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Immuron Limited
September 2018
Oral Immunoglobulins
Changing the Paradigms
of Care
www.immuron.com
ASX:IMC NASDAQ:IMRN
Forward Looking Statement
Certain statements made in this presentation are forward-looking statements
and are based on Immuron’s current expectations, estimates and projections.
Words such as “anticipates,” “expects,” “intends,” “plans,” “believes,” “seeks,”
“estimates,” “guidance” and similar expressions are intended to identify
forward-looking statements.
Although Immuron believes the forward-looking statements are based on
reasonable assumptions, they are subject to certain risks and uncertainties,
some of which are beyond Immuron’s control, including those risks or
uncertainties inherent in the process of both developing and commercializing
technology. As a result, actual results could materially differ from those
expressed or forecasted in the forward-looking statements.
The forward-looking statements made in this presentation relate only to events
as of the date on which the statements are made. Immuron will not undertake
any obligation to release publicly any revisions or updates to these forward-
looking statements to reflect events, circumstances or unanticipated events
occurring after the date of this presentation except as required by law or by
any appropriate regulatory authority.
Company Highlights
3
• Clinical stage biopharmaceutical company targeting inflammatory-mediated and
infectious diseases with oral immunotherapies
• Validated technology platform – with one registered asset generating revenue
• 2 Lead clinical assets in Phase 2 development for the treatment of multiple high value
indications, Fat Liver Disease and CDI.
• Excellent safety profile, GRAS by FDA, expedited regulatory review and approval
process
• High-value peer licensing deals and M&A underscore potential upside
• Experienced Management Team and strong support from leading KOLs and
institutions (NIH, DoD)
• Company listed on NASDAQ in 2Q 2017
Advisory Board
Dr. Arun Sanyal (MD)
University of Virginia
Former President of the
AASLD. Current Chair of the
Liver Study Section at the NIH.
IMM-124E lead PI.
Dr. Stephen Harrison (MD)
San Antonio Military Medical Center
Brooke US Army Medical Center
Internationally renowned expert
in NASH. Lead PI of Galectin’s
GR-MD-02’s Phase II trial.
Dr. Manal Abdelmalek (MD)
Duke University Medical Center
Dr. Abdelmalek is a leading
investigator in the field of
NASH.
Dr. Gerhard Rogler (MD, PhD)
Zurich University
Professor Rogler is a leader in
the field of Colitis and has
authored more than 200
original peer-reviewed articles.
Dr. Miriam Vos (MD)
Emory University
Dr. Vos specializes in the
treatment of gastrointestinal
disease in children as well as
fatty liver disease and obesity.
Dr. Dena Lyras (PhD)
Monash University
Dr. Lyras is one of the world’s
leading experts in C. difficile.
4
Organizations
Prominent Scientific Advisory Board and
Leading Research Partners
Platform Overview: Oral Immunoglobulins
5
1
Vaccines Are
Developed
2
Antibodies Are Harvested
from Colostrum
Antigen Specific
Antibodies
(IgG and IgG1)
Adjuvants+
3
Broad Therapeutic Effect
+
• Reduced gut and blood pathogens
responsible for initiating
inflammation
• Reduces systemic inflammation
• Lowers organ injury
• Strong anti-toxin properties
• Decrease toxin levels results in
decrease gut damage
• Generally Regarded as Safe
(GRAS)
Induction of
regulatory
T-cells
Clearance of
Targeted GUT
Pathogens
Competitive
Advantage
• Platform capable of producing multiple drug candidates → Long-term value creation
• Bovine IgG possesses a unique ability to remain active in the human GI tract →
delivering its full benefits to the bacteria found there
• Bovine IgG is capable of withstanding the acidic environment of the stomach and is
resistant to proteolysis by the digestive enzymes in the GI tract
• Safety established → Not absorbed into the blood
Immunotherapy Targeting Pathogenic Bacteria
Technology Platform Capable of Producing High Levels of Antibodies
against specific pathogenic and antigenic determinants
6
Targeting Virulence Factors;
• Spores
• Lipopolyscaccarride
Endotoxins
• Exotoxins
• Fimbrae & Molecules which
facilitate adhesion
• Surface Layer Proteins which
contribute to Colonisation
• Flagella (Flagellin)
Antigens Important For;
• Outer Membrane Stability
• Host Immune Evasion
• Motility
• Host Cell Adherence
• Colonization
• Cellular Invasion
7
Immunotherapy Targeting Pathogenic Bacteria
Proprietary Technology to “Weed” Harmful Bacteria
Direct Protective MOA
• Toxin Neutralization
• Suppression of Germination
• Suppression of Adhesion
• Suppression of Motility
• Suppression of Colonization
Indirect Protective MOA
• Inhibition of Toxin Induced
Inflammatory Signal Cascades
• Anti-Inflammatory Effect via
Stimulation of the Innate
Immune Response
• Enhancement of Gut Barrier
Function
• Inhibition of Epithelial Cell
Apoptosis
Immuron’s Clinical Programs
Multiple Near-Term Inflection Points
8
Program Indications
Development Stage
Program Highlights
Pre-Clinical Phase 1 Phase 2 Phase 3
Anti-Inflammatory Programs
IMM-124E NASH - Topline results reported 1Q 2018
IMM-124E ASH
- NIH Funded; UVA
- Topline results expected 2019
IMM-124E Pediatric NAFLD
- NIH Funded; Emory University
- Topline results expected 1Q 2019
IMM-124E Colitis
Collaboration with Dr. Rogler, Zurich
University - results reported 2Q 2018
IMM-124E Autism
Murdoch Childrens Research
Institue,
La Trobe & RMIT Universities
Anti-Infective Programs
IMM-529 C. difficile
- Phase 1/2 initiated 4Q 2017
- Topline results expected 1H 2019
IMM-124E /
Shigella Vaccine
Shigella
Infections
Collaboration with US Army - results
reported 1Q 2018
IMM-124E
Campylobacter;
ETEC Infections
Collaboration with US Navy - - results
reported 2Q 2018
• Hyperimmune bovine IgG powder 200mg
(30 caplets, 30 month shelf life)
• Reduces the risk of TD, reduces the
symptoms of minor GI disorders
TRAVELAN
9
Regulatory
Authority
Regulatory Pathway Indications
TGA Listed Medicine • Reduces the risk of travellers’ diarrhoea
• Reduces the symptoms of minor gastro-intestinal disorders
• Antimicrobial
Medsafe (New
Zealand)
Not marketed in New Zealand Not marketed in New Zealand
FDA (USA) Self-affirmed generally
regarded as safe (GRAS)
Dietary supplement. FDA does
not review dietary supplements
for safety and effectiveness
Hyperimmune colostrum dietary supplement
Health Canada Natural Health Product Travelan helps reduce the risk of traveller’s diarrhea.
EMA (Europe) Not marketed in Europe Not marketed in Europe
ARTG Listing for Travelan
http://www.travelanusa.com/
Australian Packaging
US Packaging
Prominent immune-reactive bands of
Campylobacter, ETEC and Shigella isolates
from Bhutan, Cambodia, Nepal and Thailand
10
Travelan immunoreactivity study:
• Armed Forces Research Institute of Medical Sciences (AFRIMS)
• Walter Reed Army Institute of Research (WRAIR)
• US Naval Medical Research Centre (NMRC)
Immuron Limited
March 2018
IMM-124E-2001 NASH Clinical Trial
Top Line Results
STUDY DESIGN IMM-124E-2001
12
Major Inclusion Criteria
Histologically proven NASH (≤12 months)
• NASH activity score (NAS) ≥4
• Cytologic ballooning score of at least 1
• 10% or more macrovesicular steatosis
• HBA1C of <9.0
SCREENING≤45D
IMM-124E 600 mg
IMM-124E 1200 mg
Placebo
FOLLOWUP4W
120 patients, 3-arms, Randomized, double
blind, Placebo – 2dose, balanced 1:1:1 design
13
STUDY ENDPOINTS
• Safety
• Hepatic Fat Fraction
PRIMARY
• liver enzymes – ALT, AST, GGT
• Glucose homeostasis and serum lipid profile
• Serum Bovine Ig – Pharmacokinetics
• Establish recommended dose
SECONDARY
• Lipopolysaccharides (LPS)
• CK-18
• Cytokines
• Adiponectin and GLP-1
MoA
STUDY POPULATIONS
14
Patients Screened: N = 237
Patients Randomized: N = 133
Study Analysis Sets:
ITT: 133FAS: 133PP: 102
Screening Failure n =
104
Early Discont. n = 21
Non-compliance n=8
Major deviations n=2
Definitions:
ITT = Intention to Treat
FAS = Full analysis set
PP = Per Protocol
SUMMARY: IMM-124E Clinical Trial Results
15
• First-In Class Anti-LPS Mechanism of Action
confirmed for IMM-124E
• Results demonstrate excellent safety and tolerability
• Statistically significant reduction in serum endotoxin/
Lipopolysaccharide (LPS) levels compared to
placebo
• Statistically significant reduction in mean serum ALT
in patients with elevated pre-treatment ALT
• Statistically significant Reduction of additional serum
NASH biomarkers associated with liver damage – AST
and CK-18
• IMM-124E retained within the GI tract and not
absorbed into the bloodstream, contributing to
favourable safety profile
• No effect on liver steatosis
FIRST IN CLASS MoA
LPS ANTAGONISM
16
• Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection. Thaiss CA et al. Science, 2018
• Non-alcoholic fatty liver and the gut microbiota. Stavros B et al. Molecular Metabolism, 2016
• Age-Associated Microbial Dysbiosis Promotes Intestinal Permeability, Systemic Inflammation, and Macrophage Dysfunction.
Thevaranjan N1, et al. Cell Host Microbe 2017.
• Hepatic TLR4 signaling in obese NAFLD. Sharifnia T, et al. Am J Physiol Gastrointest Liver Physiol 2015
• Obesity, Diet, Alcohol and
liver disease
• Dysbiosis
• “leaky gut” (LPS)
• Endotoxemia
• LPS engages TLR4
• lipogenesis,
inflammation, hepatocyte
apoptosis and fibrosis
NASH
SERUM ALANINE AMINO-TRANSFERASE (ALT)
RATE OF SUBJECTS WITH ≥30% DECREASE (n=94)*
17
30.3%
28.6%
14.3%
0%
5%
10%
15%
20%
25%
30%
35%
IMM 1200mg IMM 600mg PLB
* outlier sites excluded (site recruiting <3 patients) – as commonly practiced in clinical trials
p=0.107
SERUM ASPARTATE-AMINOTRANSFERASE AST
RATE OF SUBJECTS WITH AST DECREASE* >30%
(n=94)*
18
30.3%
14.3% 14.3%
0%
5%
10%
15%
20%
25%
30%
35%
IMM 1200mg IMM 600mg PLB
* excluded outlier sites
P=0.107
SERUM ALANINE AMINO-TRANSFERASE (ALT)
RATE OF SUBJECTS WITH ≥30% DECREASE*
19
36.4%
27.0%
13.6%
0%
5%
10%
15%
20%
25%
30%
35%
40%
IMM 1200mg IMM 600mg PLB
* excluded outlier sites, ALT BL >50
P=0.048
SERUM LIPOPOLYSACCHARIDES (LPS)
RATE OF PATIENTS WITH ≥15% DECREASE*
20
64.3%
59.1%
34.5%
0%
10%
20%
30%
40%
50%
60%
70%
IMM 1200mg IMM 600mg PLB
* Outlier sites excluded, Baseline LPS>250
P = 0.0184
SERUM LPS
OVERALL RESPONSE TO TREATMENT
TERTILE ANALYSIS
21
• Analysis aimed at
looking at the entire
population
• Shows an overall
beneficial effect across
all patients
• Minimizes risk of cut-off
selection bias
• p=0.0715 (1200mg vs.
PLB)
SERUM CYTOKERATINE-18 (CK-18)
RATE OF PATIENTS WITH ≥15% DECREASE (n=94)*
22
38.9%
15.2%
18.2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
IMM 1200mg IMM 600mg PLB
P = 0.0494* excluded outliers sites
Disease Biology Provides Targets For
Therapeutics
23
SUMMARY
24
• IMM-124E targets inflammation a major disease driver
• Inflammation drives disease progression from NAFLD to
NASH to NASH fibrosis to NASH Hepatocellular
carcinoma and NASH Cirrhosis
• Our Medical Advisory Board was particularly interested in
further evaluating the compound in NASH cirrhosis
• Huge potential to treating patients exhibiting endotoxemia
and elevated gut permeability e.g. cirrhotics either NASH or
of any cause (evaluating on de-/compensated near
compensation
• “The potential clinical applications for this drug candidate
are numerous and very exciting indeed” – Immuron MAB
IMM-124E: Fatty-Liver Portfolio – 3 Phase II
Trials
25
Two Ongoing NIH funded Phase 2 Programs: ASH and Pediatric
NAFLD
NASH
• Lead Principal Investigator: Arun Sanyal; Former President of AASLD (American Association for the Study
of Liver Diseases) and current Chair of the Liver Study Section at the NIH (National Institute of Health)
• Multi-center, double-blinded, placebo controlled trial; 25 sites running in US, Australia and Israel
• Fully recruited: 133 patients with biopsy proven NASH
• Timing: topline results reported 1Q 2018
ASH
• NIH funded; sponsored by University of Virginia
• Lead Principal Investigator: Arun Sanyal; Former President of AASLD (American Association for the Study
of Liver Diseases) and current Chair of the Liver Study Section at the NIH (National Institute of Health)
• Fully recruited: 56 patients
• Endpoint: ALT
• Timing: topline results in 2019
Pediatric
NAFLD
• NIH funded; sponsored by Emory University
• Lead Principal Investigator: Miriam Vos;
• Current enrollment: 19/40 patients
• Endpoint: ALT; 3 months treatment
• Timing: topline results in 1Q 2019
IMM-529
Neutralizing Clostridium difficile, while Sparing the
Microbiome
IMM-529 in Clostridium difficile Infection (CDI)
27
• Biologic with unique triple mechanism of action
- Targets and neutralizes the toxin B, the spores and the vegetative cells
• Potential to redefine the standard-of-care (SOC) therapy for CDI
- Stops virulence, without impacting the microbiome
- Compelling data in all three phases of the disease including (1) prevention of primary
disease, (2) treatment of primary disease and (3) prevention of recurrence
- Orally administrated, safe
• >70% survival rate in CDI mice treated with IMM-529 vs. <7% survival rate
in control groups
• Potential orphan disease designation; Potential breakthrough / fast track
designations
• Market exclusivity (biologics; High barriers to generic biosimilar entry)
IMM-529 for the Treatment of CDI
28
Market
Opportunity
• Therapeutic market is expected to grow from US$356.3 million in 2014 to over $1.5
billion by 2024 – CAGR 15%
• Nearly 30,000 patients die each year from C. difficile infections (US)
• Potential orphan disease (7 years market exclusivity and premium pricing)
Unmet Need
• Vancomycin and metronidazole are the current standard of care, accounting for 80% of
patient share (US)
• However, therapies are plagued by significant CDI recurrences (1st relapse: 25%; 2nd:
40%; 3rd: 50%) underscoring need for new treatments
• There is also growing resistance to vancomycin treatment
IMM-529
Positioning
• Highly differentiated – Neutralizes C. difficile but does not impact microbiome
• Only asset that targets not only toxin B but also the spores and the vegetative cells
responsible for recurrence
• Can be used in combination with standard of care
• Targets many isolates
Sources: GlobalData, Decision Resources, CDC
Triple Action MOA
Neutralizing C. difficile; Sparing the Microbiome
29
Spores – Infectious Particles
IMM-529 antibodies bind to
multiple epitopes on surface
antigens on spores and
prevent adheres to host cells
and limit germination.
Heat, ethanol and UV
resistant. Survive gastric acid,
adhere to cells in the colon
and germinate.
Vegetative Cells
IMM-529 antibodies bind to
multiple epitopes on the
surface layer proteins (SLP)
on vegetative cells and limit
colonization.
Fimbriae and other surface
layer proteins (SLP) contribute
to bacterial colonization.
Fimbriae are used to adhere to
other bacteria and to host cells
and is one of the primary
mechanisms of virulence
Toxin B
IMM-529 antibodies bind to
multiple epitopes effectively
neutralize toxin B, inhibiting toxin
mediated epithelial cell apoptosis
and limit toxin translocation into
the systemic circulation and
inflammatory cascades.
Toxin B is essential for
virulence. Toxin B disrupt the
cytoskeleton and tight
junctions of intestinal epithelial
cells.
3
1
2
Results of Pre-Clinical Studies
Hutton et al; Scientific Reports June 2017 | 7: 3665 | DOI:10.1038/s41598-017-03982-5
30
0 .0 0 .5 1 .0 1 .5 2 .0 2 .5 3 .0 3 .5 4 .0
0
2 0
4 0
6 0
8 0
1 0 0
S u rv iv a l
h o u rs p o s t in fe c tio n
Percentsurvival
U n in fe c te d , N o tre a tm e n t
In fe c te d , N o tre a tm e n t
In fe c te d , N o n -im m u n e Ig G tre a tm e n t
In fe c te d , IM M -5 2 9 tre a tm e n t
In fe c te d , V a n c o m y c in tre a tm e n t
PreventionStudies
Demonstrated ~70%
survival rate without
use of antibiotics vs.
0% for control group
(P<0.0001)
All studies
statistically
significant
TreatmentStudies
Demonstrated ~80%
survival rate without
use of antibiotics vs.
<7% in control group
(P<0.0001)
0 1 2 3 4
0
2 0
4 0
6 0
8 0
1 0 0
D a y s p o s t in fe c tio n
Percentsurvival
S u rv iv a l
In fe c te d , N o tre a tm e n t
In fe c te d , N o n -im m u n e Ig G tre a tm e n t
In fe c te d , IM M -5 2 9 tre a tm e n t
In fec te d , V a n c o m y c in trea tm e n t
U n in fe c te d , N o tre a tm e n t
RelapseStudies
Demonstrated ~20%
relapse rate vs.
~89% relapse rate in
control group
(P<0.0027)
Potentially only
therapeutic
(approved or in
development) that
can treat all
phases of the
disease:
1.Prophylaxis
2.Treatment
3.Recurrence
0 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0
0
1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
1 0 0
1 1 0
S u rv iv a l
D a y s a fte r v a n c o m y c in tre a tm e n t c e a s e d
Percentsurvival
In fe c te d + S O C
In fe c te d + S O C + IM M -5 2 9**
p=0.0027
Phase 1/2 Study Design
31
• Phase 1/2, randomized, double blind, placebo-controlled clinical study of IMM-529
for the treatment of CDI
• 60 subjects to be enrolled up to 3 weeks of definitive diagnosis of CDI (at least 20
subjects to be enrolled within the first 72 hours)
• Subjects randomized to IMM-529 or placebo in a 2:1 ratio
• Treatment duration: 28 days on top of SOC (vancomycin / metronidazole)
• Follow-up: 3 months overall
• Primary objective: To evaluate the safety and tolerability of IMM-529 together with
standard of care (SOC) in patients with CDI
• Secondary objective: To evaluate the effectiveness of IMM-529 together with SOC to
treat patients with CDI
Phase 1/2 Study in CDI Initiated 4Q 2017
NASH and C. difficile Comps Indicate
Potential for Substantial Growth
32
Company Ticker Program Development Stage Market Cap*
Program in NASH
ICPT Obeticholic acid Phase 3 US$2.9B
GNFT Elafibranor Phase 3 US$1.1B
CNAT ENCORE-LF Phase 2 US$195M
Program in C. Difficile
MCRB SER-109; SER-262 Phase 2 US$423M
SMMT SMT19969 Phase 1 US$143M
ASMB ABI-M101 Preclinical US$419M
*As of May 4, 2017
Capital Profile Immuron Limited (ASX:IMC NASDAQ:IMRN)
33
Current Top 10 Shareholders
Current Company
Market Capitalization
AUD$49.25M ≈ USD$36.13M (21st August 2018)
Rank Holder Name Current Qty %
1 HSBC CUSTODY NOM AUST LTD (ADR Program) 13,764,344 9.64%
2 CITICORP NOMINEES PTY LIMITED 12,715,858 8.91%
3 * GRANDLODGE PTY LTD 9,556,682 6.69%
4 AUTHENTICS AUSTRALIA PTY LTD 8,624,999 6.04%
5 * MR PETER ANASTASIOU 2,907,236 2.04%
6 INVERAREY PL 2,731,632 1.91%
7 INSYNC INVESTMENTS PTY LTD 2,500,000 1.75%
8 MR WILLIAM DAVID FRANK BIRD 2,500,000 1.75%
9 ADVANCE CLINICAL SYSTEMS 2,296,874 1.61%
10 * MR STEPHEN ANASTASIOU 2,035,371 1.43%
TOTAL TOP 20 SHAREHOLDERS 59,632,996 41.77%
BALANCE OF SHARES 83,145,210 58.23%
TOTAL SHARE ON ISSUE 142,778,206 100.00%
* Denotes a Director Related Entity
Key Milestones Expected to Drive Value
34
• IMM-124E
- NASH Phase 2 study
closed
• IMM-529
- Initiation of Phase
1/2 Trial in CDI
• IMM-124E
- NASH Phase 2
topline results
• IMM-124E
- ASH Phase 2 study
closed
- Pediatric NAFLD
Phase 2 study closed
- Colitis Preclinical
Study with Zurich
University - results
reported 2Q 2018
• IMM-124E
- ASH Phase 2 topline
results
- Pediatric NAFLD Phase 2
topline results
• IMM-529
- Topline results expected
from Phase 1/2 study in
CDI
4Q
2017
1Q
2018
2018 2019
Results from colitis preclinical studies and US
Army and US Navy trials expected 2018
Thank You

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Immuron corporate presentation september 2018 v1

  • 1. Immuron Limited September 2018 Oral Immunoglobulins Changing the Paradigms of Care www.immuron.com ASX:IMC NASDAQ:IMRN
  • 2. Forward Looking Statement Certain statements made in this presentation are forward-looking statements and are based on Immuron’s current expectations, estimates and projections. Words such as “anticipates,” “expects,” “intends,” “plans,” “believes,” “seeks,” “estimates,” “guidance” and similar expressions are intended to identify forward-looking statements. Although Immuron believes the forward-looking statements are based on reasonable assumptions, they are subject to certain risks and uncertainties, some of which are beyond Immuron’s control, including those risks or uncertainties inherent in the process of both developing and commercializing technology. As a result, actual results could materially differ from those expressed or forecasted in the forward-looking statements. The forward-looking statements made in this presentation relate only to events as of the date on which the statements are made. Immuron will not undertake any obligation to release publicly any revisions or updates to these forward- looking statements to reflect events, circumstances or unanticipated events occurring after the date of this presentation except as required by law or by any appropriate regulatory authority.
  • 3. Company Highlights 3 • Clinical stage biopharmaceutical company targeting inflammatory-mediated and infectious diseases with oral immunotherapies • Validated technology platform – with one registered asset generating revenue • 2 Lead clinical assets in Phase 2 development for the treatment of multiple high value indications, Fat Liver Disease and CDI. • Excellent safety profile, GRAS by FDA, expedited regulatory review and approval process • High-value peer licensing deals and M&A underscore potential upside • Experienced Management Team and strong support from leading KOLs and institutions (NIH, DoD) • Company listed on NASDAQ in 2Q 2017
  • 4. Advisory Board Dr. Arun Sanyal (MD) University of Virginia Former President of the AASLD. Current Chair of the Liver Study Section at the NIH. IMM-124E lead PI. Dr. Stephen Harrison (MD) San Antonio Military Medical Center Brooke US Army Medical Center Internationally renowned expert in NASH. Lead PI of Galectin’s GR-MD-02’s Phase II trial. Dr. Manal Abdelmalek (MD) Duke University Medical Center Dr. Abdelmalek is a leading investigator in the field of NASH. Dr. Gerhard Rogler (MD, PhD) Zurich University Professor Rogler is a leader in the field of Colitis and has authored more than 200 original peer-reviewed articles. Dr. Miriam Vos (MD) Emory University Dr. Vos specializes in the treatment of gastrointestinal disease in children as well as fatty liver disease and obesity. Dr. Dena Lyras (PhD) Monash University Dr. Lyras is one of the world’s leading experts in C. difficile. 4 Organizations Prominent Scientific Advisory Board and Leading Research Partners
  • 5. Platform Overview: Oral Immunoglobulins 5 1 Vaccines Are Developed 2 Antibodies Are Harvested from Colostrum Antigen Specific Antibodies (IgG and IgG1) Adjuvants+ 3 Broad Therapeutic Effect + • Reduced gut and blood pathogens responsible for initiating inflammation • Reduces systemic inflammation • Lowers organ injury • Strong anti-toxin properties • Decrease toxin levels results in decrease gut damage • Generally Regarded as Safe (GRAS) Induction of regulatory T-cells Clearance of Targeted GUT Pathogens Competitive Advantage • Platform capable of producing multiple drug candidates → Long-term value creation • Bovine IgG possesses a unique ability to remain active in the human GI tract → delivering its full benefits to the bacteria found there • Bovine IgG is capable of withstanding the acidic environment of the stomach and is resistant to proteolysis by the digestive enzymes in the GI tract • Safety established → Not absorbed into the blood
  • 6. Immunotherapy Targeting Pathogenic Bacteria Technology Platform Capable of Producing High Levels of Antibodies against specific pathogenic and antigenic determinants 6 Targeting Virulence Factors; • Spores • Lipopolyscaccarride Endotoxins • Exotoxins • Fimbrae & Molecules which facilitate adhesion • Surface Layer Proteins which contribute to Colonisation • Flagella (Flagellin) Antigens Important For; • Outer Membrane Stability • Host Immune Evasion • Motility • Host Cell Adherence • Colonization • Cellular Invasion
  • 7. 7 Immunotherapy Targeting Pathogenic Bacteria Proprietary Technology to “Weed” Harmful Bacteria Direct Protective MOA • Toxin Neutralization • Suppression of Germination • Suppression of Adhesion • Suppression of Motility • Suppression of Colonization Indirect Protective MOA • Inhibition of Toxin Induced Inflammatory Signal Cascades • Anti-Inflammatory Effect via Stimulation of the Innate Immune Response • Enhancement of Gut Barrier Function • Inhibition of Epithelial Cell Apoptosis
  • 8. Immuron’s Clinical Programs Multiple Near-Term Inflection Points 8 Program Indications Development Stage Program Highlights Pre-Clinical Phase 1 Phase 2 Phase 3 Anti-Inflammatory Programs IMM-124E NASH - Topline results reported 1Q 2018 IMM-124E ASH - NIH Funded; UVA - Topline results expected 2019 IMM-124E Pediatric NAFLD - NIH Funded; Emory University - Topline results expected 1Q 2019 IMM-124E Colitis Collaboration with Dr. Rogler, Zurich University - results reported 2Q 2018 IMM-124E Autism Murdoch Childrens Research Institue, La Trobe & RMIT Universities Anti-Infective Programs IMM-529 C. difficile - Phase 1/2 initiated 4Q 2017 - Topline results expected 1H 2019 IMM-124E / Shigella Vaccine Shigella Infections Collaboration with US Army - results reported 1Q 2018 IMM-124E Campylobacter; ETEC Infections Collaboration with US Navy - - results reported 2Q 2018
  • 9. • Hyperimmune bovine IgG powder 200mg (30 caplets, 30 month shelf life) • Reduces the risk of TD, reduces the symptoms of minor GI disorders TRAVELAN 9 Regulatory Authority Regulatory Pathway Indications TGA Listed Medicine • Reduces the risk of travellers’ diarrhoea • Reduces the symptoms of minor gastro-intestinal disorders • Antimicrobial Medsafe (New Zealand) Not marketed in New Zealand Not marketed in New Zealand FDA (USA) Self-affirmed generally regarded as safe (GRAS) Dietary supplement. FDA does not review dietary supplements for safety and effectiveness Hyperimmune colostrum dietary supplement Health Canada Natural Health Product Travelan helps reduce the risk of traveller’s diarrhea. EMA (Europe) Not marketed in Europe Not marketed in Europe ARTG Listing for Travelan http://www.travelanusa.com/ Australian Packaging US Packaging
  • 10. Prominent immune-reactive bands of Campylobacter, ETEC and Shigella isolates from Bhutan, Cambodia, Nepal and Thailand 10 Travelan immunoreactivity study: • Armed Forces Research Institute of Medical Sciences (AFRIMS) • Walter Reed Army Institute of Research (WRAIR) • US Naval Medical Research Centre (NMRC)
  • 11. Immuron Limited March 2018 IMM-124E-2001 NASH Clinical Trial Top Line Results
  • 12. STUDY DESIGN IMM-124E-2001 12 Major Inclusion Criteria Histologically proven NASH (≤12 months) • NASH activity score (NAS) ≥4 • Cytologic ballooning score of at least 1 • 10% or more macrovesicular steatosis • HBA1C of <9.0 SCREENING≤45D IMM-124E 600 mg IMM-124E 1200 mg Placebo FOLLOWUP4W 120 patients, 3-arms, Randomized, double blind, Placebo – 2dose, balanced 1:1:1 design
  • 13. 13 STUDY ENDPOINTS • Safety • Hepatic Fat Fraction PRIMARY • liver enzymes – ALT, AST, GGT • Glucose homeostasis and serum lipid profile • Serum Bovine Ig – Pharmacokinetics • Establish recommended dose SECONDARY • Lipopolysaccharides (LPS) • CK-18 • Cytokines • Adiponectin and GLP-1 MoA
  • 14. STUDY POPULATIONS 14 Patients Screened: N = 237 Patients Randomized: N = 133 Study Analysis Sets: ITT: 133FAS: 133PP: 102 Screening Failure n = 104 Early Discont. n = 21 Non-compliance n=8 Major deviations n=2 Definitions: ITT = Intention to Treat FAS = Full analysis set PP = Per Protocol
  • 15. SUMMARY: IMM-124E Clinical Trial Results 15 • First-In Class Anti-LPS Mechanism of Action confirmed for IMM-124E • Results demonstrate excellent safety and tolerability • Statistically significant reduction in serum endotoxin/ Lipopolysaccharide (LPS) levels compared to placebo • Statistically significant reduction in mean serum ALT in patients with elevated pre-treatment ALT • Statistically significant Reduction of additional serum NASH biomarkers associated with liver damage – AST and CK-18 • IMM-124E retained within the GI tract and not absorbed into the bloodstream, contributing to favourable safety profile • No effect on liver steatosis
  • 16. FIRST IN CLASS MoA LPS ANTAGONISM 16 • Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection. Thaiss CA et al. Science, 2018 • Non-alcoholic fatty liver and the gut microbiota. Stavros B et al. Molecular Metabolism, 2016 • Age-Associated Microbial Dysbiosis Promotes Intestinal Permeability, Systemic Inflammation, and Macrophage Dysfunction. Thevaranjan N1, et al. Cell Host Microbe 2017. • Hepatic TLR4 signaling in obese NAFLD. Sharifnia T, et al. Am J Physiol Gastrointest Liver Physiol 2015 • Obesity, Diet, Alcohol and liver disease • Dysbiosis • “leaky gut” (LPS) • Endotoxemia • LPS engages TLR4 • lipogenesis, inflammation, hepatocyte apoptosis and fibrosis NASH
  • 17. SERUM ALANINE AMINO-TRANSFERASE (ALT) RATE OF SUBJECTS WITH ≥30% DECREASE (n=94)* 17 30.3% 28.6% 14.3% 0% 5% 10% 15% 20% 25% 30% 35% IMM 1200mg IMM 600mg PLB * outlier sites excluded (site recruiting <3 patients) – as commonly practiced in clinical trials p=0.107
  • 18. SERUM ASPARTATE-AMINOTRANSFERASE AST RATE OF SUBJECTS WITH AST DECREASE* >30% (n=94)* 18 30.3% 14.3% 14.3% 0% 5% 10% 15% 20% 25% 30% 35% IMM 1200mg IMM 600mg PLB * excluded outlier sites P=0.107
  • 19. SERUM ALANINE AMINO-TRANSFERASE (ALT) RATE OF SUBJECTS WITH ≥30% DECREASE* 19 36.4% 27.0% 13.6% 0% 5% 10% 15% 20% 25% 30% 35% 40% IMM 1200mg IMM 600mg PLB * excluded outlier sites, ALT BL >50 P=0.048
  • 20. SERUM LIPOPOLYSACCHARIDES (LPS) RATE OF PATIENTS WITH ≥15% DECREASE* 20 64.3% 59.1% 34.5% 0% 10% 20% 30% 40% 50% 60% 70% IMM 1200mg IMM 600mg PLB * Outlier sites excluded, Baseline LPS>250 P = 0.0184
  • 21. SERUM LPS OVERALL RESPONSE TO TREATMENT TERTILE ANALYSIS 21 • Analysis aimed at looking at the entire population • Shows an overall beneficial effect across all patients • Minimizes risk of cut-off selection bias • p=0.0715 (1200mg vs. PLB)
  • 22. SERUM CYTOKERATINE-18 (CK-18) RATE OF PATIENTS WITH ≥15% DECREASE (n=94)* 22 38.9% 15.2% 18.2% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% IMM 1200mg IMM 600mg PLB P = 0.0494* excluded outliers sites
  • 23. Disease Biology Provides Targets For Therapeutics 23
  • 24. SUMMARY 24 • IMM-124E targets inflammation a major disease driver • Inflammation drives disease progression from NAFLD to NASH to NASH fibrosis to NASH Hepatocellular carcinoma and NASH Cirrhosis • Our Medical Advisory Board was particularly interested in further evaluating the compound in NASH cirrhosis • Huge potential to treating patients exhibiting endotoxemia and elevated gut permeability e.g. cirrhotics either NASH or of any cause (evaluating on de-/compensated near compensation • “The potential clinical applications for this drug candidate are numerous and very exciting indeed” – Immuron MAB
  • 25. IMM-124E: Fatty-Liver Portfolio – 3 Phase II Trials 25 Two Ongoing NIH funded Phase 2 Programs: ASH and Pediatric NAFLD NASH • Lead Principal Investigator: Arun Sanyal; Former President of AASLD (American Association for the Study of Liver Diseases) and current Chair of the Liver Study Section at the NIH (National Institute of Health) • Multi-center, double-blinded, placebo controlled trial; 25 sites running in US, Australia and Israel • Fully recruited: 133 patients with biopsy proven NASH • Timing: topline results reported 1Q 2018 ASH • NIH funded; sponsored by University of Virginia • Lead Principal Investigator: Arun Sanyal; Former President of AASLD (American Association for the Study of Liver Diseases) and current Chair of the Liver Study Section at the NIH (National Institute of Health) • Fully recruited: 56 patients • Endpoint: ALT • Timing: topline results in 2019 Pediatric NAFLD • NIH funded; sponsored by Emory University • Lead Principal Investigator: Miriam Vos; • Current enrollment: 19/40 patients • Endpoint: ALT; 3 months treatment • Timing: topline results in 1Q 2019
  • 26. IMM-529 Neutralizing Clostridium difficile, while Sparing the Microbiome
  • 27. IMM-529 in Clostridium difficile Infection (CDI) 27 • Biologic with unique triple mechanism of action - Targets and neutralizes the toxin B, the spores and the vegetative cells • Potential to redefine the standard-of-care (SOC) therapy for CDI - Stops virulence, without impacting the microbiome - Compelling data in all three phases of the disease including (1) prevention of primary disease, (2) treatment of primary disease and (3) prevention of recurrence - Orally administrated, safe • >70% survival rate in CDI mice treated with IMM-529 vs. <7% survival rate in control groups • Potential orphan disease designation; Potential breakthrough / fast track designations • Market exclusivity (biologics; High barriers to generic biosimilar entry)
  • 28. IMM-529 for the Treatment of CDI 28 Market Opportunity • Therapeutic market is expected to grow from US$356.3 million in 2014 to over $1.5 billion by 2024 – CAGR 15% • Nearly 30,000 patients die each year from C. difficile infections (US) • Potential orphan disease (7 years market exclusivity and premium pricing) Unmet Need • Vancomycin and metronidazole are the current standard of care, accounting for 80% of patient share (US) • However, therapies are plagued by significant CDI recurrences (1st relapse: 25%; 2nd: 40%; 3rd: 50%) underscoring need for new treatments • There is also growing resistance to vancomycin treatment IMM-529 Positioning • Highly differentiated – Neutralizes C. difficile but does not impact microbiome • Only asset that targets not only toxin B but also the spores and the vegetative cells responsible for recurrence • Can be used in combination with standard of care • Targets many isolates Sources: GlobalData, Decision Resources, CDC
  • 29. Triple Action MOA Neutralizing C. difficile; Sparing the Microbiome 29 Spores – Infectious Particles IMM-529 antibodies bind to multiple epitopes on surface antigens on spores and prevent adheres to host cells and limit germination. Heat, ethanol and UV resistant. Survive gastric acid, adhere to cells in the colon and germinate. Vegetative Cells IMM-529 antibodies bind to multiple epitopes on the surface layer proteins (SLP) on vegetative cells and limit colonization. Fimbriae and other surface layer proteins (SLP) contribute to bacterial colonization. Fimbriae are used to adhere to other bacteria and to host cells and is one of the primary mechanisms of virulence Toxin B IMM-529 antibodies bind to multiple epitopes effectively neutralize toxin B, inhibiting toxin mediated epithelial cell apoptosis and limit toxin translocation into the systemic circulation and inflammatory cascades. Toxin B is essential for virulence. Toxin B disrupt the cytoskeleton and tight junctions of intestinal epithelial cells. 3 1 2
  • 30. Results of Pre-Clinical Studies Hutton et al; Scientific Reports June 2017 | 7: 3665 | DOI:10.1038/s41598-017-03982-5 30 0 .0 0 .5 1 .0 1 .5 2 .0 2 .5 3 .0 3 .5 4 .0 0 2 0 4 0 6 0 8 0 1 0 0 S u rv iv a l h o u rs p o s t in fe c tio n Percentsurvival U n in fe c te d , N o tre a tm e n t In fe c te d , N o tre a tm e n t In fe c te d , N o n -im m u n e Ig G tre a tm e n t In fe c te d , IM M -5 2 9 tre a tm e n t In fe c te d , V a n c o m y c in tre a tm e n t PreventionStudies Demonstrated ~70% survival rate without use of antibiotics vs. 0% for control group (P<0.0001) All studies statistically significant TreatmentStudies Demonstrated ~80% survival rate without use of antibiotics vs. <7% in control group (P<0.0001) 0 1 2 3 4 0 2 0 4 0 6 0 8 0 1 0 0 D a y s p o s t in fe c tio n Percentsurvival S u rv iv a l In fe c te d , N o tre a tm e n t In fe c te d , N o n -im m u n e Ig G tre a tm e n t In fe c te d , IM M -5 2 9 tre a tm e n t In fec te d , V a n c o m y c in trea tm e n t U n in fe c te d , N o tre a tm e n t RelapseStudies Demonstrated ~20% relapse rate vs. ~89% relapse rate in control group (P<0.0027) Potentially only therapeutic (approved or in development) that can treat all phases of the disease: 1.Prophylaxis 2.Treatment 3.Recurrence 0 2 4 6 8 1 0 1 2 1 4 1 6 1 8 2 0 0 1 0 2 0 3 0 4 0 5 0 6 0 7 0 8 0 9 0 1 0 0 1 1 0 S u rv iv a l D a y s a fte r v a n c o m y c in tre a tm e n t c e a s e d Percentsurvival In fe c te d + S O C In fe c te d + S O C + IM M -5 2 9** p=0.0027
  • 31. Phase 1/2 Study Design 31 • Phase 1/2, randomized, double blind, placebo-controlled clinical study of IMM-529 for the treatment of CDI • 60 subjects to be enrolled up to 3 weeks of definitive diagnosis of CDI (at least 20 subjects to be enrolled within the first 72 hours) • Subjects randomized to IMM-529 or placebo in a 2:1 ratio • Treatment duration: 28 days on top of SOC (vancomycin / metronidazole) • Follow-up: 3 months overall • Primary objective: To evaluate the safety and tolerability of IMM-529 together with standard of care (SOC) in patients with CDI • Secondary objective: To evaluate the effectiveness of IMM-529 together with SOC to treat patients with CDI Phase 1/2 Study in CDI Initiated 4Q 2017
  • 32. NASH and C. difficile Comps Indicate Potential for Substantial Growth 32 Company Ticker Program Development Stage Market Cap* Program in NASH ICPT Obeticholic acid Phase 3 US$2.9B GNFT Elafibranor Phase 3 US$1.1B CNAT ENCORE-LF Phase 2 US$195M Program in C. Difficile MCRB SER-109; SER-262 Phase 2 US$423M SMMT SMT19969 Phase 1 US$143M ASMB ABI-M101 Preclinical US$419M *As of May 4, 2017
  • 33. Capital Profile Immuron Limited (ASX:IMC NASDAQ:IMRN) 33 Current Top 10 Shareholders Current Company Market Capitalization AUD$49.25M ≈ USD$36.13M (21st August 2018) Rank Holder Name Current Qty % 1 HSBC CUSTODY NOM AUST LTD (ADR Program) 13,764,344 9.64% 2 CITICORP NOMINEES PTY LIMITED 12,715,858 8.91% 3 * GRANDLODGE PTY LTD 9,556,682 6.69% 4 AUTHENTICS AUSTRALIA PTY LTD 8,624,999 6.04% 5 * MR PETER ANASTASIOU 2,907,236 2.04% 6 INVERAREY PL 2,731,632 1.91% 7 INSYNC INVESTMENTS PTY LTD 2,500,000 1.75% 8 MR WILLIAM DAVID FRANK BIRD 2,500,000 1.75% 9 ADVANCE CLINICAL SYSTEMS 2,296,874 1.61% 10 * MR STEPHEN ANASTASIOU 2,035,371 1.43% TOTAL TOP 20 SHAREHOLDERS 59,632,996 41.77% BALANCE OF SHARES 83,145,210 58.23% TOTAL SHARE ON ISSUE 142,778,206 100.00% * Denotes a Director Related Entity
  • 34. Key Milestones Expected to Drive Value 34 • IMM-124E - NASH Phase 2 study closed • IMM-529 - Initiation of Phase 1/2 Trial in CDI • IMM-124E - NASH Phase 2 topline results • IMM-124E - ASH Phase 2 study closed - Pediatric NAFLD Phase 2 study closed - Colitis Preclinical Study with Zurich University - results reported 2Q 2018 • IMM-124E - ASH Phase 2 topline results - Pediatric NAFLD Phase 2 topline results • IMM-529 - Topline results expected from Phase 1/2 study in CDI 4Q 2017 1Q 2018 2018 2019 Results from colitis preclinical studies and US Army and US Navy trials expected 2018