2017 annual report

Ori Farber

Senior Medical Manager
Haifa, Israel

advancing our
clinical pipeline

Our second core strategic priority is to advance our clinical pipeline to study Tumor Treating Fields in multiple solid tumor indications beyond GBM. Throughout more than a decade of preclinical research in 18 different cancer cell lines, Tumor Treating Fields has demonstrated a consistent anti-mitotic effect.

Although currently only approved for the treatment of GBM, we believe Tumor Treating Fields may be broadly applicable to solid tumors and may not be limited to a specific tumor type or genetic marker. Tumor Treating Fields is intended principally for use in combination with other standard of care cancer treatments. In addition to unprecedented survival results in newly diagnosed GBM, we have what we believe to be promising phase 2 pilot data in non-small cell lung cancer, pancreatic cancer and ovarian cancer. In our clinical research and commercial experience to date, Tumor Treating Fields has exhibited no known systemic toxicity, with mild to moderate skin irritation being the most common side effect.

We made significant progress in 2017 to advance our clinical pipeline. At year-end, we were recruiting for three randomized phase 3 pivotal trials – our METIS trial in brain metastases from non-small cell lung cancer, our LUNAR trial for non-small cell lung cancer and our PANOVA 3 trial for locally advanced pancreatic cancer. We completed enrollment in our STELLAR trial, a phase 2 pilot trial in mesothelioma, and secured a Humanitarian Use Device designation for Tumor Treating Fields in mesothelioma.

We saw a growing interest in Tumor Treating Fields among researchers and clinicians throughout the world with 19 investigator-sponsored trials open and recruiting at year-end and more than 100 posters or presentations with external lead authors at major medical conferences throughout the year. We also expanded our preclinical knowledge of the multi-pronged mechanism behind Tumor Treating Fields. We published preclinical research demonstrating that Tumor Treating Fields delays DNA damage repair following radiation, induces autophagy in certain cell lines and reduces cell migration and invasion.

With an ongoing commitment to research and development investments, we believe there is a range of solid tumor cancers where Tumor Treating Fields may be able to help patients.

we can leverage physics to fight cancer

AN ELECTRIC FIELD EXERTS FORCES ON CHARGED OBJECTS

By using physics to influence biology, Novocure discovered another way to treat cancer. Tumor Treating Fields utilizes the natural electrical properties of dividing cancer cells.

Tumor Treating Fields is a cancer therapy that uses electric fields tuned to specific frequencies to disrupt cell division, inhibiting tumor growth and causing affected cancer cells to die. An electric field is a field of force. Electric fields surround all charged objects. An electric field exerts forces on other charged objects within it. Tumor Treating Fields uses alternating electric fields specifically tuned to target cancer cells. Once the electric fields enter the cancer cell, they attract and repel charged proteins during cancer cell division.

TUMOR TREATING FIELDS USES ELECTRIC FIELDS TO DISRUPT CELL DIVISION

Tumor Treating Fields utilizes the natural electrical properties of dividing cancer cells.

Cellular proteins such as tubulin and septin are strongly affected by Tumor Treating Fields because they are highly polar, containing both positive and negative charges. During cell division, tubulin and septin must position themselves in a particular way in order for the cell to divide. Tumor Treating Fields exerts forces on tubulin and septin, preventing them from moving to their correct locations and disrupting cancer cell division. Tumor Treating Fields does not stimulate or heat tissue and targets dividing cancer cells of a specific size. We believe Tumor Treating Fields causes minimal damage to healthy cells. Mild to moderate skin irritation is the most common side effect reported.

Ori Farber
Senior Medical Manager

Haifa, Israel

Before joining Novocure in 2012, Ori Farber had recently completed his medical studies and was working in the emergency department of a hospital considering the next steps of his career. He wanted to do something completely different with his training. Instead of selecting a residency, he chose to work at Novocure.

“I was looking for something that would still be connected to medicine and patient care,” Ori said. “I wanted to make an impact on patients’ lives. And then I found Novocure.”

The company’s cancer treatment also combined two of his interests: medicine and bioengineering.

Ori, a Senior Medical Manager on Novocure’s Clinical Operations Team, works on all Novocure-sponsored clinical trials. He takes part in the development, preparation and execution of clinical trials. He provides medical input to his Novocure colleagues, contract research organizations and investigators throughout the clinical trials.

Ori said there is lot of work done behind the scenes in order to conduct clinical trials.

“There are many parts, details and people involved,” he said. “It’s like an orchestra. It’s a huge effort in the planning, creation and execution of the study.”

Ori said the Clinical Operations Team contributed to some of Novocure’s major accomplishments in 2017. Those accomplishments include the publication of the final EF-14 phase 3 pivotal trial data in GBM in JAMA, enrolling the first patient in the phase 3 pivotal trial in non-small cell lung cancer, and completing the preparations for opening the phase 3 pivotal trial in unresectable locally advanced pancreatic cancer.

When looking toward the future, he is most excited about Novocure’s evolving pipeline and the potential to help more cancer patients.

“Lung cancer is a good example,” Ori said. “There are so many people affected by this disease and there is so much room for improvement in the outcome and prognosis of these patients. There is a great potential to have an effect on a large patient population.”

Although Ori and the Clinical Operations Team do not treat patients, patients are always at the forefront of the work they do. Reflecting on his decision to join Novocure versus begin a residency in medicine, Ori feels he made the right choice and that he may have the opportunity to impact a larger number of patients in his role at Novocure than he would as a clinician.

“This company exists for patients,” he said. “They are always on our mind.”

ongoing clinical trials

Pre-clinical Phase II PILOT Phase III pivotal Expected Next Milestone
Brain Metastases METIS trial last patient in 2019 with final data collection in 2020
Non-small Cell Lung Cancer LUNAR trial last patient in 2019 with final data collection in 2021
Pancreatic Cancer PANOVA 3 trial last patient in 2020 with final data collection in 2022
Ovarian Cancer phase three pivotal trial open in 2H 2018
Mesothelioma STELLAR trial final data collection in mid-2018
Trial ongoing
Trial complete
Pre-clinical Phase II PILOT Phase III pivotal
Brain Metastases
Non-small Cell Lung Cancer
Pancreatic Cancer
Ovarian Cancer
Mesothelioma
Expected Next Milestone
Brain Metastases METIS trial last patient in 2019 with final data collection in 2020
Non-small Cell Lung Cancer LUNAR trial last patient in 2019 with final data collection in 2021
Pancreatic Cancer PANOVA 3 trial last patient in 2020 with final data collection in 2022
Ovarian Cancer phase three pivotal trial open in 2H 2018
Mesothelioma STELLAR trial final data collection in mid-2018

we also have pre-clinical data for Tumor Treating Fields in these areas:

Pre-clinical

breast cancer
cervical cancer
colorectal carcinoma
ependymoma
gastric adenocarcinoma
gliosarcoma
hepatocellular carcinoma
malignant melanoma
medulloblastoma
meningioma
renal adenocarcinoma
small cell lung cancer
urinary transitional cell carcinoma

Professor Ignace Vergote
Novocure clinical trial investigator

Leuven, Belgium

Professor Ignace Vergote, Chairman of the Department of Obstetrics and Gynaecology and Gynaecologic Oncology at the Catholic University of Leuven, European Union

Professor Ignace Vergote has dedicated his 32-year career to investigating treatment options and striving to improve survival in gynecologic cancers. Among gynecologic cancers, ovarian cancer is the deadliest, representing the fifth most common cause of cancer death among women in the United States. Five-year survival in ovarian cancer has slowly increased from 34 percent in 1975 to 47 percent today.

“We are making progress little by little, step by step,” said Professor Vergote, Chairman of the Department of Obstetrics and Gynaecology and Gynaecologic Oncology at the Catholic University of Leuven, European Union.

Although more women are living longer with ovarian cancer today than several decades ago, 70 percent of patients will have a recurrence and most will eventually die from the disease.

“As an oncologist, you mean a lot to patients,” he said. “Many times, you can’t cure them, but you can give them a longer life with acceptable quality of life.”

To date, Professor Vergote has authored more than 800 papers in gynecologic cancer research and his work was cited more than 40,000 times. He conducts 20 clinical trials in ovarian cancer per year and was an investigator in Novocure’s phase 2 pilot study in recurrent ovarian cancer, INNOVATE.

“There are few possibilities to treat these patients,” he said. “We must continue to investigate treatment options that may potentially improve survival in this difficult to treat disease.”

Professor Vergote became interested in Tumor Treating Fields as a potential treatment for ovarian cancer after seeing the data of Novocure’s EF-14 phase 3 pivotal trial in newly diagnosed glioblastoma and learning about the treatment’s side effect profile. In Novocure’s clinical research and commercial experience to date, Tumor Treating Fields has exhibited no known systemic toxicity, with mild to moderate skin irritation being the most common side effect.

Novocure’s INNOVATE trial examined Tumor Treating Fields in combination with standard of care chemotherapy in patients with recurrent platinum-resistant ovarian cancer. The data suggested that Tumor Treating Fields in combination with weekly paclitaxel is tolerable and safe. The data also suggested more than doubling of the progression free survival and an improvement in overall survival among patients who received Tumor Treating Fields with paclitaxel compared with historical controls.

“I’ve always been very interested in innovation and trying to find new treatment modalities to help our patients,”

Based on these results, Novocure plans to start a phase 3 trial in recurrent ovarian cancer in 2018. Professor Vergote said he plans to participate.

“I’ve always been very interested in innovation and trying to find new treatment modalities to help our patients,” he said. “I’ve always done that from the start of my career.”