Viewray: Amsterdam University Medical Centers Treats 1,000th Patient with MRIdian SMART MRI-Guided Radiation Therapy

Date: Thursday, 12 November 2020

Amsterdam UMC reaches treatment milestone while establishing key clinical evidence in tough-to-treat
cancer including pancreas, prostate, lung, liver, and kidney

CLEVELAND, November 12, 2020 — ViewRay, Inc. (Nasdaq: VRAY) announced today that the clinical
team at Amsterdam University Medical Centers (Amsterdam UMC) has treated one thousand patients
using MRIdian SMART (stereotactic MR-guided adaptive radiotherapy). Amsterdam UMC continues to
advance the practice of high-dose ablative radiation therapy with MRIdian through research and
publication of the center’s findings.

Amsterdam UMC began treating patients with MRIdian in 2016 and has been a leader in the treatment
of prostate, pancreatic, lung, liver, and kidney cancers. MRIdian SMART allows for high doses of
radiation to be delivered over a short course of therapy, given the system’s real-time soft-tissue
visualization capabilities and the ability for daily plan adaptation. To date, Amsterdam UMC has
published more than a dozen manuscripts on their experience with MRIdian and had more than 50
MRIdian-related abstracts featured at major medical meetings around the world.

Recently, Amsterdam UMC published their experience using MRIdian SMART for the treatment of
primary renal cell carcinoma in high-surgical-risk patients, given the system’s ability to deliver a
completely non-invasive outpatient ablative treatment. Unlike other therapy options, no fiducials are
required when delivering treatment on MRIdian. At 12-month follow-up, there was low toxicity (zero
grade ≥3) and high local control (95.2 percent). Findings were particularly noteworthy given that most
patients were elderly (mean age was 78.1 years) and some tumors were quite large (tumor diameter
ranged from 2.4-9.3 cm; mean 5.6 cm).

Full results, as published in the September 25, 2020 issue of Cancers, are available open access:

Additionally, Amsterdam UMC completed a prospective single arm phase 2 study of SBRT with MRIdian
for the treatment of prostate cancer. At 1-year follow-up, the study demonstrated zero grade 3
toxicities and very low grade 2 toxicities in more than 100 patients, of which more than half were highrisk
(59.4 percent). This study shows low incidence of early toxicity using MRIdian SMART while
eliminating potential complications and costs associated with implanted marker procedures.

“Because MRIdian allows us to utilize smaller uncertainty margins and employ daily adaptive planning,
we believe it is well-suited to treat a variety of tough to treat cancers for which high-dose radiation may
not typically be considered,” said Prof. Ben Slotman, M.D., Ph.D., FACR, FASTRO, Professor & Chairman,
Radiation Oncology Departments Amsterdam UMC. “In prostate cancer specifically, previous data
illustrates the quality of life challenges patients can experience after radiation therapy, such as bowel
symptoms, whereas we saw very low incidence of early GI and GU toxicity, both in clinician- and patientreported
outcome measurements in our MRIdian SBRT study.”

Final results were published in the June 12, 2020 issue of European Urology Oncology: and early toxicity
results were published in the December 2019 issue of the International Journal of Radiation

Currently, 40 MRIdian systems are installed at hospitals around the world where they are used to treat a
wide variety of solid tumors and are the focus of numerous ongoing research efforts. MRIdian has been
the subject of hundreds of peer-reviewed publications, scientific meeting abstracts and presentations.
More than 11,000 patients have been treated with MRIdian. For a list of treatment centers, please visit: