37th Annual J.P. Morgan Healthcare...

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37 th Annual J.P. Morgan Healthcare Conference January 8, 2019 2/7/2019: Correction to slide 18 and 22

Transcript of 37th Annual J.P. Morgan Healthcare...

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37th Annual J.P. Morgan Healthcare Conference

January 8, 2019

2/7/2019: Correction to slide 18 and 22

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This presentation contains forward-looking statements, which express the current beliefs and expectations of management. Such statements are based on current expectations and involve a number of known and unknown risks and uncertainties that could cause Clovis Oncology’s future results, performance or achievements to differ significantly from the results, performance or achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute to such differences are discussed in Clovis Oncology’s filings with the U.S. Securities and Exchange Commission. Forward-looking statements speak only as of the date on which they are made, and Clovis Oncology undertakes no obligation to update publicly or revise any forward-looking statement, whether as a result of new information, future developments or otherwise.

Forward-looking Statements

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Summary• Estimated $30.3 - $30.8M in Rubraca® (rucaparib) sales for Q4 2018 and $95.3 - $95.8M for FY2018

• Focused on ovarian cancer market share growth and increasing adoption of second-line maintenance treatment

• European Commission (EC) marketing authorization for the recurrent ovarian cancer maintenance treatment indication anticipated Q1 2019

– Launch in Germany planned in Q1 2019

• Breakthrough Therapy designation (BTD) granted by FDA to Rubraca in BRCA1/2-mutated metastatic castration-resistant prostate cancer (mCRPC)

– 44% RECIST response rate and 51% PSA response rate based on initial data presented at ESMO 2018

• Robust Rubraca single-agent clinical development program underway in a variety of solid tumor types, including prostate and bladder cancers

• Broad clinical collaboration with Bristol-Myers Squibb (BMS) for Opdivo® (nivolumab) and Rubraca combination in multiple tumor types

• Lucitanib combination studies planned to initiate with rucaparib and a PD-(L)1 inhibitor Q1 2019

• $518 - $521M in cash, cash equivalents and available-for-sale securities at December 31, 2018

PSA = prostate-specific antigen

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U.S. Label Expanded in April 2018 to Broad and Earlier Line Maintenance Treatment Ovarian Cancer Patient Population• Rubraca is indicated to treat women with recurrent

ovarian cancer who are in a complete or partial response to platinum-based chemotherapy, regardless of BRCA mutation status

• Indication based on data from the Phase 3 ARIEL3 clinical trial

• Approximately 160 field-based personnel in U.S. promoting Rubraca and educating HCPs

• Estimated $30.3 - $30.8M in Rubraca sales for Q4 2018 and $95.3 - $95.8M for FY2018

– Free drug was an additional approximately 25 to 27 percent of overall commercial supply for Q4 and FY2018

Source: The Lancet, vol. 390, Coleman et al, Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial, pages 1949-61 and Supplement Table S4, Copyright 2017, with permission from Elsevier..

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ARIEL3 Intent to Treat (ITT) Population Progression-Free Survival (PFS)

Investigator-Assessed PFS

At risk (events)

Rucaparib 375 (0) 228 (111) 128 (186) 65 (217) 26 (226) 5 (234) 0 (234)

Placebo 189 (0) 63 (114) 13 (160) 7 (164) 2 (167) 1 (167) 0 (167)

Rucaparib, 38% censored Placebo, 12% censored

Median(months) 95% CI

Rucaparib(n=375)

10.8 8.3–11.4

Placebo(n=189)

5.4 5.3–5.5

Hazard Ratio, 0.36 (95% CI, 0.30-0.45); p<0.0001

Source: Reprinted from The Lancet, vol. 390, Coleman et al, Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial, pages 1949-61, Copyright 2017, with permission from Elsevier.

Median(months) 95% CI

Rucaparib(n=375)

13.7 11.0–19.1

Placebo(n=189)

5.4 5.1–5.5

BICR-Assessed PFS

Hazard Ratio, 0.35 (95% CI, 0.28-0.45); p<0.0001

At risk (events)

Rucaparib 375 (0) 213 (95) 114 (143) 60 (157) 24 (162) 4 (165) 0 (165)

Placebo 189 (0) 50 (106) 13 (128) 6 (132) 2 (133) 1 (133) 0 (133)

Rucaparib, 56% censored Placebo, 30% censored

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In an Exploratory Analysis of ARIEL3, Higher Rucaparib Response Rate in Both BRCA-Mutant and Non-BRCA Disease • Included the conversion of some PRs to CRs

– CR was achieved in 18% of BRCA-mutant patients and 7% of ITT1 patients with measurable disease

Intent-to-Treat1 BRCA MutantRubraca (n=141) Placebo (n=66)

Rubraca (n=40) Placebo (n=23)

ORR 18% (n=26) 8% (n=5) 38% (n=15) 9% (n=2)

CR 7% (n=10) 2% (n=1) 18% (n=7) 0% (n=0)PR 11% (n=16) 6% (n=4) 20% (n=8) 9% (n=2)

Source: The Lancet, vol. 390, Coleman et al, Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial, pages 1949-61 and Supplement Table S4, Copyright 2017, with permission from Elsevier..CR = complete response, PR = partial response1ITT population includes BRCA mutant subgroup

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Rubraca Safety in Maintenance Treatment Setting

• In ARIEL3, most common adverse reactions (≥ 20% of patients; CTCAE Grade 1-4): nausea, fatigue/asthenia, abdominal pain/distention, rash, dysgeusia, anemia, AST/ALT elevation, constipation, vomiting, diarrhea, thrombocytopenia, nasopharyngitis/upper respiratory tract infection, stomatitis, decreased appetite and neutropenia

• In ARIEL3, most common laboratory abnormalities (≥ 25% of patients; CTCAE Grade 1-4); increase in creatinine, decrease in hemoglobin, increase in cholesterol, increase in ALT, increase in AST, decrease in platelets, decrease in leukocytes, decrease in neutrophils, increase in alkaline phosphatase and decrease in lymphocytes

• Majority of adverse reaction and laboratory abnormalities Grades 1-2

• In approximately 1100 treated patients across all trials, MDS/AML occurred in 12 patients (1.1%), including those in long term follow up; some events were fatal

CTCAE = Common Terminology Criteria for Adverse Events, ALT = Alanine Aminotransferase, AST = Aspartate Aminotransferase, MDS =Myelodysplastic Syndrome, AML= Acute Myeloid Leukemia

Source: Rubraca US Prescribing Information revised 04/2018.

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Addressing the Need to Increase Market Share and Second-line Maintenance Adoption

Rubraca Share

• “MAINTenhance” promotional campaign

– Maintain long-term PFS

– Enhance tumor response

Second-line Maintenance Adoption

• “A.C.T.” campaign to promote active treatment over observation

• A chronic disease requires chronic therapy

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In EU Rubraca Received Positive CHMP Opinion for Second-Line Ovarian Cancer Maintenance Treatment Indication• CHMP positive opinion for Rubraca ovarian cancer maintenance treatment indication at

December 2018 meeting

– Indication consistent with U.S. maintenance treatment indication

• EC marketing authorization for maintenance treatment anticipated in February 2019

• Launch in Germany planned in Q1 2019

• Other countries to follow in 2019-2020

• Early access program in place in certain EU countries to allow access to rucaparib for patients in need

CHMP = Committee for Medicinal Products for Human Use, EC = European Commission

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Rubraca Potential Across Multiple Tumor Types

• Broad clinical development program underway:

– As monotherapy in ovarian, prostate and bladder cancers

– In combination with Opdivo in ovarian, breast, prostate and bladder cancers

Ovarian Cancer

Lung Cancer

Pancreatic Cancer

Gastric Cancer

Bladder Cancer

Breast Cancer

Prostate Cancer

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Rubraca Potential in Prostate Cancer

• Second most frequently diagnosed cancer in men

– An estimated 164,000 men in the U.S. diagnosed in 2018

– Approximately 345,000 men in the EU diagnosed in 2012

• Castration-resistant prostate cancer (CRPC) has high likelihood of developing metastases

– The 5-year survival rate is ~29% for metastatic disease

– mCRPC remains an incurable disease usually associated with poor prognosis

• Approximately ~12% of mCRPC patients have a deleterious mutation in BRCA1 or BRCA2*

– These molecular markers may be used to select patients for treatment with a PARP inhibitor

*Sources: Bancroft et al. Eur Urol. 2014; 66(3):489-99; Castro et al. J Clin Oncol. 2013;31(14):1748-57; Abida et al. JCO Precis Oncol. 2017;1:1-16.

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Rubraca Granted Second Breakthrough Therapy Designation

• FDA granted Breakthrough Therapy designation (BTD) for Rubraca on October 1, 2018

– Monotherapy treatment of adult patients with BRCA 1/2-mutated mCRPC who have received

at least one prior AR-directed therapy and taxane-based chemotherapy

– TRITON2 dataset presented at ESMO served as basis for BTD

• Anticipate filing for accelerated approval in later line BRCA1/2-mutated mCRPC by

YE2019

AR = androgen-receptor

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TRITON2: Later Line Study for Potential Accelerated Approval in Prostate Cancer

TRITON2: A Phase 2 single-arm study Initiated Q4 2016

• Enrolling patients with germline or somatic BRCA mutations as well as other deleterious mutations in other HR repair genes

• All patients will have progressed after receiving one line of taxane-based chemo and one or two lines of AR-targeted therapy in the castrate-resistant setting

• Primary endpoints are confirmed radiologic ORR per modified RECIST/PCWG3 in patients with measurable disease by independent review and PSA response rate in patients without measurable disease

HR = homologous recombination, AR = androgen receptor, ORR = overall response rate, PSA = prostate-specific antigen

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TRITON2: Initial Results in mCRPC Presented at ESMO 2018• RECIST ORR of 44.0% (11/25) in patients with BRCA1/2 mutation

– Independent-assessment consistent with investigator-assessment

• Confirmed PSA response rate of 51.1% (23/45) in patients with BRCA1/2 mutation• Preliminary safety data for Rubraca in men with mCRPC are consistent with those

observed in women with ovarian cancer

Visit cutoff date: 29 June 2018. *Per modified RECIST/PCWG3 criteria. Includes patients who had measurable disease at baseline per the investigator and ≥16 weeks of follow-up or who discontinued treatment.** Includes patients who had ≥8 weeks follow-up or who discontinued treatment.

Source: Annals of Oncology (2018) 29 (suppl_8): viii271-viii302mCRPC = metastatic castration-resistant prostate cancer, CI = confidence interval, ORR = objective response rate, PCWG3 = Prostate Cancer Clinical Trials Working Group 3, RECIST = Response Evaluation Criteria In Solid Tumors v1.1, PSA = prostate-specific antigen.

PSA Response BRCA1/2 (n=45)All evaluable patients** % [95% CI]

51.1%[35.8–66.3]

RECIST Response by Investigator BRCA1/2 (n=25)

ORR*, % [95% CI] 44.0%[24.4–65.1]

Complete response, % 0%Partial response, % 44.0%

Stable disease, % 36.0%Progressive disease, % 16.0%Not evaluable, % 4.0%

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TRITON3 in Prostate Cancer: Earlier Line Comparative Study for Potential Full Approval

TRITON3: A Phase 3 comparative study Initiated Q1 2017• Enrolling patients with germline or somatic BRCA mutations and ATM mutations who

have progressed on AR-targeted therapy and who have not yet received chemo in the castrate-resistant setting

• The study will compare rucaparib to physician’s choice of AR-targeted therapy or chemotherapy in these patients

• Primary endpoint is radiologic PFS

• Study could potentially serve as confirmatory should TRITON2 study data support an accelerated approval

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Unmet Need in Bladder Cancer Provides a Novel Opportunity for Rubraca• In the U.S., an estimated 81,000 new cases of bladder cancer were diagnosed in 2018,

one of the top six most common cancers

• Approximately 20-30% of newly diagnosed bladder cancer patients have disease which has invaded the muscle

• Muscle invasive bladder cancer is a disease with a poor prognosis

– Overall survival after initial cisplatin-containing chemotherapy is 13-15 months with most patients having relapse of disease in 9 months

– After the initial 1-2 lines of anti-cancer treatments, options are limited

• Platinum therapy is today’s standard of care

• Based on TCGA bladder cancer data set, ~60% of bladder cancer tumors have alterations in homologous recombination repair genes or other genomic features associated with HRD

• Potential to treat an all-comers populationTCGA = The Cancer Genome Atlas, HRD = homologous recombination deficiency

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ATLAS in Bladder Cancer; Enrollment Underway Clovis-Sponsored Potential Registration Study

ATLAS: Phase 2 single arm study Initiated Q1 2018• Enrolling patients with relapsed metastatic urothelial carcinoma, 1 to 2 prior standard of

care regimens, measurable disease and no prior PARP

• Primary endpoint ORR

• Enrolling all-comers population - no selection based on biomarker status

− Will analyze HRD patients first, step down to all-comers population

• Enrollment expected to complete Q3 2019; initial data presentation expected at a Fall 2019 medical meeting

ORR = Overall Response Rate, HRD = homologous recombination deficiency

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Clinical Collaboration in Place to Explore Rubraca + OpdivoCombo• Broad clinical collaboration to evaluate Rubraca in combination with Bristol-Myers

Squibb’s anti-PD-1 Opdivo (nivolumab) in multiple tumor types

• Three trials planned or underway:

– ATHENA: Phase 3 in advanced ovarian cancer

– Phase 3 in advanced triple-negative breast cancer (TNBC)

– Phase 2 in metastatic castration-resistant prostate cancer (mCRPC)

• Additional Clovis-sponsored study also planned for early 2019:

– ARIES: Phase 2 in relapsed, BRCA-mutant, BRCA wild-type/LOHhigh ovarian cancer and locally advanced or metastatic bladder carcinoma

• Clovis retains all rights to Rubraca

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Nonclinical Data Show Potential Anti-PD-(L)1/rucaparib Combination Opportunity • Rucaparib and anti-PD-L1 demonstrate enhanced anti-tumor efficacy in a syngeneic

BRCA1-mutant ovarian model1

• Anti-PD-1 and anti-CTLA-4 combinations equally compelling

6/15 tumor free Day 125

13/15 tumor free Day 125

1 Clovis internal data; BrKras syngeneic model performed at Crown Biosciences.Animals were dosed on days 11-32. Anti-PD-L1 clone 10F.9G2 was used. The rucaparib treated group was not plotted past day 76 since 40% (6/15) animals had been sacrificed at that time.Anti-PD-1 = anti-programmed cell death protein 1, anti-CTLA-4 = anti-cytotoxic T-lymphocyte-associated protein

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ATHENA Evaluates Rubraca/Opdivo in Front Line Ovarian Cancer

ATHENA: Phase 3 comparative study Initiated Q2 2018• A four arm, first-line maintenance treatment study to evaluate Rubraca and Opdivo, Rubraca, Opdivo

and placebo in newly diagnosed patients with stage III/IV high-grade ovarian cancer

− Switch maintenance design; patient enrolls when surgery/chemotherapy completed

• Objective is to determine if combination of PARP and PD-1 inhibitor meaningfully extends PFS versus Rubraca as monotherapy, or versus placebo

• All-comers population, similar step down statistical plan as ARIEL3

• Study conducted in association with the GOG in the U.S. and ENGOT in Europe; cooperative group engagement should facilitate rapid enrollment

• Clovis to sponsor, conduct and fund

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BMS Sponsoring Combination mCRPC and TNBC Studies

Phase 2 in metastatic castration-resistant prostate cancer (mCRPC)

Initiated Q4 2017

• 3 arm trial - Opdivo and Rubraca, Opdivo + docetaxel + prednisone, Opdivo + enzalutamide

• Objective to determine whether the combination meaningfully affects response rate and changes in PSA

• Mandatory tumor tissue to enable biomarker evaluation

• BMS to sponsor, conduct and fund study

Phase 3 in advanced triple-negative breast cancer (TNBC)• BMS to sponsor and conduct study

• Study costs to be shared by Clovis and BMS

• Protocol for this study is in developmentPSA = prostate-specific antigen

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ARIES: Clovis-sponsored Phase 2 Study Evaluation of Rubraca and Opdivo Combination in Ovarian and Bladder Cancers

Phase 2 study Planned to initiate early 2019• Open-label, multi-cohort study evaluating the combination of Rubraca and Opdivo in

patients with: − Second- or third-line platinum-sensitive ovarian cancer

o BRCA-mutant, BRCA wild-type/LOHhigh patients

− Locally-advanced metastatic bladder cancer

o Front-line platinum-ineligible patientso Second-line following platinum-based therapy

• Objective is to assess activity and safety of combination

• Clovis to sponsor, conduct and fund

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Rucaparib Patent Exclusivity through 2035 • Rucaparib camsylate salt/polymorph patent expires in 2031

– Issued in 47 countries to date (including U.S. and Europe), applications pending in 9 countries

– Positive outcome at December 4, 2018 European opposition hearing upheld claims directed to commercial formulation of Rubraca

– Patent protection in Europe likely through 2033 with supplementary protection certificate (SPC)

• Rucaparib composition of matter patent

– In U.S., with Hatch-Waxman patent term extension likely expires in Q4 2023

– Issued in 48 countries, expires in 2020, plus up to five years patent term extension, if applicable

• High dosage strength rucaparib tablet patent expires in 2035

– Covers all commercial dosage strengths of Rubraca

– Two patents issued in U.S.; pending in U.S., Europe and 15 other jurisdictions

• Other patents and patent applications with expirations between 2020-2035

• Regulatory exclusivity in Europe through 2028, and likely 2029

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Lucitanib is an Oral Tyrosine Kinase Inhibitor

• Lucitanib is a potent inhibitor that selectively inhibits vascular endothelial growth factor receptors 1-3 (VEGFR1-3), platelet derived growth factor receptors (PDGFR) α/β and fibroblast growth factor receptors 1-3 (FGFR1-3)

Kinase Kd (nM)FGFR1 21FGFR2 41FGFR3 51VEGFR1 1VEGFR2 1.1VEGFR3 7.1PDGFRα 0.43PDGFRβ 0.26

Kinome profiling1 Kinase binding profiling2

Source: 1 Clovis internal data; KINOMEscan kinase profiling of 456 kinases with 100 nM lucitanib performed at DiscoveRx; 2 Clovis internal data; Kinase binding performed at DiscoveRx.

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Lucitanib Overview• Strong rationale to combine lucitanib with checkpoint inhibition or Rubraca

– Originally developed by Clovis and Servier with the hypothesis of activity in FGFR driven tumors; data in breast and lung cancer were insufficient to move the program forward

– Recent data for a similar drug that inhibits these same three pathways – when combined with a PD-1 inhibitor – show encouraging results and rationale for development of lucitanib in combination with a PD-(L)1 inhibitor

• Clovis-sponsored combination studies now being planned

– Clovis also intends to initiate a study of lucitanib in combination with rucaparib, based on encouraging data of VEGF and PARP inhibitors in combination

– Each of these studies is expected to initiate before the end of Q1 2019

• Clovis owns global rights (excluding China) to lucitanib

• Composition of matter expires 2030 in the U.S. not including patent term extensions; EU patent protections will be similar

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Summary• Estimated $30.3 - $30.8M in Rubraca® (rucaparib) sales for Q4 2018 and $95.3 - $95.8M for FY2018

• Focused on ovarian cancer market share growth and increasing adoption of second-line maintenance treatment

• European Commission (EC) marketing authorization for the recurrent ovarian cancer maintenance treatment indication anticipated Q1 2019

– Launch in Germany planned in Q1 2019

• Breakthrough Therapy designation (BTD) granted by FDA to Rubraca in BRCA1/2-mutated metastatic castration-resistant prostate cancer (mCRPC)

– 44% RECIST response rate and 51% PSA response rate based on initial data presented at ESMO 2018

• Robust Rubraca single-agent clinical development program underway in a variety of solid tumor types, including prostate and bladder cancers

• Broad clinical collaboration with Bristol-Myers Squibb (BMS) for Opdivo® (nivolumab) and Rubraca combination in multiple tumor types

• Lucitanib combination studies planned to initiate with rucaparib and a PD-(L)1 inhibitor Q1 2019

• $518 - $521M in cash, cash equivalents and available-for-sale securities at December 31, 2018

PSA = prostate-specific antigen