Oncotype DX Prostate Cancer Assay The Role of

Oncotype DX® Prostate Cancer Assay: The Role of Genomics In Your Decision-Making Is Active Surveillance Right For You? Prostate Cancer Management: A Guide for Patients and Caregivers 1

Topics we will address today… ü Prostate Cancer Basics ü Understanding Your Treatment Options ü Active Surveillance ü Oncotype DX® Test Overview ü Additional Resources for Patients ü Next Steps 2

Prostate cancer basics What you and your loved ones need to know: 1 in 6 SOME men will be prostate cancers diagnosed with are aggressive and prostate cancer higher risk during their lifetime 3 MOST prostate cancers are not aggressive and lower risk (favorable pathology)

Low-risk prostate cancer is often over-treated 90% OF MEN RECEIVE IMMEDIATE TREATMENT YET ONLY 3% ARE AT RISK OF PROGRESSION & DEATH Grey bar represents 10% of patients who receive Active Surveillance 4

A doctor’s perspective “We desperately need the ability to predict which patient has a localized cancer that is going to metastasize and cause suffering and death, and which patient has a cancer that is destined to stay in the patient's prostate for the remainder of his life. ” -Otis W. Brawley, MD Chief Medical Officer American Cancer Society 5

Understanding your treatment options IMMEDIATE TREATMENT OR Potential Benefits SURGERY • Men may be cured if: o Tumor has not spread o All cancer is removed o Radiation kills all the cancer Potential Risks • • • Urinary incontinence Erectile dysfunction 30 -40% chance of recurrence Use of a catheter for 1 -2 weeks Bowel control issues or rectal bleeding (for radiation) ACTIVE SURVEILLANCE* Potential Benefits • Maintains window of cure • Allows men with low-risk cancer to: o Closely monitor their cancer o Live out their entire lives without surgery or radiation o Avoid the side effects associated with surgery and radiation Potential Risks • Slight risk that cancer may grow and spread • With a schedule of close monitoring it should be caught before it spreads RADIATION *Includes biopsy; DRE (Digital Rectal Exam), PSA (Prostate-Specific Antigen) testing, and MRI (Magnetic Resonance Imaging) 6

What is Active Surveillance? A program of closely monitoring and following your prostate cancer avoiding surgery or radiation. Periodic examinations may include*: PSA Testing Digital Rectal Exam (DRE) Surveillance Biopsy Magnetic Resonance Imaging(MRI) If any changes are detected your doctor may recommend additional treatment * Timing and frequency of these examinations will be specified for you by your doctor 7

Who is eligible for Active Surveillance? Up to HALF of men with low risk cancer could be candidates for Active Surveillance Your doctor will assess your clinical risk (an estimation of your cancer's aggressiveness) to confidently recommend Active Surveillance 8

10+ years of genomic experience is a leading provider of genomic cancer diagnostic tests: Available TODAY 2004 9 2010 2013

Principles of genomics Genomics examines groups of genes and their relationships in order to identify their combined influence on your cancer’s behavior* Oncotype DX® assay evaluates genes for: Cell division *At time of diagnosis 10 Cell organization Cell aggressiveness

The Oncotype DX® test provides personalized information Predicts the UNIQUE BIOLOGY of your tumor based on biopsy tissue Examines the expression of a panel of GENES associated with prostate cancer pathology and progression, a science known as “genomics” Provides a more specific and PRECISE risk assessment than clinical risk alone 11

Quick facts about Oncotype DX® Prostate Cancer Assay GPS Who is the test for? What is the Genomic Prostate Score (GPS)? Patients with very low to low-intermediate risk disease Your Oncotype DX® results are reported as a GPS, that when combined with other clinical factors, can further clarify your risk 12 What is Favorable Pathology? Confirmation that the tumor is low risk and fully confined to the prostate

Oncotype DX® along your prostate cancer journey SCREENING DIAGNOSIS PSA DRE Biopsy Gleason Stage TREATMENT DECISION Active Surveillance OR Immediate Treatment It is a genomic test that gives you and your doctor confidence to choose the best management plan for your cancer 13

GPS helps provide a precise risk assessment GPS VERY LOW 0 More favorable 14 LOW INTERMEDIATE Likelihood of favorable pathology 100 Less favorable

Know your score. Know your risk. The LOWER YOUR GPS, The HIGHER YOUR GPS, the more favorable your tumor biology, and the more likely you can safely consider Active Surveillance the less favorable your tumor biology, and the more likely that you should consider Immediate Treatment 15

A patient’s perspective Choose with confidence “I was determined to educate myself about all of my options, and thanks to Oncotype DX®, I confidently chose Active Surveillance based on my GPS result. ” -Dan W. Oncotype DX® Prostate Cancer Patient Ambassador 16

Financial assistance is available The Genomic Access Program (GAP) takes every possible step to ensure that testing is: Affordable • If your potential out-ofpocket costs exceed $100, GAP will contact you by phone to help you understand these costs 17 Available • You are eligible regardless of your insurance status • Genomic Health contracts directly with most insurers or thirdparty payers to secure the best coverage possible Accessible • GAP contacts your insurance company to determine whether you are covered for the Oncotype DX® test • You can prequalify for patient assistance on the spot simply by providing some basic financial information

A patient’s perspective Choose with confidence “Gain as much information as possible to make the best decision for yourself. ” ” -Dan W. Oncotype DX® Prostate Cancer Patient Ambassador 18

Your Prostate Your Decision is a national campaign to educate patients and their loved ones that every man is different and every cancer is unique, and a genomic test can clarify the aggressiveness of one’s disease prior to invasive treatment. www. Your. Prostate. Your. Decision. com Watch a public service announcement Featuring baseball Hall-of-Famer & prostate cancer survivor Joe Torre 19 Joe Torre, Prostate Cancer Survivor, 4 -time World Champion and Baseball Hall-of-Famer

Resources for your prostate cancer journey 20

Next steps 21 1 LEARN MORE 2 CONSIDER YOUR OPTIONS 3 ASK YOUR DOCTOR 4 CALL about your prostate cancer you have time to choose with confidence about the Oncotype DX® Prostate Cancer Assay +1 -855 -6 PROSTATE

Thank You 22