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Concomitant Medications

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1 Concomitant Medications
Abbott Oncology A Randomized Phase 2 Study of the Efficacy and Tolerability of Veliparib in Combination with Temozolomide or Veliparib in Combination with Carboplatin and Paclitaxel Versus Placebo Plus Carboplatin and Paclitaxel in Subjects with BRCA1 or BRCA2 Mutation and Metastatic Breast Cancer Protocol Amendment 1 dated 16/Mar/12 Company Confidential © 2012 Abbott

2 Abbott Study M12-895 Site Initiation Visit Agenda
Study Team Members Study Design and Population Compound Information - Veliparib Protocol Objectives Eligibility Medical History/Concomitant Medications Study Visit Procedures Study Medication Subject Discontinuation and Survival Follow-up Safety Reporting Company Confidential © 2012 Abbott Company Confidential © 2012 Abbott Company Confidential © 2012 Abbott 2

3 Abbott Study M12-895 Site Initiation Visit Agenda (Cont.)
Vendor Training Imaging (Perceptive) Central Laboratory (ICON) Barcode Scanner PD/PG/PK Sampling BRCA Testing (Myriad) IVRS/IWRS (ClinPhone) EDC (RAVE) Good Clinical Practice Investigator Responsibilities & General Study/Visit Information Q & A Session Company Confidential © 2012 Abbott

4 Study Design and Population
Global study (16 countries) Approximately 255 subjects at approximately 85 sites Anticipated 13 month enrollment period Study population Men and women ≥ 18 years of age with measureable metastatic breast cancer and a documented BRCA1 or BRCA2 deleterious germline mutation who have received no more than one prior line of cytotoxic therapy for metastatic disease. Company Confidential © 2012 Abbott 4

5 Carboplatin/Paclitaxel 120 mg Veliparib BID + Carboplatin/Paclitaxel
Overall Study Design 80% power at two-sided  = assuming true HR 0.58 Patient Population Endpoints N = 85 40 mg Veliparib BID + Temozolomide Men and women ≥ 18 years of age Measureable metastatic breast cancer Documented BRCA1 or BRCA2 deleterious germline mutation Primary Endpoint Progression Free Survival Secondary Endpoints Overall Survival Clinical Benefit Rate Objective Response Rate Safety and Tolerability CIPN N = 85 Placebo + Carboplatin/Paclitaxel Randomization 1:1:1 N = 85 120 mg Veliparib BID + Carboplatin/Paclitaxel Primary analysis: 150 PFS Events Interim analyses: Safety: 36 subjects complete Week 18 Futility: 30 subjects on veliparib/TMZ complete Week 27 tumor assessment Company Confidential © 2012 Abbott 5

6 Veliparib (ABT-888) Oral Poly(ADP-Ribose)Polymerase (PARP) Inhibitor
Abbott Oncology Veliparib (ABT-888) Oral Poly(ADP-Ribose)Polymerase (PARP) Inhibitor

7 PARP and DNA Damage Repair
Adapted from Dawson et. al., (2004) Trends in Pharm Sciences 25, Measured in Biomarker ELISA PARP biology Activated on DNA damage Effects DNA repair PARP inhibition in cancer therapy Tumors often defective in DNA repair More sensitive to DNA damage More sensitive to PARP inhibition ↑ PARP is resistance mechanism Company Confidential © 2012 Abbott

8 ABT-888: PARP Inhibitor In vivo preclinical efficacy with: Cisplatin
Potent Inhibitor PARP-1, 2 Ki = 5, 3 nM Cellular EC50 = 2 nM Orally bioavailable % Fhuman = > 80% 30% CV Excellent pharmaceutical properties BCS class 1 Low molecular weight Highly soluble Crosses BBB Favorable metabolic profile No Cyp inhibition No Cyp induction Not a PgP substrate In vivo preclinical efficacy with: Cisplatin Carboplatin Cyclophosphamide Irinotecan Topotecan Temozolomide (TMZ) Radiation Company Confidential © 2012 Abbott

9 PARPi Potentiates TMZ by a pathway not normally exploited by TMZ monotherapy
PARP inhibition restores tumor cell sensitivity to TMZ (MMR defective, high MGMT expression) { MMR proficient + low DNA alkyltransferase G-T mismatch Adapted from Japtap and Szabo 2005 Nature Reviews/Drug Discovery Company Confidential © 2012 Abbott

10 M12-895 Protocol Discussion

11 Overview Objectives Eligibility Criteria
Medical History/Concomitant Medications Study Visits and Procedures Study Medication Study Discontinuation and Survival Follow-up Company Confidential © 2012 Abbott

12 Study Objectives Primary Secondary Tertiary
Progression Free Survival (PFS) Number of days from date of randomization to date of confirmed progression per RECIST 1.1 or date of death (if disease progression is not reached) Secondary Overall Survival (OS) All subjects will be followed until the endpoint of death or until lost to follow-up or until study termination by Abbott Clinical Benefit Rate (CBR) The proportion of subjects with at least SD (CR, PR, or SD) through the end of Week 18 Objective Response Rate (ORR) Proportion of subjects with confirmed complete or partial response per RECIST 1.1 Chemotherapy-Induced Peripheral Neuropathy (CIPN) As assessed by the EORTC QLQ-CIPN 20 questionnaire and NCI-CTCAE 4.0 grading for peripheral Neuropathy in those subjects randomized to the veliparib/placebo + carboplatin + paclitaxel treatment arms Tertiary Quality of Life (QoL) Assessed with subject completed questionnaires: EORTC QLQ-C15/BR23 Eastern Cooperative Oncology Group (ECOG) performance status Company Confidential © 2012 Abbott 12

13 Stratification Factors for Randomization
Estrogen Receptor positive and/or Progesterone Receptor Positive versus Estrogen Receptor Negative and Progesterone Receptor Negative status Prior cytotoxic therapy versus no prior cytotoxic therapy ECOG status 0‑1 versus 2 Company Confidential © 2012 Abbott 13

14 Concomitant Medications
Eligibility Criteria

15 Inclusion Criteria For Selection of Subject Population with Sufficient Disease Severity
Males and females ≥ 18 years of age Histologically or cytologically confirmed breast cancer with evidence of metastatic disease Documented deleterious BRCA1 or BRCA2 germline mutation The investigator should ensure that the testing is consistent with local guidelines, and clinical practice, and that the test uses either: Direct DNA sequencing/multiplex ligation-dependent probe amplification (MLPA); or A well-characterized methodology previously validated by sequencing, such as that used to assess founder mutations. If testing has been performed by a laboratory other than Sponsor core laboratory, subjects may be enrolled and must be re-tested by Sponsor core laboratory for confirmation of BRCA1 or BRCA2 germline mutations HER2-positive subjects must have progressed on at least one prior standard HER2-directed therapy or be ineligible to receive anti-HER2 therapy. Company Confidential © 2012 Abbott 15

16 Inclusion Criteria For Selection of Subject Population w/Sufficient Disease Severity (Cont.)
Measurable lesion by RECIST 1.1 in at least 1 site that has not received prior radiotherapy, unless progression has been demonstrated in the lesion If only a single measurable lesion exists, it cannot be a bone or cystic lesion; Bone-only lymphangitic pulmonary mets & previously irradiated tumors without subsequent progression will be considered non-measurable; ECOG Performance status of 0 to 2 Company Confidential © 2012 Abbott 16

17 Inclusion Criteria For Subject Safety and GCP
Willing to take appropriate measures to prevent pregnancy prior to study entry, during study and for 90 days following completion of study; Willing to comply with study and to sign the main IRB/EC informed consent Laboratory inclusion criteria: Bone Marrow ANC ≥1,500/mm3 (1.5 x 109/L) Platelets ≥100,000 (100 x 109/L) Hemoglobin ≥9.5 g/dL (1.4 mmol/L) Leukocytes >3,000/mm3 Renal Function Serum Creatinine OR ≤1.5 x ULN Creatinine Clearance ≥50 mL/min/1.73m2 Hepatic Function AST and/or ALT ≤2.5 x ULN (subjects with liver mets) <5 x ULN Bilirubin ≤1.5 x ULN (subjects with Gilbert’s syndrome) ≥ 1.5 x ULN^ Coagulation aPTT* ≤1.5 x ULN INR* <1.5 *Subjects on anticoagulant therapy will have an appropriate activated partial thromboplastin time (aPTT) and INR as determined by the investigator ^If no evidence of biliary obstruction Company Confidential © 2012 Abbott 17

18 Exclusion Criteria For Safety of Subject
Received anticancer agent(s), an investigational agent or radiotherapy, within 21 days prior to C1D1 Prior treatment with palliative local breast or bone lesion radiation (other than pelvis) can occur, if administered at least 14 days prior to C1D1 Subjects experiencing a significant adverse effect or toxicity (Grade 3 or 4), causally attributed to previous anticancer treatment that has not recovered to at least Grade 2 are excluded Anticancer hormonal therapy must be stopped 7 days before starting C1D1. Subjects receiving bisphosphonates or denosumab are eligible More than 1 prior line of cytotoxic chemotherapy (e.g., gemcitabine, doxorubicin, capecitabine) for metastatic disease Regimens received in the adjuvant/neoadjuvant setting within the past 6 months will also be considered towards the maximum of 1 prior line of therapy In order to count as a line of therapy, a cytotoxic agent must have been administered for at least 1 full cycle. Previous treatments with hormonal therapy (tamoxifen, aromatase inhibitors) and signal transduction agents, (e.g., trastuzumab, lapatinib, erlotinib, gefitinib, bevacizumab) are allowed and are not counted toward the prior line of therapy Company Confidential © 2012 Abbott 18

19 Exclusion Criteria For Safety of Subject (Cont.)
Prior therapy with temozolomide, a platinum agent, or a PARP inhibitor Prior taxane therapy for metastatic disease Use of taxanes as adjuvant therapy is permitted, if given more than 6 months prior to C1D1 A history of or evidence of brain metastases or leptomeningeal disease. Subjects with symptoms suggestive of CNS metastases should have a brain MRI within 21 days of enrollment to confirm the absence of CNS metastases. Contrast CT is acceptable for subjects who are unable to undergo a brain MRI History of uncontrolled seizure disorder Pre-existing neuropathy from any cause in excess of Grade 1 Known history of allergic reaction to cremophor/paclitaxel Company Confidential © 2012 Abbott 19

20 Exclusion Criteria For Safety of Subject (Cont.)
Clinically significant uncontrolled condition(s), including but not limited to: Active infection; Symptomatic congestive heart failure; Unstable angina pectoris or cardiac arrhythmia; Myocardial infarction within last 6 months; Psychiatric illness/social situations that would limit compliance with study requirements; or Any medical condition which in the opinion of the investigator places the subject at an unacceptably high risk for toxicities Pregnant or breastfeeding Company Confidential © 2012 Abbott 20

21 Exclusion Criteria For Selection of Appropriate Subject Population
Previous or concurrent cancer that is distinct in primary site or histology from metastatic breast cancer, except: Cervical carcinoma in situ Non‑melanoma carcinoma of the skin, or In situ carcinoma of the bladder Any cancer curatively treated > 3 years prior to entry is permitted; for these subjects, metastases must be histologically/cytologically confirmed breast cancer Company Confidential © 2012 Abbott 21

22 Concomitant Medications
Medical History and Concomitant Medications

23 Key Medical History Clinically significant medical conditions
History of tobacco and alcohol use Child bearing status Seizure history History of neuropathy Presence of any preexisting symptoms or recurring complaints Company Confidential © 2012 Abbott 23

24 Key Medical History Detailed Oncology History
Date of primary cancer diagnosis Pathology (histology or cytology) of primary tumor Metastasis information (including the location and histological markers, if applicable) Prior treatments by line of therapy (including dates) Cytotoxic chemotherapy (e.g., gemcitabine, doxorubicin, capecitabine, etc.) Hormonal therapy (e.g., tamoxifen, aromatase inhibitors, etc.) Signal transduction agents (e.g., trastuzumab, lapatinib, erlotinib, gefitinib, bevacizumab) Treatment with TMZ, taxanes, platinum agents, or PARP inhibitors Surgical history, including tumor resection Radiation treatments (including dates, location, and type of modality) History or symptoms of brain metastases or leptomeningeal disease History of allergic reaction to cremophor/paclitaxel Presence and severity of any symptoms/conditions associated with breast cancer Company Confidential © 2012 Abbott 24

25 Prior Therapy Antitumor treatment may be defined as, but not limited to, anticancer agents, radiotherapy, and investigational agents An investigational agent is any drug or therapy not currently approved for use in humans Anticancer Agents: No more than one prior line of cytotoxic therapy Regimens received in the adjuvant/neoadjuvant setting within the past 6 months will also be included towards the maximum of 1 prior line of therapy Prior therapy with biologic agents including vaccines and immunostimulants are allowed Prior therapy with signal transduction agents such as EGFR/HER2-direct agents, are allowed and will not count toward prior lines of therapy Anticancer hormonal therapy is not permitted within 7 days prior to C1D1 Radiation: Prior treatment with radiation is allowed as long as the last treatment was at least 28 days prior to C1D1. Prior treatment with palliative local breast or bone lesion radiation (other than pelvis) can occur within 14 days of C1D1 Company Confidential © 2012 Abbott 25

26 Concomitant Therapy Current medications or vaccines (over-the-counter, prescriptions, vitamins, and/or herbal supplements) will be collected at Screening, during study, and up to 30 days following last dose The locally approved product label, institutional guidelines, local practice, or applicable SPC for TMZ, carboplatin, and paclitaxel should be referenced for any concomitant therapy guidelines Company Confidential © 2012 Abbott 26

27 Concomitant Therapy - Allowed
Allowed during study: Premedication: Prophylactic use of a 5-HT3-antagonist is strongly recommended before TMZ administration Additional prophylactic antiemetics may be given, as appropriate To reduce the severity of hypersensitivity reactions to paclitaxel, manage according to institutional guidelines, the locally approved product label, local practice, or applicable SPC (i.e., premedication with corticosteroids, diphenhydramine, and H2 antagonists) Growth Factors: Biologic response modifiers administered for erythropoiesis and colony‑stimulating factors may be administered according to institutional or clinical practice guidelines – but not to be given prophalactically Best Supportive Care: Should be given as appropriate. Includes antiemetics, antibiotics, transfusions, nutritional support, non-radiation palliative treatment for pain, bisphosphonates Prophylactic antimicrobials should be considered in subjects receiving concurrent immunosuppressive therapy and those with lymphopenia and continued until lymphopenia resolves Surgery: Surgery required during the study needs to be discussed with the Abbott Medical Monitor Company Confidential © 2012 Abbott 27

28 Concomitant Therapy – Not Allowed
Not allowed on study: Anticancer Agents: Anticancer agents are not permitted during the treatment portion of the study. All subjects will receive carboplatin/paclitaxel with veliparib/placebo or temozolomide with veliparib during the treatment portion of the study. The locally approved carboplatin, paclitaxel, and temozolomide product labels or SmPCs should be referenced to determine if there are any contraindications associated with concomitant medications. Radiation Therapy: If needed to treat symptoms due to underlying breast cancer, the subject will be discontinued from the study Alternate Therapy: No anti-cancer Chinese medicine/herbal remedies may be taken concurrently with veliparib (a 14-day washout period must be documented) Company Confidential © 2012 Abbott 28

29 Concomitant Medications
Study Visit Procedures

30 Study Visit Procedure Timing
Informed consent must be obtained prior any study procedure; Diagnosis of a deleterious BRCA1 or BRCA2 mutation must be documented prior to randomization and genetic risk assessment and counseling should proceed per NCCN guidelines or institutional standard policy; Screening procedures must be performed within 28 days prior to C1D1; Procedures performed at Screening will serve as baseline unless repeated on C1D1; Baseline radiographic assessment performed within 21 days prior to C1D1; Post Screening and C1D1 study procedures should be performed within 4 days surrounding the scheduled study visit date except labs Company Confidential © 2012 Abbott 30

31 Elicited and/or Spontaneously Reported
Adverse Event Collection Period SAEs SAEs and Non-Serious AEs Elicited and/or Spontaneously Reported Study Drug Start Study Drug Stopped 30 Days after veliparib/placebo, TMZ, carboplatin or paclitaxel are stopped Consent Signed SAEs occurring after the informed consent is signed but prior to the initial dose of investigational product will only be collected if they are considered by the Investigator to be causally related to study required procedures. All serious and non-serious adverse events will be collected from time of study drug administration through 30 days post-therapy. Company Confidential © 2012 Abbott 31

32 Study Visit Procedures for Screening
Medical and oncology history Complete physical exam (PE), including height and weight Vital signs (heart rate, blood pressure, and body temperature) ECOG performance status 12-lead ECG Routine Laboratory tests Hematology, chemistry, aPTT/INR, and urinalysis Serum pregnancy test CT scan (chest, abdomen and pelvis) Full body bone scan BRCA1 and BRCA2 germline mutation (unless BRCA germline mutation status is known per previous Sponsor core lab testing) Company Confidential © 2012 Abbott 32

33 Subject Number Assignment
IVRS/IWRS must be contacted to obtain the subject (screening) number once subject has signed the informed consent AND before a study-specific procedure has been performed If the subject does not proceed to randomization, the reason for screen failure will be recorded on the eCRF Subjects who complete all screening procedures and meet eligibility criteria will proceed to randomization in the IVRS/IWRS prior to C1D1 Company Confidential © 2012 Abbott 33

34 Study Visit Procedures for Cycle 1 Day 1
Symptom-directed PE, including weight If a Screening PE was performed within 7 days of C1D1, PE is not required on C1D1, unless clinically indicated Vital signs ECOG performance status Routine laboratory tests: hematology, chemistry and urinalysis Urine pregnancy test If a urine test is positive on C1D1, it must be confirmed by a serum pregnancy test, and dosing should be delayed until confirmation of negative results 12-lead electrocardiogram Veliparib/TMZ Arm Only: Approximately 2 hours after the first dose of veliparib/TMZ Quality of life questionnaires Company Confidential © 2012 Abbott 34

35 Study Visit Procedures for Veliparib + TMZ Treatment Arm Only
Cycle 1 and Cycle 2 Day 15 study procedures: Physical exam Vital signs ECOG performance status Laboratory tests: hematology and chemistry Cycle 1 and Cycle 2 Day 22 study procedures Routine Laboratory tests: hematology Company Confidential © 2012 Abbott 35

36 Study Visit Procedures for Veliparib/Placebo + Carboplatin/Paclitaxel Treatment Arms Only
Cycle 1 Day 3 study procedures: Vital signs 12-lead ECG approximately 2 hours after the morning dose of veliparib/placebo Administer carboplatin/paclitaxel Cycle 1 Day 17 study procedures: Physical exam ECOG performance status Routine Laboratory tests: hematology and chemistry Day 3 of every Cycle - study procedures: Company Confidential © 2012 Abbott 36

37 Study Visit Procedures for Cycle 2 Day 1 for all treatment arms
Symptom-directed PE, including weight Vital signs ECOG performance status Routine Laboratory tests: hematology, chemistry, and urinalysis Quality of life questionnaires Company Confidential © 2012 Abbott 37

38 Study Visit Procedures for Day 1 of Each Cycle Starting with Cycle 3 for all treatment arms
Symptom-directed PE, including weight Vital signs ECOG performance status Routine laboratory tests: hematology, chemistry and urinalysis Quality of life questionnaires Questionnaires are completed every other cycle after C4 Company Confidential © 2012 Abbott 38

39 Final Visit Study Visit Procedures
Symptom-directed PE, including weight Vital signs ECOG performance status Routine laboratory tests: hematology, chemistry, and urinalysis 12-lead electrocardiogram If not performed within last 4 weeks Quality of life assessment CT scan (chest, abdomen and pelvis) AE assessment Collect unused study drug Company Confidential © 2012 Abbott 39

40 30-Day Follow-up Study Visit Procedures
Symptom-directed PE, including weight Vital signs ECOG performance status Routine laboratory tests: hematology and chemistry Quality of life assessment AE Assessment Follow-up Visit does not need to be performed for subjects who have had a Final Visit conducted ≥ 30 days after the last dose of study drug. Company Confidential © 2012 Abbott 40

41 Concomitant Medications
Study Procedure Clarifications

42 ECG Requirements 12-lead ECGs:
Required approximately 2 hours after morning veliparib dose Subjects randomized to TMZ/Veliparib arm will be required to have an ECG at C1D1 Subjects randomized to Carboplatin/Paclitaxel arm will be required to have a chair side ECG at C1D3 due to the timing of the veliparib dosing A qualified Physician (as delegated by the PI) will document any abnormal findings on the report and sign and date it Company Confidential © 2012 Abbott 42

43 Lab Results Routine Laboratory Test Results:
Local lab may be used for immediate subject management Split or concurrent samples should be drawn and sent to the central lab for analysis Qualified medical staff (as delegated by the PI) will review, initial and date all local and central lab results Veliparib/TMZ Arm: Day 1 of each cycle after Cycle 2, lab samples may be collected within 48 hours prior to dosing Carboplatin/Paclitaxel Arm: Day 1 of each cycle after Cycle 1, lab samples may be collected within 48 hours prior to dosing. If based on these results, the subject is not anticipated to be able to receive carboplatin + paclitaxel on Day 3 of the cycle, then veliparib/placebo on Day 1 should be held until dosing of the entire regimen can resume Company Confidential © 2012 Abbott 43

44 BRCA1/BRCA2 Testing Documentation of BRCA mutation status must occur by one of the following mechanisms prior to randomization: Previous diagnosis of a BRCA1 or BRCA2 mutation If the diagnostic testing for BRCA1/BRCA2 was not conducted by the Sponsor core laboratory, the investigator should ensure that the testing is consistent with local guidelines and clinical practice and that the test employs either direct DNA sequencing/MLPA or a well-characterized methodology previously validated by sequencing, such as that used to assess founder mutations. These subjects must also undergo Sponsor core laboratory BRCA gene sequencing during Screening or on C1D1 NOTE: These subjects may be eligible for randomization prior to receiving results from the Sponsor core laboratory Company Confidential © 2012 Abbott 44

45 BRCA1/BRCA2 Testing (Cont.)
Subjects considered high risk for BRCA1/BRCA2 mutation are eligible for Sponsor core BRCA testing during Screening if they meet one of the following criteria: Breast cancer diagnosed at age ≤ 45 years Diagnosed at age ≤ 50 years with first-, second-, or third-degree blood relative with breast cancer diagnosis ≤ 50 years and/or epithelial ovarian/fallopian peritoneal cancer at any age Diagnosed at age < 60 years with a triple negative breast cancer Two breast primaries when first breast cancer diagnosis occurred prior to age 50 Personal history of epithelial ovarian/fallopian tube/primary peritoneal cancer Diagnosed at any age, with ≥ 2 first-, second-, or third-degree relatives with breast and/or epithelial ovarian/fallopian tube/primary peritoneal cancer at any age First- or second-degree relative of an individual known to carry a deleterious BRCA1 or BRCA2 mutation Ashkenazi Jewish descent Male breast cancer First-, second-, or third-degree male relative with breast cancer NOTE - Patients who pre-qualify with one or more of these criteria will be eligible to screen for BRCA1/BRCA2 mutation by the Sponsor core laboratory. These subjects may be eligible for randomization upon receipt of a confirmed deleterious germline BRCA1/BRCA2 mutation by the Sponsor core laboratory. Company Confidential © 2012 Abbott 45

46 BRCA1/BRCA2 Testing (Cont.)
BRCA Bridging Study In order to permit future bridging studies to other potential BRCA assays, two tubes of blood must be obtained from all subjects to be tested at a future date. This will be in addition to the sample collected for the Sponsor core laboratory BRCA test.* *These two tubes will be collected even if no sample for the Sponsor core lab was required for entry into the study. Company Confidential © 2012 Abbott 46

47 Tumor Assessments CT scan of the chest, abdomen and pelvis
Non‑contrast CT may be performed if a subject is unable to undergo a CT scan with IV contrast due to allergy or renal insufficiency MRI scans can be conducted if local laws or requirements mandate it; sponsor or central imaging center approval is required prior to MR Performed every 9 weeks from C1D1 Tumor assessments may be conducted 8 days prior or 2 days following the scheduled assessment from C1D1 Scheduled tumor assessments will not be affected by delays in therapy and/or drug holidays Scans should be assessed per RECIST, Version 1.1 Scans will be sent to a central imaging center within 2 days of collection for review Interpretations from the central imaging center will not be sent to the site Subject treatment management will be based on review by the local investigator and/or site staff All events of disease progression must be confirmed by the central imaging center If progression is not confirmed, the subject should remain on study and continue to undergo the scheduled assessment until objective evidence of progression is obtained Company Confidential © 2012 Abbott 47

48 Tumor Assessments (Cont.)
A full body bone scan is required at Screening Subsequent bone scans will be performed as clinically indicated or per the institution’s standard of care If a lesion is identified by PE, or a skin lesion is present, a report including the information below, must be submitted to Abbott. Abbott will, in turn, review and submit for central review Location Size in mm, assessed using calipers Color (for skin lesions) For documentation, a color photograph of the lesion should be taken. This photograph should include a ruler (metric) so that scale can be determined if the photograph is reviewed at a later time. The color photograph will not be forwarded to Abbott or the central imaging vendor New lesions will not be considered progressive disease, unless confirmed as increasing destruction/lytic on CT/MRI Increasing sclerosis will not be considered PD New lesions or increasing sclerosis of existing bone lesions (flare) must be evaluated by CT/MRI Company Confidential © 2012 Abbott 48

49 Disease Progression Disease progression will be defined by RECIST, Version 1.1 Clinical data that support progression will be collected and submitted for central review – monitors may be requested by CPM to obtain copies of individual subject cytology reports for submission to Abbott. Abbott will, in turn, review and submit for central review Clinical progression may be characterized, but not limited to, An increase of at least 2 points in ECOG performance status attributable to cancer progression Requirement for palliative radiation, chemotherapy, or surgery, or death from disease progression Every effort will be made to document radiographic or clinical evidence of progression for analysis of the primary endpoint, even after discontinuation of treatment Company Confidential © 2012 Abbott 49

50 Quality of Life Questionnaires
Subjects will complete paper questionnaire worksheets EORTC QLQ-C15/BR23 38-item validated questionnaires (< 15 minutes to complete) to assess health-related quality of life items, including physical and emotional well-being, and breast symptom-specific questions Note: The QlQ-BR23 is a module of the QLQ-C30. The QLQ-C30 (30-item questionnaire) is not being used for this study; therefore, the QLQ-BR23 questionnaire administered to the study subjects will begin with question number 31. Subjects randomized to the veliparib/placebo + carboplatin + paclitaxel treatment arms will complete an addition questionnaire worksheet EORTC QLQ-CIPN20 20-item validated questionnaire (< 7 minutes to complete) to assess CIPN related symptoms Note: The QLQ-CIPN20 is a module of the QLQ-C30. The QLQ-C30 (30-item questionnaire) is not being administered for this study, therefore the QLQ-CIPN20 questionnaire administered to the study subjects will begin with question number 31. Site personnel will check the forms for completion before the subject leaves the clinic; If subject is unable to complete, qualified site personnel may administer by interview and complete the forms for the subject The data from these worksheets will be entered into EDC by the site staff Company Confidential © 2012 Abbott 50

51 Concomitant Medications
Study Medication

52 Study Medication Overview
Veliparib/placebo, temozolomide, carboplatin and paclitaxel will be supplied by Abbott Bottles/vials will be dispensed by IXRS Subjects will be provided self-administration instructions and dosing cards to record the date/time the veliparib/placebo and temozolomide were administered Subjects will be instructed to return all veliparib/placebo and temozolomide bottles (empty, partially filled or full) prior to each cycle and the Final Visit Drug accountability will be performed via the IXRS Company Confidential © 2012 Abbott 52 52

53 Study Medication Overview
Veliparib/placebo will be supplied in the following capsule strengths: 10 mg active 20 mg active/placebo 40 mg active/placebo Temozolomide will be supplied in the following capsules strengths: 5 mg 20 mg 100 mg Carboplatin will be supplied in the following strengths: 150 mg/15 mL vials 450 mg/45 mL vials Paclitaxel will be supplied in the following strengths: 100 mg/16.7 mL vials 53

54 Study Drug Storage Conditions
All clinical supplies provided by Abbott must be stored in a secure place at the proper storage conditions, until they are dispensed for subject use, destroyed or returned to Abbott 54

55 Veliparib/placebo and Temozolomide Dosing Information:
If less than 6 hours have passed since the scheduled dosing time, recommend taking the dose immediately If a subject vomits within 15 minutes of taking veliparib/placebo, another dose should be taken. This can only be repeated once. If more than 15 minutes have passed from time of dosing, no additional doses should be taken If a subject vomits within 15 minutes of taking TMZ, another dose should not be taken Company Confidential © 2012 Abbott 55 55

56 Concomitant Medications
Study Medication Veliparib + Temozolomide

57 Veliparib + TMZ Treatment Arm
Veliparib 40 mg BID is administered on Days 1 through 7 TMZ 150 to 200 mg/m2 QD Days 1 through 5 in each 28-day cycle Days 1 2 3 4 5 6 7 8-28 Veliparib Twice a Day TMZ* Once a Day with a.m. veliparib *Taken under fasting conditions (to reduce the chance of nausea and vomiting per the TMZ label recommendation) = No drug dosing Company Confidential © 2012 Abbott 57

58 TMZ Dose Escalation after Cycle 1
The starting dose of TMZ at C1D1 will be 150 mg/m2/day to be given on Days 1 thru 5. The TMZ dose is determined using the body surface area (BSA) calculated from the height obtained at baseline and the weight obtained prior to each cycle. The daily dose may be rounded down to 5% from the calculated dose in order to minimize the number of capsules per dose. The TMZ dose will be escalated to 200 mg/m2/day at C2D1 only if during Cycle 1: Platelets (nadir) are > 100,000/µL and ANC (nadir) is > 1,500/µL and No Grade 3 or 4 CTCAE non-hematological toxicities attributable to TMZ are observed If the dose was not escalated at Cycle 2, then the dose cannot be escalated in subsequent cycles. For all cycles, dose delays and reductions will be managed according to Section 5.7 of the protocol. Company Confidential © 2012 Abbott

59 Daily Dose Calculations by BSA for Temozolomide
Company Confidential © 2012 Abbott 59 59

60 150 mg/m2 per day x 5 days (Cycle 1 Dose)
TMZ Dose Modifications Following Cycle 1 Hematological Toxicity Attributable to TMZ 150 mg/m2 per day x 5 days (Cycle 1 Dose) Based on lowest counts at either Day 22 or Day 29 ANC <1000/µL or Platelets <50,000/µL ANC 1,000/µL to 1500/µLor Platelets 50,000/µL to 100,000/µL ANC >1500/μL and platelets >100,000/μL, and no Grade 3 or 4 clinically significant toxicities attributable to TMZ Postpone therapy until ANC >1500/μL and platelets >100,000/μL Postpone therapy until ANC >1500/μL and platelets >100,000/μL Increase dose to 200 mg/m2 per day × 5 days for subsequent cycle Reduce dose by 50 mg/m2 per day for subsequent cycle Maintain initial dose of 150 mg/m2 per day for subsequent cycle Company Confidential © 2012 Abbott 60

61 TMZ Dose Reductions Starting in Cycle 2 Non-Hematological Toxicity Attributable to TMZ
150 mg/m2 per day x 5 days (Cycle 1 Dose) Nausea/Vomiting CTC ≥ Grade 3 Despite optimal antiemetic therapy Fatigue, constipation, anorexia and headaches CTC ≥ Grade 3 Any other CTC ≥ Grade 3 deemed to be clinically significant by PI Hold TMZ + Veliparib Delay cycle until Grade 1 (or Grade 2, if present at baseline) Reduce Veliparib dose by one dose level Veliparib should be discontinued at the same time as TMZ Company Confidential © 2012 Abbott 61

62 Veliparib + TMZ Dose Reductions
62

63 Veliparib + TMZ Discontinuation
Subjects may receive veliparib + TMZ for up to 24 cycles, or until reaching a protocol-defined event of disease progression or experiencing unmanageable toxicity The investigator and Abbott will develop a plan to continue treatment beyond 24 cycles if a subject has not progressed If toxicities have resulted in discontinuation of either veliparib or TMZ, both are to be discontinued Subjects who discontinue treatment with veliparib + TMZ prior to an event of disease progression should remain on study and continue to follow the schedule for study visits and procedures until disease progression is experienced Company Confidential © 2012 Abbott 63

64 Concomitant Medications
Study Medication Veliparib + Carboplatin/Paclitaxel and Placebo + Carboplatin/Paclitaxel

65 Veliparib/Placebo + Carboplatin/Paclitaxel Treatment Arms
Veliparib/Placebo 120 mg BID Days 1 through 7 + carboplatin AUC 6 administered on Day 3 and paclitaxel 175 mg/m2 administered on Day 3 of each 21-day cycle Days 1 2 3 4 5 6 7 8-21 Veliparib or Placebo Twice a Day Twice a Day* Paclitaxel** IV Infusion Carboplatin = No drug dosing *Morning dose of veliparib/placebo on Day 3 of every cycle should be taken before the carboplatin/paclitaxel infusion **Paclitaxel will be infused before Carboplatin Company Confidential © 2012 Abbott 65

66 Max Dose if Serum Creatinine by IDMS Veliparib/Placebo BID
Veliparib/Placebo + Carboplatin/Paclitaxel Dose Reductions (Amendment 1) Carboplatin Dose Level Carboplatin (AUC) Max Dose if Serum Creatinine by IDMS Starting Dose 6 900 mg Dose Level -1 5 750 mg Dose Level -2 4 600 mg Paclitaxel Dose Level Paclitaxel (mg/m2) Starting Dose 175 Dose Level -1 135 Dose Level -2 110 Veliparib/Placebo Dose Level Veliparib/Placebo BID Strength Capsules per Dosing Starting Dose 120 mg 40 mg 3 BID Dose Level -1 80 mg 2 BID Dose Level -2 1 BID

67 Dose Reductions/Delays
For all cycles, dose delays and reductions will be managed according to Section 5.7 of the protocol The monitor should be contacted for subjects who require more than a 2-week delay in the re-initiation of the next cycle. All dose reductions are considered permanent. Company Confidential © 2012 Abbott 67 67

68 Veliparib/Placebo + Carboplatin/Paclitaxel Discontinuation
All subjects will continue on Veliparib/Placebo + Carboplatin/Paclitaxel until: A protocol-defined event of disease progression; or Experience unmanageable toxicity Subjects may continue on the remaining agent in combination with veliparib Any veliparib/placebo dose reduction beyond 40 mg BID will result in veliparib/placebo discontinuation If toxicities have resulted in discontinuation of both carboplatin and paclitaxel, veliparib will also be discontinued At the investigator's discretion, carboplatin and paclitaxel administration may continue after veliparib has been discontinued Subjects who discontinue treatment with veliparib/placebo + carboplatin/paclitaxel prior to an event of disease progression should remain on study and continue to follow the schedule for study visits and procedures until disease progression is experienced Company Confidential © 2012 Abbott 68

69 Concomitant Medications
Subject Discontinuation, Status Changes and Survival Follow-up

70 Removal of Subjects from Therapy or Assessment
Each subject has the right to withdraw from study treatment at any time If necessary, the investigator may discontinue a subject from study treatment at any time and for any reason, including the occurrence of an AE or noncompliance with the protocol Subjects will be withdrawn from the study if any of the following occur: Disease progression as defined by RECIST (version 1.1) Investigator believes it is in the best interest of the subject Clinically significant deterioration of the subject's medical status, as determined by the investigator Pregnancy Withdrawn consent Alternative anti-cancer therapy is indicated Any other medical reason that Abbott or the Investigator deems appropriate Company Confidential © 2012 Abbott 70

71 Discontinuation of Individual Subjects
Abbott should be informed prior to discontinuation of any subject (if discontinuing without reaching a protocol-defined endpoint) When a subject discontinues the study, a Final Visit will be conducted (preferably prior to the initiation of another anticancer therapy) These procedures should not interfere with the initiation of any new treatments or therapeutic modalities The reasons for discontinuation will be recorded Final Visit procedures will be performed, as soon as possible after discontinuation from the study Company Confidential © 2012 Abbott 71

72 Discontinuation of Individual Subjects (cont’)
All subjects will have one Follow-up Visit approximately 30 days after the last dose of study drug Follow-up Visit does not need to be performed for subjects who have had a Final Visit conducted ≥ 30 days after the last dose of study drug Subjects who discontinue treatment prior to an event of disease progression should remain on study and continue to follow the schedule for study visits and procedures until disease progression is experienced, if possible Report subject status changes to the IVRS/IWRS system within 3 days. This should be captured as a “Subject Status Change” in the IVRS/IWRS and noted as “on study – off drug” (temozolomide, carboplatin, paclitaxel, veliparib/placebo) Company Confidential © 2012 Abbott 72 72

73 Post Study Assessments- IVRS/IWRS
Report subject discontinuations to the IVRS/IWRS system within 3 days of the subject's discontinuation Post Study Assessment data is collected every month or as requested by Abbott to support data analysis for up to 3 years, until the endpoint of death, subject is lost to follow-up or until study termination by Abbott Information can be obtained through phone calls, review of medical records, etc. Data collected: Survival information (date and cause of death) If known, post study anti-cancer therapies, dates of initiation, and end dates Company Confidential © 2012 Abbott 73

74 Interim Analyses

75 Safety Interim Analyses
To ensure subject safety, an IDMC will review unblinded safety data (which will include all subjects enrolled in the study) when approximately 36 subjects enrolled under Amendment 1 have met at least one of the following criteria: Received 2 cycles of treatment Reached an event of disease progression Discontinued the study due to toxicity/adverse events Subsequent reviews will be based on recommendations from the IDMC 75

76 Futility Interim Analyses
An interim futility analyses will be conducted and reviewed after the week 27 tumor assessment of the first 30 subjects randomized to the veliparib/TMZ treatment arm If futility is declared, at the time of futility analyses any subjects currently receiving veliparib/TMZ will be allowed the option of either: Receiving veliparib + carboplatin + paclitaxel, or Discontinuing therapy and remain on study and continue to follow the schedule for study visits and procedures until they have reached an event of disease progression 76

77 Concomitant Medications
Completing Electronic Case Report Forms (eCRFs) + Non-CRF Forms Related to Adverse Event Reporting Concomitant Medications Safety Reporting Completing Electronic Case Report Forms (eCRFs) + Non-CRF Forms Related to Adverse Event Reporting

78 Adverse Event Reporting Agenda
Adverse Event/ Serious Adverse Event Definitions Key Elements of Adverse Event Reporting Common Problems When Reporting Adverse Events Completing SAE-related eCRFs Subject Identifying Information SAE Collection and Reporting Requirements Company Confidential © 2012 Abbott 78

79 Adverse Event Defined An adverse event/experience is any untoward medical occurrence in a study subject/patient administered a pharmaceutical product, which does not necessarily include a causal relationship to the study drug. Company Confidential © 2012 Abbott 79

80 What is an Adverse Event?
An adverse event may be: A sign, symptom, disease or medical diagnosis (not the intervention) An abnormal laboratory finding or changes in vital signs if: It results in premature discontinuation It necessitates therapeutic medical intervention The investigator considers it an adverse event Meets protocol-specific criteria Any worsening of a pre-existing condition or illness Any change in physical exam findings deemed by the investigator to be clinically significant Note: Any complications of an event should be reported as separate events Company Confidential © 2012 Abbott 80

81 Adverse Event: Severity
Seriousness is defined from a regulatory perspective “Severe” events are not necessarily serious “Severe” is a measure of intensity If a reported adverse event increases in severity, the initial adverse event should be given an outcome date and a new adverse event reported to reflect the change in severity. For all reported serious adverse events that increase in severity, the supplemental eCRF’s also need to be updated to reflect any changes due to the increase in severity, and the new AE serial number. Company Confidential © 2012 Abbott 81

82 What is a Serious Adverse Event?
Serious criteria: Life-threatening Hospitalization or prolonged hospitalization Important medical event requiring medical or surgical intervention to prevent serious outcome Persistent or significant disability/incapacity Death of subject Congenital anomaly Miscarriage/spontaneous abortion (Abbott specific) Elective abortion (Abbott specific) Company Confidential © 2012 Abbott 82

83 Key Elements of AE Reporting
Onset Date: Reflects when the signs and symptoms began, not when the subject reported them or was questioned about them. For Serious Adverse Events, this date may or may not reflect the date that the event became serious. Company Confidential © 2012 Abbott 83

84 Key Elements of AE Reporting:
Event Diagnosis Is a single medical concept/condition that encompasses all signs and symptoms of an event Must be supported by evidence Record diagnosis only (if known) Example: The subject experienced cough, fever, & shortness of breath and a diagnosis of pneumonia was made. Record the event diagnosis as Pneumonia Pneumonia An event diagnosis is a single medical concept/condition that encompasses all signs and symptoms of an event and must be supported by evidence (e.g. chest x-ray confirming pneumonia) Record only the diagnosis when known For example, let’s say that <Enter> the subject experienced cough, fever and shortness breath and was diagnosed with pneumonia. <Enter> Only the pneumonia should be recorded on the CRF. Company Confidential © 2012 Abbott 84

85 Key Elements of AE Reporting
Event Diagnosis Signs and symptoms not represented by the event diagnosis must be reported as separate events. Example: The subject experienced cough, fever, shortness of breath and diarrhea with a diagnosis of pneumonia. Pneumonia and diarrhea would be reported as two separate events Company Confidential © 2012 Abbott 85

86 Key Elements of AE Reporting
Event Diagnosis If a diagnosis has not been made or is unknown, record the sign/symptom, one per line. -Example: The subject experienced nausea and vomiting, but no diagnosis (such as gastroenteritis) was made or confirmed. nausea vomiting If the diagnosis has not been made or is unknown, record only the sign/symptom, one per line. For example, <Enter> if the subject experienced nausea and vomiting, but no diagnosis (such as gastroenteritis) was made, <Enter> record only the nausea and vomiting (one per line). Company Confidential © 2012 Abbott 86

87 Key Elements of AE Reporting
Final Diagnosis If signs/symptoms were initially recorded and a diagnosis was subsequently made, change the sign/symptoms to the diagnosis. Example: The subject experienced nausea and vomiting, but no diagnosis (such as gastroenteritis) was made. The signs/symptoms were recorded. Subsequent follow-up confirmed diagnosis of gastroenteritis. Nausea Vomiting The confirmed diagnosis of gastroenteritis should replace the symptoms of nausea and vomiting gastroenteritis Company Confidential © 2012 Abbott 87

88 Key Elements of AE Reporting
Confirmed diagnosis should replace the symptoms. To change the event term to the final diagnosis: Highlight the sign and symptoms Hit delete – Do not use backspace bar Enter Final Diagnosis Company Confidential © 2012 Abbott 88

89 Key Elements of AE Reporting
End Date The end date should reflect the actual date the event resolved; not the date on which the subject was questioned about it If the AE has not resolved at the end of the study an “ongoing as of” date should be used and should reflect the date of the last visit End date must be documented in the source documents Company Confidential © 2012 Abbott 89

90 Key Elements of AE Reporting
Time Course of Event Duration – if less than 24 hours Intermittent Yes would indicate sporadic No would indicate continuous Company Confidential © 2012 Abbott 90 90 90

91 Key Elements of AE Reporting
Action Taken Check all that apply none Medication taken Diagnostic/Therapeutic procedure Emergency room/Hospital outpatient <24 hours Discontinued study- related to progression Discontinued study-not related to progression Other Interruption, discontinuation, dose reduction, delay of study drug as an action taken and must be completed for Veliparib, TMZ, Carboplatin, Paclitaxel Actions taken for an AE are found in the source documents Company Confidential © 2012 Abbott 91 91 91

92 Adverse Event: Other Cause of Event
Other Cause of the Event is required when the event meets serious criteria and the causality is: Possibly related Probably not related Not related It should not be the same as the event reported. Company Confidential © 2012 Abbott 92 92 92

93 Ensuring Quality Safety Data
Adverse Events Recorded events must: Be sufficiently descriptive and clear Convey a recognized medical concept/condition Avoid abbreviations Avoid use of provisional terms such as possible, probable, rule out If a reported adverse event increases in severity the initial adverse event should be given an outcome date and a new adverse event reported to reflect the change in severity. For all reported serious adverse events that increase in severity, the supplemental eCRFs also need to be updated to reflect any changes due to the increase in severity. Company Confidential © 2012 Abbott 93 93 93

94 Common Problems: Vague or Ambiguous Terms
The event description is vague or ambiguous Example: Congestion Problem: the symptom “congestion” is ambiguous Resolution: clarify the term by adding the type of congestion Chest congestion Nasal congestion Sinus congestion Example: Cramps Problem: the event description of cramps is vague or ambiguous. Resolution: clarify the term by adding the type of cramps Menstrual cramps Abdominal cramps Leg cramps Company Confidential © 2012 Abbott 94 94 94

95 Common Problems: Provisional Terms
The event description is an unconfirmed diagnosis, such as “possible”, “questionable”, “rule out” If no confirmed diagnosis is available, then the signs/symptoms should be provided Example: Possible MI Problem: Provisional term is reported Resolution: Provide Signs/symptoms Cardiac chest pain Dyspnea Company Confidential © 2012 Abbott 95 95 95

96 Common Problems: Unrecognized Medical Concepts
The event term is an unrecognized medical concept, spelling error, or reported in a foreign language Example: Inestability Problem: event term provided in a foreign language Resolution: event terms must be reported in English Inestability = Dizziness Company Confidential © 2012 Abbott 96 96 96

97 Common Problems: Abbreviations
An abbreviation is used in the event term Problem: An abbreviation may have multiple meanings Resolution: Abbreviations should not be used, except for standard laboratory abbreviations such as ALT Example: Increased BS Report as: Increased Blood sugar Company Confidential © 2012 Abbott 97 97 97

98 Common Problems: Reporting Procedures
A procedure is reported as an adverse event Example: Hysterectomy Problem: Hysterectomy is a surgical procedure Resolution: Report the underlining condition: Uterine Fibroids Procedures should be reported as the “action taken/other specify” Company Confidential © 2012 Abbott 98 98 98

99 Common Problems: Abnormal Laboratory Values
When reporting abnormal lab values as adverse events Specify the result as: increased, decreased, elevated, etc. Example: “Elevated AST” Avoid reporting the actual results of lab tests. Don’t report: “Platelets 78,000” Report: “Thrombocytopenia” Indicate the specimen source: blood, urine, cerebrospinal fluid, etc. Don’t report : “Increased creatinine” Report: “Increased serum creatinine ” Report the condition instead of the abnormal lab value Don’t report : “Decreased Sodium” Report: “Hyponatremia” Company Confidential © 2012 Abbott 99 99 99

100 Reporting Pregnancy Pregnancy is not an adverse event.
If a subject becomes pregnant: Notify Abbott within one working day of becoming aware of the pregnancy The subject must be discontinued from the study Pregnancy information will be collected on pregnancy specific CRFs, including outcome of the pregnancy Company Confidential © 2012 Abbott 100 100

101 Reporting Adverse Events of Cancer
New primary (secondary) malignancies should be reported as adverse events. The investigator determines if event also meets SAE criteria. Treatment of new primary malignancies may involve multiple, planned hospitalizations for chemotherapy and/or radiation Recurring hospitalizations for the same malignancy will be considered as follow-up and should be documented in the narrative portion (Form 752NC) of the initial event Complications or other coincidental adverse events occurring during subsequent hospitalizations should be captured as separate adverse events Company Confidential © 2012 Abbott 101 101 101

102 SAE-Related Electronic Case Report Forms
Required eCRFs: Adverse Event Investigator SAE Supplemental SAE Study Drug Information SAE Supplemental Trigger If applicable: SAE Supplemental Microbiology SAE Supplemental Laboratory SAE Supplemental Procedures The following eCRFs must also be completed when reporting an initial SAE: Other Medications and Supplements Demographics Medical/Surgical History Tobacco and Alcohol Use Company Confidential © 2012 Abbott 102 102 102

103 Adverse Event eCRF Additional AE eCRFs may be necessary for reporting multiple SAEs at once. Each AE eCRF has an unique serial number that is specific to that adverse event. Company Confidential © 2012 Abbott 103 103 103

104 SAE Supplemental Trigger
SAE Supplemental Trigger needs to be completed to populate the SAE Supplemental pages #1- Enter Adverse event number(s) #2- Always Check Investigator SAE Supplemental and SAE Study Drug Information pages #3- Select SAE Supplemental Laboratory, Microbiology and Procedure as applicable to SAE Company Confidential © 2012 Abbott 104 104

105 SAE Study Drug Information
SAE Study Drug Information page was created to capture drug dosing information at the time of the SAE. #1- Enter AE numbers #2- Enter dose, route and frequency #3- Enter drug start date #4- Answer: Has study drug been interrupted for this event? Company Confidential © 2012 Abbott 105 105

106 SAE Study Drug Information (cont)
# 5a-Provide date last dose taken prior to interruption (if applicable) #5b-Answer if study drug was re-introduced (if applicable) #5c-Provide date re-introduced (if applicable) #5d- Answer Did event reappear? #5e- Provide which event's) reappeared #6- Answer if study drug has been permanently discontinued #7- Provide date of last dose if permanently discontinued Company Confidential © 2012 Abbott 106 106

107 Investigator SAE Supplemental
#1 Enter adverse event serial number(s) #2 Dates of hospitalization; admission date and discharge date (if applicable) #3 Transcribe the relevant admission history and physical- do not fax a copy of the H&P #4 Weight at time of event #5 Provide any risk factors relevant to events #6 Any family history relevant to events Company Confidential © 2012 Abbott 107 107 107

108 Investigator SAE Supplemental (con’t)
#7 Signs and symptoms associated with current serious adverse events #8 If the subject experienced the event before #9 Clinical course of event Company Confidential © 2012 Abbott 108 108 108

109 Investigator SAE Supplemental
Clinical Course of event should include: What lead up to the event Admitting diagnosis Relevant clinical course Diagnostic and/or therapeutic interventions and results Treatment and outcomes Final diagnosis as related to the event Resolution i.e. discharged from hospital, transferred to extend care facility The Clinical Course of event should be documented similar to hospital record progress note All relevant information found on the discharge summary should be transcribed onto the SAE eCRFs. The discharge summary should not be faxed in unless specifically requested by Abbott. Company Confidential © 2012 Abbott 109 109 109

110 Additional SAE-related Data
Lab and Procedure Data SAE supplemental Laboratory SAE supplemental Microbiology SAE supplemental Diagnostic/Therapeutic Procedures These pages should be completed with relevant SAE-related results. Transcribe test/procedure results from source documents to the eCRFs. Do not send the hospital lab reports or diagnostic reports. Only include tests performed specifically for the SAE(s) being reported. Relevant discharge summary data (laboratory and diagnostic tests and results) should be recorded on the appropriate page. Do not send in the discharge summary. If lab data or diagnostic test results are not available at the time of the SAE, they should be provided as follow-up. Company Confidential © 2012 Abbott 110 110 110

111 SAE-related Documents
If specifically requested by Abbott death certificates and autopsy reports should be faxed to Abbott The subject’s identifying information must be obscured and replaced with the subject’s unique number and protocol number. The designated Cover memo (750NC paper CRF) should be used when faxing these documents Discharge Summaries should not be faxed to Abbott unless specifically requested by Abbott. Company Confidential © 2012 Abbott 111 111 111

112 Documents Containing Subject Identifying Information
The subject’s identifying information must be obscured and replaced with the subject’s unique number and protocol number (if applicable) Case Report Forms (e.g. SAE supplemental narrative) Adverse Event Reporting Forms Local lab reports ECG/Echo reports X-rays/radiology reports Hospital discharge summaries (if requested) Admission notes History & physical Consultation reports Subject diaries Photos Autopsy reports/ Discharge summaries Company Confidential © 2012 Abbott 112 112

113 Subject Identifying Information
Subject name/initials Subject hospital identifying number US social security number or equivalent for other countries Laboratory assigned identifying numbers Subject contact information (e.g. addresses, phone numbers, addresses) Company Confidential © 2012 Abbott 113 113

114 SAE Reporting Non-CRF Process
Transcribe the SAE information on the 500 AE CRF, 750 NC through the 755NC CRFs Once access to Rave is available the most current data will need to be entered into the Rave system Company Confidential © 2012 Abbott 114 114

115 SAE Reporting Non-CRF Process
If the AE meets criteria for an SAE, and the Rave system is not accessible complete the following SAE Non-CRF forms for the initial SAE: SAE Cover Memo (Investigator to Abbott) 750NC Adverse Event CRF (Form 500AE) Subject Information (751NC) Narrative Description (752NC) Other Medications/Subject Medical History (753NC) Laboratory/Diagnostic/Therapeutic Procedures form (754NC) only if applicable to the SAE being reported. Investigator Serious Adverse Event Non-CRF Supplemental Change Form (Form 755NC) if applicable Company Confidential © 2012 Abbott 115 115

116 Cover Memo (750 NC) A new cover memo should be used with each faxed report (initial or follow-up) – Remember to check whether initial or follow-up Collect required documents and check the boxes on the SAE Cover Memo to indicate which items are being sent It is recommend photocopies of this form be made so the supply is adequate It must be signed by the principal investigator Company Confidential © 2012 Abbott 116 116

117 Adverse Event (Form 500AE)
Report the event diagnosis if known. If the event diagnosis is unknown report the signs and symptoms. One sign/ symptom per line. Signs and Symptoms vs. Event Diagnosis: If the subject’s signs and symptoms are characteristic components of a single, confirmed, event diagnosis, a single AE CRF should be completed. Enter the diagnosis in the event diagnosis field (Box #2). If, however, the subject has additional signs/symptoms that are not components of this final diagnosis, those signs/symptoms should be collected on separate AE CRFs. A separate AE CRF should be completed for a medical complication of a diagnosis. Company Confidential © 2012 Abbott 117 117 117

118 Adverse Event (Form 500AE) (con’t)
AE page continuation. Company Confidential © 2012 Abbott 118 118 118

119 Investigator SAE Supplemental (751NC)
Subject’s birth date, gender, race, weight, drug start date, study drug administration schedule at the time of the SAE, drug interruption and permanent discontinuation information should be provided, as well as information regarding previous episodes, tobacco and alcohol use. Company Confidential © 2012 Abbott 119 119 119

120 Investigator SAE Supplemental (752NC)
Dates of hospitalization; admission date and discharge date (if applicable) Transcribe the relevant admission history and physical- do not fax a copy of the H&P Provide the signs and symptoms associated with the current serious adverse event(s) Provide clinical course By no means should the sites’ inability to sign these documents hold up SAE reporting. The principal investigator may delegate signature of these forms, as appropriate, during periods of absence from site. However, his/her signature will still be required Company Confidential © 2012 Abbott 120 120

121 Investigator SAE Supplemental (752NC) (cont.)
The clinical course of the event should include: What preceded the event Signs and symptoms Admitting diagnosis and date of hospitalization Admitting History & Physical Relevant clinical course Diagnostic and/or therapeutic interventions and results Treatment and outcomes Final diagnosis as related to the event Resolution i.e. discharged from hospital, transferred to extend care facility Company Confidential © 2012 Abbott 121 121

122 Other Medications + Supplements/Medical History (753NC)
Record the name (trade name preferred) start and end date dose including units frequency reason for use Medical history: Record any relevant past medical history including onset date Family history Pregnancy history Risk factors and occupation. Company Confidential © 2012 Abbott 122 122

123 SAE Relevant Non-CRF Laboratory and Diagnostic/Therapeutic Procedures (754NC)
Record any laboratory and/or microbiology results pertaining to the diagnosis or management of the SAE. The laboratory test may have been collected in the hospital or elsewhere. Include pertinent negative as well as positive values Include the reference range for the lab test being reported Record the results of any diagnostic or therapeutic procedure performed to Laboratory/Diagnostic/Therapeutic Procedures (754NC) should be faxed to Abbott only if it is applicable to the SAE being reported. Company Confidential © 2012 Abbott 123 123

124 Investigator SAE Supplemental (755NC)
This narrative is very important to the understanding and proper assessment of the SAE by Abbott, and should be clearly and concisely written, accurately describing the course of the SAE, signed and dated by the principal investigator The clinical course should be continued on the 756 NC if needed Company Confidential © 2012 Abbott 124 124

125 Collection Timeframe . All serious and non-serious adverse events will be collected from time of study drug administration through 30 days post-therapy. Company Confidential © 2012 Abbott 125 125 125

126 SAE Reporting Requirements
Once the subject is randomized their data will be entered into EDC and both non-serious and serious adverse events will be collected. SAEs must be reported within 24 hours of site awareness by entering the data into EDC Completed by Required eCRF forms Additional required eCRF forms Investigative Site Adverse Event Form Subject Demographics Subject Medical History Tobacco and Alcohol Other Medications SAE Supplemental Form (SAESUPP1) (micro, labs, diagnostic data, if applicable) (SAESUPP2) Company Confidential © 2012 Abbott 126 126

127 SAE Reporting Requirements
Screening SAEs Since subject data will not be entered into EDC until randomization, SAEs that occur during screening will be reported using paper SAE forms (Non-CRF Process packet). Abbott Safety must be notified within 24 hours of site awareness, via fax. Completed by Required Non-CRF forms If applicable Investigative Site SAE Cover Memo (750NC) AE form (500AE) Supplemental forms: Subject Information (751NC) Narrative Description (752NC) Medications/Med Hx (753NC) Laboratory/Diagnostic/ Procedure form (754NC) Documentation of any changes to initial SAE (755NC) Company Confidential © 2012 Abbott 127 127

128 SAE Reporting Requirements
SAEs must be reported within 24 hours of site awareness by entering the data into EDC Within 24 hours of receiving additional relevant information about the SAE (lab data, diagnostic test results, etc.) the site must enter the updated SAE data into EDC or Fax reports (death certificates and autopsy reports only) to Abbott A phone call is NOT a report and does not meet your reporting obligations Company Confidential © 2012 Abbott 128 128

129 Contact Information Medical Monitor Stacie Shepherd MD, PhD Office: Fax: Cell: Safety Management Team Sharon Bolster-Mills, RN, Lead CSA Telephone: Nida Martinez, RN, Sr. CSA (Back-up) Telephone: SAFETY TEAM PHONE: SAFETY TEAM FAX: SAFETY MANAGEMENT Company Confidential © 2012 Abbott 129 129

130 Concomitant Medications
Perceptive Imaging

131 General Guidance Please adhere to Perceptive’s Imaging acquisition guidelines Please remove all confidential patient/site information and any tumor markings from the images Spiral/helical CT scanners strongly preferred CT images acquired on PET/CT scanner are acceptable as long as they are of diagnostic quality and adhere to the guidelines Company Confidential © 2012 Abbott 131 131 © 2010 Perceptive Informatics, Inc. A PAREXEL® Company

132 General Guidance: Consistency
Baseline and subsequent scans should be performed using identical techniques, including: Timing of contrast administration Brand, dosage and timing of contrast agent Scanner Axial slices Same method, radiological or physical, should be employed at each tumor assessment visit Same individual should assess on each occasion Company Confidential © 2012 Abbott 132 132 132

133 Imaging Requirements Modality Anatomy
CT (MRI) Anatomy CT Chest-Abdomen-Pelvis with i.v. Contrast MRI can be conducted in cases where local laws or requirements mandate, prior sponsor or central imaging center approval is required If iodine contrast is medically contraindicated: Chest, Abdomen, Pelvis CT without i.v. contrast  Other areas if clinically indicated Schedule at every timepoint Company Confidential © 2012 Abbott 133 133

134 CT Oral Contrast Options
Please make sure, whenever possible, to administer oral contrast In decreasing order of preference are: Radio opaque agents (examples include iodine and barium based agents) Radio-lucent agents (Whole Milk, VoLumen®, Water) Company Confidential © 2012 Abbott 134 134 © 2010 Perceptive Informatics, Inc. A PAREXEL® Company

135 Imaging Requirements Modality
Bone scan – with correlative imaging (CT/MRI) Schedule Required at baseline Subsequently if clinically indicated Company Confidential © 2012 Abbott 135 135 135

136 Image Transfer to Perceptive Informatics
Digital Transfer AGMednet (preferred) all images uncompressed DICOM Shipment of digital media Digital Media will be provided by Perceptive If using optical disc, submission shall be limited to 2 studies per disc at a maximum (1 patient / study on each disc side) Remove/Mask patient identifiers Company Confidential © 2012 Abbott 136 136 136

137 Image Transfer to Perceptive Informatics
Hardcopy Film (if digital is not possible) Duplicate original (laser-printed) hard copies films should be obtained at imaging (one tol be sent to Perceptive) Number of images per film and display FOV must be kept constant. Each hardcopy should include no more than 20 images per film Mark the RIGHT side with a point source on each projection Circle the marker on the film Note the site of injection on the film For all methods Keep imaging data (including raw/original data if possible) digitally archived until Perceptive has provided feedback to the quality of the images Send ALL images acquired to Perceptive until instructed otherwise Company Confidential © 2012 Abbott 137 137 © 2010 Perceptive Informatics, Inc. A PAREXEL® Company

138 Perceptive Contacts Patrick Raleigh Project Manager
Tel.: Julissa Pina Imaging Operations Lead Tel.: Marvin Carlos Medical Research Scientist Marvin. Annette Schmid, PhD Medical Director Company Confidential © 2012 Abbott 138 138

139 ICON Central Laboratories
Company Confidential © 2012 Abbott 139

140 Overview Laboratory Manual Laboratory Kits and expiration
Specimen Collection/Preparations Barcodes and Requisition forms Packaging and Shipping Reporting Query Process Communication 140

141 Laboratory Investigator Manual
Site Services’ Contact Information Study Summary Guide Detailed instructions: Collection Preparation Packaging & shipping Reference Ranges Copy of all requisition forms Additional forms: Supply Re-Order Form CVs, Accreditations and Licenses 141

142 Laboratory Kit Contains: Protocol specific Site specific
Barcode Labels 3 part requisition form Transport and Collection Tubes Packaging supplies for sample shipment Protocol specific Site specific Kit Type specific Expiration Date Stamped Only use one kit per subject per visit 10 business days required for all initial supply requests 142

143 Kit Expiration Each kit is stamped with an expiration date. This date is approximately 6 months of dating. If samples are received from an expired kit visit results will automatically be locked, a query will be issued to the site. ICON faxes or s expiration reports to sites. Initial notification is sent two months before the kits will expire and second time - one month before the kits will expire. It is the site’s responsibility to review their inventory, discard expired supplies and reorder if necessary. Supplies are ordered by faxing or ing the Supply Reorder Form to ICON 143

144 Example of Supply Re-Order Form
“B” kits are for the Carboplatin/Paclitaxel Arm “A” kits are for the TMZ arm All Lab Kits Beginning with Cycle 3 Day 1 – will be Universal Lab Kit

145 ICON Lab Manual Contains detailed instructions for all sample collections Specimen Collection – Quick Reference Guide includes: Test/Panel Bar Code Label Collection Container Transport Container Shipping Temperature 145

146 Before Drug Administration
Research Blood Tests Procedure Visit Schedule Before Drug Administration Sample Plan Sample Matrix PD Blood Sampling Plasma Markersa,b Day 1 of every cycle Pre-dose Final Visit At the time of clinic visit Frozen -70°C or colder Serum Markers BRCA Sequencing: Bridging Study C1D1 Blood Frozen -20°C or colder Circulating Tumor CellsC: US Sites Only C1D1, C2D1 and D1 of every other cycle there after (C4, C6, etc.) Blood Shipped Fresh on the day of collection (must be kept refrigerated at 2 to 8°C until shipped) C1D15d/C1D17e and Final Visit Blood Plasma Blood Serum a. An additional sample may be collected at the time of discontinuation due to an adverse event. b. Based on a discussion between Abbott and the investigator, samples for an individual subject may be collected at an alternate time point. c. CTC/DNA repair collection should not be the first tube drawn. d. For subjects randomized to the veliparib + TMZ treatment arm. e. For subjects randomized to the veliparib/placebo + carboplatin/paclitaxel treatment arm.

147 Research Tissue and Biopsy Samples
Procedure Visit Schedule Before Drug Administration Sampling Plan Specimen Matrix Optional with Consent Serial Biopsies C1D1 Pre-dose Flash Frozen -70°C and FPPE -20°C Final Visit At the time of clinic visit IHC/FISH FFPE tissue blocks Diagnostic, formalin fixed, paraffin embedded (FFPE) tissue blocks Optional w/Consent PG Blood Sampling Genetic (DNA) C1D1 Blood Frozen -20°C or colder

148 Collection Instructions: Blood Samples for Pharmacodynamics -PD (Plasma Markers)
The process given below should be completed in less than 1 hour from blood draw. Collect the blood sample into appropriately labeled 6-mL EDTA (S-PLS) purple top tubes (use 2 tubes for C1D1) Immediately invert the collection tube 8 to 10 times to reduce the likelihood of clot formation Centrifuge the blood samples at 1100 to 1300 x g for 15 minutes using a refrigerated centrifuge at 2ºC to 8ºC Within 15 minutes, transfer the plasma sample into labeled 2-mL cryovials total of four 2-mL cryovials for C1D1 total of two 2-mL cryovials for all subsequent cycles Barcode labels are included in the lab kit Store the samples immobile and upright at –700C or colder until shipped frozen to ICON Central laboratory.

149 Collection Instructions: Blood Samples for PD (Serum Markers)
The complete process should be accomplished in less than 90 minutes from blood draw. Collect the blood sample into a 5-mL SST (SER-1)gold top tube Immediately invert the collection tube 5 times Allow blood to clot for a minimum of 30 minutes in a vertical position, until a dense clot is observed. Centrifuge the blood samples at 1100 to 1300 x g for 15 minutes at room temperature to ensure adequate separation of the serum. Within 15 minutes, transfer the serum sample into two separate 2-mL labeled cryovials and freeze at -70°C or colder. Store the samples at –70°C or colder until they are shipped to the ICON Central laboratory on dry ice sufficient for 3 days.

150 Collection Instructions: Blood Samples for BRCA Sequencing Sample (BRCA Bridging)
In order to permit future bridging studies to other potential BRCA assays, in addition to the sample collected for the Myriad BRCA test, two 4-mL whole blood samples for DNA isolation will be collected from all subjects at C1D1 visit. Collect approximately 4 mL of blood into 2 appropriately labeled EDTA (WBDNA1 and WBDNA2) tubes. Immediately invert the collection tube 8 to 10 times to reduce the likelihood of clot formation. Store samples at –20ºC or colder within 30 minutes of the blood draw, until shipped/transported on dry ice sufficient to last for 3 days during shipment/transport to ICON central lab.

151 Circulating Tumor Cell Collection (U.S. Sites Only)
Circulating Tumor Cells (CTC) may be examined for the tumor-specific alteration of cellular proteins/peptides and/or nucleic acids. CTC sample will be collected for US patients only and shipped directly to Abbott. Collection procedure follows as: Collect 10 mL whole blood into appropriately labeled 10 mL Lavender/Yellow CellSave preservative tube Remove tube from ziploc bag and invert it 8 times to mix and prevent clotting (inadequate or delayed mixing may result in inaccurate test results) Following collection, the specimen must be kept refrigerated at 2-8°C, if needed, prior to shipping to Abbott on the day of collection Specimen should be packed with a frozen gel pack and shipped in a styrofoam container overnight to Abbott Notify Abbott of shipment via to and/or and fax the completed requisition form to

152 Collection Instructions: Blood Samples for PG (Optional)
One 4 mL whole blood sample for DNA isolation will be collected at C1D1 from each subject who consents to provide samples for PG analysis. Collect approximately 4mL of blood into an 4 mL EDTA – purple top tube (DNA) Ensure that appropriate barcode label is used Immediately invert the collection tube 8 to 10 times Store samples at -20ºC or colder within 30 minutes of the blood draw until shipped to ICON Central laboratory on dry ice sufficient for 3 days.

153 Tissue Sample Collection (Optional)
Fixed Samples (IHC and FISH, qPCR) – optional with consent; can be submitted as an archive tissue block or cut tissue on slides. From each representative FFPE tumor tissue, the local pathology laboratory should apply 10 slices of tissue with a thickness of approximately 4 to 6 microns to positively charged slides; 5 slices of tissue with a thickness of approximately 10 microns to positively charged slides. Minimum of 15 slices of tissue sections should be collected from each subject block. Two (2) quality control slides must also be prepared by the pathology laboratory and included in the shipment of slides to the ICON lab. Copy of Pathology report should be included If a site requires their paraffin block returned, please contact Brenda Chyla at or via at the time the block is shipped to ICON There are 2 types of “optional with consent” tissue sample collections in this study The fixed samples – this is an archive sample of tissue taken when the subject was diagnosed with melanoma The Serial biopsy is the second “optional with consent” type and this will be a fresh biopsy. The preferred method to collect this sample is via needle, however if a needle biopsy cannot be performed, the alternative would be via excisional or punch method. For the needle biopsy – 2 core biopsies need to be obtained but for the excisional or punch biopsy – only 1 specimen is required as long as this single specimen can be bisected into 2 adequate samples

154 Serial Biopsies Collection (Optional)
Serial Biopsies – will be obtained at the C1D1 visit prior to therapy and at the Final Visit, when feasible, for all subject who consent. At least 2 core biopsies to be obtained. Biopsies must be at least 18 gauge in diameter and 1 cm in length. If needle biopsy cannot be performed, the alternative would be to obtain the tissue via excisional or punch method A single specimen is adequate provided it can be bisected into 2 adequate samples There are 2 types of “optional with consent” tissue sample collections in this study The fixed samples – this is an archive sample of tissue taken when the subject was diagnosed with melanoma The Serial biopsy is the second “optional with consent” type and this will be a fresh biopsy. The preferred method to collect this sample is via needle, however if a needle biopsy cannot be performed, the alternative would be via excisional or punch method. For the needle biopsy – 2 core biopsies need to be obtained but for the excisional or punch biopsy – only 1 specimen is required as long as this single specimen can be bisected into 2 adequate samples

155 Core Needle Biopsy: Formalin Fixed Paraffin Embedded Preparation
Obtain core needle biopsy from patient (at least 18 gauge in diameter / 1 cm in length) Place biopsy in formalin for between 8-24 hours Embed fixed biopsy in paraffin Biopsy should be appropriately labeled Store at 4°C until shipment at ambient temperature to ICON Central laboratory

156 Core Needle Biopsy: Flash Frozen Preparation
Complete and place the label for cryovial Wrap label with scotch tape to prevent label from becoming displaced during the drop into liquid nitrogen Obtain second core needle biopsy (at least 18 gauge in diameter / 1 cm in length) Immediately after collection place this tissue sample in properly labeled cryovial Flash Freeze the cryovial in liquid nitrogen (alternatively, a dry ice bath with ethanol or methanol may be used) Store frozen at –70°C until shipment to ICON Central Lab on dry ice sufficient for 3 days

157 Pharmacokinetic (PK) Analysis
Pharmacokinetic samples confirm drug levels over time Typically, a set of samples is collected from an individual at set times after dosing Once the drug levels are measured, the absorption, distribution, metabolism, and elimination of the drug can be evaluated Accurate recording of the time between dosing and each sample collection is of key importance Keeping to the planned dosing and collection schedule is highly desirable

158 Veliparib/TMZ Arm PK collection
Procedure Visit Schedule Before Drug Administration After Veliparib AM Dose Sampling Plan Specimen Matrix Veliparib PK Samplinga C1D1 -- 0.5, 1, 2, 3 h Blood Plasma a. All samples should be drawn in conjunction with clinical lab blood draws. Note: The date and time of sample collection and the date and time of the morning dose of veliparib will be captured on the eCRF. Veliparib dose is taken 1 h (PK 1 HR) Sample 3 h (PK 3 HR) Sample Cycle 1 Day 1 0.5 h (PK 30M) Sample 2 h (PK 2 HR) Sample

159 Veliparib +TMZ Arm Veliparib PK processing
Collected only at C1D1 Approximately 4mL of blood will be collected into one 4 mL potassium EDTA (PK) purple top tube at each time point Immediately invert tube 8-10 times to reduce the likelihood of clot formation Centrifuge the blood samples at 1100 to 1300 x g for 10 minutes using a refrigerated centrifuge at 2ºC to 8ºC Using plastic pipette, transfer plasma into a labeled screw- capped polypropylene tubes (cryovial) Freeze at –20°C or colder within 2 hours of blood collection Store samples at –20°C or colder until shipped to ICON Central Lab. Please, make sure there is sufficient amount of dry ice for at least 3 days for the shipment

160 Carboplatin and Paclitaxel Arm PK Collection
Procedure Visit Schedule Before Drug Administration After Veliparib AM Dose Sampling Plan Specimen Matrix Veliparib PK Samplinga C1D3 0 ha 0.5, 1, 2, 3 h Frozen -20°C or colder C2D3 -- Paclitaxel PK Sampling 2 h 55 min after start of Paclitaxel infusionb Free Platinum (for Carboplatin) PK Sampling 25 min after start of the carboplatin infusionc Frozen -80°C or colder Blood Plasma Blood Plasma Blood Plasma Blood Plasma a. Before the administration of the morning dose of veliparib. b. Approximately 3 hours after the morning veliparib dose. c. Approximately 3.5 hours after the morning veliparib dose. Note: The date and time of the sample collection and the date and time of the last two doses of veliparib will be captured on the eCRF

161 Carboplatin and Paclitaxel Arm PK collection (cont.)
3H Post Dose (PK 3 HR) Veliparib PK before the morning dose of Veliparib (PK 0H) 1H Post Dose (PK 1 HR) Cycle 1 Day 3 0 H 0.5H Post Dose (PK 30M) 2H Post Dose (PK 2 HR) Free Platinum (PKLPA) 3h30min after the morning veliparib dose, 25 min after start of the carboplatin infusion Paclitaxel PK (PKPAC) 2h55min after start of Paclitaxel infusion, approximately 3 h after the morning veliparib dose - Paclitaxel infusion start time - Carboplatin infusion start time - ECG to be performed at approximately 2 hours after the morning dose of veliparib

162 Carboplatin/Paclitaxel Arm PK Collection (cont.)
Veliparib PK Sampling before the morning dose of Veliparib (PK 0H) Cycle 2 Day 3 0 H - Paclitaxel infusion start time approximately over 3 hours - Carboplatin infusion start time, immediately following paclitaxel infusion

163 Carboplatin and Paclitaxel Arm Veliparib PK processing
One 4mL whole blood sample will be collected at each protocol specified time point at C1D3 and C2D3. Collection procedures follow: Approximately 4mL of blood will be collected into one 4 mL potassium EDTA (PK) purple top tube Immediately invert tube 8-10 times to reduce the likelihood of clot formation Centrifuge the blood samples at 1100 to 1300 x g for 10 minutes using a refrigerated centrifuge at 2ºC to 8ºC Using plastic pipette, transfer plasma into a labeled screw- capped polypropylene tubes (cryovial) Freeze at –20°C or colder within 2 hours of blood collection Store samples at –20°C or colder until shipped to ICON Central Labs on dry ice sufficient for 3 days

164 Carboplatin and Paclitaxel Arm Paclitaxel PK processing
One 4mL whole blood sample will be collected at the C1D3 visit approximately 3 hours after veliparib morning dose. Approximately 4mL of blood will be collected into one 4 mL potassium EDTA (PK) purple top tube Immediately invert tube 8-10 times to reduce the likelihood of clot formation Centrifuge the blood samples at 1100 to 1300 x g for 10 minutes using a refrigerated centrifuge at 2ºC to 8ºC Using plastic pipette, transfer plasma into a labeled screw- capped polypropylene tubes (cryovial) Freeze at –20°C or colder within 2 hours of blood collection Store samples at –20°C or colder until shipped to ICON Central Labs on dry ice sufficient for 3 days

165 Carboplatin and Paclitaxel Arm Free Platinum processing
One 4mL whole blood sample will be collected at the C1D3 visit approximately 25 min after start of the carboplatin infusion. Collect the sample into one 4 mL potassium EDTA (PKPLA) purple top tube Immediately invert the collection tube 8 to 10 times Centrifuge the blood samples at 1100 to 1300 x g for 10 minutes using a refrigerated centrifuge at 2ºC to 8ºC Using plastic pipette, transfer plasma into a labeled screw-capped polypropylene tubes (cryovial) Samples for free platinum analysis must be shipped on dry ice to ICON Central Laboratories on the same day of draw. Samples will freeze when placed upright in the dry ice. If sample cannot be shipped the same day of draw, then sample must be frozen upright at –80ºC or colder within 1 hour after collection and must be shipped frozen to ICON Central Laboratories within 5 calendar days. If courier cannot pick the sample up on the day of the draw - place the sample upright in dry ice overnight and re-pack the dry ice when courier arrives in the morning to pick up sample. Sample cannot sit in dry ice at the site for more than 24 hours waiting for courier. This option is only to be used when the courier cannot arrive same-day but will absolutely arrive the next morning.

166 Sample Collection Overview All Arms
Visit Time Point Samples Screening Clinical Labs (chem, hem, urin); Tissue samples (Block or Slides + Pathology Report) FINAL Clinical Labs (chem, hem, urin); CTC; PD; Serial Biopsies (optional) 30DayFU Clinical Labs (chem, hem) Unscheduled Clinical Labs (chem, hem, urin) Cycle 3 Day (and every odd cycle there after – C5D1, C7D1..) Clinical Labs (chem, hem, urin); PD Cycle 4 Day (and every even cycle there after C6D1, C8D1..) Clinical Labs (chem, hem, urin); PD; CTC

167 Sample Collection Overview Veliparib +TMZ Arm
Visit Time Point Sample C1D1 Clinical Labs (chem, hem, urin); CTC; BRCA Bridging; PD; PG (optional), PK; Serial Biopsies (optional) C1D15 Clinical Labs (chem, hem), CTC C1D22 Clinical Labs (hem) C2D1 Clinical Labs (chem, hem, urin); CTC; PD C2D15 Clinical Labs (chem, hem) C2D22

168 Sample Collection Overview Carboplatin + Paclitaxel Arm
Visit Time Point Sample C1D1 Clinical Labs (chem, hem, urin); CTC; BRCA Bridging; PD; PG (optional), Serial Biopsies (optional) C1D3 PK (per protocol) C1D17 Clinical Labs (chem, hem,); CTC C2D1 Clinical Labs (chem, hem, urin); CTC; PD C2D3

169 Barcode Labels – PK / PD / PG Samples
CTC BRCA Bridging PG PK PD Archive Tissue Serial Biopsies These labels will have just one barcode on the left side. The clinical lab samples (Chemistry, CoAg, Hem, Urine, Slides) will have 2 barcodes. These DO NOT get scanned into EDC.

170 Lab Barcode Source worksheet example

171 Scanning Device Instructions and Troubleshooting
171

172 Scanning Device Instructions – Connecting the Scanner
Connect the scanning device to your computer’s USB port. Note: USB port must be on your computer (not on your keyboard or monitor). Scanner will beep 3 times once plugged in. USB Port on computer 172

173 Scanning Device Instructions – Re-programming the Scanner
The bar code scanner is programmed and ready to enter data. Scan the barcode below if your scanner requires re-programming (see troubleshooting guide). Note: You cannot scan the below bar code directly from your computer screen, only from a paper print-out. 173

174 Scanning Device Instructions – Correct Scanning Methods
The illustration below outlines correct and incorrect scanner positions. Correct alignment Incorrect alignment (off-center) 174

175 Scanning Device Indicators
Beep Indicators Low/Medium/High beep = Power up Short medium beep = Bar code decoded 4 long low beeps = Data transmission error detected; data has not been successfully entered LED Indicators Off = Scanner is on and ready to scan or no power to scanner Green = Bar code is successfully decoded Red = Data transmission error Please refer to reference manual that was included with the barcode scanner for help with troubleshooting 175

176 Scanning Device Troubleshooting
No power to scanner Check computer system power; ensure power cord to computer is connected to power source; ensure scanner cord is plugged into computer. Incorrect interface cable Contact your Field Monitor. Interface/Power cables are loose Ensure all cable connections are secure. Scanner is not decoding barcode Scanner must be re-programmed to read type of barcode being scanned. See scanner re-programming instructions. Move scanner closer to or further from barcode. Note scanner should not physically be touching the barcode (scan from approximately cm away from the barcode). Barcode is unreadable Ensure barcode is not defaced. If so, contact your Field Monitor. Scanner is decoding barcode, but data is not transmitting to the data field Ensure your curser is in the correct data field. Scanned data displays incorrectly in data field

177 PK - PD - PG (electronic scanning)
Barcode label must match the subject number, the visit, and the time point PK samples must be entered in chronological order, relative to dose 177

178 PD - PG - PK (electronic scanning) (cont.)
Steps for scanning barcodes: Plug barcode scanner into USB port on the computer used for data entry into EDC. Scanner will beep 3 times once plugged in. If your scanner does not decode a bar code follow the instructions in your troubleshooting guide. Note: barcode numbers will not be accepted until this step is completed. Scanner is now ready to accept barcodes for data entry purposes. Log into the EDC study for M and access the PG, PD or PK eCRF. Enter date and time of collection into the appropriate eCRF fields for the PG, PD or PK sample. Place the curser in the barcode data entry field labelled ‘Bar code (14-digit number)’ for the corresponding sample. Scan the barcode label from the source document worksheet, associated to the appropriate timepoint. The scanner will beep once the 14-digit barcode number has been successfully scanned. The number will then appear in the data entry field that was previously selected. Repeat (above) steps 4 through 6 for subsequent barcode entries. NOTE: It is important that barcodes be scanned in chronological order with relation to the timepoints. Please save your data every 5 minutes. Queries will fire upon saving data, but repeated saving of your data will prevent potential data loss due to system security time-out. 178

179 Attaching labels to tubes
Label samples with sample label as per Lab Manual and Summary Collection Guide Please write Subject Number on all labels Labels placed lengthwise on the collection and transport tubes before collection 179

180 This barcode not to be scanned
Requisition Form This barcode not to be scanned Barcode Subject info Collection Information Test Panels Shipping Details Collection Info Transport Info **Missing or inconsistent Subject demographics, collection date and time will result in a Data Clarification Form (DCF) being sent to the site and a delay in reporting** 180

181 Completing the Laboratory Requisition
Each specimen collection kit contains its own requisition form. The requisition form is visit and protocol specific. Please, follow instruction on completing the Laboratory Requisition Forms in Laboratory Manual.

182 Visit Specific Supplies and Packaging
Each sealed package contains all laboratory supplies for specimen collection for an individual patient at a specific visit. Please, refer to Laboratory Manual for packaging instructions specific to each type of specimen Please make sure you are sending: White copy of requisition form with Ambient Samples Yellow copy of requisition form with Frozen Samples Pink copy of requisition form stays with the site 182

183 Shipping via FedEx (US & Canada)
FEDERAL EXPRESS Shipping supplies and preprinted airbills will be furnished by ICON Laboratory with your initial lab supply shipment. Instructions for completing the airbill will be in your lab manual. For Ambient shipments only the Date & Weight need to be entered, along with the Shipper’s signature. Remember to mark airbill Saturday delivery, if applicable. Also when shipping on a Friday, the Saturday delivery box on the airbill should be checked and Saturday Stickers must be applied to the package. 183

184 FedEx International Air Waybill (Canada)
184

185 Laboratory Reporting The lab report will contain the following:
Site/Subject Demographics Test results Accession number Exclusion Flagging – “E” Panic Values – Sites will be contacted with panic values via phone and . Site receipt confirmation required. 3 attempts will be made to confirm the receipt at the site before it is escalated to the sponsor An alert will be sent to the appropriate sponsor team. Sponsor modified alerts Reports can be faxed or ed to sites Exclusions, alerts & panics will be flagged on lab reports

186 Lab Report Example 186

187 Lab Report Example (cont.)
187

188 Lab Reporting – Testing Times
Test name Shipping Conditions Testing Time* Chemistry, HCG-Qualitative Ambient 1 Day Hematology PT, INR, APTT Frozen 2 Days Urinalysis *Note: Once received at ICON 188

189 Delays in Reporting-Queries
Missing information on Requisition Form Missing Collection Date/Time Illegible documentation (hand written) Different demographic information between visits Please ensure demographic info is the same for all visits Missing Requisition Form Please ensure a requisition form is included with all samples Samples Incorrectly labeled samples Expired Kits Please ensure that sites do not use expired kits 189

190 Key Points to Take Away Use one kit per visit
Do not mix barcodes from different kits Send all required samples labeled correctly Write subject identifier on labels Complete Requisition Forms fully and clearly Ship ambient samples on day of collection Contact courier in advance For subjects randomized to carboplatin/paclitaxel – the free platinum PK samples should ship to ICON same day on dry ice Ensure dry ice has been ordered in advance of the visit (i.e. order on C1D1 for C1D3 draw) If samples cannot be shipped same day as draw, then they must be frozen upright at -80oC within 1 hour after collection and shipped frozen within 5 calendar days. Contact ICON Central Laboratories or your monitor if you have any questions

191 Please visit our website:
Contact Details US Client Services Toll Free Tel: 8 AM – 8PM EST/EDT, M-F 8 AM – 5 PM EST/EDT, Sat Global address: Please visit our website:

192 Concomitant Medications
Myriad BRCA Test Processing Instructions Company Confidential © 2012 Abbott 192

193 Myriad Supplies Each kits contains:
Protective case for vacutainer tube 10 mL EDTA (lavender top) tube Plastic seal top bag Pre-addressed overnight envelope and prepaid air bill Specimen handling, collection and shipping instructions A test request form/requisition form

194 Test Request Form/Requisition Form

195 Test Request Form/Requisition Form instructions
Enter the “Specimen Collection Date” at the top center of the form. Complete the “Ordering Healthcare Provider” section of the test request form with name of the physician at your site. Provide patient information below – Study # Subject # Gender Please, note, the same information should be indicated on the label on top right corner. This label will be affixed to the tube. Healthcare provider must sign and date the form in the section labeled Informed Consent and Statement of Medical Necessity in order for the test to be completed

196 Sample Collection Instructions:
Collect and Label Sample: Draw at least a 7mL sample of blood using the supplied 10mL purple-top EDTA tube. Peel off the bar code label found on the upper right-hand corner of the Test Request Form and place lengthwise on the sample tube. Write the Site # and Subject ID# on the sample tube. These identifiers must match exactly to the information on the test request form. Do not write patient name on the test request form or sample tube. DO NOT centrifuge, refrigerate, or freeze the sample. Room temperature is preferred. Ship this sample ambient same day.

197 Packaging and Shipping Instructions:
Prepare for Shipping: Place the blood tube into the foam-lined box and seal the box in the small plastic biohazard bag. Place the following items in the Specimen Collection and Transportation Kit: - Labeled patient sample tube of blood enclosed in the foam-lined box and plastic biohazard bag. - Completed Test Request Form Place the Specimen Collection and Transportation Kit into the FedEx Clinical Pak plastic bag. Shipping Instructions: Affix the prepaid airbill to the outside of the Federal Express mailer. Keep the Federal Express customer receipt for your records / reference. If you don’t already have a Federal Express pick-up, call Federal Express at GO-FEDEX ( ) for package pick-up. Specify that you are shipping with a prepaid airbill (also called a prepaid billable stamp). If you are outside of the United States, go to and choose your country from the drop-down list.

198 Myriad test results Sites should set up an account with Myriad to receive the results electronically Authorized site personnel will receive results within 14 days of receipt of sample via after creating account at Myriad website Test results will also be provided to the Abbott medical monitor at the same time

199 Frequently Asked Questions
How do I sign-up for this new process? You can sign up for electronic delivery of test results on-line by going to You will need your Myriad Account Number which is: and your last name, in order to create your on-line profile. What other information will I need to provide? You will be asked to provide an address where alerts will be sent. You will select a password and provide a security question and answer for password resets. The alert will be sent with a hyperlink to the ResultsNow website when test results are ready to be viewed. If I have more than one Myriad Account Number (address location), can I have all of my account number results (address locations) sent to the same address? All active Myriad Account Numbers (address locations) for which you have received test results will be displayed during the sign-up. Please indicate for which Myriad Account(s) you would like notification sent. For example, if you check both accounts below— x Account # , 320 Wakara Way, Salt Lake City, Utah x Account # 55555, 123 State Street, Salt Lake City, Utah — notifications for both accounts will be sent to the address specified in your set-up profile. If you have multiple Myriad Account Numbers (address locations), you may choose to have more than one profile ( address). Repeat the steps above for each separate account number (address location) that needs a different address.

200 Frequently Asked Questions (cont.)
What if I want my office manager or nurse to sign-up and receive the results for me? An authorized delegate for the Healthcare Provider may sign up. There is a statement in the sign-up process that states, “I am an authorized delegate of the Healthcare Provider registering, not the actual Healthcare Provider.” The delegate will be asked to provide their name and title. Will I still receive a paper copy? No. When you sign up for ResultsNow you WILL NOT receive paper copies of test results. You will be viewing your patient’s test results via a PDF file and will have the ability to print and save a copy. How do I view the test results? Your patient’s test results will be in PDF format and appear the same as the results you now get in printed form via express delivery. You can sort the list of your patient results in many ways to quickly find the one you need. Please remember to change your spam filter settings to accept from myriad.com. We suggest that you log on to monthly. How long will my test results be available electronically? Test results will be available for 90 days from the date that you receive the alert. If you need access to test results after 90 days, please contact our Customer Service Department. What other documents will be viewable via ResultsNow? All of the documents that you currently receive in paper form will be viewable and downloadable for each case, including: - Patient Test Results (file and patient copies) - “Understanding Your Genetic Test Results” which may be given to your patient - Test specifications - Additional documents, depending on the specific test and test results.

201 Myriad Supplies Each site will receive 2-4 kits initially
For additional kits, submit to: Stephanie Hamilton: Reference M study Allow 14 days for receipt of additional kits Questions: Stephanie Hamilton Clinical Research Associate Myriad Genetic Laboratories 320 Wakara Way Salt Lake City, UT Phone: x 5102 Fax: OR Customer Service

202 Concomitant Medications
Introduction to the ClinPhone IWR/IVR for Abbott (M12-895) Company Confidential © 2012 Abbott 202

203 Agenda Access to System IWR Overview IWR Account Set Up
Web Session Types Reports and Alerts Support Company Confidential © 2012 Abbott 203 203

204 Accessing the IWR system
Make sure you have: Access to the Internet An access code envelope A worksheet and your manual for guidance. Read all instructions on the Web page Complete the web form Fill in appropriate spaces on worksheet during call Company Confidential © 2012 Abbott 204 204

205 Account Creation/Envelope Activation
If you do not have an existing ClinPhone account… Create an account using the Create My ClinPhone Account link. Enter all requested details (username, , password). After the account is created a link will be sent to your which must be utilized to register the account within 30 days. Envelope Activation: Select “Activate a New TIN”. Enter the 16-digit TIN (Temporary Identification Number) from your envelope. You will be prompted to enter study specific information, e.g. site name/number. Enter a 4-digit PIN of your choice (confidential) System will now display your 8-digit permanent access code. Please record this number somewhere safe and confidential as it will be used in all subsequent sessions. NOTE: If you already have an access code for another study, you may link that code to your new envelope. Your account set-up is now complete! Document on your Envelope Activation worksheet Company Confidential © 2012 Abbott 205

206 New ClinPhone Account To set up a new Clinphone Account log onto: and select ‘Create new account’. Fill in the form and select ‘Continue’. Company Confidential © 2012 Abbott 206 206

207 New ClinPhone Account Confirmation is received by the user. This link MUST be clicked on to activate the account. Company Confidential © 2012 Abbott 207 207

208 SUL Login www.clinphone.com/signin
Select “Enter My Clinphone Online” Company Confidential © 2012 Abbott 208 208

209 Activate New Envelope Company Confidential © 2012 Abbott 209 209

210 Accessing the IWR system – Security Envelopes
Abbott Protocol: M12-895 ClinPhone Reference: ABB240 User Type: Investigator Envelope Number: XXXXX  Outside of envelope TIN: XXXX-XXXX-XXXX-XXXX Your ClinPhone Temporary Identification Number for the protocol printed on the front of this envelope is shown above. Please refer to your User Manual for instructions on how to use it. Inside of envelope Company Confidential © 2012 Abbott 210 210

211 Activate New Envelope After entering your TIN and following the prompts, IWR will display your 8-digit access code Company Confidential © 2012 Abbott 211 211

212 Log On You can now enter your username and password to access M12-895.
This is not your PIN!! Company Confidential © 2012 Abbott 212

213 General Navigation Company Confidential © 2012 Abbott 213

214 Support You can contact support via the following contacts:
You will be given a ticket number. When ing, please provide the unique study code: ABB240 Company Confidential © 2012 Abbott 214

215 User Call/Web Options Investigator/Site Personnel
Screening – Used to screen a subject Screen Failure – Used to register a subject as having failed screening Randomization – Used to randomize a subject and assign initial supply of drug. Scheduled Medication Resupply – Used to assign medication to subjects at scheduled visits. Emergency Resupply – Used to replace damaged or lost medication assigned to a subject during a scheduled resupply. Subject Status Change – Used to register a subject as on-study/off-drug(s), or off-study Emergency Code Break – Used to unblind a subject in the case of a medical emergency (PI only) Medication Arrival – Used to make drug shipped to the site available in the system Confirmation report will be triggered once any option is complete Company Confidential © 2012 Abbott 215

216 Medication Arrival Medication Arrival Call: Site User enters
Shipment Number confirms whether any medication should be marked as lost or damaged, User given the option to register additional medication shipments as arrived. Company Confidential © 2012 Abbott 216 216

217 Change Medication Status
Change Medication Status Call: Allows the Site User to update the status of medication already acknowledged as received at their site Site User provides information about medication: Damaged or Lost Company Confidential © 2012 Abbott 217 217

218 Change Medication Status
Company Confidential © 2012 Abbott 218 218

219 Screening Screening Call: Site User enters
Screening Date Date of Birth (Month/Year) Gender Once the site user confirms to proceed the system will generate the subject number. Company Confidential © 2012 Abbott 219 219

220 Screening Company Confidential © 2012 Abbott 220 220

221 Screen Failure Screen Failure Call: Site User enters
Subject number Confirmation of Date of Birth and Gender (each provided) Screen Failure Date Once the site user confirms to proceed the system will screen fail the subject Company Confidential © 2012 Abbott 221 221

222 Screen Failure Company Confidential © 2012 Abbott 222 222

223 Randomization Randomization Call: Site User enters
Subject Number Confirmation of Date of Birth and Gender (each provided) The subjects Estrogen receptor and progesterone receptor status If the subject’s received prior cytotoxic therapy The subject’s ECOG performance status grade The subject’s BSA value The following daily dose questions will be asked in case the subject is randomized to required treatment arm Subject’s daily dose for TMZ (should be 150 mg/m2/day) Subject’s daily dose for Carboplatin (should be AUC 6) Subject’s daily dose for Paclitaxel (should be 175 mg/m2) System announces the randomization number and medication to be dispensed to subject. Company Confidential © 2012 Abbott 223 223

224 Randomization Company Confidential © 2012 Abbott 224 224

225 Randomization Company Confidential © 2012 Abbott 225 225

226 Your password will be required to proceed.
Randomization Your password will be required to proceed. Company Confidential © 2012 Abbott 226 226

227 Scheduled Visit Scheduled visit Call: Site User enters
Subject Number Confirmation of Date of Birth and Gender (each provided) Confirmation of next (current) visit User will be asked if a change subject status is needed Subject’s BSA value Opportunity change doses for each pack type (Specific to treatment arm) System announces Subject Number and medication to be dispensed to patient Company Confidential © 2012 Abbott 227 227

228 Medication Replacement
Emergency Re-supply: Site User enters Subject Number Confirmation of Date of Birth and Gender (each provided) Confirmation of last visit and that replacement is needed Kit number to be replaced System announces replacement medication to be dispensed to patient Company Confidential © 2012 Abbott 228 228

229 Change Subject Status Change Subject Status Call: Site User enters
Subject Number Confirmation of Date of Birth and Gender (each provided) Confirmation of subject status Option to change subject status User will be asked if a change subject status as needed Please use work sheets as a guide to assist through the call System announces Subject new status Company Confidential © 2012 Abbott 229 229

230 Change Subject Status Company Confidential © 2012 Abbott 230 230

231 Survival Assessment Survival Assessment: Site User enters
Subject Number Confirmation of Date of Birth and Gender (each provided) Confirmation of subject status Subject survival assessment status Enter the date of death (if needed) If the subject's death due to metastatic breast Last known alive date If the subject receive any new cancer therapy Please use work sheets as a guide to assist through the call Company Confidential © 2012 Abbott 231 231

232 Survival Assessment Company Confidential © 2012 Abbott 232 232

233 Survival Assessment Company Confidential © 2012 Abbott 233 233

234 Blind Break (PI only) Functionality only available to the Investigator role. Abbott must be notified before the blind is broken unless identification of the study drug is required for medical emergency, i.e., a situation in which the knowledge of the specific blinded treatment will affect the immediate management of the subject/patient’s conditions. Abbott must then be notified within 24 hours of the blind being broken. Company Confidential © 2012 Abbott 234 Bio-Imaging Technologies, Inc. 234

235 Abbott Temperature Excursion Management System (ATEMS)
Speak to the ATEMS CBT that will need to be completed the first time utilizing ATEMS. Company Confidential © 2012 Abbott 235

236 Temperature Excursion Paper Form
Complete the paper Temperature Excursion Form located in the Investigator Site File if ATEMs in not available Once ATEMs is available, Abbott GDSM will enter the information into ATEMs to ensure all historical information is captured No updates to ATEMs by site if paper form is utilized! Company Confidential © 2012 Abbott 236

237 ClinPhone Drug Accountability
Web-based solution that enables study sites, sponsors and depots to fully track and manage the drug accountability, reconciliation, returns and destruction process Developed based upon market research with Trial Directors, CRAs, Depot personnel, Study Site Coordinators and Site Pharmacy personnel Hosted by Perceptive Informatics (via ClinPhone IVRS) Company Confidential © 2012 Abbott 237

238 An extension of IVRS Trial Supply Management
Distribution Depot to depot | Depot to site IVRS Trial Supply Management Manages shipment of medication from depot to site Manages allocation of medication packs to subjects Dispensation Subject randomization & pack allocation ClinPhone Drug Accountability Records site dispensation Records medication return and reconciliation Manages return shipments Records depot reconciliation activities (if required) Records destruction information Accountability Subject dispensing & Return documentation Reconciliation Review & confirmation of accountability data Returns Manage return of shipments Destruction Destruction confirmation Company Confidential © 2012 Abbott 238

239 Web-Based Functionality
Electronic signature Error checking Ability to add and respond to comments Company Confidential © 2012 Abbott 239

240 List of Kits at Site Search and Filter functionality
Allows you to view kit status, reconciliation status and date dispensed Company Confidential © 2012 Abbott 240

241 Lost or Damaged Kits To identify kit either perform a search or select from the Kit list: Enter the lost or damaged date Enter comment to explain Enter PIN/Save Pack list screen: all packs at site with current status. Company Confidential © 2012 Abbott 241

242 Site Accountability Returned Date (date returned by subject)
Accounted Date (date of site accountability) Returned/Unused (# of capsules returned) Used (# of capsules not returned) Comments should be utilized to denote any discrepancies Enter PIN/Save Pack list screen: all packs at site with current status. Company Confidential © 2012 Abbott 242

243 Kit Destruction If a site has an approved on-site destruction SOP:
If a discrepancy is noted during monitor reconciliation: Enter comments explaining the discrepancy Site will be alerted to these comments at the next time they access the system Enter PIN/Save Once saved – Comments will remain in audit log If a site has an approved on-site destruction SOP: Site can enter destruction date if a kit is destroyed on-site (on-site forms should be utilized) Enter PIN/Save Pack list screen: all packs at site with current status. Company Confidential © 2012 Abbott 243

244 End of Session Summary Summary page will display at the end of a session and allow you to view your transaction Company Confidential © 2012 Abbott 244

245 Monitor Reconciliation
Reconciled Date (date of monitor reconciliation) Returned/Unused (# of capsules returned) Used (# of capsules not returned) Enter comments to denote SDV or any reconciliation discrepancies Enter PIN/Save Company Confidential © 2012 Abbott 245

246 Reconciliation Discrepancies
If a discrepancy is noted during monitor reconciliation: A comment will be entered explaining the discrepancy Sites will be alerted to these comments at the next time they access the system Comments will remain in audit log Pack list screen: all packs at site with current status. Company Confidential © 2012 Abbott 246

247 Reports and Notifications
Following each transaction, a notification will be sent Notifications can be sent via or fax Documents information entered during the transaction Site number Screening or Subject number Date of session Etc. Company Confidential © 2012 Abbott 247 247

248 Help and Advice User Guides Provide: FAQs
Links to Customer Care phone and fax numbers User Worksheets Provide: All the necessary information to complete the session Space to record information provided by the IWRS Copy all worksheets prior to use to have extras available for future sessions Once you have activated your account, practice on the training system prior to making your first IWR transaction Company Confidential © 2012 Abbott 248 248

249 Help and Advice Support is available 24/7/365 via:
Telephone Fax Provide the following information when contacting Support: Study Reference – ABB240 Protocol Number – M12-895 Complete contact details - Site ID Number, Name, Fax, Phone Number, and/or Address Be specific regarding your query and include date/time of call, what you heard, subject/screening number, etc. Some manual updates/changes will require authorization from Abbott Company Confidential © 2012 Abbott 249 249

250 Concomitant Medications
M Good Clinical Practice for Clinical Investigators and Study Sites Company Confidential © 2012 Abbott 250

251 Good Clinical Practice (GCP)
What is GCP? An international ethical and scientific quality standard for designing, conducting, monitoring, auditing, recording, and reporting trials that involve the participation of human subjects Why is GCP important? Provides assurance that the rights, integrity, and confidentiality of trial subjects are protected Provides assurance that the clinical trial data and reported results are credible and accurate GCP references: International Conference on Harmonization (ICH) E6 Good Clinical Practice Country specific regulations

252 Why is Abbott putting emphasis on GCP?
To ensure ethical conduct and protection of subjects participating in Abbott clinical trials As a sponsor, Abbott must comply with its obligations for regulatory standards at global level Abbott can use data from the clinical trials only if compliance is ensured also by clinical sites. Loss of data from non-compliant clinical sites is a serious consequence for Abbott. In case of non-compliance, Abbott is obligated to take prompt action to secure compliance, including but not limited to inspection by the Sponsor, termination of the investigator’s participation in the study and notification to regulatory authorities Upon notification of regulatory agencies, further inspections and regulatory actions are possible, including Warning Letters, Disqualification/Restriction of investigator or staff

253 Working together… to ensure a successful trial in compliance to GCP
IRB/EC Safeguards the rights, the safety and the well being of trial subjects Trial Subject Participates in the clinical trial Obtains informed consent, ensures adequate medical care, collect data Investigator Responsible for the conduct of the clinical trial Interacts with the investigator and advises him Provides data Monitor Oversees the progress of the clinical trial, ensures it is conducted,recorded and reported as per requirements Reports progress of the clinical trial Regulatory Agency Inspection Official review of documents, facilities, records and resources related to the clinical trial Sponsor Audit Systematic and independent examination of trial-related activities and documents Sponsor Takes responsiblity for initiating, managing and/or financing the clinical trial

254 Implementation of the Trial
You have agreed to participate in the trial Per GCP, this means the Principal Investigator (PI) has taken responsibility for ensuring and is able to demonstrate: there is a potential for recruiting the required number of suitable subjects within agreed timelines there is an adequate number of qualified staff and compatibility of the workload for the planned duration of the study there are adequate facilities to conduct the trial properly and safely monitoring, Sponsor auditing and Regulatory inspections are permitted (and facilitated)

255 Investigator Oversight
The Principal Investigator (PI) must personally supervise study activities and individuals who assist him in order to conduct the study efficiently, safely and in a timely manner Be familiar with protocol, investigational product & GCP requirements Provide adequate information about the trial to other involved parties at the trial site (lab, pharmacy, etc) Use only EC/IRB-approved documents Document study activities as required Train your personnel on the study

256 Investigator Oversight
The Principal Investigator (PI) must personally supervise study activities and individuals who assist him in order to conduct the study efficiently, safely and in a timely manner Supervise study progress Schedule sufficient time to review subject medical charts and complete CRFs Timely review of lab reports/records and report AE as required by protocol Oversee drug administration, data handling and source documentation completion when delegated to your staff Be present at Monitoring Visits: meet with monitor and review study progress The monitor is here to help you in conducting a successful trial!

257 Qualifications, Delegation and Training
The Principal Investigator must be qualified by education, training and experience to assume responsibility for the proper conduct of the study Other individuals at study site must be qualified and trained to perform (delegated) study-related duties Delegation of Activities is OK but Study Conduct remains the PIs responsibility Delegation is to a qualified individual for a specific activity and in agreement with the protocol requirements Delegation is approved by the PI (via signature on a Delegation Log) Maintain a Delegation of Responsibilities Log and Signature Log Update when personnel changes occur

258 Qualifications, Delegation and Training
Training records must match with delegated duties

259 Medical Care of Trial subjects
Study related medical decisions must be made by a physician who is the investigator or a sub-investigator Study procedures (i.e physical examination, laboratory results review, etc.) to determine subject eligibility and continued participation in the trial Inclusion/exclusion criteria/removal from trial if subject agrees, inform his/her primary physician about subject’s study participation ascertain reason(s) for subject’s premature withdrawal, fully respecting his/her rights Adverse event assessment The review should be documented (sign/date) and should be evident throughout the study.

260 Ethics Committee / Institutional Review Boards
All IRB/EC (central and/or local) and Regulatory Authority requirements must be met for approvals and notifications of: Protocols and all amendments Informed consents and information provided to subjects Investigator’s Brochure Expedited safety reports (IND safety reports/SUSARS) Protocol deviations Premature Termination or Suspension of the Trial Study reports and results if required New information and requests for information Ensure IRB/EC approval/favourable opinion: - was obtained before starting the trial and implementing any amendments - is signed/ dated and clearly identifies the trial, the investigator, the documents reviewed and their versions. Maintain copies of : - reports submitted to the EC - reports of all actions or modifications requiring prior approval/favourable opinion and other notifications.

261 Protocol Compliance Conduct study according to the EC/IRB approved protocol Sign the protocol (and any amendment) to confirm your agreement Do not implement any protocol deviation prior to Abbott agreement and review by the Ethics Committee, except when necessary to eliminate an immediate hazard to study subjects Submit any protocol deviation implemented to eliminate an immediate hazard to study subjects as soon as possible to the Ethics Committee, to Abbott and to the Regulatory Authorities, as applicable Contact your Abbott monitor or the Abbott Medical Monitor with any questions Any deviation should be documented and explained

262 Informed Consent of Trial Subjects
Approvals Prior to screening subjects, the ICF(s) and any written information given to the subject (e.g., dosing instructions, subject diaries) must be approved by the EC Ensure the EC Approval is obtained for the ICF/other written information in the language in which it will be provided to the subject

263 Informed Consent of Trial Subjects
Administration Ensure the most current, approved version of the ICF is administered and signed by the subject before any study procedures are done The investigator or person designated should provide the subject ample time and opportunity to inquire about details of the trial and to decide whether or not to participate Ensure the subject dates his/her own signature Must be Ensure the ICF is written in a language understandable to the subject (e.g., English, Spanish, etc.) If administration of the ICF is delegated to a non-physician, make certain a process is in place where a physician is available to answer questions when needed

264 Informed Consent of Trial Subjects
Documentation Review ICF to ensure it is fully completed by the subject. Ensure all signature(s) are complete Document in the source that informed consent was obtained prior to any study-related procedures and that the subject received a copy of the signed/dated ICF/other written information (including amended informed consents) Place the original signed/dated ICF in the site records Re-Consent: The ICF and other written information should be revised whenever important new information becomes available or as required by the EC Subjects should be informed in a timely manner if new information becomes available that may be relevant to their willingness to continue in the trial.

265 Investigational Product
Review and understand the Investigator’s Brochure Maintain accurate records of study drug accountability (quantity received, dispensed to each subject, returned) Drug accountability duties may be assigned to the pharmacist or other appropriate individual who is under the supervision of the Investigator Only dispense to subjects in accordance to the approved protocol Explain the study drug correct use to each subject and ensure they are following instructions Subject needs to return used/unused supplies at scheduled visits. All unused supplies are returned to Abbott or destroyed on-site per agreement with Abbott If applicable, manage randomization process and blind breaking as per protocol

266 Investigational Product Storage
Store drug in a secure location Store drug at required temperature Monitor temperature using a calibrated thermometer Notify Abbott immediately of any temperature excursions Do Not dispense drug exposed to temperatures outside the identified range until confirmed by Abbott Do Not dispense drug that has expired or is expected to expire while the subject is dosing Quarantine drug such that no accidental dispensing errors occur Contact your monitor in case of expired drug on-site

267 Records and Reports All data must first be documented in a source record then later transcribed onto the CRF (unless protocol indicates data may be entered directly on the CRF) Source records are defined as original documents, data and records of clinical findings, observations and study visit procedures. Examples include: Medical charts, source worksheets, hospital records, physician’s notes, lab reports, subject diaries; Data from automated instruments, x-rays; Electronic medical records Source documents are both current and historical records

268 Records and Reports Regulatory Agencies can review “all” source records Ensure source records also contain information pertinent to protocol compliance and PI oversight (e.g., counseling on non- compliance to study drug, AE and concomitant medication assessment at each visit, follow-up calls) Do not use a pencil to record source data CRF data should be consistent with source documentation

269 Records and Confidentiality
All study related records must be maintained for the period of time specified by Abbott. Allow access to study records upon request for Monitoring, audits and inspections (e.g., Regulatory Authorities, Abbott, IRB/IEC) Subject Confidentiality Obscure subject identifying information on all documents sent to Abbott (e.g., discharge summaries, ECG tracings, local lab reports)

270 Good Documentation Practices
Keep Site Trial Master File up-to-date Follow Good Documentation Practices and review documents to ensure they are: Complete Are all the required documents present? Site staff listed on signature delegation log are not listed on Site Initiation Statement or training documentation Are all the pages present in each document? Legible Can handwritten entries be read? Check scan quality, is the print dark enough so that it can be read easily?

271 Good Documentation Practices
Follow Good Documentation Practices and review documents to ensure they are: Accurate Is all information entered correct and consistent? Address is complete, including country Current Are documents that have time bound limits within the required parameters? lab certification, last version of informed consent

272 Safety Reporting Be aware of risks and side effects described in Investigational Brochure Adverse Events Investigate and report adverse events Follow adverse events until resolved Serious Adverse Events (SAEs) Report serious adverse events to Abbott, IRB/EC and Regulatory Bodies as required Report all SAEs to Abbott within 24 hours of site awareness

273 Working Together, We can achieve…
Ethical conduct and protection of subjects Compliance with sponsor and regulatory requirements Compliance that allows for use of clinical data from your site We can avoid… Non-compliance and the need for corrective action

274 Concomitant Medications
Investigator Responsibilities & General Study/Visit Information Company Confidential © 2012 Abbott 274

275 Investigator Responsibilities
Review of ICH/GCP Guidelines Accessibility of study staff and study documentation Company Confidential © 2012 Abbott 275

276 Investigator Responsibilities-US and Canada
From FDA 1572 Company Confidential © 2012 Abbott 276

277 Accessibility of Study Staff and Study Documents
First monitoring visit will occur within 14 days of first subject randomization Monitoring visits to be conducted at approximately ≥ 10 week intervals PI is expected to be present (or available by phone during or shortly after) each visit. Study Coordinators should be available at every visit. Study will utilize Remote Monitoring, therefore, data must be entered into EDC within 5 business days. Queries should also be resolved within 5 business days. Source documents should be maintained and the Essential Documents Binder updated on an ongoing basis throughout the study. Company Confidential © 2012 Abbott 277

278 GCP Training Principal Investigator and Primary Study Coordinator to be instructed of his/her responsibility to comply with GCP/ICH before initiating screening activities CBTs must be completed before sites start screening subjects Company Confidential © 2012 Abbott 278

279 Ongoing Training All study staff who were not in attendance at the Site Initiation Visit must receive training on the protocol before they may perform any study activities Ongoing training may be conducted via on-site visits and/or teleconferences All training should be documented via training logs and filed in the Essential Documents Binder. Company Confidential © 2012 Abbott 279

280 Record Retention All study documents should be retained for at least two years after the last approval of a marketing application in an ICH region and until there are no pending or contemplated marketing applications in an ICH region or until at least two years have elapsed since the formal discontinuation of clinical development of the investigational product Abbott will inform the Investigator/Institution as to when trial documents no longer need to be retained Company Confidential © 2012 Abbott 280

281 Informed Consent Informed Consent Process
More than just a signature on a form Ongoing process throughout duration of study Process of obtaining consent should be documented in source documents Informed Consent Documentation All pages signed and dated (as appropriate) by: Subject Person who conducts the Informed consent discussion Principal Investigator (per IRB/EC/CA requirements) Company Confidential © 2012 Abbott 281

282 Informed Consent Reminders
Subjects must sign consent prior to conducting any study specific procedures Medication Washouts Subject must sign consent prior to washing out of a medication Review date of consent to compare the medication stop dates in EDC The date the subject signs consent is recorded as the screening visit date No screening procedures can be done until consent is signed. Site personnel providing consent should have documented delegation to do so Ensure subjects have been consented on current version of consent and re-consenting has been completed in a timely manner (at the next subject visit) Company Confidential © 2012 Abbott 282

283 Site Supplies Regulatory Binder CTC 4.0 (version 4.03)
RECIST quick references guides Subject dosing cards (Veliparib + TMZ) Subject dosing cards (Veliparib/Placebo + Carb + Taxel) Barcode scanner (1 per site) IVR/IWR access code envelopes 1 assigned for PI, maximum of 5 for study site IVR/IWR short user guides QoL (10 copies) – Data entered into EDC by site staff CIPN (10 copies) – Data entered into EDC by site staff BRCA source worksheets Lab barcode source worksheets Mini Protocols Procedure Cards

284 Study Forms Site Initiation Statement
Supplemental Training (training provided after the SIV) Site Signature/Initial/Delegation of Responsibility Log Monitoring Visit Log Study Drug Temperature Log(s) – 1 for each drug used in the study On-Site Drug Destruction Form(s) – 1 for each drug used in the study Storage Temperature Excursion Form (ATEMs)

285 Questions & Answers Company Confidential © 2012 Abbott 285 285 285


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