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Disclosure/Disclaimer. The Molecular Biomarkers in Cancer ( MBiC ) slide presentation is not an independent educational program, and no CME credits will be provided.

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  1. Disclosure/Disclaimer • The Molecular Biomarkers in Cancer (MBiC) slide presentation is not an independent educational program, and no CME credits will be provided. • This program is not intended to promote any cancer agent or class approved by the FDA/EMA or currently under clinical development. • The contents of this slide presentation are owned solely by Genentech; any unauthorized uses are prohibited. • This program is presented on behalf of Genentech and the information presented is consistent with FDA guidelines. • The following slides are selected samples from a complete presentation. They are for educational purposes only. BIO0002078200 1

  2. Types of cancer biomarkers and their utility Notes Screeningdiagnostic Prognostic Monitor progression Predictive Screening Resistance Biomarkers can play a significant role during the clinical management of cancer. Reference: Ludwig JA, Weinstein JN. Biomarkers in cancer staging, prognosis and treatment selection. Nat Rev Cancer. 2005;5:845-856. Initiatingevents Earliestmoleculardetection Earliestclinical detection Typical intervention Second-line treatment Disease burden Cost / irreversibility Ludwig JA, Weinstein JN. Nat Rev Cancer. 2005;5:845-856. Vogelstein B, et al. Nat Med. 2004;10:789-799. 2

  3. Methods of biomarker detection Notes cDNA microarrays provide a powerful tool for studying differential changes in gene expression patterns across a variety of tumor samples. Reference: Yang YH, Speed T. Design issues for cDNA microarray experiments. Nat Rev Genet. 2002;3:579-588. Cancer cells Normal cells IsolatemRNAs Tumor gene expression Make red and greenfluorescent cDNAs Hybridization Analyze data Microarrays Yang YH, Speed T. Nat Rev Genet. 2002;3:579-588. 3

  4. Measuring the risk of metastatic potential Notes • A simultaneous measurement of 70 cancer-related genes in tumor specimens by microarray technology • Evaluates genes involved in cell-cycle regulation, angiogenesis, invasion, signal transduction, and migration • Test measures the 10-year risk of metastasis for women with lymph-node–negative, ER–positive, or ER–negative disease An expression signature determined through the 70-gene microarray test can be used to stratify patients into high- and low-risk groups. Reference: Ma L, Weinberg RA. Micromanagers of malignancy: role of microRNAs in regulating metastasis. Trends Genet. 2008;24:448-456. Potential markers for metastasis Low risk Cancer Patient A No metastatic potential; conservative therapy possible Cancer biopsy High risk Cancer Patient B Metastatic potential; aggressive therapy needed Cancer biopsy ER=estrogenreceptor. van'tVeerLJ, Bernards R. Nature. 2008;452:564-570. Ma L, Weinberg RA. Trends Genet. 2008;24:448-456.Adaptedfrom Weinberg. Sci Am. 1996;275:62-70. 4

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