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Corporate Presentation JANUARY 2022
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financial conditions, and include, but are not limited to, express or implied statements regarding our current beliefs, expectations and assumptions regarding: our business, future plans and strategies for our CAR T technology and CABA
platform; the progress and results of our DesCAARTes Phase 1 trial, including our ability to enroll the requisite number of patients, dose each dosing cohort in the intended manner, and progress the trial; the expected announcement of
additional biologic activity data for the third and fourth dose cohorts in mid-2022 as well as 28-day safety data for the fourth dose cohort in the first quarter of 2022; the therapeutic potential and clinical benefits of our product candidates; our
ability to successfully complete our preclinical and clinical studies for our product candidates, including our ongoing Phase 1 DesCAARTesTM trial, planned MuSK-CAART study and other discovery programs; our ability to obtain and maintain regulatory
approval of our product candidates, including our IND submission for our MuSK-CAART program; the further expansion and development of our modular CABA platform across a range of autoimmune diseases; our ability to contract with third-party
suppliers and manufacturers, implement an enhanced manufacturing process and further develop our internal manufacturing strategy, capabilities and facilities; our potential commercial opportunities, including value and addressable market, for our
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Develop and launch the first curative
targeted cellular therapies for patients with autoimmune diseases
Cabaletta overview * 20M, 100M, and
500M refers to the number of DSG3-CAART cells infused for patients in dosing cohorts 1 to 3 (M - millions). As of January 8, 2022. Includes five disclosed product candidates and two undisclosed pipeline disease targets in our pipeline.
Developing highly specific CAAR T products to treat B cell-mediated autoimmune diseases Targeting diseases with a biologic opportunity for deep and durable, perhaps curative, responses Leveraging a clinically validated CAR T product design and
manufacturing process through Penn alliance Cash runway through at least 1Q23 with $119.3M in cash and investments at the end of 3Q21 Cell therapy pipeline2 targeting diseases that affect over 80,000 U.S. patients MuSK-CAART for myasthenia gravis
- IND submitted 4Q21 with planned trial initiation in 2022, subject to IND clearance by FDA PLA2R-CAART pre-IND interaction with FDA completed in 4Q21 for PLA2R positive primary membranous nephropathy patients DesCAARTesTM trial in patients
with mucosal pemphigus vulgaris (mPV) ongoing No DLTs or clinically relevant AEs observed in first 3 dose cohorts (20M, 100M & 500M cells) to date1 Without lymphodepletion and in patients with circulating anti-DSG3 antibodies No clear evidence
of biologic activity observed in the first 2 low dose cohorts (20M and 100M) as of 12/12/21 Using doses that are <2% of the currently planned maximum dose Dose escalation plan includes potential for up to 375x fold dose increase (20M to 7.5B)
across five cohorts Dose dependent increase in DSG3-CAART persistence was observed in third cohort during 28 days post infusion
Our scientific platform leverages
clinically validated CAR T technology CAR T Therapy Chimeric Antigen Receptor T cell Kymriah CAAR T product candidates are designed for selective and specific elimination of the pathogenic B cells CAAR T Therapy Chimeric AutoAntibody Receptor T cell
CABA CAAR T CD137 (4-1BB) Costimulatory Domain CD3-Zeta Signaling Domain HEALTHY B CELL
Foundational CAR T technology
clinically validated in treating B cell-mediated cancers Cabaletta: Advancing targeted cell therapy to autoimmunity Marketed Pivotal Clinical Preclinical / Discovery Oncology B Cell-Mediated Allo/Autoimmune Diseases CAR-T / CAAR-T T-reg, NK, TCR,
RBC, macrophage, TIL (7 programs under development)
CABA platform designed to enable
a portfolio of programs targeting B cell-mediated diseases Modular platform with "plug-and-play" architecture Clinically validated engineered T cell platform is the foundational technology PLA2R-CAART PLA2R+ membranous nephropathy
DSG3-CAART Mucosal pemphigus vulgaris MuSK-CAART MuSK+ myasthenia gravis DSG3/1-CAART Mucocutaneous pemphigus vulgaris Swapping the extracellular domain, or autoantigen, creates new product candidates FVIII-CAART Hemophilia A with FVIII inhibitors
Therapeutic Area Indication Program
Discovery2 Preclinical Phase 1 Phase 2/3 Dermatology Mucosal Pemphigus Vulgaris DSG3-CAART Mucocutaneous Pemphigus Vulgaris DSG3/1-CAART Neurology MuSK Myasthenia Gravis MuSK-CAART Nephrology PLA2R Membranous Nephropathy PLA2R-CAART Hematology
Hemophilia A w/ FVIII Alloantibodies FVIII-CAART Pipeline1 includes multiple disease targets where cure is possible Two additional undisclosed disease targets added to our pipeline portfolio through expansion of our Sponsored Research Agreement with
the University of Pennsylvania are not shown. In our discovery stage, we perform epitope mapping and optimize CAAR construct and design. Current pipeline includes 7 programs targeting diseases affecting >80,000 patients in the U.S.
DSG3-CAART for patients with mucosal
Current treatments require broad
immunosuppression associated with safety risks and transient efficacy Overview of pemphigus vulgaris Image credit: D@nderm. http://www.vgrd.org/archive/cases/2004/pv/DSCN4996%20copy.JPG Joly, Pascal, et al. "First-line rituximab combined with
short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicentre, parallel-group, open-label randomised trial." The Lancet 389.10083 (2017): 2031-2040. Werth, Victoria P., et al. "Rituximab
versus Mycophenolate Mofetil in Patients with Pemphigus Vulgaris." New England Journal of Medicine (2021). Rituximab label, 08/2020 revision. Kushner, Carolyn J., et al. "Factors Associated With Complete Remission After Rituximab Therapy for
Pemphigus." JAMA dermatology (2019). Tony, Hans-Peter, et al. "Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID)." Arthritis research & therapy
13.3 (2011): 1-14. Current Treatment Landscape Broad immunosuppression3,6 Modestly effective Poorly tolerated Rituximab plus steroids (~3,500 mg/yr)4 Response: ~40% of patients achieved a 16-week period with no lesions or medicines during 1 yr4,5
22% annual serious adverse event (SAE) rate4 4-9%3,4,5 annual risk of severe infection in PV Real world data indicate: Transient remission ~ 70% CROT6: ~30% relapse in 1 year6 >50% relapse within 2 years6 ~30% never achieve CROT6 ~1.9% lifetime
risk of fatal infection7 CROT = 8+ weeks without lesions while off systemic therapy http://www.danderm-pdv.is.kkh.dk/atlas/3-157.html http://www.dermis.net/bilder/CD008/550px/img0042.jpg Mucosal PV1 25% of U.S. pemphigus vulgaris Mucocutaneous PV2
75% of U.S. pemphigus vulgaris Associated Antibody Anti-DSG3 Anti-DSG3 + Anti-DSG1 Clinical Signs Painful blisters of the mucous membranes (mouth, nose, larynx, esophagus, eyes, genitalia, rectum) Blisters on orifices and skin US Disease Prevalence
3,250 to 4,750 9,750 to 14,250
Inclusion of all disease-relevant
epitopes enables a one-size-fits-all' approach for patients with mPV DSG3-CAART is designed to bind all known pathogenic autoantibodies Ohyama, Bungo, et al. "Epitope spreading is rarely found in pemphigus vulgaris by large-scale
longitudinal study using desmoglein 2-based swapped molecules." Journal of investigative dermatology 132.4 (2012): 1158-1168. Antibodies that target the specific extracellular domain are shown below each extracellular domain. EC5 directed
antibodies are not known to be pathogenic DSG3-CAART Costimulatory Domains anti-EC4 P2C1, P5D4, P5B6, P3A6, P5E4 2 anti-EC3 AK18 2 anti-EC2 PVB28, AK19 2 anti-EC1 AK23, Px43, Px44, 6G2C11, F779 2 EC1 EC2 EC3 EC4 Transmembrane Domain Cytoplasmic tail
% of PV sera targeting each domain1 91% 71% 51% 19% 12% EC5 EC1 EC2 EC3 EC4 CD137 CD3z DSG3 Protein
Phase 1 clinical trial in patients
with mPV evaluating up to 375x dose range (20M up to 7.5B cells) DesCAARTes study of DSG3-CAART FDA has requested, and the Company has agreed, that we will share data from part A to inform a discussion on the optimal design of part C.
According to FDA advice, the submission of part A data is not gating to planned enrollment in part B. Study Endpoint & Objectives Primary Endpoint: Adverse Events, including Dose Limiting Toxicity (DLT) DLTs include any grade 3 or 4 CRS or
neurotoxicity, or any Grade 2 CRS or neurotoxicity that failed to improve to Grade 1 or baseline within 7 days Secondary Objectives: DSG3 ELISA level changes, CAAR T expansion/persistence, change in PDAI, change in ODSS, use of systemic
medications, rate of/time to/duration of remission, manufacturing success rate Open-label study to determine the maximum tolerated dose & fractionation of DSG3-CAART Part Cohort # Subjects A - Dose Escalation (up to 375x dose increase)
Fractionated infusion at increasing dose levels A1-A5 3 (+3) per cohort B - Dose Consolidation Consolidating selected dose fractions into a single infusion B1-B2 3 (+3) per cohort C - Expansion1 Expanded subject enrollment at final
selected dose C ~12 Total ~33 (+18) Age: 18 Inadequately managed by standard immunosuppressive therapies Confirmed diagnosis Active disease Anti-DSG3 antibody positive Rituximab recently administered Prednisone > 0.25 mg/kg/day Other
autoimmune disorder requiring immunosuppressive therapies Recent investigational treatment ALC < 1,000 at screening Major Inclusion Criteria Major Exclusion Criteria SCREENING MONITORING (UP TO 4 WEEKS) TREATMENT (~1 WEEK) Next Patient
MANUFACTURING TREATMENT
Safety assessed acutely, at 28 days
& at 3 months, with data on biologic activity within 6 months DesCAARTes clinical trial assessments & timeframes * Clearance of 28-day observation window without DLTs required to initiate next dosing cohort. This information
represents data that we believe can be used to inform potential efficacy endpoints in future clinical development. Spindler, Volker, et al. "Mechanisms causing loss of keratinocyte cohesion in pemphigus." Journal of Investigative Dermatology 138.1
(2018): 32-37. Up to Wk -18 Wk -18 to -1 Day -7 to -3 Pre-infusion visit 3 Years Efficacy 15 Years Long-term follow-up 3 Months Primary safety endpoint 8-10 weeks from screening to infusion DSG3-CAART INFUSION Day 28 safety data Infusion of
DSG3-CAART in context of circulating soluble DSG3 antibody Other safety measures CRS / neurotoxicity Other adverse events Early evaluations of efficacy include1: Persistence of DSG3-CAART detected via qPCR Change in level of DSG3 antibodies
(targeting persistent reduction) Change in mPV therapy and absence of new systemic rescue therapy Change in disease activity based on clinically validated scales e.g. PDAI, ODSS Primary safety endpoint at 3 months Potential for disease flare during
planned steroid taper DLT observation window* 6 Months Biologic Activity Data Data expected within 6 months of completion for each cohort Day 28 Day 8 Acute safety data
Dose-dependent increase in
DSG3-CAART persistence observed in Cohort A3 vs. Cohorts A1 and A2 No DLTs observed to date in first 3 cohorts of DesCAARTes trial As of January 8, 2022. No clinically meaningful adverse events in any subject to date1, enabling progression to
cohort A4 with dose of 2.5B cells COHORT A1: 3 patients received fractionated dose of 20M cells COHORT A2: 3 patients received fractionated dose of 100M cells Up to Wk -18 Wk -18 to -1 Day -7 to -3 Pre-infusion visit Day 8 Acute safety data 8-10
weeks from screening to infusion DSG3-CAART INFUSION Day 28 DLT observation window 3 Months Primary safety endpoint 6 Months Biologic Activity Data COHORT A3: 3 patients received fractionated dose of 500M cells
Dose of CAART cells 2 CAART cell
expansion post-infusion 3 Range of strategies to consider for targeted cell therapy approaches in patients with autoimmune diseases Optimizing product and patient profiles - many options to consider Many options exist to optimize product and
patient profiles Target cell population 0.1-1% of B cells are DSG3+ 1 Healthy B cell Pathogenic autoreactive B cell CAART cell Phenotype of CAART cells 4 Circulating antibody titer 6 5 Preconditioning' strategies Retreatment / redosing
MuSK-CAART for patients with MuSK
6.0 - 7.5% All known extracellular
domains can be included in the CAAR design High unmet need in MuSK myasthenia gravis; a valuable CAAR target Hain, Berit, et al. "Successful treatment of MuSK antibody-positive myasthenia gravis with rituximab." Muscle & Nerve: Official
Journal of the American Association of Electrodiagnostic Medicine 33.4 (2006): 575-580. Illa, Isabel, et al. "Sustained response to Rituximab in anti-AChR and anti-MuSK positive Myasthenia Gravis patients." Journal of neuroimmunology 201 (2008):
90-94. Jiang, Ruoyi, et al. "Single-cell repertoire tracing identifies rituximab-resistant B cells during myasthenia gravis relapses." JCI insight 5.14 (2020). AChR MG Early Onset Age <50 ; F>M AChR MG Late Onset Age >50 ; M>F MuSK MG
Seronegative MG Low affinity AChR, LRP4 Total US MG Prevalence: 50,000 to 80,000 patients Typically more severe Limited treatment options Early onset - 7:1 females MuSK has similar modular structure and size as DSG3 lg1 lg2 lg3 Fz Autoantibody
titers drop after rituximab1,2 Pathogenic B cells are incompletely eliminated by rituximab and persist during relapse3 1 Similarities to pemphigus support clinical potential of CAAR T in MuSK MG 2