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Ocular Programs
June 2012
This presentation is intended to present a summary of ACT’s (“ACT”, or “Advanced Cell
Technology Inc”, or “the Company”) salient business characteristics.
The information herein contains “forward‐looking statements” as defined under the federal
securities laws. Actual results could vary materially. Factors that could cause actual results
to vary materially are described in our filings with the Securities and Exchange Commission.
You should pay particular attention to the “risk factors” contained in documents we file from
time to time with the Securities and Exchange Commission. The risks identified therein, as
well as others not identified by the Company, could cause the Company’s actual results to
differ materially from those expressed in any forward‐looking statements. Ropes Gray
Cautionary Statement Concerning Forward‐Looking Statements
2
Multiple Pluripotent Cell Platforms
‱ Single Blastomere-derived Embryonic Stem Cells
‱ Generating hESC without Destruction of Embryo
‱ Utilizes a single cell biopsy
‱ Our hESC lines exhibit all the standard characteristics and the
ability to differentiate into the cells of all three germ layers
both in vitro and in vivo.
‱ Induced Pluripotency Stem Cells (iPS)
‱ Early Innovator in Pluripotency (before iPS was even a term!)
‱ Recipient of National Institutes of Health Director's Opportunity Award
‱ Seminal paper identifying replicative senescence issue for vector-derived iPS cells
‱ Leading publication on protein induced iPS lines - avoids genetic manipulation with nucleic acid vectors
‱ Controlling Filings (earliest priority date) to use of OCT4 for inducing pluripotency
3
Final Product Definition: hESC-derived
products will be manufactured using a cell
line made in 2005 from single cell isolated
without the destruction of any embryos
The RPE layer is critical to the function and health of photoreceptors and the
retina as a whole.
– RPE cells provide trophic support and detoxification activities to photoreceptor space.
» Recycle photopigments
» Deliver, metabolize and store vitamin A
» Phagocytize and clear cellular waste
» Maintain Bruch’s membrane
» Absorbs incident light, protects space from UV damage
– RPE loss leads to photoreceptor loss and eventually blindness, such as dry-AMD
– Loss of RPE layer and appears to lead to decline of Bruch’s membrane, leading
progression from dry-AMD to wet-AMD
‱ Discrete differentiated cell population as target
‱ Failure of target cells results in disease progression
4
Retinal Pigment Epithelial Cells - Rationale
No other cell type can perform
this complete set of functions
5
RPE Cell Therapy
Early Stage AMD
(10-15M)
Intermediate AMD
(5-8M)
Late Stage AMD
(1.75M)
U.S. Patient Population
ACT’s RPE Cell Therapy should effectively
address the full range of dry AMD patients.
‱ Halt the progression of disease and vision
loss in early stage patients
‱ Restore some visual acuity in later stage
patients
Dry AMD represents more than 90 percent of all
cases of AMD
North America and Europe alone have more than
30 Million dry AMD patients who should be
eligible for our RPE cell therapy
On the Rise: Population demographics
(“baby boomers”) combined with increased
longevity predicts an increase of 50 percent
or more in the incidence rate of AMD.
RPE Engraftment – Mouse Model
Human RPE cells engraft
and align with mouse RPE
cells in mouse eye
6
Injected human RPE cells recapitulates
correct monolayer structure in eye
Human RPE cells fill in empty spaces
adjacent to mouse RPE cells
400x magnification
100x magnification
RPE Engraft and Function in Animal Studies
RPE treatment in RCS rat model of retinal dystrophy slowed the
progression of vision loss by promoting photoreceptor survival.
treated control
Photoreceptor
layer
7
photoreceptor layer is
only 0 to 1 cell thick
without treatment
Treated animal – retain 70% of full visual acuity
Control Animal – blind at 6 months
‱ Established GMP process for differentiation and purification of RPE
– Virtually unlimited supply
– Pathogen-free GMP conditions
– Minimal batch-to-batch variation
– Characterized to optimize performance
– Virtually identical expression of RPE-specific genes to controls
GMP Manufacturing
Ideal Cell Therapy Product
‱ Centralized Manufacturing
‱ Small Doses
‱ Easily Frozen and Shipped
‱ Simple Handling by Doctor
8
Characterizing Clinical RPE Lots
9
Normal female (46 XX) karyotype
of the clinical RPE lot.
Up-regulation of RPE markers and
down-regulation of hESC markers
Characterizing Clinical RPE Lots
10
Quantitative Potency Assay
Each lot is assessed by phagocytosis (critical
function in vivo) of fluorogenic bioparticles.
Flow cytometry histogram showing
phagocytosis of pHrodo bioparticles
4°C 37°C
Effects of Pigmentation
11
Melanin content can be measured spectrophotometrically and used to determine the
optimal time to harvest and cryopreserve RPE.
y = 0.0141x + 0.0007
0.00
0.50
1.00
1.50
2.00
0 20 40 60 80 100120
Absorbanceat475nm
”g/mL Melanin
Phase I - Clinical Trial Design
12
SMD and dry AMD Trials approved in U.S., SMD Trial approved in U.K.
‱ 12 Patients for each trial, ascending dosages of 50K, 100K, 150K and 200K cells.
‱ Patients are monitored - including high definition imaging of retina
High Definition Spectral Domain Optical Coherence Tomography (SD-OCT)
Retinal Autofluorescence
50K Cells 100K Cells 150K Cells 200K Cells
Patient 1 Patients 2/3
DSMB Review DSMB Review
RPE and photoreceptor activity
compared before and after surgery
Surgical Overview
13
Procedure:
‱ 25 Gauge Pars Plana Vitrectomy
‱ Posterior Vitreous Separation
(PVD Induction)
‱ Subretinal hESC-derived RPE
cells injection
‱ Bleb Confirmation
‱ Air Fluid Exchange
Preliminary Results
14
‱ Structural evidence confirmed cells had
attached and persisted
‱ No signs of hyperproliferation,
abnormal growth, or rejection
‱ Anatomical evidence of hESC-RPE
survival and engraftment.
‱ Clinically increased pigmentation
within the bed of the transplant
‱ Recorded functional visual
improvements in both patients
Images of hESC-RPE transplantation site in SMD Patient
15
SD-OCT images
Demonstrate survival and engraftment of RPE
The injected RPE cells migrate to the desired anatomical location
3mo post-op
Phase II/III Design
16
Design of future studies dependent upon information gathered
throughout PI/II study
‱ Efficacy
‱ Patient population less VA impact 20/200?
‱ Multiple Injections
‱ Further evaluation of I/E criteria
‱ Potentially less immunosuppression
‱ Other considerations of efficacy:
‱ New or more sensitive technologies
‱ Possible saline placebo injection (same eye)
Working with our
experts/investigators in
design of studies
Phase II/III Projected Timeline
17
‱ Completion of Phase I/II study 2013-2014
‱ Design of Phase II and III studies is an ongoing
process, but will become more concrete during
2013
‱ Phase III study commencement 2014-2015
RPE Cells – Additional Indications
18
‱ Myopic Macular Dystrophy (MMD)
‱ Retinopathy of Prematurity
‱ Angioid Streaks
‱ Retinitis Pigmentosa
‱ Bests Disease (vitelliform macular dystrophy)
‱ Multifocal Choroidopathy Syndromes
Combination Products
‱ Combined with other cell types (photoreceptor progenitors)
‱ Combined with anti-angiogenic agents, neuroprotective agents, etc.
Therapeutic Pipeline -
Ocular Programs
20
Retinal Pigment Epithelial Cells
 Macular Degeneration - dry AMD, Stargardt’s Disease, MMD
 Retinitis Pigmentosa
 Photoreceptor protection
Hemangioblast cells
 Ischemic retinopathy
– diabetic retinopathy, vascular occlusions
Retinal Neural Progenitor cells
Isolated Protective Factors
 Photoreceptor Loss, Modulation of MĂŒller Cells
 Protection of Retinal Ganglion cells (Glaucoma)
Corneal Endothelium, Corneal Epithelium,
Descemet’s Membrane
 Corneal Disease
Mesenchymal Stromal Cells
 Glaucoma, Uveitis
 Retinitis Pigmentosa
 Management of Ocular Surfaces
light
retina
RPElayer
Photoreceptors
Ocular Program – Corneal Endothelium
‱ More than 10 million people with corneal blindness
‱ The cornea is the most transplanted organ (1/3 of all
transplants performed due to endothelial failure)
‱ Solutions include the transplantation of whole cornea
“Penetrating Keratoplasty” (PKP)
‱ More popular: Transplantation of just corneal
endothelium & Descemet’s membrane (DSEK/DSAEK).
hESC-derived corneal
endothelium resembles
normal human corneal
endothelium
21
Ocular Program – Hemangioblasts
22
Hemangioblasts induce reparative
intraretinal angiogenesis is various
animal models of ischemic retinopathies
‱ Revascularization is observed in animals
injected either intravitreally or intravenously with
hESC-derived hemangioblasts
‱ ischemia-reperfusion injury
‱ diabetic retinopathy
‱ GFP-labeling reveals incorporation of injected
cells into the vasculature of the eye during
angiogenesis
‱ Hemangioblasts prevented BRB breakdown in
diabetic rats.
Repair of ischemic retinal vasculature in a mouse
after injection of hESC-derived hemangioblasts
Ocular Program – Hemangioblasts
23
Oxygen-induced Retinopathy Model
OIR+HBOIR+dPBS
hESC-derived
Hemangioblasts Rebuild
Functional Vasculature on
Retina Obliteration Region
and Suppress Pre-retinal
Neovascular Tufts
‱ Generated various retinal neural progenitor cell types – or RNP cells
‱ From both embryonic and iPS cell sources.
‱ Discovered a new photoreceptor progenitor cell type.
‱ Tested in mouse model for retinal degeneration - ELOVL4-TG2 mice
‱ Observed both structural and physiological consequences
After 2 months
‱ ERG - increases in both the a-wave and b-wave
‱ OCT - increases in central retinal thickness
Ocular Program – Retinal Neural Progenitors
24
hESC-derived RNP cells reversed the progression of photoreceptor
degeneration– and appeared to promote regeneration
‱ Defined culture conditions
‱ High yield from hESC and iPS
‱ Homogeneous and highly pure
preparations
ACT Management Team
Highly Experienced and Tightly Integrated Management Team
Gary Rabin – Chairman & CEO
Dr. Robert Lanza, M.D. – Chief Scientific Officer
Edmund Mickunas – Vice President of Regulatory Affairs
Kathy Singh - Controller
Rita Parker – Director of Operations
Dr. Irina Klimanskaya, Ph.D. – Director of Stem Cell Biology
Dr. Shi-Jiang (John) Lu, Ph.D. – Senior Director of Research
Dr. Roger Gay, Ph.D. - Senior Director of Manufacturing
Dr. Matthew Vincent, Ph.D. – Director of Business Development
Bill Douglass – Director of Corporate Communications & Social Media
25
Thank you
For more information, visit  www.advancedcell.com

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Clinical Outlooks for Regenerative Medicine, Boston. June 2012

  • 2. This presentation is intended to present a summary of ACT’s (“ACT”, or “Advanced Cell Technology Inc”, or “the Company”) salient business characteristics. The information herein contains “forward‐looking statements” as defined under the federal securities laws. Actual results could vary materially. Factors that could cause actual results to vary materially are described in our filings with the Securities and Exchange Commission. You should pay particular attention to the “risk factors” contained in documents we file from time to time with the Securities and Exchange Commission. The risks identified therein, as well as others not identified by the Company, could cause the Company’s actual results to differ materially from those expressed in any forward‐looking statements. Ropes Gray Cautionary Statement Concerning Forward‐Looking Statements 2
  • 3. Multiple Pluripotent Cell Platforms ‱ Single Blastomere-derived Embryonic Stem Cells ‱ Generating hESC without Destruction of Embryo ‱ Utilizes a single cell biopsy ‱ Our hESC lines exhibit all the standard characteristics and the ability to differentiate into the cells of all three germ layers both in vitro and in vivo. ‱ Induced Pluripotency Stem Cells (iPS) ‱ Early Innovator in Pluripotency (before iPS was even a term!) ‱ Recipient of National Institutes of Health Director's Opportunity Award ‱ Seminal paper identifying replicative senescence issue for vector-derived iPS cells ‱ Leading publication on protein induced iPS lines - avoids genetic manipulation with nucleic acid vectors ‱ Controlling Filings (earliest priority date) to use of OCT4 for inducing pluripotency 3 Final Product Definition: hESC-derived products will be manufactured using a cell line made in 2005 from single cell isolated without the destruction of any embryos
  • 4. The RPE layer is critical to the function and health of photoreceptors and the retina as a whole. – RPE cells provide trophic support and detoxification activities to photoreceptor space. » Recycle photopigments » Deliver, metabolize and store vitamin A » Phagocytize and clear cellular waste » Maintain Bruch’s membrane » Absorbs incident light, protects space from UV damage – RPE loss leads to photoreceptor loss and eventually blindness, such as dry-AMD – Loss of RPE layer and appears to lead to decline of Bruch’s membrane, leading progression from dry-AMD to wet-AMD ‱ Discrete differentiated cell population as target ‱ Failure of target cells results in disease progression 4 Retinal Pigment Epithelial Cells - Rationale No other cell type can perform this complete set of functions
  • 5. 5 RPE Cell Therapy Early Stage AMD (10-15M) Intermediate AMD (5-8M) Late Stage AMD (1.75M) U.S. Patient Population ACT’s RPE Cell Therapy should effectively address the full range of dry AMD patients. ‱ Halt the progression of disease and vision loss in early stage patients ‱ Restore some visual acuity in later stage patients Dry AMD represents more than 90 percent of all cases of AMD North America and Europe alone have more than 30 Million dry AMD patients who should be eligible for our RPE cell therapy On the Rise: Population demographics (“baby boomers”) combined with increased longevity predicts an increase of 50 percent or more in the incidence rate of AMD.
  • 6. RPE Engraftment – Mouse Model Human RPE cells engraft and align with mouse RPE cells in mouse eye 6 Injected human RPE cells recapitulates correct monolayer structure in eye Human RPE cells fill in empty spaces adjacent to mouse RPE cells 400x magnification 100x magnification
  • 7. RPE Engraft and Function in Animal Studies RPE treatment in RCS rat model of retinal dystrophy slowed the progression of vision loss by promoting photoreceptor survival. treated control Photoreceptor layer 7 photoreceptor layer is only 0 to 1 cell thick without treatment Treated animal – retain 70% of full visual acuity Control Animal – blind at 6 months
  • 8. ‱ Established GMP process for differentiation and purification of RPE – Virtually unlimited supply – Pathogen-free GMP conditions – Minimal batch-to-batch variation – Characterized to optimize performance – Virtually identical expression of RPE-specific genes to controls GMP Manufacturing Ideal Cell Therapy Product ‱ Centralized Manufacturing ‱ Small Doses ‱ Easily Frozen and Shipped ‱ Simple Handling by Doctor 8
  • 9. Characterizing Clinical RPE Lots 9 Normal female (46 XX) karyotype of the clinical RPE lot. Up-regulation of RPE markers and down-regulation of hESC markers
  • 10. Characterizing Clinical RPE Lots 10 Quantitative Potency Assay Each lot is assessed by phagocytosis (critical function in vivo) of fluorogenic bioparticles. Flow cytometry histogram showing phagocytosis of pHrodo bioparticles 4°C 37°C
  • 11. Effects of Pigmentation 11 Melanin content can be measured spectrophotometrically and used to determine the optimal time to harvest and cryopreserve RPE. y = 0.0141x + 0.0007 0.00 0.50 1.00 1.50 2.00 0 20 40 60 80 100120 Absorbanceat475nm ”g/mL Melanin
  • 12. Phase I - Clinical Trial Design 12 SMD and dry AMD Trials approved in U.S., SMD Trial approved in U.K. ‱ 12 Patients for each trial, ascending dosages of 50K, 100K, 150K and 200K cells. ‱ Patients are monitored - including high definition imaging of retina High Definition Spectral Domain Optical Coherence Tomography (SD-OCT) Retinal Autofluorescence 50K Cells 100K Cells 150K Cells 200K Cells Patient 1 Patients 2/3 DSMB Review DSMB Review RPE and photoreceptor activity compared before and after surgery
  • 13. Surgical Overview 13 Procedure: ‱ 25 Gauge Pars Plana Vitrectomy ‱ Posterior Vitreous Separation (PVD Induction) ‱ Subretinal hESC-derived RPE cells injection ‱ Bleb Confirmation ‱ Air Fluid Exchange
  • 14. Preliminary Results 14 ‱ Structural evidence confirmed cells had attached and persisted ‱ No signs of hyperproliferation, abnormal growth, or rejection ‱ Anatomical evidence of hESC-RPE survival and engraftment. ‱ Clinically increased pigmentation within the bed of the transplant ‱ Recorded functional visual improvements in both patients
  • 15. Images of hESC-RPE transplantation site in SMD Patient 15 SD-OCT images Demonstrate survival and engraftment of RPE The injected RPE cells migrate to the desired anatomical location 3mo post-op
  • 16. Phase II/III Design 16 Design of future studies dependent upon information gathered throughout PI/II study ‱ Efficacy ‱ Patient population less VA impact 20/200? ‱ Multiple Injections ‱ Further evaluation of I/E criteria ‱ Potentially less immunosuppression ‱ Other considerations of efficacy: ‱ New or more sensitive technologies ‱ Possible saline placebo injection (same eye) Working with our experts/investigators in design of studies
  • 17. Phase II/III Projected Timeline 17 ‱ Completion of Phase I/II study 2013-2014 ‱ Design of Phase II and III studies is an ongoing process, but will become more concrete during 2013 ‱ Phase III study commencement 2014-2015
  • 18. RPE Cells – Additional Indications 18 ‱ Myopic Macular Dystrophy (MMD) ‱ Retinopathy of Prematurity ‱ Angioid Streaks ‱ Retinitis Pigmentosa ‱ Bests Disease (vitelliform macular dystrophy) ‱ Multifocal Choroidopathy Syndromes Combination Products ‱ Combined with other cell types (photoreceptor progenitors) ‱ Combined with anti-angiogenic agents, neuroprotective agents, etc.
  • 20. 20 Retinal Pigment Epithelial Cells  Macular Degeneration - dry AMD, Stargardt’s Disease, MMD  Retinitis Pigmentosa  Photoreceptor protection Hemangioblast cells  Ischemic retinopathy – diabetic retinopathy, vascular occlusions Retinal Neural Progenitor cells Isolated Protective Factors  Photoreceptor Loss, Modulation of MĂŒller Cells  Protection of Retinal Ganglion cells (Glaucoma) Corneal Endothelium, Corneal Epithelium, Descemet’s Membrane  Corneal Disease Mesenchymal Stromal Cells  Glaucoma, Uveitis  Retinitis Pigmentosa  Management of Ocular Surfaces light retina RPElayer Photoreceptors
  • 21. Ocular Program – Corneal Endothelium ‱ More than 10 million people with corneal blindness ‱ The cornea is the most transplanted organ (1/3 of all transplants performed due to endothelial failure) ‱ Solutions include the transplantation of whole cornea “Penetrating Keratoplasty” (PKP) ‱ More popular: Transplantation of just corneal endothelium & Descemet’s membrane (DSEK/DSAEK). hESC-derived corneal endothelium resembles normal human corneal endothelium 21
  • 22. Ocular Program – Hemangioblasts 22 Hemangioblasts induce reparative intraretinal angiogenesis is various animal models of ischemic retinopathies ‱ Revascularization is observed in animals injected either intravitreally or intravenously with hESC-derived hemangioblasts ‱ ischemia-reperfusion injury ‱ diabetic retinopathy ‱ GFP-labeling reveals incorporation of injected cells into the vasculature of the eye during angiogenesis ‱ Hemangioblasts prevented BRB breakdown in diabetic rats. Repair of ischemic retinal vasculature in a mouse after injection of hESC-derived hemangioblasts
  • 23. Ocular Program – Hemangioblasts 23 Oxygen-induced Retinopathy Model OIR+HBOIR+dPBS hESC-derived Hemangioblasts Rebuild Functional Vasculature on Retina Obliteration Region and Suppress Pre-retinal Neovascular Tufts
  • 24. ‱ Generated various retinal neural progenitor cell types – or RNP cells ‱ From both embryonic and iPS cell sources. ‱ Discovered a new photoreceptor progenitor cell type. ‱ Tested in mouse model for retinal degeneration - ELOVL4-TG2 mice ‱ Observed both structural and physiological consequences After 2 months ‱ ERG - increases in both the a-wave and b-wave ‱ OCT - increases in central retinal thickness Ocular Program – Retinal Neural Progenitors 24 hESC-derived RNP cells reversed the progression of photoreceptor degeneration– and appeared to promote regeneration ‱ Defined culture conditions ‱ High yield from hESC and iPS ‱ Homogeneous and highly pure preparations
  • 25. ACT Management Team Highly Experienced and Tightly Integrated Management Team Gary Rabin – Chairman & CEO Dr. Robert Lanza, M.D. – Chief Scientific Officer Edmund Mickunas – Vice President of Regulatory Affairs Kathy Singh - Controller Rita Parker – Director of Operations Dr. Irina Klimanskaya, Ph.D. – Director of Stem Cell Biology Dr. Shi-Jiang (John) Lu, Ph.D. – Senior Director of Research Dr. Roger Gay, Ph.D. - Senior Director of Manufacturing Dr. Matthew Vincent, Ph.D. – Director of Business Development Bill Douglass – Director of Corporate Communications & Social Media 25