EX-99.2 3 ef20038771_ex99-2.htm EXHIBIT 99.2

Exhibit 99.2

 Adding FAP-Targeting Candidates to Theranostic Pipeline  Investor Presentation   November 2024  ASX: TLX | NASDAQ: TLX​  3D rendering of cancer associated fibroblast layer of tumour microenvironment. 
 

 Disclaimer   This presentation should be read together with our risk factors, as disclosed in our most recently filed reports with the Australian Securities Exchange (ASX), U.S. Securities and Exchange Commission (SEC), including our registration statement on Form 20-F filed with the SEC, or on our website.   The information contained in this presentation is not intended to be an offer for subscription, invitation or recommendation with respect to shares of Telix Pharmaceuticals Limited (Telix) in any jurisdiction, including the United States. The information and opinions contained in this presentation are subject to change without notification. To the maximum extent permitted by law, Telix disclaims any obligation or undertaking to update or revise any information or opinions contained in this presentation, including any forward-looking statements (as referred to below), whether as a result of new information, future developments, a change in expectations or assumptions, or otherwise. No representation or warranty, express or implied, is made in relation to the accuracy or completeness of the information contained or opinions expressed in this presentation.  This presentation may contain forward-looking statements, including within the meaning of the U.S. Private Securities Litigation Reform Act of 1995, that relate to anticipated future events, financial performance, plans, strategies or business developments. Forward-looking statements can generally be identified by the use of words such as “may”, “expect”, “intend”, “plan”, “estimate”, “anticipate”, “believe”, “outlook”, “forecast” and “guidance”, or the negative of these words or other similar terms or expressions. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause Telix’s actual results, levels of activity, performance or achievements to differ materially from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. Forward-looking statements are based on Telix’s good-faith assumptions as to the financial, market, regulatory and other risks and considerations that exist and affect Telix’s business and operations in the future and there can be no assurance that any of the assumptions will prove to be correct. In the context of Telix’s business, forward-looking statements may include, but are not limited to, statements about: the initiation, timing, progress and results of Telix’s preclinical and clinical trials, and Telix’s research and development programs; Telix’s ability to advance product candidates into, enrol and successfully complete, clinical studies, including multi-national clinical trials; the timing or likelihood of regulatory filings and approvals for Telix’s product candidates, manufacturing activities and product marketing activities; Telix’s sales, marketing and distribution and manufacturing capabilities and strategies; the commercialisation of Telix’s product candidates, if or when they have been approved; Telix’s ability to obtain an adequate supply of raw materials at reasonable costs for its products and product candidates; estimates of Telix’s expenses, future revenues and capital requirements; Telix’s financial performance; developments relating to Telix’s competitors and industry; and the pricing and reimbursement of Telix’s product candidates, if and after they have been approved. Telix’s actual results, performance or achievements may be materially different from those which may be expressed or implied by such statements, and the differences may be adverse. Accordingly, you should not place undue reliance on these forward-looking statements.   This presentation also contains estimates and other statistical data made by independent parties and by Telix relating to market size and other data about its industry. This data involves a number of assumptions and limitations, and you are cautioned not to give undue weight to such data and estimates. In addition, projections, assumptions and estimates of Telix’s future performance and the future performance of the markets in which it operates are necessarily subject to a high degree of uncertainty and risk.   Telix’s lead imaging product, gallium-68 (68Ga) gozetotide injection (also known as 68Ga PSMA-11 and marketed under the brand name Illuccix®), has been approved by the U.S. Food and Drug Administration (FDA), by the Australian Therapeutic Goods Administration (TGA), and by Health Canada. No other Telix product has received a marketing authorisation in any jurisdiction.  This presentation has been authorised for release by the Telix Pharmaceuticals Limited Disclosure Committee on behalf of the Board.  ©2024 Telix Pharmaceuticals Limited. The Telix Pharmaceuticals® and Illuccix® names and logos are trademarks of Telix Pharmaceuticals Limited and its affiliates – all rights reserved.  2 
 

 Transaction to add clinically-validated FAP assets to pipeline  A promising pan-cancer target with initial focus on bladder cancer  Rettig et al. Proc Natl Acad Sci USA. 1988.  Conversion to AUD$ is at an average exchange rate of AU$1 = EUR € 0.61  Strategic acquisition bolsters Telix’s focus in urology   Fibroblast Activation Protein (FAP) is one of the most exciting targets in nuclear medicine – expressed in over 90% of epithelial cancers1   Next-generation assets have potential for imaging, and both alpha and beta therapy applications  Demonstrated safety and efficacy profile in extensive pre-clinical and clinical validation   Developed by renowned radiochemist Professor Frank Roesch and team  Next generation of FAP-targeting theranostics   Bolsters pipeline with a pan-cancer program complementing Telix’s CAIX portfolio  Initial development program to focus on bladder cancer, which rounds out urology franchise  Deal summary  €7M cash (upfront) (AU$11M)  €3M cash (12 months’ time) (AU$5M)  Up to €132M subject to clinical milestones (AU$215M)  Up to €20M subject to commercial milestones (AU$33M)2  3 
 

 FAP: The Achilles’ heel of cancer?  Targeting key players in the tumour microenvironment (TME)  4  CAFs are marked by significantly increased levels of Fibroblast Activation Protein (FAP)  FAP is expressed in CAFs as well as on some tumour cells, creating a potential double-hit to the tumour  FAP is a druggable target and therefore a potential Achilles’ heel of cancer   Cancer cells can ‘manipulate’ normal fibroblasts to promote tumour growth  Permanently activated fibroblasts are known as Cancer Associated Fibroblasts (CAF)  Fibroblasts are cells which help to form connective tissue and promote the body’s normal healing process  In cancer this forms part of a protective wall around the tumour called stroma - protecting it from immune response  Stroma makes up >70% of solid tumour mass1  Micke et al., EBioMedicine. 2021.  TME  CAF  FAP  Dx/Tx 
 

 The theranostic potential of FAP  Using radiation to image, damage or destroy cancer cells  5  Zboralski et al., EJNMMI. 2022.  Novruzov et al. Molecular Imaging and Biology. 2022.  Koshkin et al. JNM. 2024.  68Ga-FAPI PET in 65-y-old patient with bladder cancer2  FAP Imaging in bladder cancer exemplifies potential for therapeutic approach  FAP is highly expressed in the TME of epithelial cancers, and on the surface of some specific cancer types, including sarcomas and mesotheliomas1  By delivering radiation to CAFs, targeted radionuclide therapy has the potential to damage or destroy the cancer stroma and cancer cells  Powerful therapy potential  Overexpressed  in cancer   Weakening of the cancer stroma may also improve the effectiveness of other therapies  Combined treatment  options  FAP targeting for imaging patients2,3 - superior to FDG - highlights its potential to address a significant unmet need through a theranostic approach  Demonstrated evidence in bladder cancer  Patient representative scans - individual results may vary. 
 

 Cracking therapeutics: A new way to target FAP  New assets have potential to overcome key challenges  6  Yadav et al. EJNMMI. 2024.  Ballal et al. Pharmaceuticals (Basel). 2021.  Martin et al. Cancers. 2023.  AIIMS, New Delhi, India.  Clinically validated for safety profile and efficacy in several cancer types, under an extensive compassionate use program1-4  First-generation FAP-targeting candidates limited by short tumour residence  Telix’s next generation candidates have a novel design enabling:  Extended tumour retention  Minimal off-target uptake  Significant radiotherapeutic dose to tumour  Improved clearance   Labelling with either 177Lu (beta) or 225Ac (alpha)  Potential for beta and alpha therapy  
 

 Clinical evidence for acquired next-gen compounds​  Proof-of-concept in-human study and extensive compassionate use ​  7  Ballal et al. Pharmaceuticals. 2021; Ballal et al. JNM. 2022; Ballal et al. JNM. 2023; Bal et al. JNM. 2024.​  AIIMS, New Delhi, India. Data on file.  Laeppchen et al. Molecules. 2024.  Successful proof of concept across diagnostic, therapeutic, for multiple indications​  FAP-targeting diagnostic has been used in >400 patients, establishing safety profile2  Safety profile established  Extensive clinical data  Used as therapy in >120 patients across sarcoma, breast, thyroid and medullary thyroid cancers to date1  Pan-cancer uses  Builds on extensive preclinical data, published in several peer-reviewed papers3  Peer-reviewed data  68Ga-DOTA.SA.FAPi PET/CT   177Lu-DOTA.(SA.FAPi)2 post-therapy serial whole-body scans  24h  168h  Radiotracer retention in metastatic sites at 168 hours  Intense accumulation of radiotracer in tumour mass (arrows) and multiple skeletal sites (right femur-arrow head).  Published data demonstrates therapeutic potential1  Patient representative scans - individual results may vary.    
 

 Compelling responses seen in late-stage cancer patients  Significant tumour mass reduction following treatment with therapeutic candidate  8  AIIMS, New Delhi, India. Data on file.  Treatment with 177Lu-based, FAP-targeted  therapeutic candidate in-licensed by Telix  Before  After  FAP-targeted PET  Patient with breast cancer1  Before  After  FDG-PET  FDG-PET  FDG-PET confirms  tumour mass reduction  in same patient  FAP-targeted PET  Clinical effect of 177Lu-based, FAP-targeted therapeutic candidate in-licensed by Telix, in a patient with breast cancer.  Response verified by FAP-targeted PET (above) and FDG-PET (right) using the diagnostic in-licensed by Telix.  Patient representative scans - individual results may vary. 
 

 Frank Roesch, PhD  Mainz, DE  Clinical development led by renowned KOLs  Broad community of supporters leading investigations  9  Renowned radiochemist in nuclear medicine  Invented the 68Ga generator   Chairs World Theranostics Conference  Ken Herrmann, MD, MBA  Essen, DE  Chair of Dept of Nuclear Medicine at University Hospital Essen  Chair of EANM Oncology & Theranostics Committee  Prolific commentator in nuclear medicine community  Frederik L. Giesel, MD, MBA  Chair of Dept of Nuclear Medicine at Uni Düsseldorf  Global leader in application of PSMA and FAP targeting in nuclear medicine  Düsseldorf, DE  “FAP-targeting is very exciting.   In the past, we have been successful in treating primarily one cancer type with a certain asset or therapeutic agent. Here we have opened a new door to treat a variety of cancer subtypes – a pan tumour target and even beyond!”  -  Prof. Dr. Frederik L. Giesel  “  Extensive clinical experience with all Roesch compounds  Widely published in both JNM and other nuclear medicine publications  Chandrasekhar Bal, MD & Sanjana Ballal, PhD New Delhi, IN 
 

 Large market opportunity   Unmet need in bladder cancer  6th most common cancer in the U.S., significant unmet need    10  American Cancer Society, Key Statistics for Bladder Cancer, accessed October 2024.   Mason. Eur Urol Open Sci. 2021.  National Cancer Institute, Bladder Cancer Prognosis and Survival Rates, accessed October 2024.  National Cancer Institute, Bladder Cancer Prognosis and Survival Rates, accessed October 2024.  Targeted radionuclide therapy.  Hemida et al. J Immunoassay Immunochem. 2022.  NCCN Guidelines Version 4.2024, Bladder Cancer.  White space opportunity for TRT5, including FAP-targeting agents   Global market for bladder cancer therapies estimated to grow by over 20% per annum over next 5 years4  No approved systemic radionuclide therapy   Studies suggest FAP expressed in over 67% of cases6  83K  new cases and 16K+ deaths per year in the U.S.1  29%  of patients develop metastatic disease2 with 5-year survival rate of 8%3  $5.6B  $13.7B  in 2024  in 2029 
 

 Adding to the bladder cancer therapy toolbox  Complements Telix's CAIX program, options for localised and disseminated disease  11  ZiP-UP (IIT)  Exploring indication expansion for TLX250 in urothelial carcinoma or bladder cancer  Phase I study of TLX250-CDx complete – awaiting readout  PERTINENCE (IIT)   Alpha candidate in non-muscle invasive bladder cancer   Phase I feasibility study of TLX250-CDx complete  Moving to first-in-human therapeutic studies with 211At (alpha) via Telix partner ATONCO  Trials of TLX250-CDx in bladder cancer  TLX250-CDx-PET CT  FDG-PET CT  Contrasted CT  3D representation with superimposed bladder based on TLX250-CDx Pelvis PET/CT Fusion images  Comparison of TLX250-CDx PET-CT with FDG-PET CT.  Patient representative scans - individual results may vary. 
 

 Pan-cancer: “Double hit” at TME – targeting hypoxia and fibrosis  A complementary approach – and a “shot in the arm” to immuno-oncology  12  FAP targeting small molecule (fibrosis / stroma)  Two well validated targets with pan-cancer potential1, 2  Head and Neck Carcinoma  Esophageal Cancer  Chordoma  Salivary Gland Cancer  Thymus Cancer  Breast Cancer  Cholangiocarcinoma  Sarcoma  Renal Cell Carcinoma  Ovarian Cancer  Cervical Cancer  Colorectal Cancer  Anal Cancer  Glioblastoma Multiforme  Hepatocellular Carcinoma  Desmoid  Gastric Cancer  Nasopharyngeal Carcinoma  Lung Cancer  Adenoid Cystic Carcinoma  Thyroid Cancer  Neuroendocrine Tumours  Pancreatic Cancer  Insulinoma  Small Intestine Cancer  Bladder Cancer  Prostate Cancer  FAP  CAIX  CAIX targeting antibody  (hypoxia)   Literature reports of CAIX expression.  Giesel et al. J Nucl Med. 2019. 
 

 Clinically validated theranostic drug candidates targeting FAP – a highly promising target   Next-generation compounds with longer tumour retention than earlier versions   Adds to Telix’s urology development pipeline with novel candidates for bladder cancer, a major market opportunity  Potential to generate further value from pan-cancer targeting   Clinical data (safety profile and efficacy) reduce development risk, guide target indications and may expedite development  Visit our website for more: Attack on Stroma  In summary: An exciting asset with big potential  Adds to urology pipeline with ability to expand to other cancer types  13  Kratochwil et al. 2019. Journal of Nuclear Medicine June 2019, 60 (6) 801-805; DOI: https://doi.org/10.2967/jnumed.119.227967  13  Maximum-intensity projections of 68Ga-FAPI PET/CT in patients reflecting 15 different histologically proven tumour entities (sorted by uptake in descending order). Ca = cancer; CCC = cholangiocellular carcinoma; CUP = carcinoma of unknown primary; MTC = medullary thyroid cancer; NET = neuroendocrine tumour.  68Ga-FAPI PET/CT: Tracer Uptake in 28 Different Kinds of Cancer1  SNMMI Image of the Year 2019   Patient representative scans - individual results may vary.    
 

 Contact details: Kyahn WilliamsonSVP Investor Relations and Corporate Communicationkyahn.williamson@telixpharma.com   A confocal microscopy image of a fibroblast.  Credit: National Cancer Institute.