主要目的：基于研究者评估的影像学变化（根据RECIST 1.1和PCWG3标准），初步评价HWH340片多次给药在胚系或体细胞BRCA1/2突变的转移性去势抵抗性前列腺癌（mCRPC）患者中的抗肿瘤作用。次要目的：初步评价HWH340片在mCRPC患者中降低血清PSA的作用；初步探索HWH340片对mCRPC患者疼痛和生存质量的影响；初步评价HWH340片在mCRPC患者中的安全性和耐受性。

开始日期2023-03-14

申办/合作机构

人福医药集团股份公司

[+1]

CTR20221020 / Active, not recruiting临床4期

一项在既往新型激素药物治疗失败且携带BRCA1/2突变的转移性去势抵抗性前列腺癌中国男性患者中评估奥拉帕利与恩扎卢胺或醋酸阿比特龙相比的疗效和安全性的随机、开放性研究（PROfound-CN）

确定奥拉帕利在患有mCRPC并携带有害或疑似有害BRCA1/2突变的受试者中的疗效（通过rPFS评估）

开始日期2022-07-29

申办/合作机构

AstraZeneca AB

[+2]

100 项与 BRCA突变去势抵抗性前列腺癌相关的临床结果

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100 项与 BRCA突变去势抵抗性前列腺癌相关的转化医学

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0 项与 BRCA突变去势抵抗性前列腺癌相关的专利（医药）

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项与 BRCA突变去势抵抗性前列腺癌相关的文献（医药）

2024-09-01·European Journal of Cancer

Adjustment for imbalances in baseline characteristics in the MAGNITUDE phase 3 study confirms the clinical benefit of niraparib in combination with abiraterone acetate plus prednisone in patients with metastatic prostate cancer

Article

作者: Capone, Camille ; Hashim, Mahmoud ; Chi, Kim ; Olmos, David ; Attard, Gerhardt ; Boegemann, Martin ; Van Sanden, Suzy ; Antoni, Laurent ; Palmer, Stephen ; Roubaud, Guilhem ; Trevisan, Marco ; Pascoe, Katie

BACKGROUNDMAGNITUDE (NCT03748641) demonstrated favourable outcomes with niraparib plus abiraterone acetate plus prednisone (+AAP) versus placebo+AAP in patients with BRCA1/2-altered metastatic castration-resistant prostate cancer (mCRPC). Imbalances in prognostic variables were reported between arms, which impacts estimation of both the clinical benefit and cost‑effectiveness of niraparib+AAP for healthcare systems. A pre-specified multivariable analysis (MVA) demonstrated improved overall survival (OS) with niraparib+AAP. Here, we used an inverse probability of treatment weighting (IPTW) model to adjust for covariate imbalances and assess time-to-event outcomes.METHODSIPTW analysis of time-to-event outcomes was conducted using data from patients with BRCA1/2-altered mCRPC (N = 225) in MAGNITUDE. Patients received niraparib+AAP or placebo+AAP. OS, radiographic progression-free survival, time to symptomatic progression, time to initiation of cytotoxic chemotherapy and time to prostate-specific antigen progression were assessed. Weighted Kaplan-Meier curves were generated for each endpoint, and adjusted hazard ratios (HR) were obtained from a weighted Cox model.RESULTSImprovements in survival outcomes were estimated for niraparib+AAP versus placebo+AAP: unadjusted median OS was 30.4 months versus 28.6 months, respectively (HR: 0.79; 95 % confidence interval [CI]: 0.55, 1.12; p = 0.183). Following IPTW, median OS increased to 34.1 months with niraparib+AAP versus a decrease to 27.4 with placebo (HR: 0.65; 95 % CI: 0.46, 0.93; p = 0.017). Similar improvements were observed for other time-to-event endpoints.CONCLUSIONSIPTW adjustment provided a more precise estimate of the clinical benefit of niraparib+AAP versus placebo+AAP in patients with BRCA1/2-altered mCRPC. Results were consistent with the pre-specified MVA, and further demonstrated the value of adjusting for baseline imbalances, particularly in smaller studies.TRIAL REGISTRATIONNCT03748641 (MAGNITUDE).

2024-08-01·Advances in Therapy

Feasibility of Indirect Treatment Comparisons Between Niraparib Plus Abiraterone Acetate and Other First-Line Poly ADP-Ribose Polymerase Inhibitor Treatment Regimens for Patients with BRCA1/2 Mutation-Positive Metastatic Castration-Resistant Prostate Cancer

Review

作者: Heeg, Bart ; Verzoni, Elena ; Ruan, Haoyao ; Robinson, Paul ; Reitsma, Friso ; Trevisan, Marco ; Breijo, Sara Martínez ; Capone, Camille ; Van Sanden, Suzy ; Daly, Caitlin ; Hashim, Mahmoud ; Pascoe, Katie ; van Beekhuizen, Sophie ; De Santis, Maria

INTRODUCTIONPoly(ADP-ribose) polymerase inhibitors (PARPi) are a novel option to treat patients with metastatic castration-resistant prostate cancer (mCRPC). Niraparib plus abiraterone acetate and prednisone (AAP) is indicated for BRCA1/2 mutation-positive mCRPC. Niraparib plus AAP demonstrated safety and efficacy in the phase 3 MAGNITUDE trial (NCT03748641). In the absence of head-to-head studies comparing PARPi regimens, the feasibility of conducting indirect treatment comparisons (ITC) to inform decisions for patients with first-line BRCA1/2 mutation-positive mCRPC has been explored.METHODSA systematic literature review was conducted to identify evidence from randomized controlled trials on relevant comparators to inform the feasibility of conducting ITCs via network meta-analysis (NMA) or population-adjusted indirect comparisons (PAIC). Feasibility was assessed based on network connectivity, data availability in the BRCA1/2 mutation-positive population, and degree of within- and between-study heterogeneity or bias.RESULTSNMAs between niraparib plus AAP and other PARPi regimens (olaparib monotherapy, olaparib plus AAP, and talazoparib plus enzalutamide) were inappropriate due to the disconnected network, differences in trial populations related to effect modifiers, or imbalances within BRCA1/2 mutation-positive subgroups. The latter issue, coupled with the lack of a common comparator (except for olaparib plus AAP), also rendered anchored PAICs infeasible. Unanchored PAICs were either inappropriate due to lack of population overlap (vs. olaparib monotherapy) or were restricted by unmeasured confounders and small sample size (vs. olaparib plus AAP). PAIC versus talazoparib plus enzalutamide was not possible due to lack of published arm-level baseline characteristics and sufficient efficacy outcome data in the relevant population.CONCLUSIONThe current randomized controlled trial evidence network does not permit robust comparisons between niraparib plus AAP and other PARPi regimens for patients with 1L BRCA-positive mCRPC. Decision-makers should scrutinize any ITC results in light of their limitations. Real-world evidence combined with clinical experience should inform treatment recommendations in this indication.

2024-06-01·European Urology Oncology

Poly (ADP-ribose) Polymerase Inhibitors Have Comparable Efficacy with Platinum Chemotherapy in Patients with BRCA-positive Metastatic Castration-resistant Prostate Cancer. A Systematic Review and Meta-analysis

Review

作者: Csizmarik, Anita ; Vékony, Bálint ; Széles, Ádám D ; Kói, Tamás ; Hadaschik, Boris ; Nyirády, Péter ; Hegyi, Péter ; Ács, Nándor ; Teutsch, Brigitta ; Szarvas, Tibor ; Fazekas, Tamás

CONTEXTTesting for mutations in Breast Cancer Gene 1/2 (BRCA) has emerged as a novel decision-making tool for clinicians. Patients with metastatic castration-resistant prostate cancer (mCRPC) harboring pathogenic BRCA mutations can benefit from poly (ADP-ribose) polymerase inhibitor (PARPi) and platinum treatments, whereas the impact of the mutation on sensitivity to cabazitaxel and prostate-specific membrane antigen (PSMA)-ligand therapy is currently unknown.OBJECTIVETo assess the efficacy of PARPi, platinum, cabazitaxel, and PSMA-ligand therapies in BRCA-positive mCRPC.EVIDENCE ACQUISITIONDatabases were queried in February 2022. We performed data synthesis by using both proportional and individual patient data. For prostate-specific antigen (PSA) response rate (≥50% decrease from baseline [PSA50]) evaluation, we pooled event rates with 95% confidence intervals (CIs). Progression-free (PFS) and overall (OS) survival analyses with individual patient data were performed with the mixed-effect Cox proportional hazard model and single-arm random-effect analysis, providing pooled medians.EVIDENCE SYNTHESISWe included 23 eligible studies with 901 BRCA-positive mCRPC patients. PSA50 response rates for PARPi and platinum were 69% (CI: 53-82%), and 74% (CI: 49-90%), respectively. Analyses of OS data showed no difference between PARPi and platinum treatments (hazard ratio: 0.86; CI: 0.49-1.52; p = 0.6). The single-arm OS and PFS analyses revealed similarities among different PARPis; pooled PFS and OS medians were 9.7 mo (CI: 8.1-12.5) and 17.4 mo (CI: 12.7-20.1), respectively.CONCLUSIONSOur data revealed that different PARPis were similarly effective in terms of PFS and OS. Moreover, we found that PARPi and platinum therapy were comparable in terms of PSA50 response rate and OS, highlighting that platinum is a valid treatment option for BRCA-positive mCRPC patients. However, prospective interventional studies comparing these agents are essential to provide a higher level of evidence.PATIENT SUMMARYIn this report, we found that different poly (ADP-ribose) polymerase inhibitors had similar efficacy, and platinum was a valid treatment option in BRCA-positive metastatic castration-resistant prostate cancer patients.

项与 BRCA突变去势抵抗性前列腺癌相关的新闻（医药）

2024-10-21

·Pharma CMC

强生「尼拉帕利阿比特龙片」获批上市，治疗前列腺癌

刚刚，强生发布公告，旗下创新治疗药物泽倍珂（尼拉帕利阿比特龙片）正式获得国家药品监督管理局批准。作为目前国内首个且唯一获批的双效复方制剂，泽倍珂联合泼尼松或泼尼松龙用于治疗携带胚系和/或体系 BRCA 基因突变的转移性去势抵抗性前列腺癌成人患者（mCRPC）。泽倍珂®是每日一次的口服复方制剂，用于联合泼尼松或泼尼松龙一线治疗携带BRCA1/2突变的转移性去势抵抗性前列腺癌成人患者，临床证实其相较标准治疗可显著延长影像学无进展生存期。近年来，中国前列腺癌的发病率显著上升。据国家癌症中心最新发布的2022年度中国恶性肿瘤疾病负担报告显示，我国前列腺癌的发病率为每10万人中18.61例，已成为男性泌尿生殖系统中最常见的肿瘤。泽倍珂®是BRCA1/2突变mCRPC成人患者的一线靶向治疗方案。作为一种高选择性聚腺苷二磷酸核糖聚合酶(PARP)抑制剂，尼拉帕利和醋酸阿比特龙的组合联合泼尼松或泼尼松龙，能够靶向mCRPC患者的两种致癌驱动因素——雄激素受体轴和BRCA1/2突变。经临床验证，泽倍珂®联合泼尼松或泼尼松龙可显著延长BRCA1/2突变mCRPC患者的影像学无进展生存期（rPFS）。此外，与安慰剂相比，尼拉帕利还显示出总体生存 (OS)改善的趋势，可显著延长至症状进展时间（TSP）和至细胞毒性化疗起始时间（TCC），同时并维持了患者的生活质量。内容来源于网络，如有侵权，请联系删除。

上市批准临床研究

2024-10-21

·美通社

强生宣布中国首个且目前唯一治疗BRCA突变转移性去势抵抗性前列腺癌的复方制剂泽倍珂®在华获批[1]

泽倍珂 ® 是每日一次的口服复方制剂，用于联合泼尼松或泼尼松龙一线治疗携带 BRCA1/2突变的转移性去势抵抗性前列腺癌成人患者，临床证实其相较标准治疗可显著延长影像学无进展生存期 [2] 。北京 2024年10月21日 /美通社/ -- 强生公司今日宣布，旗下创新治疗药物泽倍珂 ® （尼拉帕利阿比特龙片）正式获得国家药品监督管理局批准。作为目前国内首个且唯一获批的双效复方制剂 [1] ，泽倍珂 ® 联合泼尼松或泼尼松龙用于治疗携带胚系和/或体系BRCA基因突变的转移性去势抵抗性前列腺癌成人患者（mCRPC） [3] 。泽倍珂 ® 是BRCA1/2突变mCRPC成人患者的一线靶向治疗方案 [4] 。作为一种高选择性聚腺苷二磷酸核糖聚合酶(PARP)抑制剂 [5] ，尼拉帕利和醋酸阿比特龙的组合联合泼尼松或泼尼松龙，能够靶向mCRPC患者的两种致癌驱动因素——雄激素受体轴和BRCA1/2突变 [ 3] ,[6] , [7] 。经临床验证，泽倍珂 ® 联合泼尼松或泼尼松龙可显著延长BRCA1/2突变mCRPC患者的影像学无进展生存期（rPFS）。此外，与安慰剂相比，尼拉帕利还显示出总体生存 (OS)改善的趋势，可显著延长至症状进展时间（TSP）和至细胞毒性化疗起始时间（TCC），同时并维持了患者的生活质量 [8] 。近年来，中国前列腺癌的发病率显著上升。据国家癌症中心最新发布的2022年度中国恶性肿瘤疾病负担报告显示，我国前列腺癌的发病率为每10万人中18.61例，已成为男性泌尿生殖系统中最常见的肿瘤 [9] 。尽管随着我国医疗水平的提高，前列腺癌的治疗已经取得一定进展，但是mCRPC仍然是一种致命的疾病 [10],[11] 。据统计，大约10-15%的mCRPC患者携带BRCA1/2基因突变 [12] , [13] ，而携带BRCA1/2基因突变的前列腺癌往往恶性程度更高，可能具有更强的侵袭性和更高的转移性疾病比例，患者的生存结局更差 [14],[15],[16],[17],[18] 。因此，NCCN和EAU等国内外权威指南均推荐对mCRPC患者进行基因检测，以提供更加精准的治疗决策，改善患者临床获益 [19],[20] 。强生创新制药中国区总裁Cherry Huang女士表示："泽倍珂 ® 的获批再次印证了前列腺癌精准治疗时代的到来，突显了基因检测在前列腺癌诊疗中的重要意义。长期以来，强生始终关注不同疾病阶段前列腺癌患者的切实需求，持续引入创新疗法及产品组合，从前列腺癌的晚期治疗，进一步覆盖到更早期阶段。同时，我们也希望让更多患者实现前列腺癌全程管理，在早期、规范化、足疗程的诊疗中获得更长生存。" 此次泽倍珂 ® 的获批是基于一项随机、双盲、安慰剂对照的多中心III期MAGNITUDE研究。结果显示，在BRCA突变亚组中，尼拉帕利联合醋酸阿比特龙加泼尼松或泼尼松龙（AAP）显著降低影像学进展或死亡风险达47%（rPFS, HR=0.53；95%CI 0.36，0.79；p=0.0014） [3] 。在第二次期中分析时，中位随访时间为24.8个月，与安慰剂联合AAP的10.9个月相比，尼拉帕利联合AAP治疗BRCA突变亚组的中位rPFS为19.5个月（HR，0.55[95%（CI），0.39-0.78]） [21] 。此外，尼拉帕利在至症状进展时间（TSP）上有统计学意义上的获益，与对照组相比，症状进展风险显著降低了46%（未达到中位数与23.6个月相比；HR=0.54，95% CI：0.35-0.85；P=0.0071） [3] 。值得注意的是，试验还观察到，接受尼拉帕利联合APP治疗的BRCA1/2 基因突变 mCRPC 患者与接受安慰剂联合AAP治疗的患者相比，尼拉帕利在至细胞毒性化疗起始时间（TCC）上达到统计学意义和临床意义的改善（中位时间未达到 vs. 27.3 个月；HR：0.56，95% CI：0.35-0.90； p=0.0152） [3] 。在安全性方面，研究显示尼拉帕利和AAP联合用药与单药的已知安全性一致。该联合疗法最常见的不良反应（＞10%）包括肌肉骨骼疼痛、疲乏、便秘、高血压、恶心、水肿、呼吸困难等 [3] 。 [1] 强生公司基于《化学药品注册分类及申报资料要求》中2类（2.3）改良型新药新复方制剂的类别递交申请并获得了审批。2类：境内外均未上市的改良型新药。指在已知活性成份的基础上，对其结构、剂型、处方工艺、给药途径、适应症等进行优化，且具有明显临床优势的药品。2.3含有已知活性成份的新复方制剂，且具有明显临床优势。 [2] Sumanasuriya S & De Bono J. Treatment of Advanced Prostate Cancer—A Review of Current Therapies and Future Promise. Cold Spring Harb Perspect Med. 2018;8(6): a030635. [3] AKEEGA® China Prescribing Information, August 2024 [4] K. N. Chi et al. Niraparib plus abiraterone acetate with prednisone in patients with metastatic castration-resistant prostate cancer and homologous recombination repair gene alterations: second interim analysis of the randomized phase III MAGNITUDE trial. Ann Oncol 2023 Sep;34(9):772-782. [5] European Medicines Agency. Zejula (niraparib) Summary of Product Characteristics. February 2023. [6] Clinicaltrials.gov. A Study of Niraparib in Combination With Abiraterone Acetate and Prednisone Versus Abiraterone Acetate and Prednisone for the Treatment of Participants With Deleterious Germline or Somatic Homologous Recombination Repair (HRR) Gene-Mutated Metastatic Castration Sensitive Prostate Cancer (mCSPC) (AMPLITUDE). Available at: https://clinicaltrials.gov/ct2/show/NCT04497844. Last accessed: April 2023. [7] Gsk.com. GSK completes acquisition of TESARO, an oncology focused biopharmaceutical company. Available at: https://www.gsk.com/en-gb/media/press-releases/gsk-completes-acquisition-of-tesaro-an-oncology-focused-biopharmaceutical-company/. Last accessed: April 2023. [8] Merseburger AS, et al. Perspectives on treatment of metastatic castration-resistant prostate cancer. Oncologist. 2013;18(5):558-567. [9] Han B, Zheng R, Zeng H, Wang S, Sun K, Chen R, Li L, Wei W, He J: Cancer incidence and mortality in China, 2022. Journal of the National Cancer Center 2024, 4(1):47-53. [10] Sumanasuriya S & De Bono J. Treatment of Advanced Prostate Cancer—A Review of Current Therapies and Future Promise. Cold Spring Harb Perspect Med. 2018;8(6):a030635. [11] Scott RJ, et al. Genetic testing for homologous recombination repair (HRR) in metastatic castration-resistant prostate cancer (mCRPC): challenges and solutions. Oncotarget. 2021;12(16):1600-1614. [12] Abida W, et al. Prospective Genomic Profiling of Prostate Cancer Across Disease States Reveals Germline and Somatic Alterations That May Affect Clinical Decision Making. JCO Precis Oncol. 2017;2017:PO.17.00029. [13] Shore N, et al. Systematic Literature Review of the Epidemiology of Advanced Prostate Cancer and Associated Homologous Recombination Repair Gene Alterations. The Journal of Urology. 2021;205(4):977–986. [14] Scott RJ, Mehta A, Macedo GS, Borisov PS, Kanesvaran R, El Metnawy W. Genetic testing for homologous recombination repair (HRR) in metastatic castration-resistant prostate cancer (mCRPC): challenges and solutions. Oncotarget. 2021 Aug 3;12(16):1600-1614. doi: 10.18632/oncotarget.28015. PMID: 34381565; PMCID: PMC8351605. [15] Castro E, Romero-Laorden N, Del Pozo A, et al. PROREPAIR-B: A prospective cohort study of the impact of germline DNA repair mutations on the outcomes of patients with metastatic castration-resistant prostate cancer. J Clin Oncol. 2019;37(6):490-503. doi:10.1200/JCO.18.00358. [16] Cavanagh, H., & Rogers, K. M. (2015). The role of BRCA1 and BRCA2 mutations in prostate, pancreatic and stomach cancers. Hereditary cancer in clinical practice, 13(1), 16. [17] Messina, C., Cattrini, C., Soldato, D., et al (2020). BRCA mutations in prostate cancer: Prognostic and predictive Implications. J Oncol., 2020, 4986365. [18] Na, R., Zheng, S. L., Han, M., et al (2017). Germline mutations in ATM and BRCA1/2 distinguish risk for lethal and indolent prostate cancer and are associated with early age at death. European Urology, 71(5), 740–747. [19] NCCN Clinical Practice Guideline in Prostate Cancer 2024 v4. [20] EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer 2023. [21] Eleni Efstathiou, et al. 2023ASCO GU abstract 170.

临床研究上市批准诊断试剂

2024-09-03

·Business Wire

U.S. Food and Drug Administration Approves FoundationOne®CDx and FoundationOne®Liquid CDx as Companion Diagnostics for Lynparza® (olaparib) in Combination with Abiraterone for Patients with BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer

BOSTON--( BUSINESS WIRE )-- Foundation Medicine, Inc. today announced that it has received approval from the U.S. Food and Drug Administration (FDA) for FoundationOne ® CDx and FoundationOne ® Liquid CDx to be used as companion diagnostics for AstraZeneca’s and Merck’s (known as MSD outside of the United States and Canada) Lynparza ® (olaparib) in combination with abiraterone and prednisone or prednisolone for the treatment of adult patients with deleterious or suspected deleterious BRCA-mutated (BRCAm) metastatic castration-resistant prostate cancer (mCRPC). This decision from the FDA follows the approval of FoundationOne CDx for Lynparza to identify mCRPC patients with homologous recombination repair (HRR) gene alterations and the approval of FoundationOne Liquid CDx for Lynparza to identify patients with BRCA1 , BRCA2 and/or ATM alterations in mCRPC. Prostate cancer is one of the most common cancers in men. 1 BRCA1- or BRCA2-mutated mCRPC is a particularly aggressive form of the disease, 2 occurring in approximately 11% of diagnoses. 3 Despite progress in developing new treatment options for this condition, BRCA1- or BRCA2-mutated mCRPC remains difficult to treat and patients often face a poor prognosis. 4 “This approval reinforces the importance of testing for genomic mutations at metastatic diagnosis to help guide treatment decisions,” said Mia Levy, M.D., Ph.D., chief medical officer at Foundation Medicine. “Our high-quality tissue and liquid biopsy companion diagnostic tests will allow more patients to access genomic testing, regardless of specimen type, and will simplify complex decisions by generating the best information to enable better decision-making. There is a critical unmet need for first-line treatment options for patients with BRCA-mutated metastatic castration-resistant prostate cancer and this combination therapy is an important advancement.” Foundation Medicine is the only company with an FDA-approved portfolio of tissue and blood-based comprehensive genomic profiling tests. Using a tissue sample, the FDA-approved FoundationOne CDx test analyzes more than 300 cancer-related genes for genomic alterations in a patient’s tumor. From a simple blood sample, FoundationOneLiquid CDx analyzes more than 300 cancer-related genes to provide genomic insights. With today’s approval, Foundation Medicine is the only company that has seven FDA-approved companion diagnostic indications for prostate cancer. 5 Foundation Medicine is the global leader in companion diagnostic approvals. The company has 60% of all U.S. companion diagnostic approvals for next-generation sequencing (NGS) testing. 6 “This is an important milestone for men with aggressive prostate cancer,” said Courtney Bugler, President and CEO of ZERO Prostate Cancer. “Biomarker testing is an important tool for patients and families to help facilitate personalized treatment decision making, and we applaud Foundation Medicine for these additional companion diagnostic indications.” Lynparza is jointly developed and commercialized by AstraZeneca and Merck. Foundation Medicine and FoundationOne ® are registered trademarks of Foundation Medicine, Inc. About Foundation Medicine: Your Essential Partner in Cancer Care Foundation Medicine is a pioneer in molecular profiling for cancer, working to shape the future of clinical care and research. We collaborate with a broad range of partners across the cancer community and strive to set the standard for quality, scientific excellence, and regulatory leadership. Our deep understanding of cancer biology helps physicians make informed treatment decisions for their patients and empowers researchers to develop new medicines. Every day, we are driven to help our partners find answers and take action, enabling more people around the world to benefit from precision cancer care. For more information, please visit us on www.FoundationMedicine.com and follow us on LinkedIn and X . About FoundationOne ® CDx FoundationOne ® CDx is a next-generation sequencing based in vitro diagnostic device for detection of substitutions, insertion and deletion alterations (indels), and copy number alterations (CNAs) in 324 genes and select gene rearrangements, as well as genomic signatures including microsatellite instability (MSI) and tumor mutational burden (TMB) using DNA isolated from formalin-fixed, paraffin-embedded (FFPE) tumor tissue specimens. FoundationOne CDx is for prescription use only and is intended as a companion diagnostic to identify patients who may benefit from treatment with certain targeted therapies in accordance with their approved therapeutic product labeling. Additionally, FoundationOne CDx is intended to provide tumor mutation profiling to be used by qualified health care professionals in accordance with professional guidelines in oncology for patients with solid malignant neoplasms. Use of the test does not guarantee a patient will be matched to a treatment. A negative result does not rule out the presence of an alteration. Some patients may require a biopsy. For a full list of targeted therapies for which FoundationOne CDx is indicated as a companion diagnostic, please visit www.F1CDxLabel.com . About FoundationOne ® Liquid CDx FoundationOne ® Liquid CDx is a qualitative next generation sequencing based in vitro diagnostic test for prescription use only that uses targeted high throughput hybridization-based capture technology to analyze 324 genes utilizing circulating cell-free DNA (cfDNA) isolated from plasma derived from anti-coagulated peripheral whole blood of advanced cancer patients. The test is FDA-approved to report short variants in over 300 genes and is a companion diagnostic to identify patients who may benefit from treatment with specific therapies (listed in Table 1 of the Intended Use) in accordance with the approved therapeutic product labeling. Additional genomic findings may be reported and are not prescriptive or conclusive for labeled use of any specific therapeutic product. Use of the test does not guarantee a patient will be matched to a treatment. A negative result does not rule out the presence of an alteration. Patients who are negative for companion diagnostic mutations should be reflexed to tumor tissue testing and genomic alteration status confirmed using an FDA-approved tumor tissue test, if feasible. For the complete label, including companion diagnostic indications and complete risk information, please visit www.F1LCDxLabel.com . ____________________________ 1 Cancer.net. Prostate Cancer: Statistics. Updated March 2023. Accessed August 19, 2024. https://www.cancer.net/cancer-types/prostate-cancer/statistics 2 Castro E, Eeles R. The role of BRCA1 and BRCA2 in prostate cancer. Asian J Androl. 2012;14(3):409-414. https://doi.org/10.1038/aja.2011.150 3 Valsecchi AA, Dionisio R, Panepinto O, et al. Frequency of Germline and Somatic BRCA1 and BRCA2 Mutations in Prostate Cancer: An Updated Systematic Review and Meta-Analysis. Cancers. 2023; 15(9):2435. https://doi.org/10.3390/cancers15092435 4 Messina C, Cattrini C, Soldato D, et al. BRCA Mutations in Prostate Cancer: Prognostic and Predictive Implications. J Oncol. 2020;2020:4986365. Published 2020 Sep 7. https://doi.org/10.1155/2020/4986365 5 Data on File, Foundation Medicine, Inc. 2024 6 Data on File, Foundation Medicine, Inc., data as of March 2024

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