1

P E R S O N A L I S E D D I G I TA L H E A LT H I N T E R V E N T I O N

F O R E V E R Y C A N C E R PAT I E N T

Vesa Kataja, LT, dosentti

Erikoislääkäri, syöpätaudit ja sädehoito

Lääketieteellinen johtaja

KAIKU HEALTH Ltd

2

Solving highly unmet medical need in oncology

C A N C E R

I N C I D E N C E I N C R E A S I N G

P R E C I S I O N M E D I C I N E A N D

P E R S O N A L I S E D T H E R A P I E S T O B E N E F I T

P A T I E N T S

T H E R E ’ S A H I G H U N M E T M E D I C A L N E E D F O R T I M E LY M A N A G E M E N T O F T O X I C I T I E S O F T H E

P R E C I S I O N C O M B I N AT I O N T H E R A P I E S I N O R D E R T O P R O V I D E PAT I E N T S W I T H T H E M O S T

O P T I M I Z E D T R E AT M E N T S A N D T O F O L L O W O N O U T C O M E S A N D S A F E T Y I N R E A L - T I M E

The global cancer incidence was estimated to have risen to

over 18 million new cases in 2018 according to the WHO.

Several targeted therapies, such as immune checkpoint

inhibitor (ICI) and tyrosine kinase inhibitor (TKI) therapies and

combinations with precision radiation, have drastically changed

the treatment landscape of 1st and 2nd line treatments across

several indications.

3

Solution: Personalised digital healthintervention for everycancer patient

C E - M A R K E D C L A S S I M E D I C A L D E V I C E

Treatment modality specific algorithms

screen symptoms and real-world data, alert

care team and provide personalised support

for patients.

4

© K A I K U H E A L T H

Some terminology

T H E PAT I E N T A C T I V E LY E N G A G E D T O T R E AT M E N T

• PRO = Patient reported outcome

• PROM = Patient reported outcome measure

• ePRO = Electronic patient reported outcome

• ePROM = Electronic patient reported outcome measure

• DHI = Digital health intervention

• DTx = Digital therapeutics

These are not adverse eventsof treatment!

5

Value-Based Health Care (VBHC) Measuring what matters to patient is instrumental

• Efficacy metrics include OS, PFS, RFS, TTP, TTF, CR, PR, SD, PD, etc.

• Patient reported AEs collected first for safety, later also for QoL:

Systematic in trials; not so in real clinical world

Reporting has been based upon HCP interviewing patients, usually just prior to the

next planned Tx

→ Information given by the patients has been biased in many ways

→ Treatment desicions have been based on insufficient/incorrect

information

→ Elevated risks for more severe AEs of toxic Txs, stopping Tx early,

even fatalities

Efficacy-focused care

• Efficacy IS NOT effectiveness!

• For value based health care (VBHC) effectiveness must be shown

→ PROs are essential for this!

• ePROs, reported online by the patients themselves, underline the

true patient experience necessary for evaluating the effectiveness

of the therapy

• Kaiku is one of the leading applications utilised in this

Effectiveness-focused VBHC

EFFICACY = HOIDON TEHO = MITÄ TAPAHTUU TAUDILLE EFFECTIVENESS = HOIDON VAIKUTTAVAUUS = MITÄ TAPAHTUU POTILAALLE

6

• Access through native mobile application or browser-based web app

• Communication with HCPs, sending images or attachments

• Symptom tracking and timely management

• Reporting on other PROs & PREMs (e.g. QoL)

• Patient consenting

• Patiend education: Access to relevant patient support materials tailored to a

treatment phase and hospital (e.g. survivorship materials)

• Automated communication of lab results (e.g. PSA during follow-up of prostate

cancer treatment)

• Automated triage of symptom reports

• Workflow management within care team

• Patient level decision support dashboard

• Patient population dashboard (”Eagle Eye”)

• Automated triggering of PRO questionnaires based on patients’

appointment schedule

K A I K U H E A LT H P R O D U C T S A N D S E R V I C E S

Patient applications andHCP platform

Kaiku Health HCP platform

Kaiku Health Patient app

7

Capturing PROsIntelligent symptom tracking

How Kaiku Health works

Kaiku® Bridge connects with hospital information systems

Data analytics and digital interventions

Non-urgent communication

C O N F I D E N T I A L K A I K U H E A LT H

8

K A I KU H E A LT H I S U S E D F O R C A P T U R I N G A N D

P R O C E S S I N G PAT I E N T - R E P O R T E D DATA I N A L L

C O M M O N C A N C E R T Y P E S

Breast Cancer

Prostate and other urological cancers

Lung cancer

Colorectal and other GI cancers

Hematologic cancers

Melanoma and other skin cancers

Gynecological cancers

Head and neck cancers

C O M P L I A N T W I T H A L L C A N C E R C A R E PAT H WAYS

✓

Surgery

✓

Systemic Therapies

✓

RadiationTherapy

✓

Follow-up

✓

Palliative care

C O N F I D E N T I A L

9

C L I N I C A L R O U T I N E U S E

+ Successful implementations with over 45 leading oncology care units in Europe+ Usability proven with +100 000 patients in total (+ 5000 oncology patients)+ 5,8 million data points captured

A L G O R I T H M S + 30 novel symptom detection algorithms developed based on the rapidly growing real-world database

E V I D E N C E G E N E R A T I O NPublished RWD data on the ICI module. Several ongoing clinical trials, several trials in the pipeline for building strong clinical evidence on our digital therapeutics

P H A R M A P A R T N E R S Published collaboration projects with global pharma partners (Hoffmann La Roche, Amgen, MSD)

R E G U L A T O R Y C L A S S I F I C A T I O N CE-marked Class I Medical Device in Cancer Care (and upgrade to Class IIA prepared with MDR)

M A C H I N E L E A R N I N G M O D E L S First symptom prediction model implemented to a therapy monitoring module: AUC > 90 %

P O W E R F U L C O N F I G U R A B I L I T YExtremely effective configurability of new follow-up protocols and algorithms (already in + 30 indication and therapy combinations)

A W A R D W I N N I N G U X25 % of the cancer patients using Kaiku are +70 years old, patient compliance across modules > 90 %Best User Experience Design Award at Upgraded Life Festival 2017

I N T E R O P E R A B I L I T Y + 10 established integrations with different HIS, Lab and ERP systems e.g HL7, REST interfaces (Kaiku Bridge)

L O C A L I Z A B I L I T Y 7 countries (FIN, SWE,NOR, NL, GER, CH, ITA), 10 languages

L I F E S C I E N C E

D ATA S C I E N C E

Differentiating factors of Kaiku Health

10

• 95 % of cancer patients report positive impact on

treatment experience*

• 90 % of patients would recommend Kaiku Health

(Immune Checkpoint Inhibitor module) to other

patients*

• 5+ months increased life span and increased QoL

for cancer patients with a non-commercial

research-based solution in the US **

Increased vigilance and clinical efficiency

Better patient experience and ultimately better outcomes

• + 5 800 000 data entries captured*

• 10 x more outcome data points from

patients*

• 90 % response rate in follow-up

questionnaires in our cancer care modules

enabling rich longitudinal data capture*

Real-world data on the effectiveness of therapies

• 64 %-75 % reduction in need for phone calls by

patients*

• Over 300 cancer patients screened by one

coordinating nurse*

• Digital patient follow-up reduced emergency room

admissions by 5-10 % with a non-commercial

research-based solution in the US**

Our stakeholder value propositions

* Kaiku Health customer interviews / metrics

**Basch et al. 2017

PAT I E N T H E A LT H C A R E P R OV I D E R P H A R M A A N D M E DT E C H

1111

S.M.E. Iivanainen, J. Ekström, H. Virtanen, J.P. Koivunen.Predicting onset and continuity of patient-reported symptoms in cancer patients undergoingimmune checkpoint inhibitor (ICI) therapies usingmachine learning. Annals of Oncology (2019) 30 (suppl_11): xi16-xi32. 10.1093/annonc/mdz449

Iivanainen, S., Alanko, T., Peltola, K. et al. J Cancer ResClin Oncol (2019). https://doi.org/10.1007/s00432-018-02835-6

Sanna Iivanainen, Jussi Ekström, Vesa V Kataja, Henri Virtanen, Jussi Koivunen; J Clin Oncol 38: 2020 (suppl; abstr e14058)

Evidence from literature: A randomized controlled trial with 766 metastatic

cancer patients shows that digital symptom monitoring (non-commercial

research tool) during chemotherapy helps patients live longer (5.2 months

longer median overall survival), improves quality of life (31 % of patients),

and reduces hospitalization (4 %) and ER visits (7 %).

Novel results from Kaiku Health’s real-world data: the first study in the world to

publish real-world data gathered by Kaiku Health’s Immune Checkpoint Inhibitor

module show correlations between different symptoms, which might reflect

therapeutic efficiency, adverse effects, or tumor progression. A prospective feasibility

trial validating Kaiku Health’s Immune Checkpoint Inhibitor module is expected to be

published H1/2020.

Digital interventions show a significant potential for improving clinicaloutcomes in oncology

S C I E N T I F I C E V I D E N C E

12

+1 day +1 day +1 day

Actication of COVID-19 monitoring

• A patient is provided with a link to activate theCOVID-19 monitoring. The link can be providede.g. at a testing station or sent remotely when a positive case has been confirmed.

+1 day

Kaiku askspatient to perform a dailysymptomcheck*:

• High fever (over 40 ˚C) or milder fever that has lasted for several days

• Worsening cough

• Shortness of breath

• Blood or pink in sputum

• Severe fatigue

• Severe anxiety

-> In case there are signs of alarming symptoms, a patient is advised to contact the care team.

COVID-19 remote monitoring in Kaiku Health

+…

!Only severe symptoms generate

Notifications for the care team

The follow-up period can be configured

at a clinic, e.g. for

10-14 days

*) The follow-up parameters can be flexibly configured within 1-2 days

13

A sample workflow of COVID-19 team in Kaiku Health

A patient registers and starts completing daily symptom checks.

COVID-19 team receives notifications only when a patient’s situation is

worsening

COVID-19 team contacts the patient on the urgent symptoms and provides needed instructions or asks a patient to come to the hospital.

A patient is provided a flyer with a link to activate the follow-up or care team can send the link to patient.

Kaiku Health can be handed for patients already at the testing facility. If a patient

receives test that is negative, the follow-up can be automatically deactivated.

14

© K A I K U H E A L T H

Kaiku Health asks a patient to report COVID-19 related symptoms on daily basis

15

© K A I K U H E A L T H

Healthcare providers landing page, where only the urgent symptom reports are highlighted

16

© K A I K U H E A L T H

HCPs have access to a daily dashboard on patients’ symptoms

1717

R E F E R E N C E S

Co-created in Routine Cancer Care

Leading European hospitals and clinics are using our platform to better monitor their patients, reducing manual work and allowing

prioritization of clinical actions.

18

C O M

Lauri Sippola, Joel Lehikoinen, Henri

Virtanen and Kaarlo Haikonen based

on their initial market research at

Aalto University

Kaiku Health Oy

F I R S T C U S T O M E R S D O C R AT E S

C A N C E R C E N T E R A N D

R A D I O T H E R A P Y H I R S L A N D E N

Kaiku Health was taken into use by

Europe’s leading cancer centers in Finland

and Switzerland. Both Docrates Cancer

Center and Radiotherapy Hirslanden are

customers of Kaiku Health.

Kaiku Health has been to our knowledge the

first company in the world to develop an

algorithm for improving symptom management

in cancer immunotherapies based on ePROs.

Collaborations published with world

largest pharma companies such as Roche

and Amgen.

HQ: Vilhonvuorenkatu 11 A, Helsinki Finland

Team of 43 people (28 software, UX and

data and medical science professionals)

Europe leading cancer centers and global

pharmaceutical companies as customers.

C O M PA N Y F O U N D E D

D E V E L O P M E N T O F

C A N C E R I M M U N O T H E R A P Y

A L G O R I T H M S TA R T E D

S E R I E S A O F 4 , 4 M I L L I O N

E U R O S W I T H D E B I O P H A R M

I N N O V AT I O N F U N D A N D T E S I

1 9 . 5 . 2 0 2 0 M E R G E R TO

E L E K TA , S W E D E N

H I S T O R Y I N B R I E F

2 0 1 2 2 0 1 3 2 0 1 6 2 0 1 8 2 0 2 0