Apollo Proton Cancer Centre (medical oncology) for Kenyan Patients

1. THE FUTURE OF CANCER CARE Medical Oncology Apollo Hospital Information Centre, Kenya, +254 789 150 890/ +254 748 830 976/ +254 719 581 035 +254 754 680 981 info@apolloinformationcentre.com, Suite 4C, TRV Centre, 3rd Parklands Ave, Nairobi. proton.apollohospitals.com Email: apcc@apollohospitals.com INFORMATION CENTRE Cancer helpline number: 7338992222

2. INDEX 02 Legacy 03 A Ray of Hope 04 & 05 Chairman’s Message 06 & 07 Oncology Milestones 08 & 09 The Most Advanced Cancer Centre 10 & 11 Oncology Standard of Care 12 & 13 Technology Diferentiators 14 & 16 Medical Oncology

3. THE CANCER CARE LEGACY: BREATHING HOPE INTO LIVES FOR OVER 30 YEARS With the increasing global burden of cancer, advanced cancer care is becoming more and more crucial. Cancer care today means 360-degree comprehensive care, which requires commitment, expertise and an indomitable spirit from the cancer specialists. RAY OF HOPE TO 3.5 BILLION FROM OVER 147 COUNTRIES It also demands constant innovation and a fresh way of thinking. At Apollo Proton Cancer Centres, we aim to bring together the best minds in Oncology to discuss and deliberate the emerging trends in cancer management and their impact on clinical practice. The comprehensive treatment planning system involves a Tumor Board which consists of a panel of competent medical, surgical and radiation oncologists all working together to win over cancer. 1000+ Beds 2 lakh Onco Surgeries 250+ Oncologists Cancer Centres 14 over 5000+ Radio Surgeries 2 Million Chemos 600 thousand Radiation Sessions Over 4000 Over Robotic Surgeries BMT 2000 Procedures Largest number of Proton Therapies are done in south asia PET-CT `s 50000 03

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5. 1st Radio surgery program in India OUR NETWORK & MILESTONES 1st Private Hospital to install LINAC India's first CyberKnife 1995 2005 1st BMT successfully performed 1st PET-CT 1993 2008 1996 1st Tomotherapy machine installed Truebeam STX with Brain Lab Novalis Tx launched 2013 2011 2010 2016 2012 India's first pet MRI 1st Robotic Onco Surgery in India 1st 1st World's First Proton Practicum with International Faculty Launched Digital Pathology 1st Digital PET-CT in South Asia 2019 2021 2022 2019 2018 2021 1st Proton Therapy center in South Asia and the Middle East India's 1st JCI accredited Cancer Hospital India's 1st site specific robotic oncology program 1st 06 07

6. APOLLO PROTON CANCER CENTRE (APCC) IS THE FIRST AND ONLY PROTON THERAPY CENTER IN SOUTH ASIA AND MIDDLE EAST DEDICATED PEDIATRIC ONCOLOGY INFRASTRUCTURE AND EXPERTISE INDIA’S FIRST & ONLY SITE-SPECIFIC ROBOTIC ONCOLOGY PROGRAM AND IT IS INDIA'S FIRST JCI ACCREDITED CANCER HOSPITAL. MULTI-DISCIPLINARY TUMOUR BOARD APPROACH HIGH END DIAGNO STI CS IM AGING CENTER PRECISION ONCOLOGY ORGAN-SPECIFIC CANCER MANAGEMENT TEAM 08 09

7. MOST ADVANCED CANCER CARE • Personalized medicine care for cancer management • Genomic Profiling for Cancers including DNA sequencing and Digital Pathology services • Surgical oncology fully integral part of cancer care with 5 Modular Digital MRI integrated OT and inpatient beds • State-of-the-Art Proton therapy center - 3 Gantries • Advanced Radiation Oncology center • Medical Oncology, Specialist pharmacy, Nursing, Molecular MDTs and Clinical trials COLLABORATIVE CANCER CARE EXCELLENCE. EXPERTISE. EXPERIENCE. Apollo Hospitals sounded the clarion call to battle cancer over two decades back, and since then has played a pivotal role in ensuring that India emerges as a global leader in the fight against cancer. This mission to conquer cancer demands the confluence of modern technology with the collaboration and commitment of the entire oncology fraternity in the nation. At APCC we will strive to create an ecosystem of excellence, where knowledge and priceless experience is shared. We seek to create a platform that touches and enriches lives with the dynamic and powerful impact of cutting-edge technology. Our mission is to give every patient the best possible chance to conquer cancer; your support is critical for the success of this mission. Our patient referral system is guided by the unwavering values of complete transparency and regular dialogue. We understand you care for your patients; our protocols make sure that there is close communication with the primary healthcare professional and we go the extra mile to ensure that you are always a part of the treatment process. A STEP AHEAD IN CANCER MANAGEMENT We are looking to build a vibrant community that is united in its vision of curing cancer through innovation, commitment and empathy. Being a part of this community will give us a ringside view of exciting new developments in this field — be it in path-breaking clinical trials, incisive learning materials or the chance to follow deeply impactful conferences in proton therapy. 10 11

8. thereby imparting lesser radiation exposure to patients. The equipment also boasts of a wide-bore gantry which makes the scan seamless for a less claustrophobic experience and for large-sized patients. The newer reconstruction techniques allow scans to be completed almost twice as fast as the other conventional analogue PET-CT systems. TECHNOLOGY DIFFERENTIATORS COMPREHENSIVE MEDICAL CARE, BACKED BY THE LATEST TECHNOLOGICAL INNOVATIONS. 5. Digital Pathology Digital pathology — also known as “whole-slide imaging” — is the process of scanning conventional glass slides and then digitally knitting consecutive images into a single, whole image that replicates the information on the glass slide. This virtual image is paired with associated clinical information to give pathologists an integrated picture of the person’s unique cancer Pathologists can then perform additional diagnostics, including image analysis tests that are not possible on traditional glass slides. As cancer care has become one of the fastest-growing healthcare imperatives across the globe, Apollo Proton Cancer Centre (APCC) stands as a ray of hope for millions of cancer patients from 147 countries to access the most advanced cancer care, helping them with the courage to stand and stare cancer down. 6. Theranostics The Theranostics program at APCC integrates diagnostic nuclear medicine and radionuclide therapy for various cancers throughout the body using suitable tracers and treatments that target specific biological pathways or receptors. Apart from the traditional Theranostics for thyroid cancer, neuroblastoma / pheochromocytoma with radioiodine compounds, Latest Theranostics also called ‘Peptide Receptor Radionuclide / Radioligand Therapy (PRRT/ PRLT)’ for advanced, metastatic, inoperable Neuroendocrine tumours and Prostatic cancer are being done here with state-of-the-art infrastructure by using Beta and Alpha emitting radio-isotopes like Lutetium 177 and Actinium 225. APCC has a fully integrated treatment suite that ofers the most advanced treatment in surgical, radiation and medical procedures. True to the Apollo Pillars of Expertise and Excellence, the Centre brings together a powerful team of clinicians renowned globally in cancer care. 1. Proton Therapy APCC has established the first Proton Beam Therapy Centre for cancer treatment to serve over 3.5 billion people. Proton therapy is a cancer treatment that targets tumours with high accuracy, allowing for favourable outcomes with a low risk of side efects. As a result, normal, healthy tissue receives less exposure to radiation treatment, reducing the risk of complications. Fewer treatment complications may enable our physicians to deliver higher doses of radiation to the tumour. And this increased dose of proton radiation may improve a patient's chance for a successful outcome. 7. Stereotactic Radiosurgery (SRS) This is a procedure utilising very accurate targeted radiation in large doses to efectively kill a tumour or destroy a lesion. A non-invasive procedure that has been used as an efective alternative to surgery or conventional standard fractionated radiation therapy for treating small tumours. Stereotactic radiosurgery uses precisely focused radiation beams to treat tumours and other abnormal growths in the brain, spinal column and other body sites. Brain lab SRS system achieves submillimetric radiotherapy positioning and real-time monitoring through thermal surface tracking and real-time X-ray tracking. Highly beneficial for cranial and extracranial work. 2. Helical TomoTherapy/IMRT/IGRT TomoTherapy System is designed to safely and routinely deliver image-guided, intensity-modulated radiation therapy (IG-IMRT) for the treatment of cancer and other diseases. What has made the TomoTherapy System stands out when compared to conventional radiation systems in the integration of computed tomography (CT) scanner to perform daily imaging before each treatment session. APCC has the first and only helical TomoTherapy Machine in Tamil Nadu. 8. 3 Tesla MRI At APCC, we have the revolutionary 3 Tesla MRI. Operating at twice the power, it provides a greater signal-to-noise ratio, which is a major determinant in generating the highest quality image. The higher resolution images produced by the 3 Tesla MRI are beneficial when diagnosing pathological conditions involving the brain, spine, and musculoskeletal system. The resolution and clarity also allow radiologists to identify smaller lesions and anatomical structures that cannot be seen with less powerful machines. 3. Robotic Surgery Our state-of-the-art operating theatres are equipped with the ‘Da Vinci Surgical System’, the most advanced platform for minimally invasive surgery available today. The four-armed surgical robotic system is a breakthrough in surgical technology and is a crucial component of our integrated cancer care program. Robot-assisted surgery integrates advanced computer technology with the experience of skilled surgeons. This technology provides the surgeon with a 10x magnified, high definition, 3D image of the body's intricate anatomy. The robot helps replicate the surgeon’s hand movements while minimizing hand tremors. The surgery is thus conducted with enhanced precision, dexterity, and control even during the most complex procedures. 4. Digital PET-CT APCC is equipped with the most advanced state-of-the-art Digital PET-CT scanner, the first of its kind in South Asia. The fastest time of flight technology and digital detectors ofer high resolution and crystal clear images with an ability to detect lesions as tiny as 1-2 mm in size at lesser imaging times and injected doses 12 13

9. MEDICAL ONCOLOGY Personalised Therapy At APCC we deliver cutting edge chemotherapy which is individualised to each patient’s needs to maintain quality of life. Genomic tests may guide in de-escalating treatment in some patients and avoid chemotherapy. If indicated, next generation sequencing is ofered and optimal drug treatment is considered for patients to personalised therapy. This is overseen by the weekly molecular MDT. A POWERFUL COMBINATION THAT STRIKES AT THE HEART OF CANCER. Targeted Therapy At APCC we use the precision medicine approach to deliver personalized and targeted cancer treatment. We use therapeutics to target specific genes or proteins that make up cancer cells and launch an all-out attack on them to arrest the growth and spread of cancer cells. Our approach is to identify potential targets to compare the amounts of individual proteins in cancer cells with those in normal cells. Proteins that are present in cancer cells but not normal cells or those that are more abundant in cancer cells would be potential targets, especially if they are known to be involved in cell growth or survival. Medical Oncology is the use of powerful therapeutics to launch a sustained attack on cancer cells. Tremendous strides have been made in this crucial field. Medical Oncology has moved beyond conventional chemotherapy and now straddles new and revolutionary facets like personalized systemic treatments, targeted therapy, hormonal therapy and immunotherapy. For young patients, onco-fertility, genetic counselling, is ofered routinely and for older patients – the geriatric oncology program ensures safe delivery of systemic treatments. APCC’s multi-disciplinary approach leverages great expertise and skill in site-specific Medical Oncology to augment our radiation and surgical treatment so as to provide patients with a comprehensive and 360 degree treatment blueprint. Hormone Therapy Hormone therapy fights cancer by changing the number of hormones in the body to treat certain forms of cancer that rely on these chemicals to grow and spread. We use drugs to prevent hormones from making cancer cells grow and divide. At APCC, the protocols are tailor-made to the patient’s specific type of cancer. If indicated, our specialists use cutting-edge next generation sequencing to identify key genetic mutations in a patient’s tumour. These individual variations in genes allow doctors to administer very focused tumour categories and prescribe treatments to address the cancers’ individual make-up. At APCC we will use IBM Watson – one of the world’s best platforms for collating, sorting and analysing data Immunotherapy Immunotherapy leverages the patient’s immune system to form an efective arsenal against cancer. The immune system is our first line of defence against cancer; immune cells patrol cells, to destroy them. Molecular Profiling Molecular profiling is a great catalyst to improve the efficacy of systemic therapies. Our expert pathologists and molecular biologists analyse the cancer tissue sample collected for biopsy or the patient's blood sample and perform rigorous molecular biology testing on them. These tests predict the patient’s chance of responding to cancer drugs when administered for treatment. This forms the basis for bespoke treatment plans for individual cases of cancer. Genetic Counselling In Genetic Counselling, the gene mutation of the cancerous cells is checked to predict whether the patient can respond to a particular drug or not. 14 15

10. APOLLO CANCER CENTRES PRESENCE IN INDIA Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Hyperthermic lntraperitoneal Chemotherapy (HIPEC) Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is an innovative procedure used to treat cancers that have originated in or spread to the abdominal cavity, such as appendiceal cancer, pseudomyxoma peritonei, colon cancer, gastric cancer, ovarian cancer, and peritoneal mesothelioma. Benefits of HIPEC surgery: • Best survival rates of any peritoneal mesothelioma treatment • Fewer side efects than traditional chemotherapy • Safe delivery of higher drug doses than systemic chemotherapy • Local application means more cancerous cells than normal cells are exposed to the drugs, which prevents resistance to chemotherapy Pressurized lntraperitoneal Aerosol Chemotherapy (PIPAC) PIPAC is a novel therapeutic method of administering chemotherapy within the abdominal cavity. This approach allows for direct treatment of cancers within the peritoneum, an area in which systemic chemotherapy has a little efect due to a low number of blood vessels within this area to efectively transmit traditional chemotherapy. At the time of treatment, the surgical team performs a minimally invasive laparoscopic procedure that allows for direct access to the abdominal cavity. A high-pressure micro-injection pump converts liquid chemotherapy into an aerosolized spray that can reach every corner of the abdominal cavity, even typically hard-to-reach tumour cells. Apollo Proton Cancer Centre 16 17