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Biovest International, Inc.
BiovaxID: Personalized Active Immunotherapy
for Follicular Lymphoma
June 2015
Opportunity Overview
2
Biovest International, Inc.
01 Biovest Overview
§  Biovest is seeking a strategic partner to take on further clinical and commercial development
of BiovaxID
§  Biovest currently holds 93.7% interest in worldwide rights to BiovaxID
§  Majority shareholders hold 6.3% royalty
§  Clinical program calls for $15-30m in further development between 2015-2020 in order to
unlock multiple $350m - $1bn+ indications including Low Tumor Bulk and Relapsed
Refractory Follicular Lymphoma
§  Support of leading investigators and research institutions including MD Anderson, Penn
Abramson, Moffitt and Leiden
§  Cost of manufacturing reduced from more $500k to less than $50k in last 18 months –
substantial additional reduction possible
Engaging the Immune System to Fundamentally Change Cancer
Treatment
3
Biovest International, Inc.
01 Biovest Overview
§  Founded on the premise that training the immune system to recognize tumor-specific
mutations can lead to long-term disease modification and control
§  15+ years of clinical development demonstrating ability of vaccination against tumor-specific
antigens to delay or to prevent relapse / disease progression in incurable B-cell lymphomas
§  Clinical program under design to seek approval in US for use in Low Tumor Bulk and in
Relapsed Rituximab Refractory Follicular Lymphoma
§  Automated manufacturing and quality assurance processes that enable delivery of patient-
specific, tumor-specific therapeutics with commercially attractive margins
§  Technology transfer team with leading expertise in the development of highly-automated
manufacturing and quality systems for the production of personalized biologics
§  35,000 ft2 facility in Minneapolis with current capacity of approx. 500 vaccines per year
Indolent B-Cell Lymphomas Are Largely Incurable

4
Biovest International, Inc.
01 Biovest Overview
DEATH
Induction
Therapy
R-CHOP
B-R
R-CVP, etc.
2nd Induction
Therapy
… Nth Induction
Therapy
Transplant
and Disease Progression
B-R, R-CHOP
2nd Line
Therapies
Clinical Trials,
High-dose Chemotherapy,
Transplant, etc.
1st Line: R-CHOP,
B-R, R-CVP, etc. –
highly successful at
generating CR
(60-85%)
2nd Line: Alternative
1st Line therapies –
similarly successful at
generating CR
R-Refractory: Idelalisib,
immunotherapy clinical trials
involving checkpoint inhibitors
(e.g. PD-1), lenalidomide, &c.
Origin: Single
Malignant B-Cell
Tumor Formation:
Induction-resistant
cells already present
Induction-Resistant
Cells Persist:
Remission ≠ “Cured”
– rather, “minimal
residual disease”
Induction-Resistant
Cells Proliferate:
Induction-regimens
prove increasingly
ineffective in
controlling disease
progression
Transplant & Disease Progression

Clinical Trials, High-Dose Chemotherapy,
Transplant, etc.
Disease Progression
Overview
§  Anti-CD20 mAb rituximab in conjunction with
chemotherapy has demonstrated prolonged
DFS and, in some settings, OS and has
become standard first line therapy – R-chemo
is not, however, curative
§  Originating cells resistant to R-chemo persist
through multiple rounds of cytoreductive
therapy, eventually leading to disseminated or
transformed disease and death
§  Immunotherapies hold unique promise for
promoting long-term disease control
Low Tumor Bulk: Watch &
Wait, Radioimmunotherapy
Follicular Lymphoma
§  Most common indolent b-cell lymphoma
§  US Incidence: 15,000 – 20,000 per year
§  US Prevalence: Approx. 150,000
§  Median Survival: 10-13 Years
§  Age of Onset: 60’s
Indolent B-Cell Lymphomas Are Uniquely Suited to Treatment
Via Active Immunotherapy
5
Biovest International, Inc.
01 Biovest Overview
§  The B-cell receptor (“idiotype” or “Id”) of malignant B-cell clones represents a unique tumor-
specific marker that is ideally suited to targeting via active immunotherapy
§  Id vaccination seeks to build a cohort of T-cells that are 

activated against the breadth of malignant clonal 

populations (tumor heterogeneity), thereby providing 

long-term immune-surveillance and disease-control
§  Multiple programs have sought to explore the potential uses

of Id as a tumor-specific antigen for use in therapeutic 

vaccination - taken together, these point to potential 

efficacy in patients who have the ability to mount an immune 

response, and who have been immunized against the proper clonal populations
§  BiovaxID (dasiprotimut-t: Id-KLH + GM-CSF) is the only such program that has demonstrated
an ability to prolong remission duration in a multi-center, prospective, randomized, double-
blind, active-controlled clinical trial
§  BiovaxID is the only program in advanced stage follicular lymphoma that has an associated
patient population in continuous first complete remission (30% of Phase 2 at > 15 years)
BiovaxID Clinical Study Summary: 3 Studies With > 15 Years Of
Follow Up Demonstrate Safety and Efficacy
6
Biovest International, Inc.
01 Biovest Overview
Study Phase Indication Subjects Results
NCI T93-1064

9/1996 – 3/2010
Phase 2

Single Arm

Open Label
Follicular Lymphoma
First Complete
Remission following
PACE chemotherapy
N = 25 Median DFS: 62.5 mos

Median OS: Not Reached

Survival @ 165.7 mos: 80%
No vaccine-related toxicities
NCI-1033
6/2000 – 8/2005 (Open)
Phase 2

Single Arm
Open Label
Mantle Cell Lymphoma
Following EPOCH-R
induction
N = 24 Median PFS: 24.1 mos
SAE: 1 (4%)
BV301
1/2000 – 2/2012
Phase 3

Multi-Center, Double
Blind, Randomized,
Active Control
Follicular Lymphoma
First Complete
Remission following
PACE chemotherapy
Active N = 118

Control N = 59
ê in Risk of Relapse: 42% (HR: .58)

Median DFS: +15.4 mos vs. active control
(46.0 vs. 30.6)
Grade 4 SAE: 6 (3.3%)
BiovaxID Clinical Study Summary (Cont’d)
Notes:
§ BiovaxID (dasiprotimut-T) has demonstrated efficacy in reducing the risk of relapse (42%, P3 FL) and in extending
tumor remission duration (15.4 months, P3 FL), both vs. active control
§ 30% of patients who received vaccine in P2 FL trial remain tumor-free with no additional therapy (15+ years)
§ 73% of patients in Phase 2 FL showed induced cellular complete remission, no circulating malignant cells were
detectable by PCR. (Nature Medicine)
§ Anti-tumor memory T-cell persistence measured 2.5 years post-vaccination
7
Biovest International, Inc.
01 Biovest Overview
Disease Free Survival (P3 FL) 15-year Remission (P2 FL) GM-CSF OS Biomarker (P2 MCL)
BiovaxID Has An Extensively Documented Mechanism of Action
8
Biovest International, Inc.
01 Biovest Overview
Clinical Development
9
Biovest International, Inc.
01 Biovest Overview
§  Biovest is seeking to further develop BiovaxID in Follicular Lymphoma indications with low
degrees of competition and high degrees of unmet medical need
§  Clear path with FDA toward registration for use as a monotherapy in treatment naïve patients
with low tumor bulk, and in combination with immunotherapies for relapsed patients who are
refractory to rituximab
§  2 primary studies proposed
–  1. Idiotype vaccine versus watchful-waiting for advanced stage low tumor burden follicular lymphoma
•  N = 250 (150 v 100)
•  26 month treatment protocol, 1 year accrual
–  2. Idiotype vaccine plus Idelalisib versus Id vaccine plus PD-1 (nivolumab) vs Idelalisib for relapsed
Rituxan refractory follicular lymphoma
•  N = 270 (90 v 90 vs 90)
•  26 month treatment protocol, 1 year accrual
Clinical Development Rationale: Id Vaccine in Advanced Stage
Low Tumor Bulk Follicular Lymphoma
10
Biovest International, Inc.
01 Biovest Overview
§  As many as 85% (12,750-17,000 per year) of follicular lymphoma patients present with
advanced (stage 3-4) disease
§  Of these, a large number (40-50%; 5,100-8,500 per year) are asymptomatic and carry
comparably low tumor bulk
§  Owing to the relative toxicities of R-Chemo – rituximab is B-cell depletive and profoundly
immunosuppressive – these patients currently undergo observation (“Watchful Waiting” or
“Watch & Wait”) until disease progression (2-3 years)
§  Due to the toxicities mentioned above and to the relatively late-age of presentation of
follicular lymphoma (mid-60’s), a non-toxic therapy that can substantially prolong the time to
disease progression is highly desirable
§  Additionally, the development of an anti-tumor T-cell cohort prior to B-cell depletion may
improve the efficacy of B-cell depletive cytoreductive therapy
Low-Grade
"Watch-and-
Wait"
Follicular
Lymphoma
LN Biopsy
Vacc Mfg.
-3
Randomization
9 month (+6 vaccine)
Response
Assessment
(CR/PR/SD)
+ IR
-2 -1 0 1 2 3 4 6 11 23
Month Study
Completion
CR/PR/SD
Continues Vaccination
on Months 11,13,15,17
19,21,23 until Study End or
Progression
Immune Response Assessment
Endpoints:
Anti-tumor cytokine response,
Anti-Id antibody responses
Vac month 0, +6, +12 months vs
Pre-Vaccine Baseline
Dasiprotimut-T Biovest
(Id-KLH + GM-CSF) monthly
Primary Endpoint:
PFS
(HR reduction of
50% )
Observation Only
Proposed Clinical Trial Protocol
11
Biovest International, Inc.
01 Biovest Overview
Idiotype Vaccine v Watchful-Waiting for Advanced Stage Low Tumor Burden Follicular Lymphoma
Clinical Development Rationale: Id Vaccine Plus Idelalisib vs Id
Vaccine Plus Nivolumab vs Idelalisib in Relapsed Rituxan
Refractory Follicular Lymphoma
12
Biovest International, Inc.
01 Biovest Overview
§  Of the patients who present with advanced (stage 3-4) follicular lymphoma (12,750 – 17,000
per year; prevalence of 80,000 – 120,000), the great majority will receive Rituxan-containing
induction (and potentially maintenance) courses until the failure of R-therapy (3-6 years)
§  The failure of R-therapy has traditionally portended increasingly aggressive disease with
progressively more toxic and invasive therapeutic regimens such as chemotherapy and stem
cell transplant – there is no generally accepted standard of care in this setting
§  A new generation of immunopotentiating agents (e.g. imid, PI3Kδ, PD-1) have the potential to
give patients less toxic options in R-refractory settings while potentially jump-starting
immune function
§  These agents are unlikely to provide long-term disease control absent an ability to stimulate
tumor-specific immune surveillance
§  Id-vaccination’s differentiated and highly-complementary mechanism, induction agent
sparing mechanism of action and relative safety make it an ideal potential combination
partner for the range of emerging immunotherapies
Proposed Clinical Trial Protocol
13
Biovest International, Inc.
01 Biovest Overview
Three-arm Das-T/Idelalisib//PD-1 Combination Clinical Trial (Das-T+Idelalisib vs Das-T+PD1 vs Idelalisib)
Low Tumor Bulk & Relapsed Refractory Follicular Lymphoma

14
Biovest International, Inc.
01 Biovest Overview
Low Tumor Bulk Follicular Lymphoma Relapsed Rituxan Refractory Follicular Lymphoma
Metric Low High
US Population 320,000,000
NHL Incidence (per 100K)
NHL Incidence
19.6
62,720
21.1
67,520
FL % of NHL

FL Incidence
25%

15,680
33%
22,282
% Stage 3-4
Stage 3-4 Incidence
75%
11,760
85%
18,939
% LTB / Asymptomatic
LTB / Asymptomatic Incidence
35%
4,116
50%
9,470
Metric Low High
US Population 320,000,000
NHL Incidence (per 100K)
NHL Incidence
19.6
62,720
21.1
67,520
FL % of NHL

FL Incidence
25%

15,680
33%
22,282
% Stage 3-4
Stage 3-4 Incidence
75%
11,760
85%
18,939
Time to R-Failure
Life Expectancy
3 yrs.
10 yrs.
6 yrs.
13 yrs.
BiovaxID Benefits From Multiple Layers of Market Protection

§  Proprietary Cell Line: exclusive worldwide rights to BiovaxID hybridoma cell line (K6H6) necessary
for production of patient-specific, tumor-specific B-cell lymphoma Id
§  Proprietary Manufacturing: patent-protected bioreactor and purification instrumentation necessary
for the cost-effective production of patient-specific active immunotherapies
§  Proprietary Quality Control: highly-automated manufacturing and quality control processes that
ensure cGMP quality, scalability and cost-efficiency
§  Time-to-Market: extended time-to-market for any potentially competitive therapeutic; any new
product would require 7-10 years of clinical development
§  Orphan Protection: BiovaxID has obtained orphan drug status for multiple indications in the US
and in the EU – including both follicular lymphoma and mantle cell lymphoma
§  No Competition in Mechanism of Action: Id-vaccination synergizes with induction agents and is
induction regimen-sparing (e.g. rituximab)
15
Biovest International, Inc.
01 Biovest Overview
Automated Manufacturing & Streamlined Logistics Make
BiovaxID Convenient for Physicians and for Patients
16
Biovest International, Inc.
01 Biovest Overview
§  Standard biopsy è subcutaneous injection
§  Two (2) months from biopsy to vaccine
availability
§  Standard logistics for biologics – 72 hours
for delivery of biopsy to plant; several
months of Id-KLH (conjugated Ab) storage
life post-production
§  Single biopsy yields virtual lifetime supply
of vaccine
§  Current care schedule is vaccination in
months 1, 2, 3, 4, 6 – boosters under
evaluation
§  Automated manufacturing and QC ensure
scalable cGMP compliant production of
patient-specific therapeutic
> 10x reduction in cost of production achieved in last 18 mos ( > $500K to < $50K) –
clear path toward further cost optimization
§  Volker Diehl, M.D., Ph.D. (University of Cologne, Germany)
§  Prof. J.H. Veelken, M.D., Ph.D. (Leiden University Medical Center, Netherlands)
§  Alf Lindberg, M.D., Ph.D. (EVP, Head of R&D Sanofi Pasteur – Ret.)
§  Dayton Reardan, Ph.D., (Regulatory: FDA)
§  Anne Tomalin, BA, BSc (OptumInsight)
§  Adriaan Fruijtier (Regulatory: EU)
Scientific Advisory Board

Supported By Leaders in Lymphoma Care, Active Immunotherapy and Bioinformatics
§  Larry Kwak, M.D., Ph.D. (M.D. Anderson)
§  Sattva Neelapu, M.D. (M.D. Anderson)
§  Stephen Schuster, M.D. (University of Pennsylvania)
§  Eduardo Sotomayor, M.D. (Moffitt Cancer Center)
§  Joshua Brody, M.D. (Mount Sinai Hospital)
§  Brian Athey, Ph.D. (University of Michigan)
§  David States, M.D., Ph.D. (Bioinformatics)
§  Gilbert Omenn, MD, Ph.D. (University of Michigan, Bioinformatics)
§  Neil Berinstein, M.D. (University of Toronto)
§  James Mulé, Ph.D . (Moffitt Cancer Center)
§  Lindy Durrant, Ph.D. (University of Nottingham)
Clinical
Active
Immuno-
therapy
Bio-
informatics
Regulatory
17
Biovest International, Inc.
01 Biovest Overview
EU

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BiovaxID Opportunity Overview June 2015

  • 1. Biovest International, Inc. BiovaxID: Personalized Active Immunotherapy for Follicular Lymphoma June 2015
  • 2. Opportunity Overview 2 Biovest International, Inc. 01 Biovest Overview §  Biovest is seeking a strategic partner to take on further clinical and commercial development of BiovaxID §  Biovest currently holds 93.7% interest in worldwide rights to BiovaxID §  Majority shareholders hold 6.3% royalty §  Clinical program calls for $15-30m in further development between 2015-2020 in order to unlock multiple $350m - $1bn+ indications including Low Tumor Bulk and Relapsed Refractory Follicular Lymphoma §  Support of leading investigators and research institutions including MD Anderson, Penn Abramson, Moffitt and Leiden §  Cost of manufacturing reduced from more $500k to less than $50k in last 18 months – substantial additional reduction possible
  • 3. Engaging the Immune System to Fundamentally Change Cancer Treatment 3 Biovest International, Inc. 01 Biovest Overview §  Founded on the premise that training the immune system to recognize tumor-specific mutations can lead to long-term disease modification and control §  15+ years of clinical development demonstrating ability of vaccination against tumor-specific antigens to delay or to prevent relapse / disease progression in incurable B-cell lymphomas §  Clinical program under design to seek approval in US for use in Low Tumor Bulk and in Relapsed Rituximab Refractory Follicular Lymphoma §  Automated manufacturing and quality assurance processes that enable delivery of patient- specific, tumor-specific therapeutics with commercially attractive margins §  Technology transfer team with leading expertise in the development of highly-automated manufacturing and quality systems for the production of personalized biologics §  35,000 ft2 facility in Minneapolis with current capacity of approx. 500 vaccines per year
  • 4. Indolent B-Cell Lymphomas Are Largely Incurable
 4 Biovest International, Inc. 01 Biovest Overview DEATH Induction Therapy R-CHOP B-R R-CVP, etc. 2nd Induction Therapy … Nth Induction Therapy Transplant and Disease Progression B-R, R-CHOP 2nd Line Therapies Clinical Trials, High-dose Chemotherapy, Transplant, etc. 1st Line: R-CHOP, B-R, R-CVP, etc. – highly successful at generating CR (60-85%) 2nd Line: Alternative 1st Line therapies – similarly successful at generating CR R-Refractory: Idelalisib, immunotherapy clinical trials involving checkpoint inhibitors (e.g. PD-1), lenalidomide, &c. Origin: Single Malignant B-Cell Tumor Formation: Induction-resistant cells already present Induction-Resistant Cells Persist: Remission ≠ “Cured” – rather, “minimal residual disease” Induction-Resistant Cells Proliferate: Induction-regimens prove increasingly ineffective in controlling disease progression Transplant & Disease Progression
 Clinical Trials, High-Dose Chemotherapy, Transplant, etc. Disease Progression Overview §  Anti-CD20 mAb rituximab in conjunction with chemotherapy has demonstrated prolonged DFS and, in some settings, OS and has become standard first line therapy – R-chemo is not, however, curative §  Originating cells resistant to R-chemo persist through multiple rounds of cytoreductive therapy, eventually leading to disseminated or transformed disease and death §  Immunotherapies hold unique promise for promoting long-term disease control Low Tumor Bulk: Watch & Wait, Radioimmunotherapy Follicular Lymphoma §  Most common indolent b-cell lymphoma §  US Incidence: 15,000 – 20,000 per year §  US Prevalence: Approx. 150,000 §  Median Survival: 10-13 Years §  Age of Onset: 60’s
  • 5. Indolent B-Cell Lymphomas Are Uniquely Suited to Treatment Via Active Immunotherapy 5 Biovest International, Inc. 01 Biovest Overview §  The B-cell receptor (“idiotype” or “Id”) of malignant B-cell clones represents a unique tumor- specific marker that is ideally suited to targeting via active immunotherapy §  Id vaccination seeks to build a cohort of T-cells that are 
 activated against the breadth of malignant clonal 
 populations (tumor heterogeneity), thereby providing 
 long-term immune-surveillance and disease-control §  Multiple programs have sought to explore the potential uses
 of Id as a tumor-specific antigen for use in therapeutic 
 vaccination - taken together, these point to potential 
 efficacy in patients who have the ability to mount an immune 
 response, and who have been immunized against the proper clonal populations §  BiovaxID (dasiprotimut-t: Id-KLH + GM-CSF) is the only such program that has demonstrated an ability to prolong remission duration in a multi-center, prospective, randomized, double- blind, active-controlled clinical trial §  BiovaxID is the only program in advanced stage follicular lymphoma that has an associated patient population in continuous first complete remission (30% of Phase 2 at > 15 years)
  • 6. BiovaxID Clinical Study Summary: 3 Studies With > 15 Years Of Follow Up Demonstrate Safety and Efficacy 6 Biovest International, Inc. 01 Biovest Overview Study Phase Indication Subjects Results NCI T93-1064
 9/1996 – 3/2010 Phase 2
 Single Arm
 Open Label Follicular Lymphoma First Complete Remission following PACE chemotherapy N = 25 Median DFS: 62.5 mos
 Median OS: Not Reached
 Survival @ 165.7 mos: 80% No vaccine-related toxicities NCI-1033 6/2000 – 8/2005 (Open) Phase 2
 Single Arm Open Label Mantle Cell Lymphoma Following EPOCH-R induction N = 24 Median PFS: 24.1 mos SAE: 1 (4%) BV301 1/2000 – 2/2012 Phase 3
 Multi-Center, Double Blind, Randomized, Active Control Follicular Lymphoma First Complete Remission following PACE chemotherapy Active N = 118
 Control N = 59 ê in Risk of Relapse: 42% (HR: .58)
 Median DFS: +15.4 mos vs. active control (46.0 vs. 30.6) Grade 4 SAE: 6 (3.3%)
  • 7. BiovaxID Clinical Study Summary (Cont’d) Notes: § BiovaxID (dasiprotimut-T) has demonstrated efficacy in reducing the risk of relapse (42%, P3 FL) and in extending tumor remission duration (15.4 months, P3 FL), both vs. active control § 30% of patients who received vaccine in P2 FL trial remain tumor-free with no additional therapy (15+ years) § 73% of patients in Phase 2 FL showed induced cellular complete remission, no circulating malignant cells were detectable by PCR. (Nature Medicine) § Anti-tumor memory T-cell persistence measured 2.5 years post-vaccination 7 Biovest International, Inc. 01 Biovest Overview Disease Free Survival (P3 FL) 15-year Remission (P2 FL) GM-CSF OS Biomarker (P2 MCL)
  • 8. BiovaxID Has An Extensively Documented Mechanism of Action 8 Biovest International, Inc. 01 Biovest Overview
  • 9. Clinical Development 9 Biovest International, Inc. 01 Biovest Overview §  Biovest is seeking to further develop BiovaxID in Follicular Lymphoma indications with low degrees of competition and high degrees of unmet medical need §  Clear path with FDA toward registration for use as a monotherapy in treatment naïve patients with low tumor bulk, and in combination with immunotherapies for relapsed patients who are refractory to rituximab §  2 primary studies proposed –  1. Idiotype vaccine versus watchful-waiting for advanced stage low tumor burden follicular lymphoma •  N = 250 (150 v 100) •  26 month treatment protocol, 1 year accrual –  2. Idiotype vaccine plus Idelalisib versus Id vaccine plus PD-1 (nivolumab) vs Idelalisib for relapsed Rituxan refractory follicular lymphoma •  N = 270 (90 v 90 vs 90) •  26 month treatment protocol, 1 year accrual
  • 10. Clinical Development Rationale: Id Vaccine in Advanced Stage Low Tumor Bulk Follicular Lymphoma 10 Biovest International, Inc. 01 Biovest Overview §  As many as 85% (12,750-17,000 per year) of follicular lymphoma patients present with advanced (stage 3-4) disease §  Of these, a large number (40-50%; 5,100-8,500 per year) are asymptomatic and carry comparably low tumor bulk §  Owing to the relative toxicities of R-Chemo – rituximab is B-cell depletive and profoundly immunosuppressive – these patients currently undergo observation (“Watchful Waiting” or “Watch & Wait”) until disease progression (2-3 years) §  Due to the toxicities mentioned above and to the relatively late-age of presentation of follicular lymphoma (mid-60’s), a non-toxic therapy that can substantially prolong the time to disease progression is highly desirable §  Additionally, the development of an anti-tumor T-cell cohort prior to B-cell depletion may improve the efficacy of B-cell depletive cytoreductive therapy
  • 11. Low-Grade "Watch-and- Wait" Follicular Lymphoma LN Biopsy Vacc Mfg. -3 Randomization 9 month (+6 vaccine) Response Assessment (CR/PR/SD) + IR -2 -1 0 1 2 3 4 6 11 23 Month Study Completion CR/PR/SD Continues Vaccination on Months 11,13,15,17 19,21,23 until Study End or Progression Immune Response Assessment Endpoints: Anti-tumor cytokine response, Anti-Id antibody responses Vac month 0, +6, +12 months vs Pre-Vaccine Baseline Dasiprotimut-T Biovest (Id-KLH + GM-CSF) monthly Primary Endpoint: PFS (HR reduction of 50% ) Observation Only Proposed Clinical Trial Protocol 11 Biovest International, Inc. 01 Biovest Overview Idiotype Vaccine v Watchful-Waiting for Advanced Stage Low Tumor Burden Follicular Lymphoma
  • 12. Clinical Development Rationale: Id Vaccine Plus Idelalisib vs Id Vaccine Plus Nivolumab vs Idelalisib in Relapsed Rituxan Refractory Follicular Lymphoma 12 Biovest International, Inc. 01 Biovest Overview §  Of the patients who present with advanced (stage 3-4) follicular lymphoma (12,750 – 17,000 per year; prevalence of 80,000 – 120,000), the great majority will receive Rituxan-containing induction (and potentially maintenance) courses until the failure of R-therapy (3-6 years) §  The failure of R-therapy has traditionally portended increasingly aggressive disease with progressively more toxic and invasive therapeutic regimens such as chemotherapy and stem cell transplant – there is no generally accepted standard of care in this setting §  A new generation of immunopotentiating agents (e.g. imid, PI3Kδ, PD-1) have the potential to give patients less toxic options in R-refractory settings while potentially jump-starting immune function §  These agents are unlikely to provide long-term disease control absent an ability to stimulate tumor-specific immune surveillance §  Id-vaccination’s differentiated and highly-complementary mechanism, induction agent sparing mechanism of action and relative safety make it an ideal potential combination partner for the range of emerging immunotherapies
  • 13. Proposed Clinical Trial Protocol 13 Biovest International, Inc. 01 Biovest Overview Three-arm Das-T/Idelalisib//PD-1 Combination Clinical Trial (Das-T+Idelalisib vs Das-T+PD1 vs Idelalisib)
  • 14. Low Tumor Bulk & Relapsed Refractory Follicular Lymphoma
 14 Biovest International, Inc. 01 Biovest Overview Low Tumor Bulk Follicular Lymphoma Relapsed Rituxan Refractory Follicular Lymphoma Metric Low High US Population 320,000,000 NHL Incidence (per 100K) NHL Incidence 19.6 62,720 21.1 67,520 FL % of NHL
 FL Incidence 25%
 15,680 33% 22,282 % Stage 3-4 Stage 3-4 Incidence 75% 11,760 85% 18,939 % LTB / Asymptomatic LTB / Asymptomatic Incidence 35% 4,116 50% 9,470 Metric Low High US Population 320,000,000 NHL Incidence (per 100K) NHL Incidence 19.6 62,720 21.1 67,520 FL % of NHL
 FL Incidence 25%
 15,680 33% 22,282 % Stage 3-4 Stage 3-4 Incidence 75% 11,760 85% 18,939 Time to R-Failure Life Expectancy 3 yrs. 10 yrs. 6 yrs. 13 yrs.
  • 15. BiovaxID Benefits From Multiple Layers of Market Protection
 §  Proprietary Cell Line: exclusive worldwide rights to BiovaxID hybridoma cell line (K6H6) necessary for production of patient-specific, tumor-specific B-cell lymphoma Id §  Proprietary Manufacturing: patent-protected bioreactor and purification instrumentation necessary for the cost-effective production of patient-specific active immunotherapies §  Proprietary Quality Control: highly-automated manufacturing and quality control processes that ensure cGMP quality, scalability and cost-efficiency §  Time-to-Market: extended time-to-market for any potentially competitive therapeutic; any new product would require 7-10 years of clinical development §  Orphan Protection: BiovaxID has obtained orphan drug status for multiple indications in the US and in the EU – including both follicular lymphoma and mantle cell lymphoma §  No Competition in Mechanism of Action: Id-vaccination synergizes with induction agents and is induction regimen-sparing (e.g. rituximab) 15 Biovest International, Inc. 01 Biovest Overview
  • 16. Automated Manufacturing & Streamlined Logistics Make BiovaxID Convenient for Physicians and for Patients 16 Biovest International, Inc. 01 Biovest Overview §  Standard biopsy è subcutaneous injection §  Two (2) months from biopsy to vaccine availability §  Standard logistics for biologics – 72 hours for delivery of biopsy to plant; several months of Id-KLH (conjugated Ab) storage life post-production §  Single biopsy yields virtual lifetime supply of vaccine §  Current care schedule is vaccination in months 1, 2, 3, 4, 6 – boosters under evaluation §  Automated manufacturing and QC ensure scalable cGMP compliant production of patient-specific therapeutic > 10x reduction in cost of production achieved in last 18 mos ( > $500K to < $50K) – clear path toward further cost optimization
  • 17. §  Volker Diehl, M.D., Ph.D. (University of Cologne, Germany) §  Prof. J.H. Veelken, M.D., Ph.D. (Leiden University Medical Center, Netherlands) §  Alf Lindberg, M.D., Ph.D. (EVP, Head of R&D Sanofi Pasteur – Ret.) §  Dayton Reardan, Ph.D., (Regulatory: FDA) §  Anne Tomalin, BA, BSc (OptumInsight) §  Adriaan Fruijtier (Regulatory: EU) Scientific Advisory Board
 Supported By Leaders in Lymphoma Care, Active Immunotherapy and Bioinformatics §  Larry Kwak, M.D., Ph.D. (M.D. Anderson) §  Sattva Neelapu, M.D. (M.D. Anderson) §  Stephen Schuster, M.D. (University of Pennsylvania) §  Eduardo Sotomayor, M.D. (Moffitt Cancer Center) §  Joshua Brody, M.D. (Mount Sinai Hospital) §  Brian Athey, Ph.D. (University of Michigan) §  David States, M.D., Ph.D. (Bioinformatics) §  Gilbert Omenn, MD, Ph.D. (University of Michigan, Bioinformatics) §  Neil Berinstein, M.D. (University of Toronto) §  James Mulé, Ph.D . (Moffitt Cancer Center) §  Lindy Durrant, Ph.D. (University of Nottingham) Clinical Active Immuno- therapy Bio- informatics Regulatory 17 Biovest International, Inc. 01 Biovest Overview EU