EX-99.1 2 d372609dex991.htm EX-99.1 EX-99.1

Exhibit 99.1 Rain Therapeutics M a n a g e m e n t P r e s e n t a t i o n N o v. 2022


R A I N T H E R A P E U T I C S Forward Looking Statements This presentation contains “forward-looking statements” within the meaning of the federal securities laws, which statements are subject to substantial risks and uncertainties and are based on estimates and assumptions. Other than statements of historical facts, all statements included in this presentation are forward-looking statements, including statements concerning the ability of our clinical trials to demonstrate safety and efficacy of our product candidates and other positive results, the timing and focus of our ongoing and future preclinical studies and clinical trials and the reporting of data from those studies and trials, our plans relating to commercializing our product candidates, if approved, including the geographic areas of focus and sales strategy, the size of the market opportunity for our product candidates, including our estimates of the number of patients who suffer from the diseases we are targeting, our expectations regarding the approval and use of our product candidates as first, second or subsequent lines of therapy or in combination with other drugs, the success of competing therapies that are or may become available, our estimates of the number of patients that we will enroll in our clinical trials, the beneficial characteristics, safety, efficacy and therapeutic effects of our product candidates, the timing or likelihood of regulatory filings and approvals, including our expectation to seek an accelerated approval pathway and special designations, such as orphan drug designation, for our product candidates for various diseases, our ability to obtain and maintain regulatory approval of our product candidates, and our plans relating to the further development of our product candidates, including collaborations with research partners and additional indications we may pursue. In some cases, you can identify forward-looking statements by terms such as “may,” “might,” “will,” “objective,” “intend,” “should,” “could,” “can,” “would,” “expect,” “believe,” “design,” “estimate,” “predict,” “potential,” “plan” or the negative of these terms, and similar expressions intended to identify forward-looking statements. These statements involve known and unknown risks, uncertainties and other factors that could cause our actual results to differ materially from the forward-looking statements expressed or implied in this presentation including our limited operating history, the significant losses that we have incurred since inception, the substantial additional capital that we will require to finance our operations in the future, our ability to identify and acquire or in-license products, our dependence on our lead candidates, our ability to enroll patients in our clinical trials, the fact that interim results of our clinical trials may not be indicative of future results and those risks described in “Risk Factors” and “Management's Discussion and Analysis of Financial Condition and Results of Operations” in our Annual Report on Form 10-K for the year ended December 31, 2021 and subsequent filings with the Securities and Exchange Commission. We cannot assure you that we will realize the results, benefits or developments that we expect or anticipate or, even if substantially realized, that they will result in the consequences or affect us or our business in the way expected. Forward-looking statements are not historical facts, and reflect our current views with respect to future events. Given the significant uncertainties, you should evaluate all forward-looking statements made in this presentation in the context of these risks and uncertainties and not place undue reliance on these forward-looking statements as predictions of future events. All forward-looking statements in this presentation apply only as of the date made and are expressly qualified in their entirety by the cautionary statements included in this presentation. We disclaim any intent to publicly update or revise any forward- looking statements to reflect subsequent events or circumstances, except as required by law. We obtained the industry, market and competitive position data used throughout this presentation from our own internal estimates and research, as well as from industry and general publications, and research, surveys and studies conducted by third parties. Internal estimates are derived from publicly available information released by industry analysts and third-party sources, our internal research and our industry experience, and are based on assumptions made by us based on such data and our knowledge of the industry and market, which we believe to be reasonable. In addition, while we believe the industry, market and competitive position data included in this presentation are reliable and based on reasonable assumptions, we have not independently verified any third-party information, and all such data involve risks and uncertainties and are subject to change based on various factors. These and other factors could cause results to differ materially from those expressed in the estimates made by the independent parties and by us. This presentation contains information on commercial products as well as discussions of investigational products that are under preclinical or clinical investigation and which have not yet been approved for marketing by the U.S. Food and Drug Administration (FDA). Investigational products are currently limited by Federal law to investigational use, and no representations are made as to their safety or effectiveness for the purposes for which they are being investigated. C O R P O R A T E P R E S E N T A T I O N 2


R A I N T H E R A P E U T I C S Rain Therapeutics Overview Milademetan (RAIN-32), an oral MDM2 inhibitor, represents a “pipeline in a program” opportunity CASH PRECISION ONCOLOGY PRECISION ONCOLOGY RUNWAY STRATEGY STRATEGY Precision oncology, small molecule ON-GOING PLANNED 3Q 2022 ending cash of ~$91 mm strategy MANTRA Phase 3 MANTRA-4 Phase 1/2 Phase 3 MANTRA topline data anticipated Evaluates To evaluate Pipeline programs unified in targeting milademetan in milademetan combo* in 1Q 2023, ahead of anticipated end of patients with DD in patients with genetically-defined patient cash runway in 2H 2024 LPS CDKN2A loss tumors; populations anticipated start in 1Q 2023 MANTRA-2 Phase 2 Evaluates milademetan in patients with MDM2- amplified solid tumors *Milademetan + Roche’s atezolizumab. C O R P O R A T E P R E S E N T A T I O N 3


R A I N T H E R A P E U T I C S Rain’s Corporate Leadership Avanish Vellanki, MBS, MBA Robert Doebele, MD, PhD Richard Bryce, MBChB Nelson Cabatuan, CPA Cofounder, Chairman and Cofounder, President & Executive VP & Senior VP, Chief Executive Officer Chief Scientific Officer Chief Medical Officer Finance & Administration Vijaya Tirunagaru, PhD Mehdi Paborji, PhD Lucio Tozzi Nora Ku, MD Senior VP, Senior VP, Head of Senior VP, Vice President, Clinical Head of Research Technical Operations Head of Clinical Development Operations Tina Kim-Hafken Jamie S. Blose, PharmD, Flor Nicolas, MPH Elaine MacNeilly Vice President, Head of MBA, JD Vice President, Head Executive Director, Patient Global Regulatory Affairs Senior VP, of Drug Safety Advocacy and Engagement Head of Legal Affairs C O R P O R A T E P R E S E N T A T I O N 4


R A I N T H E R A P E U T I C S Milademetan Value Proposition Key RAIN Perspectives on a clinical stage, oral, small molecule inhibitor of the MDM2-p53 complex Dosing Schedule Supports Efficacy Targeted Clinical Strategy to Maximize Opportunities • Identified intermittent • Targeting large schedule QD (3/14) to patient markets address on-target exhibiting both cytopenic toxicities of MDM2-dependence the class AND WT p53 tumors C O R P O R A T E P R E S E N T A T I O N 5


R A I N T H E R A P E U T I C S Milademetan Strategy: Identifying MDM2 Dependence The market opportunity in p53 WT cancers is large, with the initial strategy for milademetan focused on cancers exhibiting MDM2-dependence p53 WT Cancer Market Opportunity Clinical Indications MDM2-Dependent Cancers p53 WT Annual Advanced Cancer Population (US): Cancer Mechanism of MDM2 dependency 1 ~460,000 WD / DD Liposarcoma MDM2 Amp Potential 15% MDM2 Dependent, MDM2-amp (CN≥8) MDM2 Amp 2 p53 WT Intimal Sarcoma MDM2 Amp Merkel cell carcinoma MDM2 overexpression mGATA3 ER+ breast MDM2 overexpression 85% ARF Other p53 WT CDKN2A-del cancers p14 loss 1 Globocan 2020 Report, Rain estimates based on adv cancer annual treatable patients 2 Based on Rain estimates of Well-differentiated (WD)/Dedifferentiated (DD) LPS, MDM2-amp solid tumors, intimal sarcoma, Merkel cell carcinoma, mGATA3 ER+ BC and CDKN2A-del cancers C O R P O R A T E P R E S E N T A T I O N 6


R A I N T H E R A P E U T I C S MDM2-p53 Axis & Milademetan MoA Wildtype p53 responds to normal cellular injury to protect against cancer via induction of cellular apoptosis or senescence • Mutated p53 incapable of target gene binding and function Dysregulated MDM2 can facilitate or support oncogenicity • MDM2 gene amp • MDM2 over-expression • MDM2 regulator loss (p14ARF) As an inhibitor of MDM2 and by impeding MDM2-p53 interaction, milademetan restores / reactivates wildtype p53 Source: Rain Therapeutics C O R P O R A T E P R E S E N T A T I O N 7


R A I N T H E R A P E U T I C S Rain Therapeutics Pipeline Rain’s pipeline encompasses a late clinical stage program in MDM2-dependent cancers, and an early research program for a novel target in DNA repair Milademetan (RAIN-32) 2022 ELIGIBLE INDICATION MANTRA PRECLINICAL PHASE 1 PHASE 2 PHASE 3 PARTNER PLANNED DATA ANNUAL US POP Enrollment Completed Mila monotherapy WD/DD Liposarcoma -- - 1Q 2023 ~1,400 Enrolling Mila monotherapy - 4Q 2022 (interim) ~8,000 MDM2-amp Basket 2 CDKN2A loss, p53 WT ~45,000 4 Mila + atezolizumab Planned: 1Q 2023 Adv Solid Tumors Rain anticipated clinical studies RAD52 Research Program 2022 ELIGIBLE INDICATION PRECLINICAL PHASE 1 PHASE 2 PHASE 3 PARTNER PLANNED DATA ANNUAL US POP HRD+ Tumors - - C O R P O R A T E P R E S E N T A T I O N 8


R A I N T H E R A P E U T I C S Summary: Ongoing Clinical Trials for Milademetan T R I A L S C H E M A S E N D P O I N T S & P O P U L A T I O N • Primary / Secondary Endpoints: PFS, OS, DCR, ORR, DoR Milademetan • Unresectable / metastatic DD LPS ± WD component 260 mg, qd, 3/14 • Progression following at least 1 prior chemotherapy WD/DD 1:1 Randomize 1 N ≈ 175 Liposarcoma including anthracycline therapy Trabectedin 1.5 mg/m2, • Disease progression within 6 months of screening IV over 24h, q3w • PFS analysis at 105 events • Primary / Secondary Endpoints: ORR, DoR, PFS, GMI, BASKET: Pan Solid Milademetan 2 N ≈ 65 Tumors DCR, OS 3 260 mg, qd, 3/14 MDM2 CN ≥8 & p53 WT • Relapsed / refractory, advanced or metastatic solid tumors • Failed SOC therapies • Primary / Secondary Endpoints: Safety and confirmation of Milademetan the RP2D in combination, ORR, DoR, DCR,PFS, GMI, PK BASKET: Pan Solid 260 mg, qd, 3/14 2 N ≈ 30 • Dose de-escalation safety confirmation Tumors + CDKN2A loss & p53 WT • Relapsed / refractory, advanced or metastatic solid tumors Atezolizumab • Progressed on or refractory to a prior ICI therapy 1 Randomized patients 2 Targeted enrollment 3 Planned protocol amendment from CN ≥12 to CN ≥8 C O R P O R A T E P R E S E N T A T I O N 9 MANTRA MANTRA-4 MANTRA-2 Phase 3 Phase 1/2 Phase 2 Enrollment Closed Enrollment Open


Milademetan ( L i p o s a r c o m a )


R A I N T H E R A P E U T I C S Liposarcoma Overview T O T A L A D D R E S S A B L E M A R K E T 2 1 Liposarcomas 20% of all sarcomas Liposarcoma US annual incidence ~3,500 WD/DD is 65% of LPS WD/DD LPS incidence p53 WT & MDM2 amplified in ~2,300 3-6 nearly 100% of WDLS/DDLS cases TAM in WD/DD LPS ~1,400 DDLS A P P R O V E D T H E R A P I E S I N L P S Efficacy in WDLS Drug Company Approved Mechanism WD/DD LPS (mPFS) 8 2015 DNA binding / alkylator 2.2 mo 9 2016 Microtubule targeting 2.0 mo 1 TM Mack. Cancer, 1995 Jan 1;75(1 Suppl):211-44. November 2, 2017 2 7 Bock et al., Int. J. Environ. Res. Public Health 2020, 17, 2710. Newly diagnosed adv DD LPS, unresectable early DD LPS, resectable 3 Pedeutour et al., Genes Chromosomes Cancer 24:30–41, 1999. disease progressing to adv DD LPS, and WD LPS progressing to DD LPS 4 8 Italiano et al., Int. J. Cancer: 122, 2233–2241 (2008). Demetri et al., J Clin Oncol 34:786-793, 2015 5 9 Kashima et al., Modern Pathology volume 25, pages 1384–1396(2012) Demetri et al., J Clin Oncol 35:3433-3439. 2017 11 6 The Cancer Genome Atlas Research Network, Cell 171, 950–965,


R A I N T H E R A P E U T I C S Milademetan Phase 1 (U101) Trial Select Treatment Emergent Adverse Events Schedule A, B, and C Cohorts (n=78) Schedule D All doses (n=29) Schedule D 260mg (n=20) Organ Class n (%) All Grades Grade ≥ 3 Dosing Schedule All Grades Grade ≥ 3 All Grades Grade ≥ 3 for 4 Cohorts All drug-related TEAEs 74 (95) 43 (55) 25 (86) 5 (17) 18 (90) 4 (20) Blood and lymphatic disorders Schedule A: QD 21/28 Thrombocytopenia 52 (67) 27 (35) 13 (45) 4 (14) 9 (45) 3 (15) Anemia 33 (42) 14 (18) 5 (17) 0 Schedule B: QD 28/28 4 (20) 0 Neutropenia 10 (13) 8 (10) 1 (3) 1 (3) 1 (5) 1 (5) Schedule C: QD 7/28 Gastrointestinal disorders Nausea 57 (73) 2 (3) 20 (69) 0 16 (80) 0 Schedule D: QD 3/14 Vomiting 22 (28) 2 (3) 13 (45) 1 (3) 10 (50) 1 (5) Diarrhea 26 (33) 0 9 (31) 0 5 (25) 0 General disorders Fatigue 36 (46) 3 (4) 12 (41) 0 8 (40) 0 Source: Gounder et al., 2020 EORTC-NCI-AACR (ENA) Conference 12


R A I N T H E R A P E U T I C S Milademetan Phase 1 (U101) Trial Observed Progression Free Survival in LPS Patients P R O G R E S S I O N - F R E E S U R V I V A L : L P S P AT I E N T S O N LY Phase 1 results revealed Schedule A/B Schedule C/D Schedule D, 260mg (n=30) (n=23) (n=16) PFS data for n=53 Median PFS, mo 6.3 7.4 7.4 patients with LPS (95% CI) (3.8, 10.0) (2.7, 14.6) (1.8, 14.6) Schedule A-B (qd 21/28 and 28/28) Schedule C-D (qd 7/28 and 3/14) Lowest mPFS (Schd A- Schedule D, 260mg (3/14) B) was 6.3 mo mPFS of Schd D at 260mg was 7.4mo Months Source: Gounder et al., 2020 EORTC-NCI-AACR (ENA) Conference 13 Survival Probability


Milademetan P h a s e 2 M A N T R A -2 ( M D M 2 A m p B a s k e t )


R A I N T H E R A P E U T I C S MANTRA-2 Study & Status MANTRA-2 trial is evaluating milademetan monotherapy in patients with MDM2 gene amplified and p53 wild type advanced solid tumors Overview Patient Demographics All Subjects N = 15* • Targeting n=65 pts Age, years • 10 active centers in US Median (min, max) 54.0 (33.0, 75.0) Sex, n (%) • Selecting patients with MDM2 gene copy Female 10 (67) Of 17 patients enrolled, 2 number (CN) of ≥ 8 Male 5 (33) 15 have received first Race, n (%) 1 • Patients enrolled based on local NGS for CN, dose of milademetan Asian 2 (13) centrally confirmed by Rain’s diagnostic partner, Other 2 (13) Tempus White 11 (73) Baseline ECOG, n (%) • Of 15 patients receiving at least one dose of 0 7 (47) 3 milademetan, 10 patients evaluable for efficacy 1 8 (53) Lines of prior therapy • Evaluable tumor types included: lung, breast, Median (min, max) 4.0 (1.0, 11.0) biliary, pancreatic and others 1 *2/17 patients pending data entry in EDC As of Oct 26, 20222 2 Planned amendment to protocol revising CN ≥ 12 to CN ≥ 8 3 Of patients unevaluable for efficacy, one (1) patient not yet received first scan, two (2) withdrew consent 15 for reasons unrelated to study drug and two (2) did not have central CN confirmation (CN <8) Note: Data shown reflects interim analysis, and is preliminary, subject to change


R A I N T H E R A P E U T I C S Interim MANTRA-2 Analysis: Patient Outcomes Two (2) Partial Responses and two (2) near-PRs observed of 10 evaluable patients Patient Tumor Diameter Change Adrenal ACC UPS Gastric Bladder Breast Biliary NSCLC Pancreatic CTNNB1 MYB-NFIB None CDH1 RB1 PIK3CA IDH2 EGFR del19 KRAS I35T loss loss E542K R172W KRAS G12D G12D 30% 25% 20% 9/10 efficacy evaluable 10% 5% patients had post-baseline 0% tumor assessment as of 0% the data cut-off date -4% -7% -10% -20% -27% -30% -29% 1 -30% 2 -34% -40% Note: Data cutoff as of 26 Oct 2022, and reflects interim analysis subject to change 1 Patient died post first scan due to COVID; response will not be confirmed 16 2 Response pending confirmation and treatment ongoing


R A I N T H E R A P E U T I C S Interim MANTRA-2 Analysis: Duration on Therapy Two (2) Partial Responses and two (2) near-PRs observed of 10 evaluable patients Patient Treatment Duration 3202-1010-003 Bilia 003 ry 3202-1010-0 UPS 004 04 1 009 3202-1003-009 ACC 005 3202-1006-005 Bladder 011 A total of eight (8) patients 3202-1006-011 Breast are actively enrolled in 3202-1006-013 013 Gastric 1 MANTRA-2 3202-1006-014 014 Pancreatic 3202-1006-010 010 Adrenal 2 007 3202-1010-007 NSCLC Liver 012 3202-1010-012 Sarcoma 0 8 16 24 32 40 Weeks PD Treatment Ongoing Consent Withdrawn PR Death Note: Data cutoff as of 26 Oct 2022, and reflects interim analysis subject to change 1 Includes five (5) efficacy evaluable patients, one (1) patient dosed but not at first scan, and two (2) patients recently enrolled as of the data cutoff 17 2 Patient died post first scan due to COVID; response will not be confirmed


R A I N T H E R A P E U T I C S TEAE by Preferred Term: Regardless of Attribution (Safety Population) Preliminary AE data in-line with prior Phase 1 study of milademetan Safety Population Safety Population N=15 N=15 Any Grade Grade 3 or higher Any Grade Grade 3 or higher Subjects with any hematologic Subjects with any non- Drug safety profile of 7 (46.7%) 3 (20.0%) 10 (66.7%) 5 (33.3%) hematologic AEs- n (%) adverse events - n (%) milademetan preliminarily consistent with prior Phase 1 trial Thrombocytopenia* 5 (33.4%) 3 (20%) Fatigue 7 (46.7%) 0 Diarrhea 5 (33.3%) 1 (6.7%) Anemia 1 (6.7%) 0 Vomiting 5 (33.3%) 0 Blood creatine increased 1 (6.7%) 0 Abdominal pain 4 (26.7%) 0 Leukocytosis 1 (6.7%) 0 + Nausea 3 (20.0%) 0 Leukopenia 1 (6.7%) 0 Non-Hematologic AEs are listed with 15% cutoff Neutropenia 1 (6.7%) 1 (6.7%) Includes all AEs in SOC of Blood and lymphatic system disorders and Investigations * Thrombocytopenia events also include platelet count decrease + Leukopenia events also include white blood cell count decrease; reported for the same patient 18 Note: Data cutoff as of 26 Oct 2022, and reflects interim analysis subject to change


Milademetan P h a s e 1 / 2 M A N T R A -4 ( C D K N 2 A L o s s / W T p 5 3 B a s k e t )


R A I N T H E R A P E U T I C S MANTRA-4: IO Combo in CDKN2A Loss, p53 WT Adv Solid Tumors 1 In the US, there are 45,000 patients annually with advanced cancers exhibiting p53 WT and CDKN2A loss 2 Mechanism: CDKN2A Loss Increases MDM2 Activity Milademetan Antiproliferative Potency 10,000 Exon 1ß CDKN2A gene CDKN2A gene TP53 low expression Milademetan Cmax: 1625 ng/ml (2.6 µM) ARF p14 / 1,000 Cancer mutation Normal Partial p53 ARF activity p14 p53 MDM2 100 MDM2 10 No CDKN2A loss* & CDKN2A loss* & 1 CDKN2A loss Mutant TP53 WT TP53 p53-induced cellular N=146 N=35 N=30 Proteosomal degradation apoptosis or senescence Source: Rain Therapeutics Error bars represent Median with 95% CI MDM2 CN >12 1 NCI SEER, Globocan, TCGA based on loss of 2 copies of CDKN2A * Homozygous CDKN2A loss 2 Ishizawa et al., Cancer Res. 2018 May 15;78(10):2721-2731; Mutation/CN: CCLE database C O R P O R A T E P R E S E N T A T I O N 20 IC50 (nM)


R A I N T H E R A P E U T I C S MANTRA-4: Milademetan + Atezolizumab (Phase 1/2) Key Objectives and Rain and Roche will evaluate the safety of MDM2 + PD-L1 inhibition in patients with CDKN2A Eligibility: loss, p53 wildtype adv solid tumors prior to commencing Phase 2 studies in MDM2- dependent populations Dose De-Escalation Cohort (Phase 1): • Inclusion criteria: patients with Phase 1 (n=3-18) Phase 2 (n=12-27) advanced solid tumors with CDKN2A Evaluate safety of milademetan and atezolizumab combination in a Evaluate efficacy, safety and tolerability in patients with loss and TP53wt, that have failed dose de-escalation design to determine RP2D in patients with CDKN2A loss, p53 WT advanced solid tumors prior IO therapy CDKN2A loss, p53 WT advanced solid tumors. • 3+3 dose de-escalation to establish tolerable combination dose for dose DOSE LEVEL DOSE LEVEL expansion cohort Milademetan: 260mg po od q3/14d Dose Expansion Cohort (Phase 2): Atezolizumab 1680mg iv q4w 0 • Efficacy signal seeking cohort and 0 (n=3-6) evaluation of safety and tolerability DLT Milademetan RP2D qd q3/14d Milademetan: 200mg po od q3/14d Phase 2 Opportunities: Atezolizumab 1680mg iv q4w Atezolizumab 1680mg iv q4w 1 (n=3-6) If safety is acceptable, the milademetan DLT / atezolizumab combination may be 1 evaluated in additional tumors including: Milademetan: 160mg po od q3/14d Atezolizumab 1680mg iv q4w DLT, dose-limiting toxicity; RP2D, recommended Phase 2 dose. • MDM2 gene-amplified cancers, 2 1 (n=3-6) Subject to subsequent discussions with Roche and outcome of the Phase 1 safety study. • Merkel cell carcinoma, and / or • CDKN2A loss cancers 21


R A I N T H E R A P E U T I C S Key Upcoming Milestones Rain anticipates multiple near-term developmental milestones for milademetan Milademetan (RAIN-32) MDM2 inhibitor INDICATION 4Q 2022 1Q 2023 2Q 2023 WD/DD MANTRA Phase 3: Topline Results LPS MDM2-amplified MANTRA-2 Phase 2 Basket: Interim data MANTRA-2 Phase 2: Interim Data Solid tumors (p53 wt) CDKN2A loss MANTRA-4 Phase 1/2: Trial Start MANTRA-4 Phase 2: Trial Start Solid tumors (p53 wt) Clinical Data Trial Starts C O R P O R A T E P R E S E N T A T I O N 22


Appendix


R A I N T H E R A P E U T I C S Rain’s Corporate Governance Board of Directors Scientific Advisory Board Avanish Vellanki, MBA Robert Doebele, MD, PhD Chairman & CEO, Rain Therapeutics President & CSO, Rain Therapeutics Aaron Davis, MBA Trever Bivona, MD, PhD CEO, Boxer Capital Professor in Residence, UCSF Gorjan Hrustanovic, PhD Lori Kunkel, MD Managing Director, BVF LP Former CMO, Loxo & Pharmacyclics Franklin Berger, CFA Chris Kirk, PhD FMB Research President & CSO, Kezar Stefani Wolff Simon Powell, MD, PhD COO & EVP of Product Development, Nurix Memorial Sloan Kettering Tran Nguyen, MBA Nick Saccomano CFO & COO, Prothena Former CSO, Array BioPharma Peter Radovich, MBA COO, Mirum 24