2012 world stem cell & regenerative medicine congress, london

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Leading Regenerative Medicine World Stem Cells & Regenerative Medicine Congress May 2012

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Page 1: 2012 World Stem Cell & Regenerative Medicine Congress, London

Leading Regenerative Medicine

World Stem Cells & Regenerative Medicine Congress

May 2012

Page 2: 2012 World Stem Cell & Regenerative Medicine Congress, London

This presentation is intended to present a summary of ACT’s (“ACT”, or “Advanced Cell

Technology Inc”, or “the Company”) salient business characteristics.

The information herein contains “forward-looking statements” as defined under the federal

securities laws. Actual results could vary materially. Factors that could cause actual results

to vary materially are described in our filings with the Securities and Exchange Commission.

You should pay particular attention to the “risk factors” contained in documents we file from

time to time with the Securities and Exchange Commission. The risks identified therein, as

well as others not identified by the Company, could cause the Company’s actual results to

differ materially from those expressed in any forward-looking statements. Ropes Gray

Cautionary Statement Concerning Forward-Looking Statements

2

Page 3: 2012 World Stem Cell & Regenerative Medicine Congress, London

Multiple Pluripotent Cell Platforms

• Single Blastomere-derived Embryonic Stem Cells

• Generating hESC without Destruction of Embryo

• Utilizes a single cell biopsy

• Our hESC lines exhibit all the standard characteristics and the

ability to differentiate into the cells of all three germ layers

both in vitro and in vivo.

• Induced Pluripotency Stem Cells (iPS)

• Early Innovator in Pluripotency (before iPS was even a term!)

• Recipient of National Institutes of Health Director's Opportunity Award

• Seminal paper identifying replicative senescence issue for vector-derived iPS cells

• Leading publication on protein induced iPS lines - avoids genetic manipulation with nucleic acid vectors

• Controlling Filings (earliest priority date) to use of OCT4 for inducing pluripotency

3

Final Product Definition: hESC-derived

products will be manufactured using a cell

line made in 2005 from single cell isolated

without the destruction of any embryos

Page 4: 2012 World Stem Cell & Regenerative Medicine Congress, London

RPE Clinical Program

Page 5: 2012 World Stem Cell & Regenerative Medicine Congress, London

The RPE layer is critical to the function and health of photoreceptors and the retina as a whole.

– RPE cells recycle photopigments, deliver, metabolize and store vitamin A, transport iron and small molecules between retina and choroid and maintain Bruch’s membrane

– RPE loss leads to photoreceptor loss and eventually blindness, such as dry-AMD

– Loss of RPE layer and appears to lead to decline of Bruch’s membrane, leading progression from dry-AMD to wet-AMD

• Discrete differentiated cell population as target

• Failure of target cells results in disease progression

5

Retinal Pigment Epithelial Cells - Rationale

RPE cell as Target

Page 6: 2012 World Stem Cell & Regenerative Medicine Congress, London

• Pigmented RPE cells are easy to identify – aids manufacturing

• Small dosage vs. other therapies

• The eye is generally immune-privileged site, thus minimal

immunosuppression required

• Ease of administration, with no separate device approval and

straightforward surgical procedure

RPE cell therapy may impact over 200

retinal diseases

6

Retinal Pigment Epithelial Cells - Rationale

Page 7: 2012 World Stem Cell & Regenerative Medicine Congress, London

Risk: Middle-aged adults have about a 2% risk of developing AMD - the risk increases to almost 30% in adults over age 75.

Expense: In 2012, the worldwide financial burden of vision loss due to AMD is estimated at >US$350 billion, with >US$250

attributed to direct health care expenditures.

On the Rise: Population demographics (“baby boomers”) combined with increased longevity predicts an increase of 50

percent or more in the incidence rate of AMD.

7

The Unmet Medical Need

Early Stage AMD

(10-15M)

Intermediate AMD

(5-8M)

Late Stage AMD

(1.75M)

Few Drusen Deposits

Small in size

Geographic Atrophy: 1M

CNV Occurrence: 1.2M

Large Drusen Deposits

Pigment Change

Grade 0 0.5%

Grade 1 3%

Grade 2 9%

Grade 3 27%

Grade 4 43%

Probability of progression

to late stage AMD within 5 yrs U.S. Patent Population

We process 80 percent of all our information

through our eyes. AMD represents a huge impact

on QOL in later life

Page 8: 2012 World Stem Cell & Regenerative Medicine Congress, London

RPE Engraftment and Function – Pre-clinical

Human RPE cells engraft

and align with mouse RPE

cells in mouse eye

8

treated

RPE cells rescued

photoreceptors and

slowed decline in acuity

in RCS rat

control treated

Page 9: 2012 World Stem Cell & Regenerative Medicine Congress, London

• Established GMP process for differentiation and purification of RPE – Virtually unlimited supply

– Pathogen-free GMP conditions

– Minimal batch-to-batch variation

– Characterized to optimize performance

– Virtually identical expression of RPE-specific genes to controls

GMP Manufacturing

Ideal Cell Therapy Product • Centralized Manufacturing

• Small Doses

• Easily Frozen and Shipped

• Simple Handling by Doctor

9

Page 10: 2012 World Stem Cell & Regenerative Medicine Congress, London

Characterizing Clinical RPE Lots

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Normal female (46 XX) karyotype

of the clinical RPE lot.

Up-regulation of RPE markers and

down-regulation of hESC markers

Page 11: 2012 World Stem Cell & Regenerative Medicine Congress, London

Characterizing Clinical RPE Lots

11

Quantitative Potency Assay

Each lot is assessed by phagocytosis (critical function in vivo) of fluorogenic bioparticles.

Flow cytometry histogram showing

phagocytosis of pHrodo bioparticles

4°C 37°C

Page 12: 2012 World Stem Cell & Regenerative Medicine Congress, London

Effects of Pigmentation

12

Melanin content can be measured spectrophotometrically and used to determine the optimal time to harvest and cryopreserve RPE.

y = 0.0141x + 0.0007

0.00

0.50

1.00

1.50

2.00

0 20 40 60 80 100 120 A

bsor

banc

e at

475

nm

µg/mL Melanin

Page 13: 2012 World Stem Cell & Regenerative Medicine Congress, London

Phase I - Clinical Trial Design

13

SMD and dry AMD Trials approved in U.S., SMD Trial approved in U.K.

• 12 Patients for each trial, ascending dosages of 50K, 100K, 150K and 200K cells.

• Patients are monitored - including high definition imaging of retina

High Definition Spectral Domain Optical Coherence Tomography (SD-OCT)

Retinal Autofluorescence

50K Cells 100K Cells 150K Cells 200K Cells

Patient 1 Patients 2/3

DSMB Review DSMB Review

RPE and photoreceptor activity

compared before and after surgery

Page 14: 2012 World Stem Cell & Regenerative Medicine Congress, London

Phase I – Endpoints

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PRIMARY ENDPOINTS:

Safety Assessment acceptable, in the absence of:

Adverse event related to cell product

Any contamination with an infectious agent

Cells exhibiting tumorigenic potential

SECONDARY

ENDPOINTS

Successful engraftment via:

OCT, fundus and other similar imaging evidence

ERG showing enhanced activity

Evidence of rejection:

Imaging evidence that cells are no longer in the correct location

ERG showing that activity has returned to pre-transplant conditions

Page 15: 2012 World Stem Cell & Regenerative Medicine Congress, London

RPE Clinical Program – to date

15

World-leading eye surgeons and retinal

clinics participate in clinical trials, DSMB

and Scientific Advisory Board

• US Clinical Trial Sites • Jules Stein Eye (UCLA)

• Wills Eye Institute

• Bascom Palmer Eye Institute

• Massachusetts Eye and Ear Infirmary

• Stargardts: 1st cohort complete, cleared to treat next cohort

• Dry AMD: 1st cohort complete, will submit data on patients 2

& 3 to DSMB in late May

• European Clinical Trial Sites • Moorfields Eye Hospital

• Aberdeen Royal Infirmary

• 1st SMD patient treated, about to treat patients 2 & 3

ClinicalTrials.gov US: NCT01345006, NCT01344993 UK: NCTO1469832

Page 16: 2012 World Stem Cell & Regenerative Medicine Congress, London

Surgical Overview

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Drs. Steven Schwartz and Robert Lanza

• Subretinal injection of 50,000 RPE cells in a volume of

150µl delivered into a pre-selected area of the

pericentral macula

• Procedure:

• 25 Gauge Pars Plana Vitrectomy

• Posterior Vitreous Separation (PVD Induction)

• Subretinal hESC-derived RPE cells injection

• Bleb Confirmation

• Air Fluid Exchange

Straight-forward surgery that is performed on outpatient basis

Page 17: 2012 World Stem Cell & Regenerative Medicine Congress, London

Preliminary Results

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• Structural evidence confirmed cells had

attached and persisted

• No signs of hyperproliferation,

abnormal growth, or rejection

• Anatomical evidence of hESC-RPE

survival and engraftment.

• Clinically increased pigmentation

within the bed of the transplant

Page 18: 2012 World Stem Cell & Regenerative Medicine Congress, London

Preliminary Results

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Recorded functional visual improvements in both patients.

• SMD Patient: BCVA improved from hand motions to 20/800 and improved from 0 to 5

letters on the ETDRS visual acuity chart

• Dry AMD Patient: Vision improved in the patient with dry age-related macular

degeneration (21 ETDRS letters to 28)

• Nine Month Follow-up:

• Visual acuity gains remain stable for both patients; SMD Patient continues to

show improvement.

• Similar trends observed for latest AMD and SMD patients

• Update on U.K. SMD01 Patient (3 month follow-up)

• ETDRS: Improved from 5 letters to 10 letters

• Subjective: Reports significantly improved ability to read text on TV

Page 19: 2012 World Stem Cell & Regenerative Medicine Congress, London

Images of hESC-RPE transplantation site in SMD Patient

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pre-transplant 1wk post-op 6wk post-op

Color fundus photographs

Clinically increased pigmentation within the bed of the transplant

Page 20: 2012 World Stem Cell & Regenerative Medicine Congress, London

Images of hESC-RPE transplantation site in SMD Patient

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SD-OCT image collected at month 3 show survival and engraftment of RPE

Migration of the transplanted cells to the desired anatomical location

3mo post-op

Page 21: 2012 World Stem Cell & Regenerative Medicine Congress, London

Phase II/III Design

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• Design of future studies dependent upon information gathered throughout PI/II

study

• Efficacy

• Patient population less VA impact 20/200?

• Multiple Injections

• Sub macular Injections

• Further evaluation of I/E criteria

• Potentially less immunosuppression

• Other considerations of efficacy:

• New or more sensitive technologies

• Possible saline placebo injection (same eye)

Working with our

experts/investigators in

design of studies

Page 22: 2012 World Stem Cell & Regenerative Medicine Congress, London

RPE Cells – Additional Indications

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• Myopic Macular Dystrophy (MMD)

• Retinopathy of Prematurity

• Angioid Streaks

• Retinitis Pigmentosa

• Bests Disease (vitelliform macular dystrophy)

• Multifocal Choroidopathy Syndromes

Combination Products

• Combined with other cell types (photoreceptor progenitors)

• Combined with anti-angiogenic agents, neuroprotective agents, etc.

Page 23: 2012 World Stem Cell & Regenerative Medicine Congress, London

Therapeutic Pipeline -

Ocular Programs

Page 24: 2012 World Stem Cell & Regenerative Medicine Congress, London

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Retinal Pigment Epithelial Cells

Macular Degeneration - dry AMD, Stargardt’s Disease, MMD

Retinitis Pigmentosa

Photoreceptor protection

Hemangioblast cells

Ischemic retinopathy

– diabetic retinopathy, vascular occlusions

Retinal Neural Progenitor cells

Isolated Protective Factors

Photoreceptor Loss, Modulation of Müller Cells

Protection of Retinal Ganglion cells (Glaucoma)

Corneal Endothelium, Corneal Epithelium,

Descemet’s Membrane

Corneal Disease

Mesenchymal Stromal Cells

Glaucoma, Uveitis

Retinitis Pigmentosa

Management of Ocular Surfaces

light

retina

RP

E la

yer

Pho

tore

cept

ors

Page 25: 2012 World Stem Cell & Regenerative Medicine Congress, London

ACT MSC Program

Page 26: 2012 World Stem Cell & Regenerative Medicine Congress, London

Ocular Program –

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Proprietary scaled

manufacturing for generating

“young” MSCs from hESC

and iPS lines

• hESC-and IPS-MSCs are expanded to large numbers in vitro • Avoid senescence problem of “old” MSC’s

• Renewable cell source and “Off-The-Shelf” therapy

• hESC-derived MSCs are HLA I+, HLA II-

• Higher immunosuppressive potency relative to adult MSC

• MSCs can migrate to injury sites in eye, exert local

immunosuppressive effects, and repair damaged tissue

Ocular Products in Development ▫ Inflammatory diseases of the eye

▫ Photoreceptor/neuron-protective activity

▫ Tolerance to ocular grafts and devices

▫ Delivering therapeutic proteins to the eye

Page 27: 2012 World Stem Cell & Regenerative Medicine Congress, London

Mesenchymal SCs – Hemangioblast Derived

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33,000 units MSCs from hESC-MSCs

1 unit MSCs

from adult BM

Compared to Adult MSC

• Less labor-intensive

• Single Bank Regulatory Process

No need to derive new banks

Quality controls are easier to manage

• Larger yield of MSCs

Compared to hESC-direct

• Less labor-intensive

• Larger yield of MSCs

• Faster acquisition of markers

hESC Direct HB Method

Start 350,000 ESC 200,000 EB’s

Collect 48 days 44 days

Yield 4 Million 85 Million

Strongly advantageous to derive MSCs

from our hESC/HB method vs adult or

hESC-direct MSC

Page 28: 2012 World Stem Cell & Regenerative Medicine Congress, London

ACT Management Team

Highly Experienced and Tightly Integrated Management Team

Gary Rabin – Chairman & CEO

Dr. Robert Lanza, M.D. – Chief Scientific Officer

Edmund Mickunas – Vice President of Regulatory Affairs

Kathy Singh - Controller

Rita Parker – Director of Operations

Dr. Irina Klimanskaya, Ph.D. – Director of Stem Cell Biology

Dr. Shi-Jiang (John) Lu, Ph.D. – Senior Director of Research

Dr. Roger Gay, Ph.D. - Senior Director of Manufacturing

Dr. Matthew Vincent, Ph.D. – Director of Business Development

Bill Douglass – Director of Corporate Communications & Social Media

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Page 29: 2012 World Stem Cell & Regenerative Medicine Congress, London

Thank you For more information, visit www.advancedcell.com