James Cummings
Analyst · Piper Jaffray. Sir, your line is now open
Thanks Stan. Today, I’ll provide you with an overview of our NanoFlu vaccine program. Our nanoparticle influenza vaccine is based on the hemagglutinin antigen, or HA, which is found on the surface of the flu virus. In the figure on the right, the globular head region, featured in red, contains the receptor binding region of HA. This is above the stem domain seen in gray, which supports the head domain and anchors the HA structure to the viral envelope. The receptor binding region or globular head domain on the HA protein is the target for antibodies that prevent flu virus from binding to cells. These antibodies are highly strength-specific and dominate the immune response to conventional inactivated influenza vaccines. Antibodies to this receptor binding site can be detected by hemagglutination inhibition or HAI, which is an established surrogate marker protection from influenza. This surrogate marker of protection is recognized by the FDA and other regulatory agencies, and can be used as a basis for licensure. On slide 16, we see a label figure, as well as an actual cross-sectional image of our influenza nanoparticle. As you can see, there are multiple hemagglutinin antigens self-assembling around the nanoparticle core. This results in a very stable HA nanoparticle, which as I’ll show you in the next few slides, is highly immunogenic. The preclinical goals for our NanoFlu program were straight forward; to evaluate our HA-based nanoparticle influenza vaccine, adjuvant it with Matrix-M in the ferret model, which is the gold standard for preclinical influenza vaccine testing to assess the vaccines’ immunogenicity and its protective efficacy. We compared our NanoFlu vaccine with two leading commercial influenza vaccines from the 2016, ’17 season, Fluzone and Fluzone HD, which are both produced by the more historic egg-based approach. In addition to immunogenicity, we evaluated protective efficacy using an intranasal challenge with a recent H3N2 strain that was matched to the current vaccines, as well as it drifted historical H3N2 strain, which is unmatched in the current vaccines. With the study design, we used our NanoFlu vaccine, as well as the two commercially approved vaccines and a placebo to immunized groups of ferrets on day zero and day 21 with blood draws on day 21 before the second immunization and day 42. All the ferrets were challenged intranasally on day 49 with either the matched H3N2 strain, represented in the vaccines, or in unmatched or drifted H3N2 strain that was not represented in the vaccines. On slide 19, we’ve provided a table to describe the vaccine compositions. The Novavax NanoFlu vaccine contains the recommended strains for the upcoming 2017-18 year, and reflects the composition of the vaccine to be used in our upcoming Phase 1/2 clinical trial. As you can see, there was a small difference in the H1N1 strains among the vaccines with NanoFlu having an A Michigan strain from the 2017-18 recommendations and Fluzone and Fluzone HD having A Califoria as their H1N1 strain from the 2016-17 recommendations. All vaccines have the same H3N2 strain A Hong Kong, as well as the same B Victorian strain, B Brisbane. Slide 20 depicts the HAIs induced at day 42 against our selected flu strains. The X-axis of each graph depicts the type of test article either placebo, NanoFluid Matrix-M featured in red, or Fluzone HD or Fluzone. The Y-axis represents the HAI titers demonstrated, so the higher the value the better the HAI, which is a recognized surrogate for protection. As you can clearly see, NanoFlue vaccine produced superior haemagglutination inhibition responses across all strains that were represented in any of the vaccines. The NanoFlu produced antibodies demonstrated superior HAI responses for A Michigan, A California, A Hong Kong and B Brisbane. On slide 21, even in the case of the H1N1, which was slightly mismatched between the vaccines, we see that NanoFlu, represented in red, produces significantly superior HAIs in both A Michigan, which is represented in NanoFlu and not in the Fluzone and Fluzone HD products but also in A California, which is not represented in NanoFlu but is found in Fluzone and Fluzone HD. Looking at the numeric data, featured in the boxes below the graphs, the NanoFlu provided a statistically significant increase in HAIs over the responses obtained with commercially available vaccine. These data are evidence to the broadening of protection that is found with our NanoFlu vaccine adjuvanted with Matrix-M. Influenza immunogenicity can be evaluated through micro-neutralization testing where the antibody stops the virus from growing in cells. This functional assessment of vaccine immunity is generally more sensitive in measuring humoral immunity in influenza. Micro-neutralization is routinely used at the CDC, the World Health Organization and many labs around the world. For A Michigan, on the upper left hand side of the table, we see NanoFlu in red, producing a titer of over 5,000 with Fluzone HD in blue, yielding a titer of about 32. For A California, NanoFlu produces a titer of over 4,000 with Fluzone HD producing a titer of about. For A Hong Kong, NanoFlu produces a titer of approximately 1,200 with Fluzone HD yielding in titer of about 80. In all of these graphs, we see confirmation of the HAI data that the NanoFlu vaccine, depicted in red, provide superior influenza micro- neutralization across all strains from H1 100 fold higher than the commercially available seasonal influenza vaccines. Again, using influenza micro-neutralization, we look back across more than 15 years of H3N2 strains. The data speak for themselves. It’s a NanoFlu vaccine, depicted in red on our figure, provides significantly superior micro-neutralization of H3N2 strains across more than 15 years of drift. On the left hand of the slide, from 2014 H3N2 Hong Kong strain down to the 1999 H3N2 Panama strain on the far right of the table. In the April 2009 strain, for example, NanoFlu has a micro-neutralizing titer of 768 versus Fluzone HDs producing a level of 6. These data illustrate a broadening of functional immune responses against drifted strains. This is an important advantage of the NanoFlu vaccine. The importance of the drifted strain coverage can by illustrated by the following scenario. During the recent 2014-15 influenza season and the Northern Hemisphere and several times in the last few decades, an H3N2 mismatch between the recommended annual vaccine strain and the circulating A H3N2 viruses, caused by antigenic drift, resulted in a significant increase in influenza cases and bad outcomes, especially in our elderly population. This was due largely, to the lack of cross protection against drifted strains in the currently approved vaccines. The NanoFlu vaccine preclinical data addresses this very significant challenge for influenza vaccines and could lead to a better influenza vaccine. On slide 24, we show influenza challenge data, which is generated from ferrets infected with flu by placing live virus into their nose, and followed over about a week to see if the vaccine reduces the presence of virus in the nasal passage. For these challenge graphs on slide 24, the X axis depicts the days post challenge and the Y axis represents the nasal watch virus titers; thus, the lower the line the smaller the area under the curve and the better to protection. On the left hand side of the slide and looking at the challenge of ferrets with the matched H3N2 strain, that’s the H3N2 strain represented in all of vaccines, NanoFlu seen as the green line, delivered significantly superior protection compared to the commercially available strains. Turning toward the right hand portion of the slide and the data from the challenge with the unmatched or drifted strain of H3N2 from 2007, NanoFlu, seen as a green line, again demonstrates significantly superior protection compared to the commercially available vaccines Fluzone HD, Fluzone and to placebo. In summary, our nanoparticle influenza vaccine demonstrated greater protection in the preclinical ferret model, both in matched and in drifted flu virus when compared to the market leader in older adults, Fluzone HD. Additionally, NanoFlu can be manufactured with very high yields, excellent purity and high levels of potency. The NanoFlu vaccine, with the features I’ve described, has been scaled up and manufactured in GMP process in preparation for clinical testing. These data may signal a major improvement in seasonal influenza vaccines. They also provide the basis for us to proceed into a Phase 1/2 clinical trial later this year to confirm in humans the preclinical findings we’ve discussed today. As Stan will discuss, good immunogenicity from our upcoming Phase 1/2 clinical trial may lead to a near-term pathway to a pivotal Phase 3 study and licensure. Back to you, Stan.