GAME CHANGER IN IMMUNOTHERAPY - ASIT biotech · 2020-03-12 · asit biotech: company overview 4 a...

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GAME CHANGER IN IMMUNOTHERAPY INVESTORS PRESENTATION NON-CONFIDENTIAL PRESENTATION JANUARY 2019

Transcript of GAME CHANGER IN IMMUNOTHERAPY - ASIT biotech · 2020-03-12 · asit biotech: company overview 4 a...

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GAME CHANGER IN IMMUNOTHERAPY

INVESTORS PRESENTATION

NON-CONFIDENTIALPRESENTATION

JANUARY 2019

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Disclaimer

This presentation (“Presentation”) has been prepared by ASIT Biotech (“ASIT”) to provide an overview of the Company, it does not constitute a prospectus, an audit or due diligence review and should not be construed as such. While the information contained in this Presentation is believed to be accurate, no representation or warranty, express or implied, is made as to the fairness, accuracy, reasonableness or completeness of the information contained herein. Neither the Company nor any other person accepts any liability for any loss howsoever arising, directly or indirectly, from this Presentation of its contents.

The Presentation includes forward looking statements and includes assumptions about future developments, operations and results. Although such statements are believed to be reasonable, there can be no assurances that such assumptions and views of the future are accurate, or that estimates and projections will be realized. Forward looking statements are subject to a variety of risks and uncertainties as they relate to future events and are dependent on circumstances that may or may not materialize in the future. No representation, warranties or other assurances will be made by ASIT concerning the anticipated performance of the company.

This document and its contents may not be viewed by persons within the United States (within the meaning of Regulation S under the Securities Act) other than (i) by QIBs (qualified Institutional Buyers) or (ii) in “offshore transactions” within the meaning of Regulation S. This document and any materials distributed in connection with this document are not directed to, or intended for distribution to or use by, any person or entity that is a citizen or resident or located in any locality, state, country or other jurisdiction where such distribution, publication, availability or use would be contrary to law or regulation or which would require any registration or licensing within such jurisdiction. The distribution of this document in certain jurisdictions may be restricted by law and persons into whose possession this document comes should inform themselves about, and observe any such restrictions. This document does not constitute or form part of, and should not be construed as, an offer, solicitation or invitation to subscribe for, underwrite or otherwise acquire, any securities of ASIT nor should it or any part of it from the basis of, or be relied on in connection with, any contract to purchase or subscribe for any securities of the Company, nor shall it or any part of it from the basis of or be relied on in connection with any contract or commitment whatsoever.

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WHO IS ASITBIOTECH ?

1

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ASIT Biotech: Company Overview4

A CLINICAL STAGE

BIOPHARMACEUTICAL

COMPANY SPECIALIZED IN

ALLERGY IMMUNOTHERAPY

QUOTED ON THE BELGIAN

AND FRENCH STOCK

EXCHANGES

WWW.ASITBIOTECH.COM

ASIT HAS ROBUST SCIENTIFIC AND CLINICAL SUPPORT:

26 ACTIVE AND MOTIVATED COLLABORATORS AND

A NETWORK OF HIGH CALIBER COLLABORATIVE CENTERS

Raised €86 million since inception

€23.4M IPO (2016)

€15.4M private placement (2018)

€12M convertible bonds (2018)

Cash position (30.6.18) : €13.5 million, reinforced by

a €12 million convertible bond issued in July 2018.

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ASIT Biotech: Management & Collaborators

MANAGEMENT

5

Michel Baijot, Managing Director & CEO

Yves Désiront, Director & CFO

Philippe Ghem, Chief Commercial Officer

Vincent Bille, VP CMC

Nicolas Bovy, Head of Research

Sabine Pirotton, Head of Project Management

Gilles Della Corte, Chief Medical Officer

Rémy von Frenckell, Head of Clinical Development

Vincent Theunissen, Head of Human Resources

DIRECTORSLouis Champion, Chairman

Michel Baijot , Managing Director

Refinance Consulting SA: Yves Désiront, Director & CFO

Everard van Straten, Director

Francois Meurgey, Director

Harry Welten, Director

Meusinvest: Philippe Degeer, Director

S.F.P.I.: François Fontaine, Director

Claus Bachert, MD, PhD

and Team

Stephen Durham, MD, FRCP

Mohamed Shamji

and Team

Ralph Mösges, MD, PhD

and Team

COLLABORATORS

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THERE IS AN OPPORTUNITY IN EVERY CHALLENGE

2

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PATIENTS

MARKET

DYNAMICS

* 7% severe, 58% moderate, 35% mild AR

ALLERGY

TREATMENT

MARKET IS

LARGE AND

GROWING

$12B

ONLY 45% ARE CORRECLTY DIAGNOSED*

400MPATIENTS

SUFFER

FROM

ALLERGIC

RHINITIS

(AR)

50%

DUE TO

DUST

MITE

55%

DUE TO

GRASS

POLLEN

MANY AR PATIENTS ARE

ALSO ASTHMATICS AND

ARE MORE LIKELY TO BE

RECEPTIVE TO A PREVENTIVE

APPROACH

The AIT market is <15% of the allergy drug market because of inefficient therapies

ALLERGOLOGISTS ARE EASY TO TARGET

< 100 REPS IN US AND < 100 REPS IN EU

7

1/3 OF PATIENTS WITH MODERATE TO

SEVERE AR ARE

NOT ADEQUATELY

CONTROLLED BY PHARMACOTHERAPY

ALLERGY

IMMUNOTHERAPY

MARKET

$1.8B

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Long and cumbersome AIT treatments result in low acceptance and poor compliance

YEAR 1 YEAR 2 YEAR 3 TREATMENT SUCCESS

SCIT

SUBCUTANEOUS

IMMUNOTHERAPY

SLIT

SUBLINGUAL

IMMUNOTHERAPY

Only 50% of

patients offered

immunotherapy

accept it

40 TO 60 DOCTOR’S VISITS REQUIRED

DAILY DOSING UP TO 360 DOSES/YEAR

<10% of eligible

patients complete the

3 year treatment course**

Inefficient

intervention

generating a lot of

dissatisfaction

Eligible patients not

satisfied by

symptomatic treatments

COMPLIANCE*

End Y1

SCIT 80%

SLIT <40%

COMPLIANCE*

End Y2

SCIT <40%

SLIT <20%

* Source: Kiel MA et al. J Allergy Clin Immunol 2013; 132: 353-60

** (23% compliance for SCIT and 7% for SLIT after Y3)*acceptance rate (50%)

Inefficient

intervention

generating a lot of

dissatisfaction

PATIENTS

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There is an opportunity in allergy immunotherapy (AIT) to migrate from old, inefficient therapies to a new generation of preventive treatment

9

ASIT BIOTECH

IS LEADING A

REVOLUTION IN

CREATION OF A

NEW GENERATION OF EFFECTIVE AND

EFFICIENT AIT

HUGE REMAINING

UNMET NEED

AND

MARKET POTENTIAL

CHANGE THE

GAME AND

BECOME A LEADER

IN THE FIELD

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ASIT’S INNOVATIVE SOLUTION FOR AIT

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ASIT has developed a versatile platform for allergy immunotherapy11

ASIT BIOTECH TREATMENTS CONSISTING OF A UNIQUE MIXTURE OF HIGHLY PURIFIED PEPTIDES FROM DIFFERENT SELECTED SIZES, PRODUCED FROM NATURAL SOURCES OF ALLERGENS, AND FREE OF ADJUVANT

THE ASIT+TM PLATFORM OFFERS:

A validated production process

at commercial scale

Validated QC procedures

A scalable solution that is

applicable to various allergens

(e.g., House Dust Mites, Peanuts)

Already available Ex-vivo

screening, immunogenicity and

therapeutic models

HIGH GRADE

PURIFICATION

OF ALL ALLERGENS

FROM NATURAL

EXTRACTS

STANDARD

ENZYMATIC

HYDROLYSIS

SELECTION OF

ALLERGEN

FRAGMENTS

BASED ON SIZE

DISTRIBUTION*

HIGHLY

PURIFIED

ALLERGEN

FRAGMENTS

WITH OPTIMAL

SIZE

DISTRIBUTION

* 1-10 kDa

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Allergy is an inappropriate immune response against a harmless substance

Mast Cells

release histamine

and other pro-

inflammatory agents

Allergens are

processed by DC

activated by pro-

inflammatory agents

T Cells cause B Cells

to produce

pro-allergic IgE

antibodies

Dendritic Cells

activate

pro-allergic T Cells

IgE bind to

allergens and

attach to

Mast Cells

These chemicals

cause inflammation

and allergic symptoms

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1 2 3 4 5 6

Sneezing Redness Severe Reaction

Cough Runny Nose

Allergic Reaction

B Cell

Plasma

Cell IgET CellDendritic Cell

Allergen

Histamine

IgE Bridging

Mast Cell

Mast Cells (and

Basophils) remain

inactive and do not

release histamine

ASIT allergen

fragments reprogram

the immune system

and activate

regulatory DC

Reg. T Cells cause Reg.

B Cells to produce

anti-allergic IgA

and IgG4 antibodies

+ reduction in IgE

Dendritic Cells

activate anti-allergic

Regulatory T Cells

IgA / IgG4 blocking

antibodies prevent

IgE antibodies from

binding allergens

There is no

inflammation or

allergic symptoms

1 2

3

4 5 6

Mast Cell

B Cell

Regulatory

B Cell

IgG4 / IgARegulatory T Cell

Regulatory

Dendritic Cell

gp-ASIT+TM

IgE bound

by gp-ASIT+ Inactive

Mast Cell

Allergen

gp-ASIT+™ allergy immunotherapy induces a natural regulation of the immune system in 3 weeks

Long term AIT

Pro inflammatory feedback

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ASIT’s short course immunotherapy is much more efficient than current AIT13

YEAR 1 YEAR 2 YEAR 3 TREATMENT SUCCESS

CURRENT

IMMUNOTHERAPYCUMBERSOME SCHEDULE + POOR COMPLIANCE

UP TO 60 DOCTOR’S VISITS IN 3 YEARS

<10% of eligible

patients complete

the treatment course

ASIT+TM

IMMUNOTHERAPYMUCH EASIER SCHEDULE + BETTER COMPLIANCE

4 VISITS IN 3 WEEKS BEFORE EACH SEASON

Expected much higher

acceptance,

satisfaction and

compliance

ONLY 4 VISITS for gp-ASIT+™ treatment are expected to provide protection for the entire pollen season

…and protection mechanism are already in place 1 week after the last visit

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European clinical development in grass pollen rhinitis14

Trial # patients Aim Timing Design

Phase IIaBTT007

65• Safety and clinical tolerability

• Immunogenicity

• Clinical efficacy assessed by CPT

2013

• Open-label

• Dose-escalation

• Single center in Germany

Phase IIbBTT008

200• Dose-finding assessed by CPT

• Immunogenicity

• Safety and clinical tolerability

2014

• Double-blind - placebo controlled

• Dose-escalation

• Multiple centers in Germany

Phase IIIBTT009

549• Clinical efficacy

• Safety and clinical tolerability2017

• Double-blind – placebo controlled

• 57 centers in Germany, Belgium,

France, Italy, Spain, Czech Republic

Phase IBTT004

27• Safety and clinical tolerability

• Immunogenicity 2010

• Double-blind - placebo controlled

• Dose-escalation

• Single center in Belgium

Note: CPT = conjunctival provocation test

Phase IIIABTT011

624• Clinical efficacy

• Safety and clinical tolerability2019

• Double-blind – placebo controlled

• 82 centers in Germany, Belgium,

France, Czech Republic, Hungary, Poland

Started

CLINICAL DATA FROM PHASE II AND PHASE III HAS BEEN PUBLISHED BY WORLD-CLASS SCIENTIFIC PARTNERS IN HIGHLY RANKED JOURNALS

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In Phase III, gp-ASIT+™ demonstrated safety and efficacy15

PL: Placebo; LPP: Lolium Perenne Peptides (gp-ASIT+™)

* CSMS : Combined Symptom-Medication Score

** CPT: conjunctival provocation test (score from 1 to 4; most severe patients = CPT 3 & 4)

# ASIT received positive scientific advice from the German regulator, the Paul-Ehrlich Institute, and is now preparing a redesigned confirmatory Phase III study (First patient in planned in Jan 2019)

0

0,5

1

1,5

All patients Most severe**

CS

MS

Placebo

gp-ASIT+

CSMS OVER

ENTIRE

POLLEN

SEASON

P=0.03 P=0.05

0

0,5

1

1,5

2

All patients Most severe**

CS

MS

Placebo

gp-ASIT+

CSMS:

PEAK

POLLEN

PERIOD

P=0.04 P=0.05

17.9% 24.4%

15.5% 19.8%

In a Phase III study (BTT 009)

• gp-ASIT+™ resulted in a statistically significant improvement

in CSMS* during the peak pollen period and the entire pollen

season in the whole Phase III patient population

• The predefined absolute average 20% difference in CSMS*

between placebo and the treatment group was nearly achieved

over the peak season despite a poor results in Germany, which

was heavily weighted in the study#

• In a patient subgroup with the highest CPT** reactivity at

baseline (more than ½ of patients), CSMS* improvement was

even higher

Secondary endpoint

• Reactivity to the conjunctival provocation test (CPT) decreased

significantly in 60.0% of patients treated with gp-ASIT+™

compared with 35.6% in the placebo group

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Reliable immunological data correlates with strong efficacy data *16

* Blood samples from a representative sub-group of Phase III patients in Belgium (n=32) were compared from V8 (after the grass pollen season) vs. V6 (after treatment before the pollen season)

** CSMS : Combined Symptom-Medication Score

The production of sIgE due to exposure

to natural allergens during the pollen

season was blunted in a sub-group of

Belgian patients* receiving gp-ASIT+™

compared to those receiving placebo

0

10

20

30

40

gp-ASIT+ Placebo

sIg

E(k

UA/L

) sp

ecif

ic

to g

rass

po

llen

P<.001

IgE PRODUCTION

DURING THE POLLEN SEASON

BELGIUM *

Data from 32 patients in Belgium

showed a 35% reduction in CSMS**

during the peak pollen period and

>50% reduction for the entire

pollen season (both highly

significant)

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ABT 011CONFIRMATORY PHASE IIIFOR GP-ASIT+TM

4

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ABT011 phase III study design18

‒ 1:1 (active : placebo)‒ 624 allergic patients

‒ PRIMARY : Clinical efficacy during pollen season based on reduction in the combined symptom-medication score (CSMS)

‒ SECONDARY : ‒ Safety and clinical tolerability‒ Immunogenicity (1 site in Belgium)

‒ Double-blind‒ Placebo controlled‒ 82 centers‒ 6 countries in Europe

(BE - CZ – DE – HU –FR – PO)

# PATIENTS OBJECTIVES DESIGN

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Potential pitfalls of real-life exposure trials in grass pollen allergies

Addressing the complexity of

Operations

• overweighting of a centeror a country

• absence of pollen or out of order pollen traps

• weakly allergic patients' selection

• poor quality of medication use and symptom data due to a bad reporting by the patients

In gpASIT009:

3 CROs overseen by a reduced ASIT Team

30% of the patients had neither symptoms nor

medication intake during the season peak

Late start/recruitment

Pollen traps out of order around 2 large sites

Many missing data from patients (21.5% of patients

with less than 50% compliance to fill in the diary

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1. The new Phase III study is subcontracted to a single Top Ten CRO experienced in allergy

studies, ICON.

2. Oversight is internally executed by a well-staffed clinical operations team including a

Team Leader with a 30-years clinical development experience, a Chief Medical Director with a

30-years clinical development experience, 2 Clinical Project Managers with 10-years clinical

development experience each.

3. Pollen count monitoring is centralized by the European Aeroallergen Network from the

University of Vienna in order to guarantee the reliability of the pollen count data used for

the statistical analysis.

4. High pollen count and high-quality data recording history has been used to select the

clinical centers.

9 Improvements to secure ASIT011 (1/2)20

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Historical pollen data of the last 5 years provided by the European Aeroallergen Network (EAN)21

Site selection

Definition of patient visit planning

Sites

Bachert (Ghent)

Hellings (Leuven)

Rombaux (WSL)

Site

Volgmann (Hannover)

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5. To avoid recruitment issues and overweighting of a single center or a country, 82 clinical

centers spread over 6 countries are involved in the current Phase III clinical study and each

center is limited to a maximum number of randomized patients.

6. A medical history over the last two years is required for each patient in order to select the

most allergic ones.

Only patients with moderate to severe RC during the 2017-2018 seasons based on strict criteria

(ARIA) AND significant sIgE level AND SPT wheal diameter

7. Online follow-up of the recruitment for each site according to a provisional agenda

established on historical grass pollen data over the last 5 seasons.

8. Paper diaries are replaced by electronic diaries (including an alert system) to significantly

improve patient engagement for better data recording and quality.

9. Earlier launch allowing a longer randomization and treatment period prior to the grass pollen

season.

9 Improvements to secure ASIT011 (2/2)22

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Patient Recruitment

RECRUITMENT TARGET

23

Country # Sites # Screened# Randomized

in 2-2,5 months period

Enrollment Start

Date*

Enrollment End

Date**

Belgium 5 54 38 11-Jan-2019 03-Apr- 2019

Czech Republic 7 76 53 02-Jan-2019 25-Mar-2019

France 6 65 46 02-Jan-2019 17-Mar-2019

Germany 28 305 213 02-Jan-2019 03-Apr-2019

Hungary 9 98 69 02-Jan-2019 11-Mar-2019

Poland 27 294 205 02-Jan-2019 03-Apr-2019

Total 82 892 624

* start dates are country/site specific based on the start of the pollen season in the site area.

** end date is a conservative estimation based on the pollen data of the last 5 years provided by the

European Aeroallergen Network

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ASIT+TM

PIPELINE

DEVELOPMENT:

HDM-ASIT+TM

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Higher impact on asthmatic patients

Longer duration of exposure to the allergen

A recent market research confirmed the need for more convenient solutions

It is a global, growing epidemy

Higher unmet needs for House Dust Mites allergies (HDM) than for Grass pollen

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House Dust Mite immunotherapy - hdm-ASIT+™

First Phase I/II showing

good safety and tolerability profile for the product candidate

no difference overall between treated group and placebo group with regard to immunogenicity parameters

Design of new prototypes with an immunogenicity profile equivalent to gp-ASIT+™

Characterization of the allergenicity and antigenicity of candidates in collaboration with Dr M. Shamji

Selection of a product candidate with an immunological profile equivalent to gp-ASIT+™

First-in-man

clinical trial

could start in

H2 2019

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ASIT+TM

PIPELINE

DEVELOPMENT:

PNT-ASIT+TM

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Most FA reactions are triggered by peanuts, milk, shell-fish, eggs, tree nuts and wheat.

However, peanut allergy is one of the most common and severe forms of FA, with a cumulative diagnosed prevalence of c. 6.0m18 both in the US and in the EU-5.

Caregivers reported a willingness-to-pay of USD20.8bn annually (USD3,504 per year per child) for food allergy treatment.

No treatment exists today for FA. 2 Pioneers have recently initiated an FDA submission for a Peanut AIT but they are far from offering an optimal solution, leaving substantial room for innovative therapies.

The immunotherapy market for Peanut allergies is estimated above $5 billions

Food allergies: 220m patients worldwide - A Leading cause of anaphylaxis

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Program funded with 6 million euros by the Walloon Region to develop 3 new drug candidates for food allergies (peanut, cow’s milk and egg white)

First peptide-based product for immunotherapy of food allergy, using ASIT+™ platform

Selection of a product candidate with an immunological profile equivalent to gp-ASIT+™

Characterization of the allergenicity and antigenicity of candidates in collaboration with Dr M. Shamji

Completion of industrialization process for the manufacture of clinical batches of pnt-ASIT+™

Peanut immunotherapy - pnt-ASIT+™

First-in-man

clinical trial

could start in

H2 2019

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ASIT Biotech expected milestones30

pnt-ASIT+™

(phase I)

Peanut:

pnt-ASIT+™

hdm-ASIT+™

(phase I )

House dust mite:

hdm-ASIT+™

Other food:

Egg white / cow’s milk

2019 2020

gp-ASIT+™

confirmatory phase IIIGrass pollen:

gp-ASIT+™

H1 H2 H1

Candidate Selection

FDA

Meeting

Results

Results*

Results*

Filing (GER)

H2

*Note: We are in contact with different compagnies for partnership and/or for the financing of our Phase 1

trials and we cannot predict the timing/outcome of those discussions

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5 analysts

cover

ASIT biotech

Lead compound:

300-500 M€ peak sales

Early Pipeline:

>1 B€ peak sales

ANALYSTS PEAK SALES ESTIMATES

31

Peak sales per project Date Gp-ASIT(M€)

hdm-ASIT(M€)

Pnt-ASIT(M€)

Kepler Cheuvreux Nov 2018

360 300 860

Gilbert Dupont Nov 2018

384 325 N.A.

KBC Securities June 2016

280 240 N.A.

Bryan Garnier Sept2018

500 430 N.A.

Edison May 2018

403 373 1448

Valuations only consider US & EU5, leaving significant HDM market potential in Asia

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ANALYSTS COVERAGE

Analyst Reco Target Price *

KBC Securities Hold 2,00 €

Kepler Cheuvreux Buy 3,00 €

Gilbert Dupont Accumulate 4,50 €

Bryan Garnier Corporate 4,50 €

Edison Corporate 6,30 €

32

* This information does not constitute an offer to sell or subscribe, or the solicitation

of an order to buy or subscribe for securities in France, Europe, the US or any other

country. Corporate: ASIT biotech have agreed on a service for the production and

distribution of financial analyses with Edison and Bryan Garnier. Status 16 Jan 2019.

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SUMMARY4

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Near-term critical milestones impacting company valuation

Phase III, low-risk innovative product opportunity for grass pollen allergy

immunotherapy with results expected in Q4 2019

Access to a pipeline of products for food and house dust mite allergies,

using a similar small peptide approach with strong IP, aiming at changing the

game in allergy immunotherapy. Start PhI/II in 2019.

First launch expected in 2-3 years

Additional clinical milestones supporting the efficacy/safety of our pipeline

OPPORTUNITY FOR A

POTENTIAL INVESTOR

* An allergy to grass pollen is the largest cause of allergic rhinitis, impacting millions of patients

34An investment opportunity in a new franchise with a novel approach to allergy immunotherapy

Short term opportunity (Around 12 months)

Mid term opportunity

Mid to Long term opportunity (commercialization together with committed partners)

▪ Low capitalization compared to

a solution adapted to millions of

patients

▪ Our technology adapts to most

allergies, a fast-growing market

with no real effective solution

An opportunity to gain market leadership in a large growing market with gp-ASIT+™,

a short course preventive treatment (3 weeks treatment), acting already 1 week after treatment completion

We plans to address the market in partnership with major players to continue the development and

the commercialization of gp-ASIT+™ and/or ASIT’s pipeline of potential new products, preferably through equity

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www.asitbiotech.com

Registered address

Avenue Ariane 5

1200 Brussels, Belgium

Operations

Rue des Chasseurs Ardennais 7,

4031 Liège, Belgium

Contact: [email protected]