MATWIN Programme 2015 Support for the Proof of Concept Project Application Form



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MATWIN Programme 2015 Support for the Proof of Concept Project Application Form For internal use only: Cancéropôle partner: Date of receipt: File number: MATWIN is a nationwide programme that identifies and supports the maturation of oncology research projects up to the preclinical Proof of Concept. The present form presents your project from an industrial point of view. The assessment is a major step of the process. The project will be assessed according to five criteria: (i) innovation components & value, (ii) translational potential, (iii) commercial potential & competitive landscape, (iv) technology transfer setup & value creation, (v) project feasibility & project management. For assistance do not hesitate to ask technology your transfer office and/or institution partner (Cancéropôle, research institution ). Before filling a MATWIN form (Eurobiomed Petit guide des questions à poser avant de se lancer dans un projet collaboratif innovant ): A clear and precise project you must be able to describe your project in two sentences. An original and innovative project in what your project is original in relation to the existent; what differentiates your project from the national and international competition; what results and knowledge must be protected (PI) or acquired (license)? A vision of the market with concrete outcomes the size of the potential worldwide market resulting from the project; what is the aimed segment thanks to your technology, product or service; what are the benefits for users (patient, prescriber, payer, medical insurance); the essential tools to address this market share (positioning)? A consistent development plan a provisional budget for the duration of the project; the necessary chaining tasks for the realization of the project plan (who makes what, milestones, go/no go); the way of creating value on the project (exclusive license, internal development, product s time-to-market)? An appropriate organization for shared results a skill-based network of professional partners; each project s partner must be able to benefit from results and value-creation; the management to assure a good quality. Research Project Title Acronym Key words Project Coordinator Title; Name Position Name office Address E-mail Phone / Mobile Technology Transfer Office Patent Office Name office Contact name Address E-mail Phone / Mobile

TABLE OF CONTENTS Project identity card P 3 Coordinator and partners p 5 Intellectual property p 6 Research and development plan p 7 Project management and feasibility p 9 Commercial potential and competitive landscape p 10 Undertaking p 11 CONTACT DETAILS The application form must be returned both to: The MATWIN Platform by e-mail a pdf format The Cancéropôle Partner by e-mail a pdf format & by mail the original copy MATWIN - Cancéropôle IDF Cécile FAURIE Institut Bergonié, 229 cours de l Argonne 33076 Bordeaux cedex Cancéropôle CLARA Ophélie PHILIPOT Bâtiment Domilyon, 321 avenue Jean Jaurès 69007 Lyon Cancéropôle GE Rachel GROUBET Hôpital de Hautepierre, 1av. Molière 67098 Strasbourg Cancéropôle GO Jean-Luc CAILLOT Maison de la Recherche en Santé, 63 quai Magellan 44000 Nantes Cancéropôle GSO Karine MARENDZIAK Hôpital La Grave, Place Lange TSA 60033 31059 Toulouse cedex 9 Cancéropôle NO Véronique PANCRE 6 rue du Pr Laguesse, CS 50027 59045 Lille cedex Cancéropôle PACA Clara DUCORD Faculté de Médecine Timone, 27 bld Jean Moulin 13005 Marseille cecile.faurie@matwin.org; 06 84 01 61 70 ophilipot@canceropole-clara.com; : 04 37 90 17 25 rachel.groubet@canceropole-ge.org; 03 88 12 84 19 jeanluc.caillot@chu-nantes.fr; 02 53 48 28 75 karine.marendziak@canceropole-gso.org; 06 82 76 75 07 veronique.pancre@canceropole-nordouest.org; 03 20 74 35 83 clara.ducord@univ-amu.fr; 04 91 32 47 02 : www.matwin.org Page 2 on 11

PROJECT IDENTITY CARD Project classification status & current concepts Organ Sites Bone Cancer Brain Cancer Breast Cancer Endocrine/Neuroendocrine Cancer Gastrointestinal/Oesophageal Cancer Genitourinary / Gynaecologic Cancer Haematological Malignancies Head and Neck Cancer Lung/Bronchus Cancer Lymphoid Malignancies Melanoma Metastasis Nervous System Cancer Paediatric Cancer Pancreatic Adenocarcinoma Prostate Cancer Sarcomas and Soft Tissue Cancer Skin Cancer Other Biomarkers; Early detection Diagnostic Predictive Prognostic Technology development and/or marker discovery Technology and/or marker evaluation Technology and/or marker testing in a clinical setting Cancer chemistry Drug delivery Drug discovery and design Imaging agents and radio-therapeutics Proteomics, metabolomics, biological mass spectrometry Structural and chemical biology Discovery In vitro studies In vivo studies Preclinical Experimental and molecular therapeutics Biological therapeutic agents Drug discovery Drug resistance Gene and vector-based therapy Mechanisms of drug action New molecular targets Pharmacology, pharmacogenetics and pharmacogenomics Preclinical radiotherapeutics Small molecule therapeutic agents Immunology Cancer immunotherapy, preclinical and clinical Clinical immunology, biological therapy Tumour immunobiology Medical device Analytical test Prototype (α, β, pre-industrial) Test development Validation Molecular and cellular biology Cancer systems biology Cell cycle Cell death Cell growth signalling pathways Cellular stress responses Chromosome / DNA damage and repair Epigenetics Innovative technologies in cancer research Metabolism and cancer MicroRNAs and other noncoding RNAs Molecular genetics Oncogenes and tumours suppressor genes Oncogene regulation and transcription factors Targets Target identification Target validation Technological platforms Genomics Imaging Metabolomics Proteomics Therapeutics small molecules indirect action, anti-angiogenic, anti-metastatic targeted action, cellular signal transduction inhibitor resistance modifiers, DNA repair, drug efflux inhibitors miscellaneous antibodies Other biological: gene cellular, protein Treatment - therapy Localised: discovery, development, clinical application Systemic: discovery, development, clinical application Tumour biology Angiogenesis, vasculogenesis, microcirculation Migration and invasion Tumour adhesion Tumour metastasis and Cancer progression Tumour microenvironment Abstract (max 400 words) Page 3 on 11

Executive summary Application domain; indication and use Innovative component Objectives Target population Target profile Target product/device profile Project description. Project category & unmet medical needs: addition indication for an existing product or a new product? Strategic fit and values, how well does this product fit with the core expertise and capabilities of the team. Value of the product to patient, offer therapeutic, safety or ease of use, advantages over existing or upcoming product. Competitive position: does the product have a competitive advantage? IP position. Rationale for success: why the team believes in the success of the product. Success factors: statement that would drive to a successful outcome. Key risk factors: statement identifying key risks. Consequence of stopping the project, what would happen? Possible alternative to the project. Page 4 on 11

COORDINATOR AND PARTNERS Project coordinator and partners Name Know-how, knowledge, competences, skill (ie: management, collaborations, industrial and/or technology transfer ) Partner s details one table for each partner Title; Name Position Address E-mail Phone / Mobile Publications and awards of the coordinator and his partners Main publications of associated partners scientific and technical relevant to the project (max 5 for each one) Current and pending research awards held by the team; for each of them indicate leader, title, duration, level of support, funding body and type. Page 5 on 11

INTELLECTUAL PROPERTY Patent one table for each patent filed or upcoming Patent title Field of application Inventors Patent co-owners (institutions) Date of Invention disclosure Date of patent filing PCT number Awarded countries TTO management Potential agreement limiting use of IP? Expected potential intellectual property by the end of the project Existing partnerships (or in progess) involved parties and partnership Key competiting intellectual property Publication reference or PCT: list and indicate status of any competing IP (http://worldwide.espacenet.com/?locale=en_ep) How does it impact on the development of your modality? Page 6 on 11

RESEARCH & DEVELOPMENT PLAN A work plan is a planning and management tool which provides a framework for planning the work and is a guide during the period for carrying out that work. It is a scientific roadmap with an increased clarity. When it is approved, he serves as a guide to actions to be taken in order to reach the objective. It is written so as to be transparent to anyone and justifying the actions to be taken. Describe the scientific project and the work plan: scientific hypothesis, rationale, milestones, Go/No-Go criteria, task, methodology, design, deliverable, regulatory constraints, Gantt chart, timelines, expectations in terms of technology transfer A milestone is a scheduled and important checkpoint that marks the completion of a work package, a major deliverable or a set of deliverables have been completed after successfully conducting the planned work (tasks). Milestones are used to validate the project progression and make Go/No-Go decisions based on progress measured against objectives and on project value. Deliverables are reviewed at each milestone to validate if Go/No-Go criteria are met and to decide whether to further proceed with the project. It is essential to formulate as precisely as possible milestones, deliverables, Go/No-Go criteria. Research & development plan I. Scientific background: relevant results, mechanism of action, proof of concept in animal models, clinical/epidemiological data. II. Innovative component: clinical indication, critical unmet need, economic/social impact, benefit of the targeted health issue. III. Objectives. IV. Research status: e.g. credentialing; supporting tools; modality creation; preclinical development, in vivo/in vitro. V. Scientific description & work plan. VI. Supporting references. Milestones and decision making process one table for each Work package. Main objective Workpackage 1 (WP1) title Task 1 Task 2 Deliverable 1 Identified risks of the WP 1 Go/No-Go criteria Decision if Go criteria is met Decision if Go criteria is not met Y; M Timeline Gantt chart specifies tasks, deliverables and timelines. Deliverable WP 1 _ Task 1 WP 1 _ Task 2 Year 1 Year 2 Year 3 1 2 3 4 1 2 3 4 1 2 3 4 Simplified budget. Duration Staff costs Running costs Equipment costs Subcontracting Total WP1 WP Total Page 7 on 11

MATWIN provides a high added-value pedagogical support but no funding, however to appreciate the needs, list the sources of funding. Funding source K Date obtained -expected Page 8 on 11

PROJECT MANAGEMENT AND FEASIBILITY Describe decision points by which scientific discoveries will be transformed into clinical modalities: Management process and coordination between partners (meetings, progress tracking, regular reporting Decision-making process to track project progress. Project feasibility. Page 9 on 11

COMMERCIAL POTENTIAL AND COMPETITIVE LANDSCAPE Targeted market As far as it is in the public domain, indicate the current and forecasted size of the worldwide market. Provide an indication to assess commercial potential of your modality (price of products/devices; your project will compete with; number of patients ). Competitive landscape which of the following options would best describe your proposed work? Fulfils a currently unmet Competes with current Improves on current need alternatives alternatives Products/devices already on the market that your modality will compete with or replace As far as it is in the public domain, describe the products/devices currently on the market and used by healthcare professions that your modality would compete with or replace. For each one, indicate the name(s) of the company marketing it. Competing academic/industrial groups and research & development stage of their projects As far as it is in the public domain, list academic and industrial groups who are conducting research on projects that could competing with your modality once in the market. For each one, specify the topic and stage of their research, the expected launch date of their project compared with your modality and the competitive advantage of your modality. SWOT analysis Strengths Opportunities Weaknesses Threats Page 10 on 11

UNDERTAKING Head(s) of Departement I confirm that I have read and that I support this application. I am not aware of any relevant information that has been withheld or of any information given that is misleading. I agree to the research carried out in my department. All necessary licences and approvals have been obtained or are being sought Name and Department Date and Signature Host institution I confirm that this application is submitted with the agreement of the host institution. The host institution is not aware of any relevant information that has been withheld or of any information given in the application that is misleading. I confirm that I have read and the host institution accepts the terms and conditions and any supplementary terms and conditions published with and/or referred to in the application form. The host institution understands that the terms and conditions may change during the process and it would then be required to sign its agreement to the new terms & conditions. Name and Institution Date and Signature TTO, Patent Office I confirm that this application is submitted with the agreement of the TTO Name and institution Date and Signature Collaborator s) I enclose a project application form for approval, completed in accordance with the guidelines. I am not aware of any relevant information that has been withheld or of any information given that is misleading. I have read the relevant undertakings, the supplementary terms and conditions published with and/or referred to in the application form and, if this application is successful, I agree to abide by them. I understand that the terms and conditions may change during the process and I would then be required to sign my agreement to the new terms & conditions. Name and position Date and Signature Project Leader I, undersigned confirm that I have (i) completed all sections and that all information given in this form is complete and true, (ii) obtained the agreement of collaborators and institutional contacts for their participation, (iii) gathered signatures of any named collaborators and institutional contacts. I agree that if the application be successful, some completed fields could be used for publication on the MATWIN website. I authorise the MATWIN society to share my application form for assessment, under confidentiality agreement condition for each person who accesses this. Name Date and Signature Page 11 on 11