The document discusses three major health issues - diabetes, cancer, and Alzheimer's disease. For diabetes, it notes the obesity epidemic is a major driver and interventions like bariatric surgery can help treat or cure early diabetes. For cancer, it describes how increased understanding of cancer drivers and immune-oncology is improving treatment. For Alzheimer's, it states that diagnosis is often late and there are no treatments to modify the disease course, but efforts are being made to target amyloid and tau proteins.

1. Bringing J&J Innovation
to Life
CADTH Meeting
APRIL, 2015

2. Innovation Centers

3. ‘The patients are waiting!’
- Dr. Paul Janssen
ONCE EVERY
Someone dies from diabetes or
related medical issues
8 SECONDS

4. • The diabetes epidemic is a “secondary epidemic” primarily following the
epidemic in obesity.
– If the obesity epidemic were to resolve, or disappear, type 2 diabetes would
largely disappear as well, even without active diabetes-specific interventions.
– Surgical interventions largely aimed at treatment of obesity ( i.e. bariatric
surgery) often result in “cure” of early diabetes or remission or regression, or
significant clinical improvement of later disease.
• The lipocentric view of diabetes suggests the abnormalities in excessive
adipose tissue accumulation and ectopic deposition of fatty acids
largely drives both insulin resistance and decrease insulin secretion
contributing to the development of diabetes.
4
The Diabetes Epidemic Will Strain the
Capacity of Healthcare Systems if Left
Unchecked

5. 5
Intervention at the Pre-diabetic Stage
Provides an Opportunity to Change the
Course of Disease
Persistent Insulin Resistance and Progressive β-cell Decline

6. Intervention of Pre-Diabetes Will Require
Identification, Lifestyle Changes, and
Treatment
• Biomarkers that aid in the identification of individuals that are
most likely to progress to Type 2 Diabetes
• Education and other methods to increase compliance towards
healthy lifestyle changes
• Development of therapies that focus on the root causes of
diabetes (e.g. insulin resistance) which can delay/prevent the
onset of frank diabetes
– insulin sensitizers, b cell regeneration

7. ‘The patients are waiting!’
- Dr. Paul Janssen
One person dies of
melanoma EVERY HOUR

8. • The underlying pathways that lead to proliferative dysregulation are
continuing to be better understood
• Targeted therapies are moving cancer treatment towards more
individually tailored treatments
• Combinations of existing and novel therapies are being explored to
increase 5yr survival times across a number of cancer types
• Therapies designed to evoke powerful immune responses towards
tumors are dramatically changing outcomes in a subset of late-stage
tumor types
8
Increased Understanding of Oncogenic
Drivers and the Rise of Immuno-oncology
is Changing Cancer Treatment

9. Immuno-Oncology: An Exciting New
Approach for Patients Living with Cancer
9
Confidential
Reactivation and redirection of patient’s
immune response towards malignant cells
Four Approaches
1. T Cell Checkpoints
• PD1 and PD-L1 antibodies (BMS,
Merck, Genentech, AZ/Medimmune)
• Ipilumumab (BMS)
2. T Cell Redirection
• Blinotumumab (Amgen BiTE)
3. Chimeric Antigen Receptor T cells
• Infusion of engineered T cells
4. Vaccines

10. The Future Treatment Paradigms in Oncology
will Continue to Be More Personalized
• Approaches to rationally guide combination strategies
• Next generation immunotherapy agents/mechanisms
• Mechanisms of resistance to emerging immunotherapy (PD1, PDL1, CTLA4)
• Novel tumor antigen ID approaches and vaccine technologies
• Identification of pre-disposing mutations and subsequent prevention of disease
10
Confidential

11. ‘The patients are waiting!’
- Dr. Paul Janssen
1 in 3 Seniors Who Die
Each Year Have Been
Diagnosed With
Alzheimer’s or Another
Dementia

12. Alzheimer’s Disease Presents a Staggering
Problem to Ageing Individuals, their
Caregivers, and Society
12
• Only one in four people with Alzheimer’s have been diagnosed (Alzheimer’s
Disease International)
• The direct and indirect costs of caring for people with Alzheimer’s and
dementia in the Canada is approximately $33B per year, worldwide it is greater
than $600B (Alzheimer’s Society Canada)
• One in five Canadians aged 45 and older provides some form of care to
seniors living with long-term health problems - in 2011, family caregivers spent
in excess of 444 million unpaid hours looking after someone with cognitive
impairment, including dementia. (Alzheimer’s Society Canada)
• There are currently no treatments that result in modification of the course of
disease

13. The Challenges Presented by Alzheimer’s
Disease Include Insufficient and Late
Diagnosis, as Well as a Lack of Treatment
Options
13
• Brains of individuals with Alzheimer’s
Disease are characterized by the
presence of plaques (beta-amyloid) and
tangles (tau)
• The presence of plaques and tangles can
proceed the development of symptoms
• Both beta-amyloid and tau are the focus
of a number of novel therapeutic
approaches
Image credit: Jannis Productions. Rebekah Fredenburg, computer animation; Stacy Jannis, illustration/art direction

14. The Future Treatment of Alzheimer’s Disease
Will be Dependent on Identification of
Individuals Early in Disease and Generation of
Effective Treatments
14
• More sensitive and specific methods for determining which individuals will go
on to develop disease
• Beta-amyloid targeted treatments have had a challenging clinical history,
although there are still many efforts underway that are hopeful
• Tau-based approaches are currently moving towards later-stage clinical testing
and may provide new treatment options for people living with disease
• The evolving understanding of the brain biology and disease pathogenesis will
provide the field with new insights to disease prevention, management, and
treatment
• Public-private partnerships will be essential in the development of both new
diagnostics as well as therapeutics

15. Tapping Innovation in Canada
Boston IC
Janssen Canada
Innovation Incubator
Consortium
Montreal
Boston IC
Janssen Canada
JJMP
Innovation Incubator
Dedicated Fund
Toronto
Janssen Canada
Alberta Diabetes Foundation
Government of Alberta
California IC Judges
$600k
Dedicated Fund
Edmonton
Janssen Canada
Government of British Columbia
Government of Alberta
California IC representatives
$1m
Dedicated Fund
Vancouver
California IC
Janssen Canada
Government of Canada
National Contest
Canada-wide
California IC
Janssen Canada
Neuroscience TA
Dedicated Fund
Toronto
Janssen Pharmaceuticals NV
Industry Consortium
Toronto
BetaLogics
Janssen R&D
Industry Consortium
Toronto

16. Thank You !!