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Opexa Therapeutics, Inc.
NASDAQ: OPXA
Precision Immunotherapy
September 2015
The Woodlands, TX
Precision Immunotherapy®
2
Forward-Looking Statements
All statements in this presentation other than those of historical fact, including statements regarding our preclinical and
clinical development plans for Tcelna® and OPX-212, our research and other development programs, our ability to
undertake certain activities and accomplish certain goals, projected timelines for our research and development
activities and possible regulatory approvals, if any, our expectations regarding the relative benefits of our product
candidates versus competitive therapies, our expectations regarding the possibility of licensing or collaborating with
third parties regarding our product candidates or research, and our expectations regarding the therapeutic and
commercial potential of our product candidates, research, technologies and intellectual property, are forward-looking
statements. The words “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “design,” “intend,” “expect,”
“potential” and similar expressions, as well as the negative version of these words and similar expressions, are intended
to identify forward-looking statements. Our forward-looking statements do not constitute guarantees of future
performance, and are subject to a number of risks and uncertainties that could cause actual results to differ materially
and adversely from those anticipated or implied in such statements. Our forward-looking statements are based upon
our current expectations and involve assumptions that may never materialize or may prove to be incorrect. Actual
results and the timing of events could differ materially from those anticipated as a result of various risks and
uncertainties which include, without limitation, risks associated with the process of discovering, developing and
commercializing drugs that are safe and effective for use as human therapeutics and risks inherent in the effort to build
a business around such drugs. Although we believe our expectations are reasonable, we do not in any way guarantee
future results, level of activity, performance or achievements. In addition, neither we nor any other person assumes
responsibility for the accuracy and completeness of any forward-looking statements. Our forward-looking statements in
this presentation speak only as of the date of this presentation. We assume no obligation or undertaking to update or
revise any statements to reflect any changes in our expectations or any change in events, conditions or circumstances on
which any such statement is based. You should, however, review additional disclosures we make that further describe
risks and uncertainties relevant to us in additional detail in our filings with the Securities and Exchange Commission
including our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q. You may get these documents for free
by visiting EDGAR on the SEC web site at http://www.sec.gov.
3
Opexa Investment Highlights
 PIPELINE
• Tcelna®: Phase 2b for secondary progressive multiple sclerosis (SPMS), limited
competition, $7BN overall market potential
• OPX-212: Pre-IND for neuromyelitis optica (NMO), no approved therapies, orphan
indication
 TECHNOLOGY
• Personalized T-cell immunotherapy platform for autoimmune diseases
• Potential to yield multiple candidates tailored to each patient’s disease profile
• Company owned and scalable cGMP manufacturing facility
• Strong patent estate (98 domestic and international)
 VALIDATION
• Option agreement secured with Merck Serono for Tcelna – strong potential partner
• FDA Fast Track designation for Tcelna in SPMS
• Esteemed Scientific Advisory Board
4
Recent and Upcoming Expected Milestones
Tcelna: Multiple Sclerosis
 1H 2014: Completed Enrollment in Phase 2b SPMS trial
 Q1 2015: Received additional $3M payment from Merck Serono for Tcelna
development
 Q3 2015: 85% of all patient visits in Abili-T trial have been completed
• 2H 2016: Top line results expected for Abili-T Phase 2b SPMS trial
OPX-212: Neuromyelitis Optica
 1H 2014: Initiated Early Development Plan
 Q3 2015: Secured $5 million in milestone funding to support OPX-212 NMO
development, including Phase I/II proof-of-concept clinical trial
• 2015: Expect to complete preclinical and IND enabling studies and file IND by
year-end
5
Financials
Cash and Cash Equivalents (MM) as of June 30, 2015 ~$18.3
Shares outstanding (MM) as of June 30, 2015 ~53.4
Warrants (MM) outstanding as of June 30, 2015 ~28.4(1)
Stock Options (MM) outstanding as of June 30, 2015 ~3.3(2)
Debt None
(1) Weighted average exercise price =$.80 as of June 30, 2015
(2) Weighted average exercise price = $2.28 as of June 30, 2015
OPEXA’S NOVEL APPROACH;
PRIMING THE IMMUNE SYSTEM
6
7
Root cause of MS: Activated T-cells degrade myelin and
damage myelin producing cells
Adapted by permission from Macmillan Publishers Ltd: NATURE REVIEWS
IMMUNOLOGY 3, 483-492 (June 2003), copyright (2003)
Cytokines
Damage
Damage
• In MS patients, the faulty immune system is
not able to prevent the attack of a small sub-
population of myelin reactive T-cells (MRTC)
• MRTCs cross the blood brain barrier, enter
the brain, and bind to antigen presenting
cells (APC), causing a release of pro-
inflammatory cytokines which lead to a two
pronged attack through:
1. Destruction of myelin sheath, the protective
coating of nerve fibers
2. Destruction of oligodendroglial cells, which
are responsible for producing myelin
Myelin peptide
Result
Destruction of the myelin sheath and myelin producing cells,
thereby preventing remyelination
8
Tcelna could address the root cause of MS by preventing
demyelination and enabling remyelination
Adapted by permission from Macmillan Publishers Ltd: NATURE REVIEWS
IMMUNOLOGY 3, 483-492 (June 2003), copyright (2003)
Opexa’s Strategy
Tcelna programs the immune system to specifically
recognize MRTC as pathogenic, thereby inhibiting further
destruction of the myelin sheath and potentially enabling
remyelination
• Therapeutic dose of Tcelna (attenuated T-cell
clones) is injected subcutaneously
• This triggers an immune response specifically
targeting circulating MRTC
• Immune cells, including Tregs, have been primed,
or sensitized, we believe, to specifically target the
pathogenic MRTC for elimination or regulation
• Elimination of harmful MRTC may lead to:
1. Stabilization of disease by preventing further
destruction of myelin
2. Improvement in condition by allowing
oligodendroglial cells to remyelinate axons
(neuroprotection)
9
ImmPath® manufacturing platform
Cryopreservation
Formulation/
Irradiation of
each dose as
required
Administration: 5
subcutaneous
injections/year
Manufacturing and QC Dispensation
35 days
Epitope Profiling
1 day14 days
- Red Cross
- Blood Group Alliance
Epitope Profiling Expansion of antigen specific T-cells
Annual course of treatment consists of 5 doses manufactured
from a single procurement of blood product
10
Clinical evidence for Tcelna MoA
T-cell technology demonstrated a significant reduction in reactive T-cells (52 week study results of MS)
0%
-92%
-87%
-79%
-77%
-65%
-100%
-90%
-80%
-70%
-60%
-50%
-40%
-30%
-20%
-10%
0%
Week 0 Week 5 Week 13 Week 21 Week 28 Week 52
• Results from Tcelna dose ranging studies:
 Published in Clinical Immunology
(2009) 131, 202-215
• Each dose consisting of 30-45 x 106 cells
ReductioninMRTC
Dose 1 Dose 2 Dose 3 Dose 4
MRTC: Myelin Reactive T-cells
11
Phase 2b RRMS prior clinical trial
Tcelna showed 37% improvement over placebo (mITT)
(secondary endpoint measurement, primary MRI endpoint measure not met)
0.214
0.339
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
37% Reduction in Annualized Relapse Rate (ARR)
Tcelna
Placebo
n=94 n=48
Relapses/Patient/Year
37%
Total mITT population
n=142
IMMPATH®: OPEXA’S PROPRIETARY
T-CELL IMMUNOTHERAPY PLATFORM
12
13
Leveraging ImmPath® platform in new
indications
Potential New Targets:
Certain diseases with known antigen profile
• Grave’s Disease
• Idiotypic thrombocytopenic purpura
• Myasthenia Gravis
• Pemphigus vulgaris/foliaceus
• Primary Biliary Cirrhosis
• Type 1 Diabetes
• Hashimoto’s thyroiditis
• Vitiligo
Certain diseases with unknown antigen profile
• RA
• Celiac
• Psoriasis
• Uveitis
• IBD
• Sjögren’s
Secondary Progressive
Multiple Sclerosis
Neuromyelitis
optica
ImmPath®: Personalized, Precision Immunotherapy Platform
Phase 2b
Preclinical
14
Expansion of Pipeline Increases
Partnering Opportunities
Autoimmune
diseases with
known antigens
• Development stage programs
- i.e. OPX-212 for NMO
• Orphan disease benefits
Autoimmune
diseases with
unknown antigens
• Discovery stage programs
• Possible expansion to large
markets (e.g. RA, Psoriasis)
Multiple Sclerosis
Japan
• Quick access to market
• Leverage U.S. trial success
TCELNA® FOR MULTIPLE SCLEROSIS
15
16
Tcelna in Secondary Progressive MS
SPMS
450,000 Individuals in North America diagnosed with MS;
30-45 % potentially have an SPMS diagnosis
Market Size:
$7 Billion (est.)
Relapsing Remitting MS;
Clinically Isolated Syndrome;
Primary Progressive MS
• Secondary Progressive MS market
potential in North America could
exceed $7 billion (for all therapies)
• Roughly 150,000 SPMS patients in
North America
• Only one drug approved for SPMS in
U.S. (none in EU or Asia)
- Drug not suitable for chronic use
due to severe side effects
Tcelna being developed to be a
potential therapy of choice in SPMS
17
Tcelna®
Lead Program Targeting Secondary Progressive MS patients
Fast Track Designation by FDA
• Phase 2b is fully enrolled: 190 patients with SPMS
• Top line data expected in 2H 2016
• Design
– Double-blind, 1:1 randomized, placebo-controlled
– 35 clinical sites in USA and Canada
– Two annual courses of personalized therapy
– Efficacy Endpoints: Primary-Whole Brain Atrophy, Secondary-Disease Progression
• Immune Monitoring being conducted in parallel
– Comprehensive biomarker analysis
18
Merck Serono Agreement
Agreement signed 2013; strong potential partner
• Option and License Agreement for worldwide rights to all Multiple
Sclerosis indications, excluding Japan
• If Merck Serono exercises option:
– Merck Serono to fund Phase 3, pre-commercial and commercial activities
– Opexa has potential to receive up to an additional $220 million in option
exercise and milestone payments
– Opexa has potential to receive royalties ranging from 8% to 15% of annual net
sales, with step-ups occurring if net sales exceed $500 million, $1 B & $2 B
• Merck Serono increased their commitment to Opexa’s MS program this
year
– In anticipation of the Phase IIb trial results expected in 2H 2016, Merck
Serono gave Opexa $3 million of support in March 2015 to begin planning for
Phase III studies
LEVERAGING THE T-CELL PLATFORM:
OPX-212 FOR NEUROMYELITIS OPTICA
(NMO)
19
20
NMO: A rare disease of the Central Nervous System
• Neuromyelitis optica (NMO) is a rare or orphan
autoimmune disease
• Immune system cells and antibodies mistakenly attack
and destroy myelin cells in the optic nerves and the
spinal cord
• Individuals with NMO develop optic neuritis, which
causes pain in the eye and vision loss, and transverse
myelitis, which causes weakness, numbness, and
sometimes paralysis of the arms and legs
• There are no FDA-approved therapies for NMO
• Affects any age varying from 3 to 90 years, the average
age of onset ~41 years
An orphan disease with no FDA-approved therapy
Image reprinted with permission from MultiView, Inc.
21
Key Milestones Achieved to Date in OPX-212
Development Program
Funding support
• Recently secured $5 million private funding for OPX-212 to advance further
NMO development, including Phase I/II clinical study
KOL support
• Engaged key thought leaders to validate scientific hypothesis and discuss
clinical trial design
– Benjamin Greenberg, M.D., University of Texas, Southwestern Medical Center
– Michael Levy, M.D., Ph.D., The Johns Hopkins Hospital
FDA feedback
• Conducted Pre-IND meeting to discuss pre-clinical and clinical program to
support OPX-212 development in NMO
Patient support
• Collected NMO patient blood samples to conduct pre-IND activities, process
development and research into mechanism of action
22
NMO disease pathogenesis
NMO
Pathogenic T-Cells
Anti-AQP-4
Plasma
Cell
Binding to AQP4
channels on the
astrocytes
Increase astrocyte
permeability
Neuroinflammation
AQP-4
expression
Complement
activation
Axonal loss
CD4+ T-cell CD69 Infiltration of
macrophages and
granulocytes
Neutrophils Eosinophils
↑ IL-17/IL-8
B-cell
Macrophages
Demyelination
Activated T-cell/Th-17
Necrosis
B-Cells
Inflammatory Cells
NMO Lesion
AQP4 antibodies that penetrate
the CNS and bind to AQP4
channels on the astrocyte
Astrocyte damage leads to
• Inflammation
• Oligodendrocyte injury
• Demyelination
• Neuronal loss
Migration of
inflammatory cells
leads to localized
inflammation
23
Potential intervention points for T-cell therapy
T-cell therapy believed to inhibit AQP-4 autoantibody, pro-inflammatory cytokines and
prevent infiltration of macrophages and granulocytes
Without the pathogenic T-cell, the
B-cell does not signal the
production of the AQP-4 antibody
Possible results:
• Reduce tissue damage
• May favor repair and
remyelination of axons
• Reduce frequency and severity of
Relapses of clinical disease
OPX-212 expected to down
regulate pathogenic AQP-4 T-cells
NMO
Pathogenic T-Cells
Anti-AQP-4
Plasma
Cell
Binding to AQP4
channels on the
astrocytes
Increase astrocyte
permeability
Neuroinflammation
AQP-4
expression
Complement
activation
Axonal loss
CD4+ T-cell CD69 Infiltration of
macrophages and
granulocytes
Neutrophils Eosinophils
↑ IL-17/IL-8
B-cell
Macrophages
Demyelination
Activated T-cell/Th-17
Necrosis
B-Cells
Inflammatory Cells
Expected to prevent
infiltration of
Neutrophils,
Eosinophils and
Macrophages
Preventing the damage of the
AQP-4 channel of the astrocyte
NMO Lesion
OPX-212 OPX-212
24
NMO Investment Thesis
• Any therapy that could achieve tolerization of the AQP-4 reactive T-
cells may offer a cure for NMO
• OPX-212 has the potential to address the root cause of NMO
• OPX-212 leverages Opexa’s T-cell platform to B-cell mediated
orphan diseases
• Opexa currently retains world wide rights to OPX-212
• Higher prevalence of NMO in Asia could complement Opexa’s MS
rights in Japan
• IND filing expected by 12/31/15
25
Experienced Management Team and Board of Directors
Neil Warma, President & CEO, Director
› 19+ years international healthcare experience with large Pharma and emerging
biotechnology companies
› Former Senior Management, Novartis Pharmaceuticals, Basel, Switzerland
› Former CEO, Viron Therapeutics, Inc.
› Co-founder and President of MedExact Inc., a company subsequently acquired
Karthik Radhakrishnan, Chief Financial Officer
› 10+ years of health care capital markets experience
› Formerly, Vice President at ING Investment Management
› MBA, MS in Engineering, CFA charter holder
Don Healey, Ph.D., Chief Scientific Officer
› 25+ years of experience in cellular immunology and immune regulation
› Former Director of Immunology, Argos Therapeutics
Donna Rill, Chief Development Officer
› 30 years in cell and gene therapy research and clinical application
› Designed and validated cGMP Cell & Gene Therapy Laboratories, Vector Production
facilities, and Translational Research Labs
Jason Kralic, Ph.D., VP, Business Development
› Former Head of Business Development for the Neurosciences Therapy Area
Unit at GlaxoSmithKline
› Ph.D. in Pharmacology from University of N. Carolina at Chapel Hill School of
Medicine
Board of Directors
Timothy Barabe
Board member of Arqule, Inc.; Former
CFO of Affymetrix, Human Genome
Sciences, Inc., Regent Medical UK and
Sandoz GmbH
Dr. Hans-Peter Hartung
Chair of Neurology at Heinrich-Heine
University, Germany; Executive Board
member of ECTRIMS
Gail J. Maderis
Former CEO, BayBio, Former CEO of
Five Prime Therapeutics, Founder of
Genzyme Molecular Oncology
Michael S. Richman
CEO, Amplimmune
Scott B. Seaman
Executive Director,
Alkek Foundation
Neil K. Warma
President & CEO, Opexa
26
SPMS Scientific Advisory Board
 Dawn McGuire, M.D., FAAN (Chair)
• Advisory Council of the Gill Heart Institute
• Former Vice President of Clinical Research at Elan Pharmaceuticals
 Hans-Peter Hartung, M.D
• Chair of Neurology at Heinrich-Heine University, Düsseldorf
• Executive Board member of ECTRIMS, World Health Organization Advisory Board on MS
 Mark S. Freedman, M.D.
• Director of the Multiple Sclerosis Research Unit at Ottawa Hospital
• Multiple Sclerosis Society of Canada, National MS Society (USA)
• ACTRIMS committee member
 Clyde Markowitz, M.D.
• Director of MS Center at the University of Pennsylvania
 Doug Arnold, M.D.
• James McGill Professor Neurology and Neurosurgery at the Montreal Neurological Institute
 Edward Fox, M.D., Ph.D.
• Director of Multiple Sclerosis Clinic of Central Texas
• Advisory Committee, Lone Star Chapter of the National Multiple Sclerosis Society
27
Opexa Investment Thesis
PIPELINE
• Tcelna: Secondary Progressive MS, limited competition, $7BN potential market
• OPX-212: Recently launched development program in NMO, no approved
therapies, orphan indication
• Precision Immunotherapy potentially optimizes benefit-risk profile
VALIDATION
• Option agreement secured with Merck Serono – strong potential partner
• FDA Fast track designation for Tcelna in SPMS
• Esteemed Scientific Advisory Board
TECHNOLOGY
• Proprietary Platform: potential to yield multiple drug candidates
• Differentiated, personalized approach
• Strong patent estate (98 domestic and international)

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Opxa presentation 20150903

  • 1. Opexa Therapeutics, Inc. NASDAQ: OPXA Precision Immunotherapy September 2015 The Woodlands, TX Precision Immunotherapy®
  • 2. 2 Forward-Looking Statements All statements in this presentation other than those of historical fact, including statements regarding our preclinical and clinical development plans for Tcelna® and OPX-212, our research and other development programs, our ability to undertake certain activities and accomplish certain goals, projected timelines for our research and development activities and possible regulatory approvals, if any, our expectations regarding the relative benefits of our product candidates versus competitive therapies, our expectations regarding the possibility of licensing or collaborating with third parties regarding our product candidates or research, and our expectations regarding the therapeutic and commercial potential of our product candidates, research, technologies and intellectual property, are forward-looking statements. The words “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “design,” “intend,” “expect,” “potential” and similar expressions, as well as the negative version of these words and similar expressions, are intended to identify forward-looking statements. Our forward-looking statements do not constitute guarantees of future performance, and are subject to a number of risks and uncertainties that could cause actual results to differ materially and adversely from those anticipated or implied in such statements. Our forward-looking statements are based upon our current expectations and involve assumptions that may never materialize or may prove to be incorrect. Actual results and the timing of events could differ materially from those anticipated as a result of various risks and uncertainties which include, without limitation, risks associated with the process of discovering, developing and commercializing drugs that are safe and effective for use as human therapeutics and risks inherent in the effort to build a business around such drugs. Although we believe our expectations are reasonable, we do not in any way guarantee future results, level of activity, performance or achievements. In addition, neither we nor any other person assumes responsibility for the accuracy and completeness of any forward-looking statements. Our forward-looking statements in this presentation speak only as of the date of this presentation. We assume no obligation or undertaking to update or revise any statements to reflect any changes in our expectations or any change in events, conditions or circumstances on which any such statement is based. You should, however, review additional disclosures we make that further describe risks and uncertainties relevant to us in additional detail in our filings with the Securities and Exchange Commission including our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q. You may get these documents for free by visiting EDGAR on the SEC web site at http://www.sec.gov.
  • 3. 3 Opexa Investment Highlights  PIPELINE • Tcelna®: Phase 2b for secondary progressive multiple sclerosis (SPMS), limited competition, $7BN overall market potential • OPX-212: Pre-IND for neuromyelitis optica (NMO), no approved therapies, orphan indication  TECHNOLOGY • Personalized T-cell immunotherapy platform for autoimmune diseases • Potential to yield multiple candidates tailored to each patient’s disease profile • Company owned and scalable cGMP manufacturing facility • Strong patent estate (98 domestic and international)  VALIDATION • Option agreement secured with Merck Serono for Tcelna – strong potential partner • FDA Fast Track designation for Tcelna in SPMS • Esteemed Scientific Advisory Board
  • 4. 4 Recent and Upcoming Expected Milestones Tcelna: Multiple Sclerosis  1H 2014: Completed Enrollment in Phase 2b SPMS trial  Q1 2015: Received additional $3M payment from Merck Serono for Tcelna development  Q3 2015: 85% of all patient visits in Abili-T trial have been completed • 2H 2016: Top line results expected for Abili-T Phase 2b SPMS trial OPX-212: Neuromyelitis Optica  1H 2014: Initiated Early Development Plan  Q3 2015: Secured $5 million in milestone funding to support OPX-212 NMO development, including Phase I/II proof-of-concept clinical trial • 2015: Expect to complete preclinical and IND enabling studies and file IND by year-end
  • 5. 5 Financials Cash and Cash Equivalents (MM) as of June 30, 2015 ~$18.3 Shares outstanding (MM) as of June 30, 2015 ~53.4 Warrants (MM) outstanding as of June 30, 2015 ~28.4(1) Stock Options (MM) outstanding as of June 30, 2015 ~3.3(2) Debt None (1) Weighted average exercise price =$.80 as of June 30, 2015 (2) Weighted average exercise price = $2.28 as of June 30, 2015
  • 6. OPEXA’S NOVEL APPROACH; PRIMING THE IMMUNE SYSTEM 6
  • 7. 7 Root cause of MS: Activated T-cells degrade myelin and damage myelin producing cells Adapted by permission from Macmillan Publishers Ltd: NATURE REVIEWS IMMUNOLOGY 3, 483-492 (June 2003), copyright (2003) Cytokines Damage Damage • In MS patients, the faulty immune system is not able to prevent the attack of a small sub- population of myelin reactive T-cells (MRTC) • MRTCs cross the blood brain barrier, enter the brain, and bind to antigen presenting cells (APC), causing a release of pro- inflammatory cytokines which lead to a two pronged attack through: 1. Destruction of myelin sheath, the protective coating of nerve fibers 2. Destruction of oligodendroglial cells, which are responsible for producing myelin Myelin peptide Result Destruction of the myelin sheath and myelin producing cells, thereby preventing remyelination
  • 8. 8 Tcelna could address the root cause of MS by preventing demyelination and enabling remyelination Adapted by permission from Macmillan Publishers Ltd: NATURE REVIEWS IMMUNOLOGY 3, 483-492 (June 2003), copyright (2003) Opexa’s Strategy Tcelna programs the immune system to specifically recognize MRTC as pathogenic, thereby inhibiting further destruction of the myelin sheath and potentially enabling remyelination • Therapeutic dose of Tcelna (attenuated T-cell clones) is injected subcutaneously • This triggers an immune response specifically targeting circulating MRTC • Immune cells, including Tregs, have been primed, or sensitized, we believe, to specifically target the pathogenic MRTC for elimination or regulation • Elimination of harmful MRTC may lead to: 1. Stabilization of disease by preventing further destruction of myelin 2. Improvement in condition by allowing oligodendroglial cells to remyelinate axons (neuroprotection)
  • 9. 9 ImmPath® manufacturing platform Cryopreservation Formulation/ Irradiation of each dose as required Administration: 5 subcutaneous injections/year Manufacturing and QC Dispensation 35 days Epitope Profiling 1 day14 days - Red Cross - Blood Group Alliance Epitope Profiling Expansion of antigen specific T-cells Annual course of treatment consists of 5 doses manufactured from a single procurement of blood product
  • 10. 10 Clinical evidence for Tcelna MoA T-cell technology demonstrated a significant reduction in reactive T-cells (52 week study results of MS) 0% -92% -87% -79% -77% -65% -100% -90% -80% -70% -60% -50% -40% -30% -20% -10% 0% Week 0 Week 5 Week 13 Week 21 Week 28 Week 52 • Results from Tcelna dose ranging studies:  Published in Clinical Immunology (2009) 131, 202-215 • Each dose consisting of 30-45 x 106 cells ReductioninMRTC Dose 1 Dose 2 Dose 3 Dose 4 MRTC: Myelin Reactive T-cells
  • 11. 11 Phase 2b RRMS prior clinical trial Tcelna showed 37% improvement over placebo (mITT) (secondary endpoint measurement, primary MRI endpoint measure not met) 0.214 0.339 0 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 37% Reduction in Annualized Relapse Rate (ARR) Tcelna Placebo n=94 n=48 Relapses/Patient/Year 37% Total mITT population n=142
  • 12. IMMPATH®: OPEXA’S PROPRIETARY T-CELL IMMUNOTHERAPY PLATFORM 12
  • 13. 13 Leveraging ImmPath® platform in new indications Potential New Targets: Certain diseases with known antigen profile • Grave’s Disease • Idiotypic thrombocytopenic purpura • Myasthenia Gravis • Pemphigus vulgaris/foliaceus • Primary Biliary Cirrhosis • Type 1 Diabetes • Hashimoto’s thyroiditis • Vitiligo Certain diseases with unknown antigen profile • RA • Celiac • Psoriasis • Uveitis • IBD • Sjögren’s Secondary Progressive Multiple Sclerosis Neuromyelitis optica ImmPath®: Personalized, Precision Immunotherapy Platform Phase 2b Preclinical
  • 14. 14 Expansion of Pipeline Increases Partnering Opportunities Autoimmune diseases with known antigens • Development stage programs - i.e. OPX-212 for NMO • Orphan disease benefits Autoimmune diseases with unknown antigens • Discovery stage programs • Possible expansion to large markets (e.g. RA, Psoriasis) Multiple Sclerosis Japan • Quick access to market • Leverage U.S. trial success
  • 15. TCELNA® FOR MULTIPLE SCLEROSIS 15
  • 16. 16 Tcelna in Secondary Progressive MS SPMS 450,000 Individuals in North America diagnosed with MS; 30-45 % potentially have an SPMS diagnosis Market Size: $7 Billion (est.) Relapsing Remitting MS; Clinically Isolated Syndrome; Primary Progressive MS • Secondary Progressive MS market potential in North America could exceed $7 billion (for all therapies) • Roughly 150,000 SPMS patients in North America • Only one drug approved for SPMS in U.S. (none in EU or Asia) - Drug not suitable for chronic use due to severe side effects Tcelna being developed to be a potential therapy of choice in SPMS
  • 17. 17 Tcelna® Lead Program Targeting Secondary Progressive MS patients Fast Track Designation by FDA • Phase 2b is fully enrolled: 190 patients with SPMS • Top line data expected in 2H 2016 • Design – Double-blind, 1:1 randomized, placebo-controlled – 35 clinical sites in USA and Canada – Two annual courses of personalized therapy – Efficacy Endpoints: Primary-Whole Brain Atrophy, Secondary-Disease Progression • Immune Monitoring being conducted in parallel – Comprehensive biomarker analysis
  • 18. 18 Merck Serono Agreement Agreement signed 2013; strong potential partner • Option and License Agreement for worldwide rights to all Multiple Sclerosis indications, excluding Japan • If Merck Serono exercises option: – Merck Serono to fund Phase 3, pre-commercial and commercial activities – Opexa has potential to receive up to an additional $220 million in option exercise and milestone payments – Opexa has potential to receive royalties ranging from 8% to 15% of annual net sales, with step-ups occurring if net sales exceed $500 million, $1 B & $2 B • Merck Serono increased their commitment to Opexa’s MS program this year – In anticipation of the Phase IIb trial results expected in 2H 2016, Merck Serono gave Opexa $3 million of support in March 2015 to begin planning for Phase III studies
  • 19. LEVERAGING THE T-CELL PLATFORM: OPX-212 FOR NEUROMYELITIS OPTICA (NMO) 19
  • 20. 20 NMO: A rare disease of the Central Nervous System • Neuromyelitis optica (NMO) is a rare or orphan autoimmune disease • Immune system cells and antibodies mistakenly attack and destroy myelin cells in the optic nerves and the spinal cord • Individuals with NMO develop optic neuritis, which causes pain in the eye and vision loss, and transverse myelitis, which causes weakness, numbness, and sometimes paralysis of the arms and legs • There are no FDA-approved therapies for NMO • Affects any age varying from 3 to 90 years, the average age of onset ~41 years An orphan disease with no FDA-approved therapy Image reprinted with permission from MultiView, Inc.
  • 21. 21 Key Milestones Achieved to Date in OPX-212 Development Program Funding support • Recently secured $5 million private funding for OPX-212 to advance further NMO development, including Phase I/II clinical study KOL support • Engaged key thought leaders to validate scientific hypothesis and discuss clinical trial design – Benjamin Greenberg, M.D., University of Texas, Southwestern Medical Center – Michael Levy, M.D., Ph.D., The Johns Hopkins Hospital FDA feedback • Conducted Pre-IND meeting to discuss pre-clinical and clinical program to support OPX-212 development in NMO Patient support • Collected NMO patient blood samples to conduct pre-IND activities, process development and research into mechanism of action
  • 22. 22 NMO disease pathogenesis NMO Pathogenic T-Cells Anti-AQP-4 Plasma Cell Binding to AQP4 channels on the astrocytes Increase astrocyte permeability Neuroinflammation AQP-4 expression Complement activation Axonal loss CD4+ T-cell CD69 Infiltration of macrophages and granulocytes Neutrophils Eosinophils ↑ IL-17/IL-8 B-cell Macrophages Demyelination Activated T-cell/Th-17 Necrosis B-Cells Inflammatory Cells NMO Lesion AQP4 antibodies that penetrate the CNS and bind to AQP4 channels on the astrocyte Astrocyte damage leads to • Inflammation • Oligodendrocyte injury • Demyelination • Neuronal loss Migration of inflammatory cells leads to localized inflammation
  • 23. 23 Potential intervention points for T-cell therapy T-cell therapy believed to inhibit AQP-4 autoantibody, pro-inflammatory cytokines and prevent infiltration of macrophages and granulocytes Without the pathogenic T-cell, the B-cell does not signal the production of the AQP-4 antibody Possible results: • Reduce tissue damage • May favor repair and remyelination of axons • Reduce frequency and severity of Relapses of clinical disease OPX-212 expected to down regulate pathogenic AQP-4 T-cells NMO Pathogenic T-Cells Anti-AQP-4 Plasma Cell Binding to AQP4 channels on the astrocytes Increase astrocyte permeability Neuroinflammation AQP-4 expression Complement activation Axonal loss CD4+ T-cell CD69 Infiltration of macrophages and granulocytes Neutrophils Eosinophils ↑ IL-17/IL-8 B-cell Macrophages Demyelination Activated T-cell/Th-17 Necrosis B-Cells Inflammatory Cells Expected to prevent infiltration of Neutrophils, Eosinophils and Macrophages Preventing the damage of the AQP-4 channel of the astrocyte NMO Lesion OPX-212 OPX-212
  • 24. 24 NMO Investment Thesis • Any therapy that could achieve tolerization of the AQP-4 reactive T- cells may offer a cure for NMO • OPX-212 has the potential to address the root cause of NMO • OPX-212 leverages Opexa’s T-cell platform to B-cell mediated orphan diseases • Opexa currently retains world wide rights to OPX-212 • Higher prevalence of NMO in Asia could complement Opexa’s MS rights in Japan • IND filing expected by 12/31/15
  • 25. 25 Experienced Management Team and Board of Directors Neil Warma, President & CEO, Director › 19+ years international healthcare experience with large Pharma and emerging biotechnology companies › Former Senior Management, Novartis Pharmaceuticals, Basel, Switzerland › Former CEO, Viron Therapeutics, Inc. › Co-founder and President of MedExact Inc., a company subsequently acquired Karthik Radhakrishnan, Chief Financial Officer › 10+ years of health care capital markets experience › Formerly, Vice President at ING Investment Management › MBA, MS in Engineering, CFA charter holder Don Healey, Ph.D., Chief Scientific Officer › 25+ years of experience in cellular immunology and immune regulation › Former Director of Immunology, Argos Therapeutics Donna Rill, Chief Development Officer › 30 years in cell and gene therapy research and clinical application › Designed and validated cGMP Cell & Gene Therapy Laboratories, Vector Production facilities, and Translational Research Labs Jason Kralic, Ph.D., VP, Business Development › Former Head of Business Development for the Neurosciences Therapy Area Unit at GlaxoSmithKline › Ph.D. in Pharmacology from University of N. Carolina at Chapel Hill School of Medicine Board of Directors Timothy Barabe Board member of Arqule, Inc.; Former CFO of Affymetrix, Human Genome Sciences, Inc., Regent Medical UK and Sandoz GmbH Dr. Hans-Peter Hartung Chair of Neurology at Heinrich-Heine University, Germany; Executive Board member of ECTRIMS Gail J. Maderis Former CEO, BayBio, Former CEO of Five Prime Therapeutics, Founder of Genzyme Molecular Oncology Michael S. Richman CEO, Amplimmune Scott B. Seaman Executive Director, Alkek Foundation Neil K. Warma President & CEO, Opexa
  • 26. 26 SPMS Scientific Advisory Board  Dawn McGuire, M.D., FAAN (Chair) • Advisory Council of the Gill Heart Institute • Former Vice President of Clinical Research at Elan Pharmaceuticals  Hans-Peter Hartung, M.D • Chair of Neurology at Heinrich-Heine University, Düsseldorf • Executive Board member of ECTRIMS, World Health Organization Advisory Board on MS  Mark S. Freedman, M.D. • Director of the Multiple Sclerosis Research Unit at Ottawa Hospital • Multiple Sclerosis Society of Canada, National MS Society (USA) • ACTRIMS committee member  Clyde Markowitz, M.D. • Director of MS Center at the University of Pennsylvania  Doug Arnold, M.D. • James McGill Professor Neurology and Neurosurgery at the Montreal Neurological Institute  Edward Fox, M.D., Ph.D. • Director of Multiple Sclerosis Clinic of Central Texas • Advisory Committee, Lone Star Chapter of the National Multiple Sclerosis Society
  • 27. 27 Opexa Investment Thesis PIPELINE • Tcelna: Secondary Progressive MS, limited competition, $7BN potential market • OPX-212: Recently launched development program in NMO, no approved therapies, orphan indication • Precision Immunotherapy potentially optimizes benefit-risk profile VALIDATION • Option agreement secured with Merck Serono – strong potential partner • FDA Fast track designation for Tcelna in SPMS • Esteemed Scientific Advisory Board TECHNOLOGY • Proprietary Platform: potential to yield multiple drug candidates • Differentiated, personalized approach • Strong patent estate (98 domestic and international)