * These results were presented at SITC 2021. Database cut-off date was May 14, 2021 18 ** Company assessment. ESMO-MCBS used for reimbursement in Europe: https://www.esmo.org/guidelines/esmo-mcbs/scale-evaluation-forms-v1.0-v1.1


Prespecified Subgroup Low Monocytes* Clinically meaningful improvement for all efficacy parameters +19.6 months median OS (HR 0.44; p=0.008) Efti + Paclitaxel Placebo + Paclitaxel Benefit +19.6 months mOS 32.5 months 12.9 months HR 0.44 (p=0.008) +2.3 months mPFS 7.5 months 5.2 months HR 0.40 (p=0.006) ORR 44% 32% +12% • Clinically meaningful, absolute and relative improvement for all efficacy parameters. • Statistical significance for PFS and OS. • ESMO scale of magnitude** = level 4/5 (would be very supportive for reimbursement). Notes: * Database cut-off date was May 14, 2021 19 ** Company assessment. ESMO-MCBS used for reimbursement in Europe: https://www.esmo.org/guidelines/esmo-mcbs/scale-evaluation-forms-v1.0-v1.1


Prespecified Subgroup Luminal B* Overall Survival +4.2 months median OS (HR 0.67, p=0.049) Efti + Paclitaxel Placebo + Paclitaxel Benefit +4.2 months mOS 16.8 months 12.6 months HR 0.67 (p=0.049) +1.6 months mPFS 7.2 months 5.6 months HR 0.69 (p=0.158) ORR 43% 33% +10% • Clinically meaningful improvement. • Statistical significance for OS. • ESMO scale of magnitude** = = level 3/5 (would be supportive for reimbursement). Notes: * Database cut-off date was May 14, 2021 20 ** Company assessment. ESMO-MCBS used for reimbursement in Europe: https://www.esmo.org/guidelines/esmo-mcbs/scale-evaluation-forms-v1.0-v1.1


Prespecified Subgroup No Prior Taxane* Overall Survival +4.8 months median OS (HR 0.74, p=0.076) Efti + Paclitaxel Placebo + Paclitaxel Benefit +4.8 months mOS 22.3 months 17.5 months HR 0.74 (p=0.08) +0.2 months mPFS 7.4 months 7.2 months HR 0.87 (p=0.229) • Clinically meaningful improvement. • Important in multivariate predictive model • ESMO scale of magnitude** = = level 3/5 (would be supportive for reimbursement). Notes: * Database cut-off date was May 14, 2021 21


AIPAC-003: Phase III in MBC General Concept (subject to further regulatory interactions) 1) Primary Endpoint: Overall Survival • Preferred endpoint for Phase III and approval by regulatory agencies in such a patient population. • Seems to be a better fit for active immunotherapies such as efti. 2) Treatment • Paclitaxel will be allowed to be continued beyond 6 cycles to accommodate for EU & US standards and as a lesson from AIPAC. 3) Patient Population on Target • Immutep will define the patient population and statistical read-out in a way to increase likelihood of success. 4) Statistical Design • Will be robust and pre-agreed with regulatory agencies to ensure success later during MAA/BLA procedures. 22


Efti + anti-PD-1 Combination TACTI-002 trial Update from SITC, 10-14 November 2021 23


TACTI-002 (Phase II) Design & Status TACTI-002: Two ACTive Immunotherapeutics in NSCLC and HNSCC UNSELECTED FOR PD-L1 In collaboration with PART A: S ST 1 LINE MET. NSCLC C R PART B: COMBINED E ORR, PFS, OS, PK, ND IMMUNOTHERAPY 2 LINE MET. NSCLC, E biomarker, safety and PEMBROLIZUMAB + EFTI FOR 12 REFRACTORY TO PD-1/PD-L1 MONTHS + 12 MONTHS tolerability N PEMBROLIZUMAB MONO TARGETING THERAPY I N PART C: G ND 2 LINE MET. HNSCC AFTER Recruitment Status Report Sites in Europe / US / Australia PLATINUM THERAPY ✓ Fully approved in all countries ✓ Up to 183 patients in three indications 30 mg efti (IMP321) s.c. • Part A (N=36) completed; Treatment 200 mg pembrolizumab â extension cohort (N=74 recruiting) (Keytruda ) i.v. ✓ Part C (N=39) completed ✓ Part B (N=36); completed Notes: 24 ORR – overall response rate, DCR – disease control rate, PFS – progression free survival, OS – overall survival, QoL – Quality of life


(1) TACTI-002 Results nd 2 line HNSCC (Part C) • ORR (iRECIST) in ITT of 29.7% and 35.5% evaluable pts • Responses are deep with 5 (13.5%) CRs and long lasting • ORR of 64.3% (40.7) in pts with CPS ≥ 20 (≥1) • OS rates at 12 months for all PD-L1 groups in the range of 50% or above … patients still under therapy Notes: (1) Database cut-off date was August 4, 2021 (efficacy) Graphs represent all patients with at least one post baseline assessment. One patient has no official RECIST assessment as this was done < 6 weeks 25 and this does not qualify according to RECIST. Per local investigator assessment. iRECIST… Immune Response Evaluation Criteria In Solid Tumors


(1) TACTI-002 Results nd 2 line HNSCC (Part C), DoR and Benchmarking Duration of Response (DoR) Benchmarking against Pembro for confirmed responders (N=10) • ORR clearly higher (≥ factor 2) in all PD-L1 subgroups and overall • PFS and OS rates at 6 and12 months respectively are higher in all PD-L1 subgroups and overall with efti combination PD-L1 (CPS) Pembro alone** TACTI-002 ≥ 20 21.9% 64.3%* • Median duration of response ORR ≥ 1 17.3% (2% CR) 40.7%* (20.8% CR*) not yet reached (%) # Overall pop. 14.6% 35.5% • all ongoing responses lasting Not reached with mDoR 9+ months Overall pop. 18.4 min. 9+ months at (mths) cut-off Notes: (1) Database cut-off date was August 4, 2021 (efficacy) 26 * - only patients evaluated where PD-L1 results available (N=14 for CPS ≥ 20) (N=27 for CPS ≥ 20); # - ITT(N=37); ** Data for pembro derived from KN040 (EEW Cohen et al., The Lancet 2018)


st 1 line HNSCC Treatment options and positioning for efti + pembro (1) (1) Median DoR from KN-048 , Median OS from KN-048 , unselected for PD-L1 unselected for PD-L1 Chemo + 10.7-11.0 months 4.3 Cetuximab 11.6 months Pembrolizumab 22.6 to 14.9 for CPS ≥ 20 Chemo + 13.0 months 6.7 Pembrolizumab to 14.7 for CPS ≥ 20 ➢ OS slightly improved by ~2 months with ➢ ORR increased with chemo plus pembro (1) chemo + pembro, but pembro alone non- (36% vs. 17% pembro alone) inferior to chemo ➢ DoR drops dramatically if you add chemo ➢ Substantially more toxicities in the chemo + → not the case with efti pembro setting compared to pembro alone → Buy ORR by much shorter DoR→ less → Buy moderate OS benefit with a lot add. benefit for pts on the long run and may explain toxicity moderate OS improvement Combination of efti + pembro May lead to higher ORR with same DoR and excellent safety profile Notes: (1) B Burtness et al.: Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell 27 carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. The Lancet 2019, https://doi.org/10.1016/S0140- 6736(19)32591-7


st TACTI-003 Trial in 1 line HNSCC Current Design + Status In collaboration with Design: • Randomised study with ORR as primary endpoint • Sites worldwide (AU, US, Europe) • Approx. 154 pts: either to be randomized to have sufficient pts in each group or in an experimental arm Status: ▪ Ongoing, recruiting. ▪ Fast Track designation granted by FDA in April 2021 28


Summary and Outlook 29


Near-Term Milestones Advancing Registration Relevant Trials Remainder of 2021 and 2022 2021 till today ✓ Final Results from randomized, placebo controlled Registration relevant trials MBC trial (AIPAC) Phase III preparations in MBC (AIPAC-003) ✓ Fast Track designation in 1st line HNSCC from US st 1 line HNSCC: Recruitment and updates from FDA randomized trial (TACTI-003) ✓ TACTI-002 – recruitment & data delivered e.g. at st 1 line NSCLC: Completion of recruitment & first data ASCO & SITC for from the extension cohort (TACTI-002) nd ✓2 line NSCLC Ongoing regulatory (EMA/FDA) engagement nd ✓2 line HNSCC INSIGHT-003: Data from Efti + a-PD-1 + Chemo st ✓ TACTI-003 – Start randomized trial in 1 line HNSCC combination ✓ Final results of INSIGHT-004 Extension of IP portfolio ✓ Progress from IMP761 Potential new studies (financed) ✓ Expansion of IP portfolio Updates from IMP761 ✓ Strong financial position Updates from partnered programs (e.g. GSK, Novartis, CYTLIMIC and EOC Pharma) ✓ Validation of LAG-3/MHC-II interaction by RELATIVITY-047 results Notes: N.B. The actual timing of future data readouts may differ from expected timing shown above. These dates are provided on a calendar year basis. 30 A tick denotes that the item has been completed.


Summary Global leadership position in Multiple active clinical trials LAG-3 with 4 LAG-3 related (including partnered product candidates in candidates), with further immuno-oncology and significant data read-outs in autoimmune disease 2022 Compelling clinical data from Established collaborations efti & strong rationale to with e.g. Merck (MSD), Pfizer, combine with multiple FDA Merck KGaA, Novartis and approved treatments GSK 31


Thank you!