Enterprise Interest I am an employee of ThermoFisher Scientific.

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1 Enterprise Interest I am an employee of ThermoFisher Scientific.

2 Developing a multiplex next-generation sequencing assay to study highly clonal tumor samples Dumitru Brinza, Ph.D Clinical Next-Generation Sequencing Division 2 For Research Use Only. Not for use in diagnostic procedures. The world leader in serving science

3 Thermo Fisher Scientific s NGS Oncology Portfolio Category 1 25 Genes Genes > 100 Genes Solid tumor profiling Oncomine BRCA Research Assay Somatic mutations + germline Oncomine Focus Assay 50 DNA genes + 23 RNA genes; hotspots, indels, CNVs, Fusions Ion AmpliSeq Cancer Hotspot Panel v2 50 genes; hotspots, indels Oncomine Comprehensive Assay 143 genes, hotspots, indels, CNVs, Fusions Ion AmpliSeq Comprehensive Cancer Panel 400 genes Heme-Onc profiling Ion AmpliSeq AML Research Panel 19 genes Oncomine Myeloid Research Panel coming in November 2017 Oncomine Childhood Cancer Research Panel (In Development) Oncomine cfdna Lung Research Assay 11 genes, hotspot driver mutations Oncomine Pan-Cancer cftna Research Assay (In Development) Oncomine cfdna Colon Research Assay 14 genes, hotspot driver mutations Liquid biopsy cell-free NA solutions Oncomine cfdna Breast Research Assay 10 genes, hotspot driver mutations Oncomine Lung Cell-Free Total Nucleic Acid Research Assay 12 genes, hotspots, indels, CNVs, Fusions coming in September 2017 Oncomine Breast cfdna Research Assay v2 12 genes, hotspots, indels, novel TP53, CNVs coming in September 2017 Immuno-Oncology (IO) solutions Ion AmpliSeq Immune Repertoire Research Assay coming in September 2017 Oncomine Tumor Mutation Burden Research Assay (In Development) Oncomine Immune Response Research Assay Custom Oncology solutions Ion AmpliSeq Custom Panels The content provided herein may relate to products that have not been officially released and are subject to change without notice. 3 For Research Use Only. Not for use in diagnostic procedures.

4 Oncomine cftna/cfdna Assays 2x8hr Clinical Research Workflow Prep Sequence Analyze cftna/cfdna Isolation Library Prep Template Prep Sequencing Analysis Lab-created Report MagMAX cfdna or cftna Isolation Kit Oncomine cfdna or cftna Assays Ion Chef Instrument Ion S5 and Ion S5 XL Systems Also enabled on Ion PGM and Ion Proton Systems Variant caller in Torrent Suite and Ion Reporter Software Oncomine Knowledgebase Reporter Single blood tube Refined variant data Compatible with cftna, cfdna and FFPE input amounts down to 1ng Validated limit of detection (with 20ng input) down to: Hotspot (SNV,Indel) TP53 whole target (SNV,Indel) RNA Fusions CNV 0.1% 0.5% 1% 2%(CN >10) or 5%(CN >4) Validated using a single tube of blood Targeted, tumor type-specific panels allow maximum multiplexing, driving down sequencing costs In development, Pan-Cancer Assay allows to maximize content Integrated Analysis and Reporting Software 4 For Research Use Only. Not for use in diagnostic procedures.

5 Core Technology and Variant Analysis Method Assay Gene Specific Primer Molecular tags Analysis cfdna molecule with tumor variant Wild type cfdna molecule Variant Amplification, tagging and sequencing Variant calling 5 For Research Use Only. Not for use in diagnostic procedures.

6 In Development Oncomine Pan-Cancer Cell-Free TNA Research Assay Coverage: Key hotspot mutations Fusions CNVs MET exon 14 skipping Single Pool design (DNA & RNA) SNV LOD down to 0.1% with 20 ng input Same Sensitivity & Specificity Whole target SNV/Indel calling at 0.5% CNV fold change X Expect 4 libraries on a 540 chip Assay Configuration Unique Genes DNA RNA Pan-Cancer TNA (DNA + RNA) Hotspot Genes AKT1 ALK ARAF BRAF CHEK2 CTNNB1 DDR2 EGFR ERBB2 ERBB3 ESR1 FGFR1 FGFR2 FGFR3 FGFR4 FLT3 GNA11 GNAQ GNAS HRAS IDH1 IDH2 KIT KRAS MAP2K1 MAP2K2 MET MTOR NRAS NTRK1 NTRK3 PDGFRA PIK3CA RAF1 ROS1 SF3B1 SMAD4 SMO Tumor Suppressor Genes APC ATM FBXW7 PIK3R1 PTCH1 PTEN TP53 TSC1 TSC2 Copy Number Genes CCND1 CCND2 CCND3 CDK4 CDK6 EGFR ERBB2 FGFR1 FGFR2 FGFR3 MET MYC * Highlighted are the most commonly mutated genes in AML Gene Fusions ALK BRAF ERG ETV1 FGFR2 FGFR3 MET NTRK1 NTRK3 RET ROS1 The content provided herein may relate to products that have not been officially released and are subject to change without notice. 6 For Research Use Only. Not for use in diagnostic procedures.

7 Minimum read coverage ng of input cfdna Testing Limits of Detection with Higher Amount of Input cfdna ,05% 0,09% 0,11% PUSH THE LIMIT 0,15% 0,25% 0,40% Limits of Detection with Sensitivity 90.0±5.0% Specificity 99.6±0.2% 0,60% 0 0 0,00% 0,10% 0,20% 0,30% 0,40% 0,50% 0,60% 0,70% Limit of Detection ng cfdna 0.6% LOD 5 ng cfdna 0.25% LOD 10 ng cfdna 0.15% LOD 20 ng cfdna 0.1% LOD 40 ng cfdna 0.05% LOD *Data based on fragmented Acrometrix Oncology Hotspot Control diluted into fragmented gdna from the background GM24385 to create mixtures with variants at 0.01% to 1% frequency Oncomine cfdna Assays enable detection of somatic mutations down to biological limitation of the sample Specificity >99% at 0.1% and 0.05% LOD 7 For Research Use Only. Not for use in diagnostic procedures.

8 Acute Myeloid Leukemia (AML) Acute myeloid leukemia (AML) clones at frequency <0.01% commonly represent a significant, if not the main, clone at the time of relapse. 7 Million White per 1mL of blood input DNA is not a limiting factor Experimental setup: 300,000 cells (1µg) DNA Ion S5 System Oncomine Lung cfdna Assay Ion 540 Chip (~80 million reads) Detected >250,000 ssdna molecules per target Potential for 0.001% LOD 8 For Research Use Only. Not for use in diagnostic procedures.

9 Analytical Performance at 0.001% Limit of Detection = ~ = ~ 1µg of DNA 3 dsdna mutant molecules present at 0.001% 3 ssdna mutant molecules present at 0.001% Limit of detection per mutant with cfdna assays Limit of Detection 0.1% 0.01% 0.001% Input amount gdna or cfdna (ng) 20ng 200ng 1000ng (1µg) Mutant Molecules (expected mean) Sensitivity (observed mean) Specificity (observed mean) Data based on fragmented Acrometrix Oncology Hotspot Control diluted into fragmented gdna from the background GM24385 to create mixtures with variants at 0.001% Oncomine cfdna Assays maintain sensitive performance with larger amount of input cfdna Specificity of 93% at 0.001% LOD 9 For Research Use Only. Not for use in diagnostic procedures.

10 Variants Called from Horizon cfdna Multiplex Reference Set Expected allelic frequency Detected allelic frequency (%) by Oncomine Lung cfdna Assay Workflow Sample EGFR E746_A750d elelrea EGFR L858R EGFR T790M EGFR V769_D770i nsasv KRAS G12D NRAS A59T NRAS Q61K PIK3CA E545K 0.1% HDX % HDX % HDX % WT OncoNetwork Consortia Report Limit of Detection 0.1% Average Sensitivity 94.8% Average Specificity 99.8% 10 For Research Use Only. Not for use in diagnostic procedures.

11 AF (%) Retrospective Research Study with Oncomine Lung cfdna Assay 3 2,5 cfdna alterations 2.55% 2 1,5 1 0, % 0.15% 0.07% 0.08% Dx Month EGFR del15 KRAS EGFR T790M Presented at IAP / ESP Congress, September 29 th 2016, by Jose Luis Costa 11 For Research Use Only. Not for use in diagnostic procedures.

12 Oncology Informatics Providing Sample-to-Answer Workflow Oncomine Knowledgebase Reporter Prioritize variants, find the relevant few Sequencing analysis Torrent Suite Software Annotate and filter Ion Reporter Software with Oncomine plug-in Create custom reports Oncomine Knowledgebase Reporter What is it? What does it do? Streamlines sequencing runs and creates BAM files Calls variants, identifies and annotates cancer drivers Link variants to relevant, published evidence Benefit Start your targeted sequencing analysis Identify likely driver variants Quickly create custom, lab-generated reports Data journey Sequencing reads to BAM file BAM file to VCF file VCF file to PDF report 12 For Research Use Only. Not for use in diagnostic procedures.

13 Oncomine Knowledgebase Reporter Quickly create custom, lab-generated reports Oncomine Knowledgebase Reporter 13 For Research Use Only. Not for use in diagnostic procedures.

14 For Research Use Only. Not for use in diagnostic procedures Thermo Fisher Scientific Inc. All rights reserved. All trademarks are the property of Thermo Fisher Scientific and its subsidiaries. 14 For Research Use Only. Not for use in diagnostic procedures.