© 2014 VARIAN MEDICAL SYSTEMS. ALL RIGHTS RESERVED.
January 14, 2014
INVESTOR MEETING
JP MORGAN HEALTHCARE
CONFERENCE
© 2014 VARIAN MEDICAL SYSTEMS. ALL RIGHTS RESERVED.
CLINICAL ADVANCES AND
FUTURE OPPORTUNITIES
IN RADIOTHERAPY Dr. Deepak Khuntia,
Vice President, Medical Affairs
Varian Medical Systems
3 INVESTOR MEETING – JPM 2014
Forward-Looking Statements
Except for historical information, this news release contains forward-looking statements within the meaning of the Private
Securities Litigation Reform Act of 1995. Statements concerning industry outlook, including growth drivers; the company’s
future orders, revenues, backlog, or earnings growth; future financial results; market acceptance of or transition to new
products or technology such as TrueBeam and radiographic flat panel detectors, image-guided radiation therapy,
stereotactic radiosurgery, filmless X-rays, proton therapy, and security and inspection, and any statements using the
terms “could,” “believe,” “outlook,” or similar statements are forward-looking statements that involve risks and
uncertainties that could cause the company’s actual results to differ materially from those anticipated. Such risks and
uncertainties include global economic conditions; the impact of the Affordable Health Care for America Act (including
excise taxes on medical devices) and any further health care reforms (including changes to Medicare and Medicaid),
and/or changes in third-party reimbursement levels; currency exchange rates and tax rates; demand for the company’s
products; the company’s ability to develop, commercialize, and deploy new products such as the TrueBeam platform; the
company’s ability to meet Food and Drug Administration (FDA) and other regulatory requirements for product clearances
or to comply with FDA and other regulatory regulations or procedures; changes in the regulatory environment, including
with respect to FDA requirements; challenges associated with the successful commercialization of the company’s particle
therapy business; the effect of adverse publicity; the company’s reliance on sole or limited-source suppliers; the impact of
reduced or limited demand by purchasers of certain X-ray products, including those located in Japan; the company’s
ability to maintain or increase margins; the impact of competitive products and pricing; the potential loss of key
distributors or key personnel; challenges to public tender awards and the loss of such awards or other orders; and the
other risks listed from time to time in the company’s filings with the Securities and Exchange Commission, which by this
reference are incorporated herein. The company assumes no obligation to update or revise the forward-looking
statements in this release because of new information, future events, or otherwise.
4 INVESTOR MEETING – JPM 2014
Multileaf Collimators (MLC) On-Board Imager (OBI) High Definition MLC
Highlights of the Last Decade
RapidArc
RADIOSURGERY SUITE
5 INVESTOR MEETING – JPM 2014
Radiosurgery Adoption Rising
97% increase projected
Source: SG2 Consulting, Skokie, Illinois, U.S.
SRS/SBRT National Forecast
US Adult Market, 2013-2023, in thousands
330
280
230
180
130
80
2013 2018 2023
6 INVESTOR MEETING – JPM 2014
Lung Leading Expansion
Source: SG2 Consulting, Skokie, Illinois, U.S.
O Projected 10-Year Growth in SRS/SBRT Radiosurgery
Lung
Brain/CNS
Prostate
GI
Bone mets
Head and Neck
140% increase in lung procedures
0 20K 40K 60K 80K
7 INVESTOR MEETING – JPM 2014
Brain Stereotactic Radiosurgery
The Lancet, Vol. 363, May 22, 2004
Survival in patients with single metastasis
Survival by treatment unit
• Patients receiving
SRS boost live
longer versus
traditional
radiation alone
• Linac and Cobalt
SRS equivalent
8 INVESTOR MEETING – JPM 2014
Prostate SBRT on the Rise!
ASTRO SBRT MODEL POLICY 4/17/2013
“It is ASTRO’s opinion that data supporting the use of SBRT for prostate
cancer have matured to a point where SBRT could be considered an
appropriate alternative for select patients with low to intermediate risk
disease.”
9 INVESTOR MEETING - ASTRO 2013
Head and Neck Cancer:
Targeted Drugs Improve RT Outcome
Median survival rises from 14.9 months to 24.4 months
Post Thoracic Surgery
Neuropathy
Post Thoracic Surgery
Neuropathy Source: Bonner et al, NEJM, 345;6, Feb. 9, 2006
Radiotherapy plus Cetuximab for Squamous-
Cell Carcinoma of the Head and Neck
Courtesy of Paul Harari, MD
10 INVESTOR MEETING – JPM 2014
Advanced IMRT: Sparing Memory
Kempermann & Neumann Science 302: 1689 (2003)
Even low doses to hippocampus
damages memory
Avoiding hippocampus saves memory
11 INVESTOR MEETING - ASTRO 2013
Hippocampal Sparing Whole Brain RT
Black area: Hippocampus
Red contour: Hippocampal avoidance region
Gondi et al. IJROBP.Vol 78, No. 4, pp. 1244-1252, 2010
Gondi et al. ASTRO 2013 Plenary Session
12 INVESTOR MEETING – JPM 2014
SBRT Now Being Used for Pancreas!
13 INVESTOR MEETING - ASTRO 2013
BIG DATA: Survival prediction in
NSCLC
Dehing-Oberije (MAASTRO), IJROBP 2009;74:355
AUC 0.75
15 INVESTOR MEETING - ASTRO 2013
Introducing RapidPlan™
• Increase Confidence
• Good starting point Beginner
• Improve Consistency
• Clinician skills & experience Experienced
• Increase Efficiency Busy clinics
• Increase Participation
• Increase Consistency Clinical trials
Improving Quality and Speed of Treatment Planning
16 INVESTOR MEETING – JPM 2014
Targeted
Therapies
Molecular Imaging
Genomics
Patient
Self-Care
Equicare
Personalized Medicine
17 INVESTOR MEETING – JPM 2014
Radiation Medicine: New Opportunities
Emphysema
Post Thoracic Surgery
Neuropathy
Cardiac Arrhythmia
(atrial fibrillation) Depression
Plantar Fascitis
18 INVESTOR MEETING – JPM 2014
Emphysema: Role for Radiosurgery?
Courtesy of Billy Loo, MD Stanford University
19 INVESTOR MEETING – JPM 2014
Arrhythmia: A Non-invasive Approach
Normal Sinus Rhythm
Atrial Fibrillation
20 INVESTOR MEETING - ASTRO 2013
Functional Disorders: A Hopeful Outlook?
Pioneering Work in:
• Epilepsy
• OCD
• Depression
• Cluster headaches
© 2014 VARIAN MEDICAL SYSTEMS. ALL RIGHTS RESERVED.
QUESTIONS AND ANSWERS
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