LYSARC, ACADEMIC PARTNER OF LYMPHOMA CLINICAL RESEARCH. EN

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LYSARC, ACADEMIC PARTNER OF LYMPHOMA CLINICAL RESEARCH EN www.lysarc.org

THE LARGEST EUROPEAN ACADEMIC ORGANIZATION DEVOTED TO CLINICAL RESEARCH OPERATIONS IN THE LYMPHOMA FIELD Lymphoma is the 6th most common cancer worldwide and the 1st blood cancer. LYSARC, the Lymphoma Academic Research Organisation, is a scientifically independent, non-profit organization focused on lymphoma clinical research. It gathers around 170 engaged and qualified staff (MDs, PharmDs, PhDs, Engs, MBAs ) having for lot of them, beyond their knowledge of the public research sector, a work experience in pharma, biotech and/or service companies. A STRONG INSERTION IN THE ACADEMIC ENVIRONMENT AND RESEARCH-DRIVEN TRIALS A LONG-STANDING EXPERIENCE OF INTERNATIONAL PARTNERSHIPS WITH ACADEMIA AND INDUSTRY LYSARC, created in 2000, is the operational organization associated to the research activities of LYSA, the Lymphoma Study Association, a cooperative group, international leader of lymphoma research. This internationally renowned network of lymphoma experts closely collaborates with LYSARC at all stages of its studies. LYSARC clinical trials are mostly multinational and are conducted in collaboration with other cooperative groups or learning societies, hospitals, universities, local CROs, and healthcare companies throughout 4 continents. Any project run by LYSARC must receive prior approval from LYSA s Board of Directors, following its assessment by LYSA s Scientific Board. Such selection process guarantees the scientific interest of those research programs performed by LYSA-LYSARC. LYSARC and LYSA are together accredited by the French National Cancer Institute French Cooperative Intergroup of International Dimension in the Field of Cancer.

FROM FIRST-IN-MAN TO REGISTRATION TRIALS AND BEYOND LYSARC conducts clinical trials in the field of lymphoma, these studies having a sole academic purpose or also contributing to industrial developments: Phase I trials, including first-in-man Phase IIa and IIb trials Phase III trials, including international pivotal studies aimed at registration Phase IV trials on marketed drugs, for safety surveillance NON-INTERVENTIONAL AND ANCILLARY STUDIES LYSARC conducts non-interventional studies and supports numerous biological, histopathological, imaging, biostatistical and bioinformatics ancillary studies such as: Specific long term, post-protocol, clinical follow-up studies (survival, late toxicities) Registers on public health topics Studies of clinical-biological correlations Meta-analyses Exploration of genetic data of sub-populations LE LYSARC, ACADEMIC PARTNER OF LYMPHOMA CLINICAL RESEARCH I 3

A FACILITATED ENROLMENT OF PATIENTS Studies performed by LYSARC benefit from the large patient recruitment potential offered by the network of 130 LYSA centers in France, Belgium, Portugal and Israel and through its numerous collaborations with foreign academic groups, partners of LYSA (in Europe, Asia, North America and Australia), for studies requiring a greater enrolment or dealing with rare histological subtypes of lymphoma. LYSARC has developed the smartphone application ClinTrial Refer LYSA to help study centers to increase lymphoma patient recruitment in LYSA protocols.. Executive Assistant Quality Assurance Coordinator of Feasibility Studies, Transverse Tools and Projects General Manager Belgium Operational Team CALYM* GLOBAL CARE* FINDMED* AN EFFICIENT CLINICAL RESEARCH ORGANIZATION LYSARC is a specialty, fully integrated clinical research organization, usually sponsor of those trials it conducts. All clinical research functions are represented at LYSARC: this, plus highly professional support functions -in particular finance and legal- make it quite reactive, from the elaboration and signature of the first agreements (accelerated by the routine use of electronic signature) to production of the final study report. LYSARC benchmaks its efficiency against industry for startup timelines (benchmark survey carried out by LEEM -The French Association of Pharmaceutical Companies- on France s attractiveness for international clinical research): for all measured criteria, LYSARC overperforms versus benchmark. CLINICAL OPERATIONS Project Management and Regulatory Affairs Division Biometry Division Medical Affairs, Monitoring & Site Management and Pharmacovigilance Division PLATFORMS Pathology (LYSA-P) Biology (LYSA-BIO) Imaging (LYSA-IM) Early Phase (EARLY) SUPPORT FUNCTIONS Legal Finance Information Systems Human Resources Administration * Partnership research structures funded by the French National Research Agency for research under the Investment for the Future program.

LYSA-LYSARC PLATFORMS LYSARC brings its operational means and LYSA its scientific experts to several key platforms for the study of lymphoma therapies and biomarkers: LYSA-P PATHOLOGY PLATFORM CENTRALIZED REVIEW OF PATIENT TUMOR SAMPLES - More than 16,000 cases reviewed to date - Dedicated laboratory - High-tech equipment for digitalization, analysis and sharing of microscopic slides - Automated high throughput analysis on large patient cohorts - Large collection of annotated tumors: slides, paraffin blocks, frozen tissue, TMAs, DNA/RNA EARLY EARLY PHASE CLINICAL TRIALS PLATFORM PHASES I/IIA, FIRST-IN-MAN, FIRST-IN-LYMPHOMA OR FIRST COMBO STUDIES - Large experience in lymphoma early clinical development: more than 40 trials so far - Structured and reactive clinical trial management - Expanded access to patients through a network of selected expert LYSA sites, accredited early-phase centers ( CLIP 2 centers) by the French NCI - Pharmacokinetics and pharmacodynamics tailored to study treatment LYSA-IM IMAGING PLATFORM CENTRAL REVIEW OF PATIENT IMAGES LYSA-BIO BIOLOGY PLATFORM PRE-ANALYTICAL MANAGEMENT OF BIOLOGICAL SAMPLES - Up to 4,000 images reviewed per year (PET, TDM, MRI) - Web exchange platform (Imagys software) with a FDA approved viewer - Real-time review (48 hours max) of images used for treatment decision-making - Research on new evaluation parameters - Collection, labeling, samples management (plasma, DNA/RNA, fresh blood, live cells) in a controlled environment - Personalized blood analyses - Tailored immunological monitoring - Specific genetic analyses LE LYSARC, ACADEMIC PARTNER OF LYMPHOMA CLINICAL RESEARCH I 5

WHY LYSARC AS A RESEARCH PARTNER? A unique expertise and experience in lymphoma LYSARC puts its operational expertise and its long-standing experience of clinical research in the lymphoma field at the service of LYSA and its academic and industry (pharma, biotech, in vitro diagnosis, medical imaging) partners to help them answering at the shortest the unmet medical needs for this cancer. A professional approach to clinical research LYSARC is ISO 9001:2008 certified for the management and follow-up of its partnering activities. It pays specific attention to time, quality and budget objectives meeting. Tools used by LYSARC for its activities are similar to those used by industry, with a focus on research data and material digitalization (ecrf, imaging software, digital pathology ). All staff benefit from The Lymphoma Academy, an online training tool developed by LYSARC. Unparalled clinical databases and annotated biological collections This very precious material, from more than 20,000 patients, is stored in optimal security conditions (data center, biobanks). It is the subject of scientific collaborations with academia and industry. High quality and safety standards LYSARC conducts its research in compliance with international quality standards: GCP, GLP, ICH. It has in-house regulatory affairs, pharmacovigilance and quality assurance departments. LYSARC is regularly audited by its partners and also audits study sites, its own services, its vendors, and validates the tools it uses for clinical research activities. All LYSARC staff receive training on quality assurance and internal standard operating procedures. All protocols and informed consent forms of trials performed by LYSARC undergo review by patients committees in the framework of a collaboration with the French Ligue Against Cancer. Research tax credit LYSARC is accredited for the French research tax credit scheme. Eligible entities (must be subject to corporate tax in France) having collaborative R&D projects with LYSARC can save up to 30 % of audited R&D expenses.

SOME EXAMPLES OF CLINICAL TRIALS PROMOTED BY LYSARC AND CONDUCTED WITH LYSA AND ITS PARTNERS SCOPE OF WORK Project management Legal and finance Methodological advice Trial design * Study documents Regulatory affairs Blood and tumor banking Pre-analytical and analytical histopathology * Digital pathology * Pathology central review * Imaging central review * IMP supply IVRS/IWRS Study monitoring Study sites local support Medical monitoring Pharmacovigilance Data management Biostatistics Medical writing (CSR) Quality assurance Training Ro-CHOP: a clinical program in the long run In partnership with a leading biopharmaceutical company in onco-hematology, the addition of romidepsin to CHOP chemotherapy in first line for peripheral T-cell lymphoma patients has been the subject of a complete clinical evaluation by LYSA- LYSARC, from phase I to an international phase III registration trial. PRIMA: a phase III clinical trial with many outputs PRIMA phase III clinical trial, conducted in 25 countries in collaboration with a big pharmaceutical group, led to the registration of rituximab as a two-year maintenance therapy for follicular lymphoma patients responding to first-line immunochemotherapy. PRIMA also generated many ancillary biological studies leading to a significant number of results and publications (including the Lancet). GAINED: the role of imaging This international multicenter phase III clinical trial aims at showing an improvement of two-year event-free survival of patients with diffuse large B-cell lymphoma following a treatment associating the monoclonal antibody obinutizumab GA-101 and a polychemotherapy such as CHOP-14 or ACVBP-14. Treatment adaptation was realized according to TEP real-time central reading: 688 patients, mean reading time 1.65 day, median 0. GALEN: a multi-partner early phase study Phases Ib and II clinical study of obinutuzumab combined with lenalidomide for the treatment of follicular lymphoma and refractory or relapsed aggressive B-cell lymphoma (large cell and mantle cell lymphomas). LYSARC conducts this trial in collaboration with LYSA and two pharmaceutical companies. * In collaboration with LYSA experts LE LYSARC, ACADEMIC PARTNER OF LYMPHOMA CLINICAL RESEARCH I 7

LYSARC IS A MEMBER OF CALYM Carnot institute Research consortium devoted to the acceleration of innovation and its transfer in the lymphoma field. www.calym.org CALYM is a member of the GLOBAL CARE Initiative www.globalcare-initiative and FINDMED www.findmed.fr consortia ELI, The European Lymphoma Institute Association of 13 European academic groups conducting joint research, communication and education actions on lymphoma. www.eli.eu/fr/en Groupes Coopérateurs en Oncologie Network of French cooperative groups sponsoring cancer clinical research. www.gco-cancer.org CONTACT partnering@lysarc.org LYSARC Centre Hospitalier Lyon-Sud Secteur Sainte Eugénie Pavillon 6D 69495 Pierre-Bénite cedex FRANCE www.lysarc.org Tel. +33 4 72 66 93 33 January, 2017 - Copyright : donfiore Fotolia, LYSA, LYSARC, Adobe Stock, Shutterstock