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Corporate Presentation November 2022
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Aura Biosciences Highlights Novel
Platform to Treat Cancer Developing virus-like drug conjugates (VDCs) that bind to tumor associated HSPGs and deliver a therapeutic payload Targeting ocular tumors, bladder cancer and other solid tumor indications Ocular Oncology Franchise
Multi-billion-dollar market opportunity to treat early-stage choroidal melanoma(CM) and other ocular tumors Standard of care is invasive and may lead to blindness and eye loss Demonstrated tumor control and visual acuity preservation in both IVT and
SC clinical studies in CM Advancing to Phase 3 study globally Strong Cash Position Cash, cash equivalents and marketable securities of $112m* Expected to fund operations into 2024 SC - Suprachoroidal; IVT - Intravitreal: HSPG -
heparan sulfate proteoglycans * - As of 9/30/2022
Pipeline Targeting Life-Threatening
Cancers with High Unmet Needs Program OTHER SOLID TUMORS OCULAR ONCOLOGY Preclinical Phase 1 Phase 2 Phase 3 Planned Milestones Choroidal Metastasis (Breast, lung and other cancer metastasis in the eye) Primary Choroidal Melanoma (Suprachoroidal
administration) Cancers of the Ocular Surface Non-Muscle Invasive Bladder Cancer Other HSPG*-Expressing Tumors (e.g., Cutaneous Melanoma, HNSCC) Q4 2022 - Initiate Phase 3 trial 2023 - Phase 2 efficacy (~12 mos) Q4 2022 - IND 2023
- Initiate Phase 1 trial 2024 - Phase 1 data 2023 - Phase 1 data Global Commercial Rights for All Product Candidate Indications *VDCs bind to the tumor associated glycosaminoglycans (GAG) epitopes that are part of the heparan
sulphate chain of HSPGs. Schiller et al. Viruses 2022, 14(8), 1656
Experienced Executive Team and Board
Elisabet de los Pinos, PhD Founder & Chief Executive Officer Cadmus Rich, MD Chief Medical Officer, Head of R&D Julie Feder Chief Financial Officer Mark De Rosch, PhD Chief Operating Officer 20+ average years of experience 20+ Regulatory
drug and device approvals CEO (acq AstraZeneca) CEO (acq Merck) David Johnson Board Chair
Targeted Oncology Platform - Virus-Like
Drug Conjugates (VDCs) Virus-Like Particles Conjugated to a Cytotoxic Payload Selective Binding to Tumor Associated HSPGs* Virus-Like Particle (VLP) Virus-Like Drug Conjugate (VDC) Cx Cytotoxic Drug Kines et al; International Journal of Cancer,
138;901-911, February 2016; Kines et al; Molecular Cancer Therapeutics, 17(2) February 2018; Kines et al; Cancer Immunology Research, May 2021 Potential Key Differentiation: Potency, Binding and Selectivity Potential Treatment of Multiple
Solid Tumors *VDCs bind to the tumor associated glycosaminoglycans (GAG) epitopes that are part of the heparan sulphate chain of HSPGs. Schiller et al. Viruses 2022, 14(8), 1656
Bel-sar is a VDC with a Novel Dual
Mechanism of Action Light Activatable Drug Bel-sar Bel-sar is a novel VDC that consists of VLP conjugated to ~200 molecules of light activatable drug Potential Key Differentiation: Agnostic to Genetic Mutations, Less Susceptible to Resistance
Mechanisms, Long Term Anti-tumor Immunity Kines et al; Cancer Immunology Research, May 2021 Bel-sar - Belzupacap Sarotalocan; HSPGs - heparan sulfate proteoglycans VDCs bind to the tumor associated glycosaminoglycans (GAG) epitopes
that are part of the heparan sulphate chain of HSPGs. Schiller et al. Viruses 2022, 14(8), 1656
Ocular Oncology Franchise Bel-sar INN:
belzupacap sarotalocan Target Indications: Early-Stage Choroidal Melanoma Choroidal Metastasis Other Ocular Cancers
Choroidal Melanoma - High Unmet
Medical Need with No Drugs Approved Choroidal Melanoma is a Rare and Life-Threatening Ocular Cancer Kaliki et al; Eye (Lond) 2017 Feb; 31(2): 241-257; Clearview & Putnam & Assoc. Market Research; Source: Peddada. J Contemp
Brachytherapy. August 2019 Most common primary intraocular cancer in adults Impacts 11,000 patients in US/Europe per year ~80% patients diagnosed with early-stage disease Melanoma cells Melanocytic Lesion Benign nevus cells Standard of Care is
Radiotherapy or Enucleation Blindness, Eye Loss, and Disfiguration The choroid is the part of the uvea that is behind the retina
Current Standard of Care is Invasive
with Significant Co-Morbidities Standard of Care Often Results in Irreversible Vision Loss and Does Not Reduce Rate of Developing Metastasis Standard of Care is Radiotherapy or Enucleation
Bel-sar has the Potential to be the
First Approved Therapy in Primary Choroidal Melanoma No radioactive co-morbidities Preservation of vision Local tumor control Opportunity to treat early and reduce risk of metastases Improvement in safety and quality of life intravitreal
suprachoroidal Bel-sar is Delivered by Simple Intravitreal or Suprachoroidal Injection Goals of Treatment Light Activation with Standard Ophthalmic Laser Bel-sar - Belzupacap Sarotalocan
Ocular Oncology Franchise Represents
a Multi-Billion Dollar Commercial Opportunity Ocular Oncology Franchise total addressable market ~80% of patients are diagnosed at the early stage (indeterminate lesions (ILs) and small tumors) Current radiotherapy treatment Leaves ~70% of patients
with major irreversible vision loss within 5-10 years ~100 Ocular Oncologists in US/EU - focused call point <20 Field Based Team Intend to add small sales force to launch globally 33,500 ClearView & Putnam & Assoc. Epidemiology
Analysis Choroidal Melanoma and Choroidal Metastasis American Cancer Society- Retinoblastoma statistics Batsi et al Cornea 2003 Ocular Surface squamous neoplasia: a review Multibillion dollar market opportunity Cancers of the Ocular Surface
Retinoblastoma Choroidal Melanoma Choroidal Metastasis 11,000 patients/year 20,000 patients/year 500 patients/year 2,000 patients/year 11,000 Choroidal Melanoma patients diagnosed each year (US/EU) Choroidal Melanoma - Initial Indication
Ocular Oncology Franchise Bel-sar
INN: belzupacap sarotalocan Initial Target Indication: Early-Stage Choroidal Melanoma Clinical program
Goal for Bel-sar: Eliminate
Malignant Cells in the Choroid and Preserve Vision Response to Treatment Evaluated by Local Tumor Control Baseline Measurement 3mm 3mm 3mm Many early-stage melanomas have a small component of melanoma cells within a benign nevus Bel-sar targets
mostly the malignant cells and not the benign nevus, retina or other ocular structures (Unchanged Tumor Height) Malignant cells are replaced by fibrosis so there is a minimal reduction in size of the overall lesion after treatment Fibrotic Scar
Unaffected nevus cells Melanoma cells Benign nevus cells Post-treatment Measurement Treatment Bel-sar - Belzupacap Sarotalocan
Study Design and Clinical Endpoints
in Phase 1b/2 IVT Trial Dose escalation and expansion study with up to two cycles of therapy Evaluated safety and efficacy over 12 months Additional follow up in registry trial for 4 years to evaluate vision, tumor control and onset of metastases
Key Endpoints Aligned with Ocular Oncology Clinical Practice and FDA Endpoint Definition Threshold Methodology Tumor Thickness Growth Rate Tumor Thickness Growth over 12 Months Ultrasound Tumor Progression Growth in Tumor Height >0.5mm or >1.0
mm in Largest Basal Diameter (LBD)* Ultrasound and Digital Photography Visual Acuity Loss Long Term Loss 15 letters ETDRS-BCVA ETDRS BCVA - Early Treatment of Diabetic Retinopathy Study Best Corrected Visual Acuity *Not due to
inflammation/swelling, hemorrhage or pigmentary changes by Investigator judgement
Phase 1b/2 IVT - Key Patient
Populations and Objectives Enrichment Strategy to Enroll Subjects with Actively Growing Tumors Provides Important Insight into How Bel-sar May Perform in Phase 3 Trial Primary Objective: Safety Drug or treatment related adverse events (AEs) /
serious adverse events (SAEs) Secondary Objective: Efficacy Tumor thickness growth rate before and after treatment Local tumor control Visual acuity preservation All Patients Enrolled with Clinical Diagnosis of Choroidal Melanoma or Indeterminate
Lesions All Treated Patients Patients Treated with 2 Cycles Safety Evaluation (All Treated) Efficacy Evaluation Therapeutic Regimen (2 Cycles) Patients with Active Growth Treated with 2 Cycles n=56 n=20 Bel-sar - Belzupacap
Phase 1b/2 - Demonstrated
Favorable Safety Profile Majority of AEs Were Transient and Resolved Without Clinical Sequelae Safety Profile Supports Indication as a First Line Treatment in Early-Stage Disease *J. Contemp Brachytherapy. J. 2019 Aug; 11(4): 392-397.; Arch
Ophthalmol. 2000;118(9):1219-1228; Curr. Opin. Ophthalmol. 2019 May;30(3):206-214; Eye 2017 Feb;31(2):241-257 **High-Risk Subjects are those with tumors <3mm to fovea or optic nerve AU-011 Treatment Related AEs 15% Subjects
(n=56) Final Grade I/II Grade III Vitreous Inflammation 83.9% 7.1% Anterior Chamber Inflammation 67.9% 3.6% Increase in Intraocular Pressure 46.4% 0 Pigmentary Changes/Peritumoral 37.5% 0 Keratic Precipitates 23.2% 0 Floaters/Vitreous Opacity 19.7%
1.8% Decreased visual acuity 19.6% 1.8% Treatment Related SAEs (n=56) Vision Loss (juxtafoveal tumor, n=2) 3.6% SAE of vision loss in two subjects with tumors close to fovea due to pigmentary changes at the edge of the tumor SAEs are listed
separately in the SAE table Completed Ph 1b/2 IVT trial (AU-011-101) Adverse Event Radiotherapy* Bel-Sar Surgeries secondary to AEs (e.g., Cataracts) 40%+ ~13% Radiation Retinopathy 40%+ 0% Neovascular Glaucoma 10% 0% Dry Eye Syndrome 20% ~2%
Strabismus 2%+ 0% Retinal Detachment 1-2% ~2% Vision Loss ( 15 letters) ~70% ~21% Serious Adverse Event Radiotherapy* Bel-Sar Scleral Necrosis 0-5% 0% Enucleation/Eye Loss 10-15% 0% Vision Loss in High-Risk Subjects** ( 30 letters) ~90%
4.6%+ Cross-trial comparison of AU-011-101 and Radiotherapy +77% (43/56) of patients in Ph1b/2 IVT trial were at high risk for vision loss ; 2/43= 4.6% Bel-Sar - Belzupacap Sarotalocan
Phase 1b/2 IVT- 70% Tumor Control
Rate and Statistically Significant Growth Rate Reduction Positive Data in Two Efficacy Endpoints in Patients with Early-Stage Choroidal Melanoma Cohorts 1-9 include single dose escalation cohorts and multiple dose escalation cohorts up to 1 cycle of
treatment; Cohorts 10-12 include 2 cycles of treatment at the highest dose Lower Doses/Regimens Highest/Therapeutic Dose/ Regimen p=0.018, n=14 Tumor Control Rates at 12 months Change in Tumor Growth Rate Historical Growth Rate (mm/yr) Bel-sar
Growth Rate (mm/yr) Disease-modifying effect supports tumor is inactive and malignant cells have been targeted by bel-sar Completed Ph1b/2 IVT trial (AU-011-101) Bel-sar - Belzupacap Sarotalocan 0.555 0.072
Visual Acuity was Preserved in
Majority of Patients with IVT Administration of Bel-sar Vision was Preserved in Majority of Patients Whereas Radiotherapy Often Leads to Irreversible and Long-Term Severe Vision Loss Populations Total Patients (n) Vision Preservation Rate Failure:
Long-term loss 15 letters All Dose Cohorts All Treated Patients 56 86% (48/56) Patients with Active Growth - High Risk for Vision Loss 17 76% (13/17) Therapeutic Regimen (2 cycles) All Treated Patients 20 75% (15/20) Patients with Active
Growth 14 71% (10/14) Vision Preservation Rates Phase 1b/2 IVT Study Follow up 12 months 1 patient had loss 15 letters at Week 52 visit which recovered within 15 letters at the next visit which was ~3 weeks after standard of care (SOC); all
other post-SOC data excluded for all subjects Completed Ph1b/2 IVT trial (AU-011-101) Bel-sar Subjects Mean ( 95%CI) Change from Baseline in logMAR scores Over 2 Years rMCC Study Matched Plaque Patients Mean ( 95%CI) Change from Baseline
in logMAR Score Over 5 Years rMCC Study Retrospective Match Case Control Study (rMCC) to evaluate visual acuity outcomes of bel-sar vs radiotherapy. Matching performed by independent statistician.. 43 bel-sar patients with HRVL were matched to 150
radiotherapy patients. Bel-sar - Belzupacap Sarotalocan
Phase 2 Suprachoroidal Study
Evaluating Suprachoroidal
Administration to Determine Optimal Administration Route for Phase 3 Trial Small Tumors with Active Growth Tumor thickness 0.5 mm and 2.5 mm LBD 10 mm Active tumor growth (>0.3mm) within 2 years of screening Single Dose
Cohorts - Completed Multiple Dose Cohorts 20 g x 1 Laser 40 g x 1 Laser 40 g x 2 Lasers 40 g x 2 Lasers QWx2 40 g x 2 Lasers QWx3 Up to 3 cycles Cohort 1 (n=1) Cohort 2 (n=3*) Cohort 3 (n=2) Cohort 4 (n=3) Cohort
5 (n=3) 80 g x 2 Lasers QWx3 Up to 3 cycles Cohort 6 (n=10) ONGOING Ph2 SC Trial Design: Dose Escalation Phase *2 subjects were planned; third subject was additionally enrolled due to dose error in 1 subject ClinicalTrials.gov Identifier:
NCT04417530 suprachoroidal Goal: To Determine Safety, Optimal Dose and Therapeutic Regimen with Suprachoroidal Administration Patient Population Representative of Early-Stage Disease (IL/CM) SC - Suprachoroidal; IL - Indeterminate
Lesion; CM- Choroidal Melanoma; LBD - Largest Basal Diameter
Phase 2 SC - Interim Tumor Control
Rates Demonstrated Dose Response Tumor Progression: change from baseline in thickness 0.5mm; or in LBD 1.5mm confirmed by at least one repeat assessment 19-Aug-2022 cutoff, interim data Populations Total Patients (n) Tumor Control Rate