1 Transforming Science into Medicine - BioLineRx

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1 Transforming Science into Medicine Corporate Presentation October 2021

Transcript of 1 Transforming Science into Medicine - BioLineRx

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Transforming Science into Medicine

Corporate PresentationOctober 2021

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2 Forward-Looking Statements2

This presentation contains “forward-looking statements.” These statements include words like “may,”

“expects,” “believes,” “plans,” “scheduled,” and “intends,” and describe opinions about future events.

These forward-looking statements involve known and unknown risks and uncertainties that may cause

the actual results, performance or achievements of BioLineRx to be materially different from any

future results, performance or achievements expressed or implied by such forward-looking

statements.

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3 Who are We?3

NASDAQ: BLRX

Ticker / Exchange BLRX (NASDAQ)

Headquarters Tel Aviv, Israel

Market cap ~$140 million (15-Oct-21)

Shares outstanding ~47.3 million (American Depositary Shares)

Cash ~$66 million (30-Jun-21)

Cash runway H1 2024

Employees ~40 (30 in R&D)

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4 Investment Highlights4

Multiple opportunities for value enhancement

➢ Final phase 2 PDAC data showed improvement across all endpoints; planning next development steps – randomized study under potential collaborations

➢ Significant milestones over next 12 months, including pre-NDA meeting and NDA submission

Compelling valuation and financial condition

➢ ~$140 million market cap (15-Oct-21)➢ ~$66 million cash as of June 30, 2021➢ Cash runway – H1 2024

Singular focus on novel oncology compounds

➢ Motixafortide (BL-8040) program – phase 3 for SCM completed; in phase 2 for pancreatic cancer and AML

➢ AGI-134 program – in phase 1/2a for solid tumors

SCM – stem cell mobilization; AML – acute myeloid leukemia

Advancing towards potential registration of

Motixafortide in SCM

➢ Positive top-line results from Phase 3 GENESIS trial in SCM; highly statistically significant improvement in all primary and secondary endpoints (p<0.0001)

➢ ~90% of patients transplanted following one dose and one apheresis➢ Company moving forward towards NDA submission in H1 2022

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5 Pipeline Targeting Multiple Oncology Indications5

PROGRAM INDICATION PRE-CLINICAL PHASE 1

Stem-cell mobilization

Solid tumors

ONCOLOGYMotixafortide (BL-8040)

AGI-134

Skin lesionsOTHERBL-5010

Pancreatic cancer *

PHASE 3REGULATORY

APPROVALPHASE 2 PARTNERS

*BioLineRx retains all rights to BL-8040 under a clinical trial collaboration with

AML

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Motixafortide (BL-8040):CXCR4 Antagonist

Oncology Combination Platform for Solid and Hematological Indications

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Pre-Approval

Stem Cell Mobilization for Multiple Myeloma

Robust mobilization of HSPCs for transplant

Phase 2

Acute Myeloid Leukemia

Mobilization of leukemic cells from bone-marrow protective niche,

sensitization to anti-cancer treatment and induction of

apoptosis

Motixafortide – Best-in-Class CXCR4 Antagonist for Multiple Indications7

Phase 2

Cancer Immunotherapy for Solid Tumors

Mobilization of immune cells to peripheral blood; infiltration of

immune T cells into tumor; reduction of immunosuppression in

tumor microenvironment

HSPC – Hematopoietic stem and progenitor cell

• A 14-amino acid synthetic cyclic peptide, high-affinity CXCR4 antagonist with long receptor occupancy (>48 hours)

• CXCR4 is over-expressed in more than 70% of cancers and its high expression levels correlate with disease severity

• CXCR4 and its ligand CXCL12 (SDF-1) play a critical role in trafficking of CXCR4 expressing cells such as HSPCs, immune and cancer cells

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Motixafortide in SCM

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Significant unmet medical need in SCM

• Multiple apheresis sessions required

• 30-50% of patients are poor mobilizers

• For poor mobilizers, 1-4 daily injections of plerixafor on top of G-CSF are required

BL-8040 best-in-class CXCR4 antagonist offers a more effective and convenient mobilization option for all patients

• Robust HSCT mobilization; may support faster engraftment

• Single administration on top of SoC

• Less apheresis sessions and reduced hospitalization costs

SCM for Patients Undergoing Autologous HSC TransplantationPatients with hematological malignancies often require HSC transplant after treatment to restore their immune system

HSC – hematopoietic stem cell; SCM – stem cell mobilizationPlerixafor = Mozobil = AMD3100

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10 Stem Cell Mobilization OpportunityRare indication showing significant growth and major unmet need

* CIMBTR 2019 Summary Slides (US) – https://www.cibmtr.org/ / EBMT Transplant Activity Survey 2018 Summary (EU) – https://www.ebmt.org/

Growing number of hematopoietic autologous stem-cell transplantations (HSCTs), especially in MM

o An estimated ~45,000 auto-HSCTs were conducted in EU and US in 2018*

o Global potential market estimated at ~$500 million

o ~90% of auto-HSCTs are in MM and lymphomas

o #MM auto-HSCTs is growing (doubled since 2010)

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54%

36%

10%

Multiple Myeloma

Lymphomas

Other

BL-8040 could become new SoC and expand the market

• BL-8040 could expand beyond poor mobilizers to primary up-front treatment as standard of care

• Potential expansion in other autologous indications, such as lymphomas and sickle cell anemia

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GENESIS Phase 3Top-Line Results

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Primary endpoint

• % pts mobilizing ≥6 x 106 CD34+ cells*/kg following single dose of BL-8040 in up to 2 apheresis sessions

Main secondary endpoint

• % pts mobilizing ≥6 x 106 CD34+ cells*/kg following single dose of BL-8040 in 1 apheresis session

Additional secondary endpoints

• Time to neutrophil engraftment

• Time to platelet engraftment

• Time to engraftment defined

GENESIS Phase 3 – Autologous HSCT in MM Pts – Design and Endpoints Randomized (2:1), placebo-controlled, multi-center study in combination with G-CSF, n=122, NCT03246529

Study completed; final results announced May 2021*

* Company announcement: https://ir.biolinerx.com/node/12551/pdf

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13 >90% of Patients Needed Only ONE Dose of BL-8040 for Transplantation

All patients (N=122)BL-8040+G-CSF

(N=80)Placebo+G-CSF

(N=42)

Treatment effect

Fold increase P value

Based on local lab - actual clinical decision making

92.5% 26.2% 65.1% 3.5 <0.0001

Based on central lab for regulatory purposes

70.0% 14.3% 54.6% 4.9 <0.0001

The primary endpoint: % pts mobilizing ≥6 x 106 CD34+ cells/kg following single dose of BL-8040 in up to 2 aphereses

• 12 sensitivity analyses were done on primary endpoint and all were statistically significant (<0.0001)

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All patients (N=122)BL-8040+G-CSF

(N=80)Placebo+G-CSF

(N=42)

Treatment effect

Fold increase P value

Based on local lab - actual clinical decision making

88.8% 9.5% 78.8% 9.3 <0.0001

Based on central lab for regulatory purposes

67.5% 4.8% 61.7% 14.1 <0.0001

~90% of Patients Needed Only ONE Apheresis for TransplantationPositions Motixafortide on top of G-CSF as SOC upfront mobilization agent

The secondary endpoint: % pts mobilizing ≥6 x 106 CD34+ cells/kg following single dose of BL-8040 in 1 apheresis

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15 Motixafortide Provides Clear Clinical Differentiation to Plerixafor*Indirect comparison to Plerixafor

Endpoint Study Treatment Arm Placebo Arm Treatment Effect

GENESIS primary endpoint: % of subjects collected ≥ 6x106 CD34+ cells/kg in up to two aphereses

Motixafortide + G-CSF(Single administration)

92.5% 26.2% 65.1%

Plerixafor* + G-CSF(Two Administrations)

71.6% 34.4% 37.2%

GENESIS secondary endpoint: % of subjects collected ≥ 6x106 CD34+ cells/kg in one apheresis

Motixafortide + G-CSF 88.8% 9.5% 78.8%

Plerixafor* + G-CSF 54.2% 17.3% 36.9%

*Indirect comparison; Plerixafor’s efficacy endpoints were calculated using the percentage of CD34+ cells determined by the central laboratory applied to the WBC count from the local laboratory, therefore the correct comparison is to BL-8040’s local lab results. Source: FDA Review

Endpoint Treatment Arm Placebo Arm Treatment Effect

GENESIS primary endpoint 70.0% 14.3% 54.6%

GENESIS secondary endpoint 67.5% 4.8% 61.7%

Regulatory purposes – GENESIS Central Lab

Real-Life Decision-Making – Local Labs

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Higher # cells collected in single apheresis enables transplantation of optimal # of cells, potentiallyproviding significant savings on time to engraftment

Higher # of cells collected also permits cryopreservation for additional transplantation(s)

Certainty regarding number of apheresis sessions required could enable more efficient utilization of apheresis units at transplantation centers

G-CSF + BL-8040 G-CSF+ Placebo

Median # of mobilized cellsin single apheresis

~11M ~2M

Higher # of Cells Mobilized Provides Meaningful Differentiationfor Motixafortide

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Study conducted with IQVIA, alongside very positive Phase 3 GENESIS study, assessed Motixafortide + G-CSF vs. G-CSF alone for SCM in MM patients prior to ASCT

Costs directly associated with primary mobilization

Primary Collection

Costs directly associated with rescue therapy (incl plerixafor)

Rescue Therapy

Cost associated with transplantation (incl length of stay)

Transplantation

Costs and QALY accrued over lifetime (incl previous phases)

Life-long horizon

Health Resource Utilization (HRU) Data Inputs:

Net cost savings:

~$17,000*

* Excludes cost of MotixafortideQALY= Quality adjusted life years

Motixafortide plus G-CSF was associated with a statistically significant HRU decrease during the

ASCT process compared to SoC G-CSF alone

Pharmacoeconomic Study: Motixafortide on Top of G-CSF Demonstrates Significant Cost Benefits

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Pharmacoeconomic study positions Motixafortide as SOC and demonstrates

commercial viability of Motixafortide in SCM

Leaving substantial room to optimize pricing strategy

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18 Motixafortide Provides Clear Differentiation to Current SOC in SCMOne administration, one apheresis, 90% success; significant cost savings

Study met all primary and secondary endpoints with exceptionally high level of statistical significance (p<0.0001)

Combination is safe and tolerable

~90% of patients in treatment arm underwent transplantation following one administration and oneapheresis

Results compare favorably to plerixafor phase 3 results*

Higher # of cells collected potentially enables faster engraftment, as well as cryopreservation for additional transplantation(s)

Pharmacoeconomic study positions Motixafortide as SOC and demonstrates commercial viability in SCM

o $17,000 in cost savings# leaves substantial room to optimize pricing strategy

Company working aggressively to gain regulatory approval – plans to submit NDA in H1/22

• Indirect comparison• # not including the cost of Motixafortide

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Motixafortide in Cancer Immunotherapy - PDAC & Solid Tumors

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PDAC incidence significant and growing: 460K cases WW in 2018, estimated 815K in 2040

Poor outcomes in PDAC:

• 5y survival rate 8-10%, minimal change in last 30y

• Multiple late-stage failures

• >50% PDAC patients diagnosed with (stage IV) disease = COMBAT Cohort 2 population

• 5y survival rate ~3%, mOS of 3-5 months

Lack of efficacious treatment options (in all lines):

• 1L Gem/FOL-based; 2L vice versa

• 2L Onivyde is the only approved regimen

• Immunotherapy has no effect* => need to co-target alternative pathways

2L PDAC represents a multi-billion $ addressable market

• ~85% of patients treated 1L and then 40% 2L

• ~130K 2L pts in major markets#

BL-8040 is the most advanced CXCR4 antagonist in clinical development for PDAC

• Failed trials based on single promising endpoint, while BL-8040 improves multiple endpoints in homogenous population => better prediction of future success

• Plan to expand beyond PDAC 2L into additional treatment lines and other solid tumors (1L PDAC study initiated^)

2L Pancreatic Cancer Market Represents Significant OpportunityCold tumor where IO has no effect; significant market opportunity with high unmet medical need

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GLOBOCAN 2018; graph produced from WHO Cancer Tomorrow website - link# 2L calculation based on e2025: ~400K Pancreatic cancer pts in major markets (US&CA 68K, Europe 146K, China 146K, JP 47K) - link* Pembro only approved in MSI-H PDAC (~1% of pts) ^ BL-8040/PD-1i/Chemotherapy – NCT04543071

China

Europe

USA+CA

Estimated pancreatic cancer cases # 2018-2040

Japan

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21COMBAT Phase 2a Study– Cohort 1: Dual Combination

MoA demonstrated by mono / dual combination (in patient biopsies - representative MultiOmyxTM data*):

o Increased activated cytotoxic T cells

o Decreased myeloid derived suppressor cells in tumormicroenvironment

o Reduction in tumor cell numbers

Supported by 2 additional independent studies#

Phase 2a open-label, multi-center study to assess the safety and efficacy of BL-8040 and pembrolizumab in subjects with metastatic pancreatic cancer: NCT02826486 (n=37)

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*Representative MultiOmyxTM data taken SD patient and long treatment duration (11 combo cycles ~34 weeks). Data shown before treatment vs. after ~7w of treatment (end of cycle 2)# (1) Fogelman et al, SITC 2009; (2) Morpheus Study, ASCO GI 2020

End

Cyc

le 2

Scre

enin

g

In collaboration with Bockorny et al., Nat Med (2020)Bockorny et al, Clin Cancer Res (2021)

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22 Rationale for Motixafortide Triple Combo in Cohort 2Tumors with low immune visibility require multi-modal approach to advance treatment beyond SoC limitations

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Adapted from Chen and Mellman

Chemotherapy

Motixafortide (BL-8040)

Checkpoint Inhibitor

Chemotherapy induces tumor death, reducing tumor burden

Chemotherapy induces immunogenic cell death, leading to activation & expansion of new tumor-reactive T-cell clones

Motixafortide facilitates effector T cell mobilization/ trafficking from BM/LN to periphery and infiltration into TME;

Motixafortide facilitates TME modulation: ↑activated CTLs and ↓MDSCs/Tregs

PD1 maintains & restores activity of T cells within tumor

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23 Design of Triple Combination – Cohort 2Triple combination: BL-8040 and pembro on top of SOC in 2L PDAC

EndpointsORR according to RECIST 1.1 criteriaDisease control rate (DCR)Duration of responsePFS and OSSafety and tolerability

Main inclusion/exclusion criteria18 years old and aboveMetastatic disease at first diagnosis (Stage IV) Progressed after first-line gemcitabine-based treatmentNo previous surgeries for PDAC, no previous locally advanced diseaseNo prior PD-1 or PD-L1 treatment

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Dr Hidalgo, Dec 2020 – KOL Webinar – Link* All n=43, evaluable n=38

Study completed; final results presented in December 2020 *

In collaboration with Bockorny et al., Nat Med (2020)Bockorny et al, Clin Cancer Res (2021)

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Change from Baseline in Target lesions

Data shown for subjects treated with the triple combination and have at least one Post Monotherapy D5 (BL) Scan

Triple Combo Shows Tumor Shrinkage Over Time (SD→PR)Majority of patients achieved PRs and SDs with triple combo

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Dr Hidalgo, Dec 2020 – KOL Webinar – Link

Partial

Response

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25 Consistent and Meaningful Improvement Across All Study EndpointsDemonstrated in hard-to-treat PDAC patients (caveated by limitations of small single-arm study)

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# Based on benchmarking conducted – see KOL Webinar Link1 Macarulla Mercade et al, Pancreas 2020; 2 Petrelli et al Eu J Cancer 2017; 3 Onivyde SMPC; 4 Wang Gillam Eu J cancer 2019

Summary of COMBAT Results

COMBAT 2 data showed improvement across all efficacy parameters compared to best matching population benchmark

Prolonged mOS and mPFS

Improved Confirmed ORR

Responses and stable disease were generally durable

Favorable safety compared to Onivyde label

COMBAT HISTORICAL DATA#

mOS 6.5 months 4.7 months1

mPFS 4.0 months 2.7-3.1 months2,3

cORR 13.2% 7.7%3

DCR 63.2% 29-52%2,4

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AGI-134Cancer Immunotherapy

Universal Anti-Cancer Vaccine with Unique MoA

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27 What is the Alpha-Gal and Anti-Gal Story?27

Xenotransplantation experiments in the 1980’s-90’s found that, when introduced to humans, the alpha-Gal-positive tissue was bound by pre-existing human anti-Gal antibodies, which were the main cause of the rejection of porcine heart valves

AGI-134 coats tumor cells with alpha-Gal to make them look like foreign tissue and harness the pre-existing immune machinery, to evoke an immune response against the tumor

AGI-134: a fully synthetic alpha-Gal glycolipid for IT injection

a-Gal linker phospholipid

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28 AGI-134 – Mechanism of Action28

AGI-134 directs pre-existing anti-Gal antibodies to the tumor and induces activation of multiple immune system effector arms against the patient’s own neoantigens

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29AGI-134 Monotherapy - Phase 1/2a Study DesignPart 1 successfully completed

Endpoints

Safety and tolerability

Determine MTD and RP2D

Pharmacodynamic and biomarker assessments

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PART 1 PART 2

Monotherapy Expansion

25mg 50mg 100mg 200mg3 Deep Lesions Deep & Superficial Lesions

1

32

1 1

3

2

Accelerated Escalation MonotherapyAccelerated Dose Escalation Dose Expansion

Open-label study to evaluate the safety and tolerability of AGI-134 intratumoral as a monotherapy, in unresectable/metastatic solid tumors (NCT03593226) (n=40)

• Part 1 of study successfully completed - AGI-134 was found to be safe and well tolerated with no dose-limiting toxicities observed

• Part 2 initial results expected H2 2021

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Looking Ahead

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31 Upcoming Major Clinical and Regulatory Milestones in Next 12 Months31

BL-8040 Pharmacoeconomic study results in SCM H2 2021

BL-8040 Pre-NDA meeting with FDA (SCM) H2 2021

AGI-134 Initial results from part 2 of Phase 1/2a trial H2 2021

BL-8040 NDA submission (SCM) H1 2022

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32 Investment Summary32

Multiple opportunities for value enhancement

➢ Final phase 2 PDAC data showed improvement across all endpoints; planning next development steps – randomized study under potential collaborations

➢ Significant milestones over next 12 months, including pre-NDA meeting and NDA submission

Compelling valuation and financial condition

➢ ~$140 million market cap (15-Oct-21)➢ ~$66 million cash as of June 30, 2021➢ Cash runway – H1 2024

Singular focus on novel oncology compounds

➢ Motixafortide (BL-8040) program – phase 3 for SCM completed; in phase 2 for pancreatic cancer and AML

➢ AGI-134 program – in phase 1/2a for solid tumors

SCM – stem cell mobilization; AML – acute myeloid leukemia

Advancing towards potential registration of

Motixafortide in SCM

➢ Positive top-line results from Phase 3 GENESIS trial in SCM; highly statistically significant improvement in all primary and secondary endpoints (p<0.0001)

➢ ~90% of patients transplanted following one dose and one apheresis➢ Company moving forward towards NDA submission in H1 2022