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one Target: infinite Hope™Corporate Presentation
Q2, 2017
Forward Looking Statements
Certain statements in this presentation are “forward-looking statements. Any statements that express or involve discussionswith respect to predictions, expectations, beliefs, plans, projections, objectives, assumptions or future events or performance(often, but not always using words or phrases such as “expect”, “seek”, “endeavour”, “anticipate”, “plan”, “estimate”,“believe”, “intend”, or stating that certain actions, events or results may, could, would, might or will occur or be taken, orachieved) are not statements of historical fact and may be “forward-looking statements”. Forward-looking statements arebased on expectations, estimates and projections at the time the statements are made that involve a number of risks anduncertainties which would cause actual results or events to differ materially from those presently anticipated. Forward-lookingstatements are based on expectations, estimates and projections at the time the statements are made and involve significantknown and unknown risks, uncertainties and assumptions. A number of factors could cause actual results, performance orachievements to be materially different from any future results, performance or achievements that may be expressed orimplied by such forward-looking statements. These include, but are not limited to, the risk factors discussed in the publicfilings made by Medicenna with the applicable securities commissions in Canada, including the filing statement datedFebruary 27, 2017. Should one or more of these risks or uncertainties materialize, or should assumptions underlying theforward-looking statements prove incorrect, actual results, performance or achievements could vary materially from thoseexpressed or implied by the forward-looking statements contained in this document. These factors should be consideredcarefully and prospective investors should not place undue reliance on these forward-looking statements. Although theforward-looking statements contained in this document are based upon what Medicenna currently believes to be reasonableassumptions, Medicenna cannot assure prospective investors that actual results, performance or achievements will beconsistent with these forward-looking statements. Except as required by law, Medicenna does not have any obligation toadvise any person if it becomes aware of any inaccuracy in or omission from any forward-looking statement, nor does itintend, or assume any obligation, to update or revise these forward-looking statements to reflect new events orcircumstances.
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Medicenna: Corporate HighlightsØ Publicly listed (TSXV: MDNA), clinical-stage, immuno-oncology company
developing a novel therapy targeting the Interleukin-4 Receptor (IL4R) biomarker
Ø Every year >1 million cancer patients afflicted with IL4R tumors1
Ø MDNA55 (lead): highly compelling, Phase II clinical data for recurrent glioblastoma (rGB), the most common and aggressive form of brain cancer
Ø MDNA55 market opportunity: $650 million in annual sales for rGB; >$2 billion including other brain cancers1,2
Ø MDNA55 has Orphan Drug (FDA, EMA) & Fast Track Designations (FDA)
Ø Exciting pre-clinical IL-2, IL-4 and IL-13 Superkine platform
Ø Well funded with $14M US non-dilutive grant and $14M CAD Private Placement
Ø Seasoned management with technology platform protected by 12 patent families
1. BioXcel Strategic Analysis Report, 2014.2. Decision Resources, Inc Glioblastoma Report, Sept 2013
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Treatment Pathway for Glioblastoma (GB)
Surgery(85-90%)
GBDiagnosis
Radiotherapy+
Chemotherapy
Relapse
Chemotherapy
Surgery MDNA55 Treatment(Direct infusion into tumor - CED)
Add’l Chemo.or Experimental
Therapies
GB is uniformly fatal; virtually all tumors will recur (rGB)
55% of GB Chemo.
Resistant*
* Expression of the DNA repair protein O6-methylguanine-DNA methyltransferase (MGMT) is responsible for resistance to alkylating agents used in GB treatment.
25%
75% of rGB is non-operable
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MDNA55: Targeted Dual-Action ImmunotherapeuticA Powerful Molecular Trojan Horse
Ø Potently toxic to tumor cells with a wide therapeutic window
Ø Simultaneously purges the Tumor Microenvironment (TME) and un-blinds the immune system to cancer cells
Ø Proven payload efficacy– identical to Medimmune’s anti-CD22 immunotoxin, Moxetumomab Pasudotox, currently in PhIII trial for Hairy Cell Leukemia1
Ø Reliable, cost-efficient fermentation-based manufacture
1 https://www.medimmune.com/our-therapy-areas/oncology.html
PE AAs 253-364, 381-608Circularly Permuted
Interleukin-4 (cpIL-4)
Catalytic domain of Pseudomonas Exotoxin A (PE)
Tumor Targeting Domain Tumor Killing “Cytotoxic” Domain
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MDNA55: Brain Cancer Market Opportunity
Tumor Type Annual Incidence Projected Market
Recurrent Glioblastoma (rGB) 33,3001 $650M2
Metastatic Brain Cancer 91,5003 $1.30B4
Pediatric Glioma 3,8001 $50M4
TOTAL 133,500 $2.0B
1. Decision Resources Glioblastoma Report, Sept 20132. Assumes peak sales for rGB monotherapy and combination therapy at $43K per patient – BioXcel Strategic Analysis Report, 20143. Breast, Colon and Kidney Cancer Metastasis to Brain – BioXcel Strategic Analysis Report, 20144. Assumes 33% treatable with MDNA55 and priced at $43K per patient - BioXcel Strategic Analysis Report, 2014 6
Current Therapies Do Not Address Key Challenges
Therapeutic Challenges Rationale for MDNA55
Ø 55% of GBs are chemo-resistant 1
Ø Immunosuppressive tumor microenvironment (TME) comprises 40% of GB tumor mass 2
Ø Blood Brain Barrier (BBB) blocks transport of therapeutic to tumor
Ø High doses are required due to BBB causing systemic toxicities
Ø MDNA55 targets resistant tumors3
Ø IL4R over-expressed in GB and its TME (Myeloid Derived Suppressor Cells) but not in normal brain 4
Ø Delivery by direct injection (CED) of MDNA55 by-passes the BBB
Ø Precision delivery achieves high doses without systemic exposure
1. Hegi ME (2005). N Engl J Med;352(10):997-1003.2. Kennedy B, et al (2013). J Oncol. Vo; 2013: 486912.3. Shimamura, et al.(2007.Cancer Res;67:9903-9912.4. Kohanbash et al (2013).Cancer Res.;73(21):6413-23 7
Compelling Efficacy in Non-Resected rGB (n=25)
Pre-treatment 9 months
Pre-treatment Week 26
Complete Response (CR): 5/25
PartialResponse(PR): 9/25
High Objective Response
Rate
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Kawakami, et al (2003)Interleukin-4-Pseudomonas exotoxin chimeric fusion protein for malignant glioma therapy Journal of Neuro-Oncology Vol 65 p 15-25
MDNA55: Clinical EfficacyLong Term Survival Results Consistent With Immunotherapy Benefits
Superior Long Term Survival When Compared to Avastin Despite Poorer Patient Population (N =57)
0 300 600 900 1200 15000
50
100
Days
Per
cent
sur
viva
l
Non-Resectable Recurrent GBM:Survival of Responders vs Non Responders
Responders (CR + PR): MS = 379 days (n=14)
Non-Responders (SD + PD) MS = 98 days (n=11)
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SD – Stable diseasePD – Progressive diseaseInvestigators Brochure (page 82)
2nd Generation Infusion Will Improve Outcomes
Images courtesy of John Sampson, Duke University
• Inaccurate catheter placement
• Drug leakage due to backflow
• Inadequate tumor coverage
• Image-guided catheter placement
• New catheters prevent backflow
• Real-time monitoring ensures tumor coverage
Real-Time Monitoring of
Drug Distribution
1st Generation CED: Past Studies 2nd Generation CED: Future Studies
Saito and Tominaga (2012), Neurol Med Chir (Tokyo) 52, 531
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NeuroExact™: Personalized Molecular NeurosurgeryCombining Personalized Therapy with Precision Delivery
DRUG: MDNA55 Selectively Targets Tumor Over-Expressing the IL4R
DELIVER: Precise Image Guided Convection Enhanced Delivery of MDNA55
DISTRIBUTE: Ensure Complete Tumor Coverage with MDNA55 Using Real Time Monitoring
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12
US Sites Participating in the Study
OSU (Columbus, OH)
Cleveland Clinic (Cleveland, OH)
Weill Cornell +MSKCC(New York, NY)
Duke (Durham, NC)
UT Southwestern (Dallas, TX)
UT San Antonio (San Antonio, TX)
UCSF(San Francisco, CA)
JWCI (Santa Monica, CA)
Marcus Neuroscience Institute(Boca Raton, FL)
Future Indications: 1 Million IL4R Cancers Annually>2000 Patient Biopsies Analyzed Consistently Show IL4R Over-Expression1-14
78%
B-Cell CLL
67%
Hodgkins Lymphoma
56%
Biliary Tract
73%
Bladder
82%
Breast
89%
Colorectal
75%
Head and Neck
79%
NSCLC
96%
Mesothelioma
60%
Ovarian
60%
Pancreatic
91%
Anaplastic Thyroid
1. BioXcel Strategic Analysis Report, 20142. Ishige et al (2008); Int J Cancer;123(12):2915-22.3. Joshi et al (2014 Cancer Med. 3(6):1615-28.4. P. Leland, et al (2000) Mol Med; 6(3): 165–178.5. Koller , et al (2010); Carcinogenesis 31(6), 1010-17
6. Strome SE, et al (2002).Clin Cancer Res.n;8(1):281-6.7. Puri, et al (1996). Cell Immunol.10;171(1):80-6.8. Kawakami, et al (2005) Blood; 105(9): 3707–3713.9. Kay, et al (2005) Leuk Res.;29(9):1009-18.10. Kawakami, at al (2002). Clin Cancer Res.;8(11):3503-11.
11. Burt, et al (2012) Clin Cancer Res;18(6):1568-7712. Kioi, et al (2005) Cancer Res;65(18):8388-9613. Kawakami et al (2002) Cancer Res.;62(13):3575-80.14. Joshi et al (2015) Discov. Med.;20(111):273-84.
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IL-2 Superkines: Tunable Immune Modulators
RECENT IL-2 DEAL ACTIVITYIL-2 Agonist: MDNA109
Clinical collaboration for NKTR-214 in combination with Opdivo
RECENT IL-2 DEAL ACTIVITYIL-2 Antagonist: MDNA209
Acquired by Celgene for $300M upfront and $475M in contingent value rights
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Secured Exclusive World Wide Rights from Stanford University
MDNA109 Synergizes With Anti-PD-1 ImmunotherapyCombination Therapy Produces Robust Responses
Ø MDNA109 and anti-PD-1 produce limited efficacy alone
Ø Combination treatment sufficient to cure most mice without increased toxicities
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15
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USD$14M Non-Dilutive Grant Validates Platform
Ø Diligence by top-tier scientific, clinical, regulatory, chemistry manufacturing and control, intellectual property & venture capital teams
Ø Solid third-party platform validationØ Funds MDNA55 Phase 2b rGB clinical development and next generation
pre-clinical IL-4 Empowered Cytokine programØ The USD$14.1M grant effectively provides 2:1 leverage on USD$7M
investment1
Ø Favorable grant repayment terms begin post-launch (low single digit royalties to a maximum payment amount of 4 times the original grant)
1. http://www.cprit.state.tx.us/images/uploads/rfa-172-txco.pdf
Recipient of Cancer Prevention & ResearchInstitute of Texas (CPRIT) Grant
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Multiple Near Term Value Inflection MilestonesPursue Accelerated Approval for rGB in 2018
Milestone Estimated Timing
Commenced Enrollment in Phase 2b rGB TrialFirst Patient In - Phase 2b rGB TrialCommence Phase 2 Metastatic Brain Cancer Trial Q3/2017Complete Enrollment in Phase 2b rGB Trial Q4/2017Report rGB Phase 2b Interim Top-Line Results Q1/2018End of Phase 2 Meeting with FDA Q2/2018Commence IND Enabling Studies with MDNA109 Q2/2018Pursue Accelerated Approval for rGB Q3/2018Report Interim Top-Line Results from P2 Metastatic Brain Cancer Trial
Q3/2018
Commence IND Enabling Studies with MDNA57 Q4/2018
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Seasoned Management and Experienced BoardManagement Team
Fahar Merchant, PhD: Chairman, President & CEOFormer CEO Sophiris Bio (TSX); Former Director, President & CTO at KS Biomedix (LSE); Founder, President & CEO of Avicenna Medica and IntelliGene Expressions
Sam Denmeade, MD: Chief Scientific OfficerProf Oncology at JHU; Former CSO at Sophiris Bio; Co-founder and Chief Clinical Advisor of Inspyr Therapeutics
Elizabeth Williams, CPA,CA: Chief Financial OfficerFormer VP Finance & Admin and interim CFO at Aptose (TSX and Nasdaq); Previously with Ernst & Young
Martin Bexon, MD: Head of Clinical DevelopmentFormer Medical Director at CSL Behring; Medical Director at Hoffman La Roche (UK and Switzerland)
Nina Merchant, MESc.: Chief Development OfficerFormer SVP Development at Sophiris Bio; Formerly VP Development at KS Biomedix (LSE); Previously at Avicenna Medica, IntelliGene, Pharmacia and Sanofi Pasteur
Patrick Ward, MBA: Chief Operating Officer Former COO of Aviara Pharma; President/COO at Ocusoft, Executive Director at Encysive Pharma
Shafique Fidai, PhD: Head of Corp DevelopmentFormer VP of Business Development at Sophiris Bio; Formerly with Xenon Pharma, Chromos
Board of DirectorsFahar Merchant, PhD Chairman, President & CEO
Albert Beraldo, CPA, CA Independent DirectorFounder, President and CEO of Alveda Pharmaceuticals until its acquisition by Teligent, Inc. (NASDAQ: TLGT); Former President and CEO of Bioniche (TSX) and Director of Telesta (TSX); Currently Independent Director of Helix Biopharma (TSX).
Chandra Panchal, PhDIndependent DirectorFounder, Chairman and CEO of Axcelon; Former Co-Founder, President, and CEO of Procyon Biopharma Inc (TSX); Former Senior Executive VP of Business Development at Ambrilia Biopharma Inc. (TSX)
Andrew Strong, JDIndependent DirectorPartner at Pillsbury Winthrop Shaw Pittman - leading the Life Sciences Team in Houston, TX. Formerly General Counsel and Compliance Officer for the Texas A&M University System. Led formation of bio-manufacturing company, Kalon Biotherapeutics; CEO of Kalon until its sale to FujiFilm Diosynth Biotech. Director of Ashford Hospitality Prime (NYSE)
Nina Merchant, M.E.ScDirector, Chief Development Officer
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World Class Advisors and CollaboratorsCollaborators & InventorsClinical & Scientific Advisors
John Sampson, MD, PhD, MBADuke University: Principal Investigator and Expert in Drug Delivery to the Brain
Stewart Grossman, MDJohns Hopkins University: Novel therapies for primary & metastatic brain tumors
Nicholas Butowski, MDUCSF:Principal Investigator; Novel therapies for brain cancer
Guido Kroemer, MD, PhD University of Paris:Chair: SAB and Expert in Cancer Immunotherapy
Ralph Smalling, MScRegulatory Advisor: Former VP Regulatory Affairs at Amgen; Filed 40 INDs; 5 NDAs
Michael Rosenblum, PhD MD Anderson Cancer CenterHead, Immunopharmacology and Targeted TherapyCollaborator: MDNA57
Raj Puri, MDUSFDADirector at CBERInventor of MDNA55
Aaron Ring, MD, PhDYale UniversityAsst. Prof Immunobiology & Cancer BiologyCo-Inventor of IL-2 Superkines
Chris Garcia, PhDStanford UniversityCo-Inventor of IL-2, IL-4 and IL-13 Superkines
Haya Loberboum Galski. PhDHebrew University of JerusalemInventor of Fully Human Payloads
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Capitalization
20
Publicly Listed as of March 3, 2017
Ø Listed on the TSX Venture on March 3, 2017 at $2.00 per share following a successful Reverse Takeover
Ø Trading under the Ticker “MDNA”Ø Fully funded for two years with cash on hand and funds remaining to
be advanced under the CPRIT grant
NumberIssued and Outstanding 24,307,343Fully Diluted* 28,852,583
* Fully diluted includes 4,402,383 options and warrants with a $2.00 exercise price and 142,857 options and warrants with a $1.40 exercise price
Medicenna Public Company Comparables
Company (Listing/Symbol) Price(10-Mar-17)
Market Cap (MM)
Enterprise Value (MM) Lead Indication (Stage)
ZIOPHARM Oncology, Inc. (NASDAQ:ZIOP) US$6.13 $811.5 $855.7 Breast Cancer (PhII), Recurrent Glioblastoma
(Ph I)(w/ CED*)
Newlink Genetics Corporation (NASDAQ:NLNK) US$17.54 $512.5 $387.5 Malignant Brain Tumor (Ph II)
Agenus Inc. (NASDAQ:AGEN) US$3.35 $329.4 $364.9 Glioblastoma and Recurrent Glioblastoma (Ph II)
Stemline Therapeutics, Inc. (NASDAQ:STML) US$8.25 $206.7 $159.8 Recurrent Glioblastoma (Ph I/II)
Kadmon Holdings, Inc. (NYSE:KDMN) US$3.21 $166.4 $199.2 Glioblastoma (Ph II)
Vascular Biogenics Ltd. (NASDAQ:VBLT) US$5.35 $143.6 $98.4 Recurrent Glioblastoma (Ph III)
Diffusion Pharmaceuticals Inc. (NASDAQ:DFFN) US$3.70 $38.3 $37.7 Glioblastoma (Ph II)
Average $315.5 $300.5Median $206.7 $199.2
Medicenna Therapeutics1
(TSXV:MDNA) C$2.80 $53.0(C$70.5M) $46.0 Recurrent Glioblastoma (Ph II)
(1)Enterprise value based on net debt as of Dec 31, 2016
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All amounts in USD, unless noted otherwise
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Medicenna: Corporate Highlights
Thank Youone Target: infinite Hope™
www.medicenna.com