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P er son alized Onc ol ogy Sol uti ons Experience real-world results, one case at a time Metastatic colorectal cancer Personalized TumorGraft™ case study: 44-year-old female diagnosed with metastatic colorectal cancer who had 3 prior regimens1 First line: FOLFOX (5-Fluorouracil, Leucovorin, Oxaliplatin) plus Bevacizumab (Avastin); Second line: FOLFORI (5-Fluorouracil, Leucovorin, Irinotecan); Third line: Cetuximab monotherapy PERSONALIZED TUMORGRAFT™ RESPONSE TO DRUG TESTING First round of drug testing (fourth line of treatment) 1200 Control Irinotecan 100mg/kg; q7dx3 1000 3 Tumor Volume (mm ) 800 600 400 200 0 0 4 6 8 11 13 15 18 20 22 25 28 32 35 39 42 46 47 49 53 56 Time (Days) 1. Patient’s pelvic tumor regressed by 60% following Irinotecan monotherapy (partial response) • The patient had resolution of the hydronephrosis • Patient remained in partial response for >50 months 2. Additional drug testing revealed that maximal response in the patient’s Personalized TumorGraft™ was achieved with Laptinib combined with Xeloda (fifth line of treatment) • Patient’s tumor regressed (partial response) for 6 more months 1 Manuel Hidalgo, Elizabeth Bruckheimer, N.V. Rajeshkumar, et al. A Pilot Clinical Study of Treatment Guided by Personalized Tumorgrafts in Patients with Advanced Cancer. Mol Cancer Ther June 2011. RESPONSE TO FOURTH-LINE TREATMENT Before Irinotecan Treatment After Irinotecan Treatment Pelvic Metastases Resolution of Hydronephrosis Further investigations: second response to Irinotecan therapy 500 IRINOTECAN • In an effort to understand why the patient had a second response to Irinotecan, Champions’ scientist compared her levels of Irinotecan and its active metabolite SN-38 to other Personalized TumorGrafts™ 450 400 6000 350 SN-38 (ng/gm) IRINOTECAN (ng/gm) 5000 4000 3000 2000 300 250 • The patient’s Personalized TumorGraft™ activated Irinotecan to its active metabolite SN-38 more readily than those of other patients 200 150 100 1000 50 0 0 CRC005 CBI0805 CRC005 CBI0805 Case study conclusion • The Personalized TumorGraft™ revealed that the patient would respond best to one of the three combined treatments she received previously • Patient responded to two courses of Champions-guided treatment • The patient would have likely never received Irinotecan again if not for Personalized TumorGraft™ testing Personalized Oncology Solutions Champions Oncology, Inc. One University Plaza, Suite 307 Hackensack, NJ 07604 Phone: 201.808.8400 www.ChampionsOncology.com © Champions Oncology 2011