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A CD117-Amanitin Antibody Drug Conjugate (ADC) Effectively Depletes Human and Non-Human Primate Hematopoietic Stem and Progenitor Cells (HSPCs): Targeted Non-Genotoxic Conditioning for Bone Marrow Transplant Bradley Pearse , Jennifer Proctor,

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  1. A CD117-Amanitin Antibody Drug Conjugate (ADC) Effectively Depletes Human and Non-Human Primate Hematopoietic Stem and Progenitor Cells (HSPCs): Targeted Non-Genotoxic Conditioning for Bone Marrow Transplant Bradley Pearse , Jennifer Proctor, Sean McDonough, Rajiv Panwar, Ganapathy Sarma, Lena Kien, Junia Dushime, Hillary Adams, Sharon Hyzy, Melissa Brooks, Rahul Palchaudhuri, Qing Li, Pranoti Sawant, Tahirih Lamothe, Nidhi Jain, Katia George, Charlotte McDonagh, Anthony Boitano, Michael Cooke Magenta Therapeutics Cambridge, MA

  2. Financial Disclosures Magenta Therapeutics • Shareholder • Inventor • Salary • Employment

  3. Current Transplant Conditioning Agents are Non-Specific and Genotoxic Acute toxicities can include: • Neutrophil loss (infections) • Platelet loss (bleeding) • Anemia • T-cell depletion (infection) • Thymic damage (infection) • Mucositis Long-term toxicities can include: • Secondary malignancies • Organ damage • Infertility • Stunted growth

  4. Targeted Conditioning: Patient Preparation for Transplant & Stem Cell Gene Therapy Opportunity: Applications in transplant: • Less toxic conditioning • Gene therapy • Potential for disease control • Hematologic malignancies • Immune preservation • Avoid secondary malignancy and infertility

  5. CD117 (C-kit) is an Ideal Target for ADC-Mediated Conditioning A single dose of CD117 ADC Restricted expression profile enables robust engraftment in mice Hematopoietic Stem Cell Common Myeloid Progenitor Common Lymphoid Progenitor Small Lymphocyte Mast Erythrocyte Natural killer cell Cell Myeloblast T cell B cell Megakaryocyte Basophil Eosinophil Monocyte Neutrophil Plasma cell Platelet Macrophage CD117 is overexpressed in >60% of AML and MDS patients (Ludwig et al. Haematologica 1997, 617-621)

  6. Engineered Half-Life for Appropriate Clearance in Transplant Non-human primate pharmacokinetics Concentration (ng/mL) Group Half Life (Hours) Engineered half-life IgG 11 Wild-type IgG 60 Days Post Administration

  7. Amanitin Conjugation to Effectively Deplete Target Cells Prior to Transplant Amanitin Benefit Non-DNA damaging inhibitor of RNA Avoid risks of secondary malignancy polymerase II and infertility Cytotoxic to quiescent and dividing Deplete HSCs with anti-tumor activity cells Potent cytotoxicity on low copy Allows for substantial elimination of number cells CD117+ cells Full synthetic access by Serum stable license from Heidelberg Low off-target toxicity Low membrane permeability Pharma

  8. Anti-CD117 Amanitin ADC Demonstrates Potent Killing of AML and Human CD34+ Cells in vitro

  9. Single Dose of Anti-CD117-Amanitin ADC Selectively Depletes Human CD34+ cells in Humanized Mice

  10. A Single Dose of Anti-CD117-Amanitin ADC Extends Survival in AML Xenograft Models

  11. The Engineered Anti-CD117-Amanitin ADC Effectively Depletes Target Cell Populations in Cynomolgus Monkeys

  12. The Timing of ADC-Mediated Depletion and Clearance Provides a Window for Transplant Conditioning

  13. Engineered Anti-CD117-Amanitin ADC is Safe and Well-Tolerated in Non-Human Primates at Efficacious Doses Anti-CD117-AM PBS (d35) Tissue 0.3 mg/kg (d35) (magnification) Liver (10x) Kidney (10x)

  14. Summary and Next Steps • An ADC targeting CD117 may be a promising approach for conditioning in: • Autologous transplant for gene therapy • Allogeneic transplant for hematologic malignancies Additional TCT • CD117-Amantin ADC effectively depletes hematopoietic stem and progenitor cells: abstracts on ADC conditioning: • In vitro • in humanized mice Jennifer Proctor Poster 129 • in non-human primates 2/20 • CD117-Amantin ADC extends survival in Acute Myeloid Leukemia xenograft Sharon Hyzy Poster 262 models 2/20 • An engineered half-life ADC is well-tolerated in NHPs with appropriate Rahul Palchaudhuri pharmacokinetics and pharmacodynamics for the transplant setting 2/21 5:30-5:45 Next Steps: • IND-enabling activities in 2019 • Evaluation of ADC-mediated conditioning in NHP transplant models

  15. Acknowledgements Magenta Therapeutics Michael Cooke Tony Boitano Charlotte McDonagh Jennifer Proctor Rajiv Panwar Sean McDonough Ganapathy Sarma Lena Kien Junia Dushime Hillary Adams Rahul Palchaudhuri Sharon Hyzy Qing Li Melissa Brooks Pranoti Sawant Tahirih Lamothe Nidhi Jain Katia George Heidelberg Pharma

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