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RAYSEARCH/REVIEW/2015

ADVANCING CANCER TREATMENT

RAYSEARCH/REVIEW/2015

ADVANCING CANCER TREATMENT

CONTENTS02

LETTER FROM THE CEO

CONTINUED SUCCESS FOR RAYSTATION – A STRONG FOUNDATION FOR FURTHER EXPANSION

04 THE CANCER CHALLENGE

ACCESS TO RADIATION THERAPY FOR THE MASSES

10MARKET DEVELOPMENT

A STRONG MARKET MOMENTUM

14FEATURING RAYSTATION

RAYSTATION – THE ART OF TREATMENT PLANNING

20CUSTOMER SERVICE

ALWAYS AT HAND TO SUPPORT

26WORLD-CLASS KNOW-HOW

DEDICATION AT WORK

32LOOKING AHEAD

RAYCARE – THE NEXT GENERATION OIS

36PARTNERS

KEY PARTNERSHIPS PAVE THE WAY FOR SUCCESS

40 MAJOR ORDERS

THE FRONTRUNNER’S CHOICE

42FACTS & FIGURES

RAYSEARCH IN SUMMARY

44FACTS & FIGURES

RAPID SALES AND EARNING GROWTH

THE WORLD NEEDS MORE RADIATION THERAPYThe starting point for everything we do at RaySearch is to improve people’s quality of life by advancing cancer care in the world. Cancer is now the leading cause of prema-ture death and the number of cases continues to increase every year. Our task is great, essential and very engag-ing. Clinics around the world fight cancer by combining radiation therapy, chemotherapy and surgery, which are all an important part of the solution. However, radiation therapy is greatly underdeveloped, particularly in low- and middle-income countries – despite the fact that 50 percent of all cancer patients would benefit from such treatment, and that investment in radiation therapy has positive eco-nomic benefits. Establishing a radiation therapy clinic may be expensive, but radiation therapy is all in all the most cost-effective way to treat cancer. This fact is beginning to spread around the world, and at RaySearch we can offer the most advanced and easy to use software for optimal radiation therapy.

BETTER CARE WITH MODERN SOFTWAREOur greatest contribution to date in the fight against can-cer is RayStation, the most advanced treatment planning system for radiation therapy with support for adaptive radiation therapy, a user-friendly interface, automated workflows and unique multi-criteria optimization.

Advanced software such as RayStation contributes to both improved radiation therapy processes, and ensures that treatment machines have a longer lifespan and can be used more efficiently. This means that clinics that want to improve and develop their care no longer have to purchase the latest hardware but can achieve as good results by selecting RayStation as their treatment planning system.

RayStation retains its leading position through con-tinuous product development. At the turn of the year 2015/2016, we launched RayStation 5, which is currently the only commercial system that supports treatment plan-ning for carbon ion therapy. Particle therapy is the most advanced form of radiation therapy and RayStation now supports both ion- and proton therapy. For proton therapy, we had seven new customers in 2015, early 2016 and now have a market share of 30 percent.

The most groundbreaking new feature in RayStation 5 is Plan Explorer, a unique tool that allows the system to automatically generate a large number of treatment plans for different treatment techniques and types of machines, which the user can choose from based on the clinical goals. Plan Explorer contributes to both better care for the patient – thanks to improved quality of the treatment plans in general – and improved efficiency.

No other treatment planning system supports as many different types of treatment machines as RayStation, and

JOHAN LÖFCEO AND FOUNDER

RAYSEARCH LABORATORIES

CONTINUED SUCCESS FOR RAYSTATION –

A STRONG FOUNDATION FOR FURTHER EXPANSION

in 2015 we consolidated this position further. We signed an agreement with Accuray that will allow RayStation to support treatment planning for the TomoTherapy and CyberKnife systems. This ensures enhanced efficiency for clinics that use Accuray’s systems together with con-ventional machines. It also presents great business oppor-tunities for us, as Accuray has an installed base of over 800 systems and RayStation becomes the only indepen-dent system that can generate treatment plans for their machines.

During 2015 – RayStation’s sixth year on the market – we doubled our order intake from 159 to 317 million SEK. Some of the world’s most respected cancer clinics chose RayStation for their treatment planning, including MD Anderson, The University of Florida Health Proton Ther-apy Institute in the United States and the Gustave Roussy institute in France. Such prominent customers contribute towards our continued growth.

RAYCARE BRINGS A NEW PERSPECTIVEDuring the past year, we have achieved a number of import-ant milestones in the development of our next contribution to improving cancer care: RayCare.

RayCare is the next generation of OIS. When the sys-tem is launched in 2017, the world’s cancer clinics will get access to a comprehensive information system for all disciplines of cancer care – radiation therapy, chemo-therapy and surgery. RayCare will be able to manage the workflow and store information about a cancer patient’s entire treatment course, which opens up new possibilities for data analysis and evaluation of treatment outcome. To ensure that we meet the clinics’ needs, the development work is conducted in close collaboration with leading can-cer clinics. In early 2016, our clinical partners were The University Medical Center in Groningen, The University of California San Francisco and Iridium Kankernetwerk.

We knew that the market needed a modern OIS when we started developing RayCare. And I knew that RaySearch was in the best position to develop it. But the interest in RayCare actually surpasses my expectations. The recep-tion is already overwhelmingly positive when we demon-strate the system to potential customers.

A GLOBAL PLAYERDuring 2015, we expanded our geographical footprint sig-nificantly, particularly in Asia. We established an office in Singapore during the year and also began the process of opening offices in China, Japan and South Korea. Our presence in Asian markets is critical to both our vision and financial targets. Despite being home to 60 percent of the world’s population, the availability of radiation therapy in many parts of Asia is very limited, and many countries

are undertaking major investments in their healthcare systems, with cancer treatment as a central component.

As RayStation users increase in number and spread throughout the world, we also intensify our investments in customer support. Swift and adequate support is crucial – both for us and for our customers. Our customer service team is growing and is established in a growing list of coun-tries. Our ambition is to be available around the clock and to offer assistance in the language that best suits the user.

A STRONG TEAM FOR FUTURE CHALLENGESThe number of radiation therapy clinics in the world is likely to increase in the coming decade. The driving forces include the rise of cancer incidences, increased understanding of the benefits of radiation therapy and large healthcare investments in Asia. The market is therefore undergoing steady growth. But we will continue to grow significantly faster than the market. Our ambition is a market share of over 30 percent in the not too distant future.

A summary of 2015 illustrates that our financial result has also followed a positive trend. Revenue increased by 39 percent and we have had our best annual financial result ever. This is very satisfying when considering how much we are investing in both new markets and in product development.

It is a privilege to operate a business such as RaySearch. The drive and innovativeness within the company are hard to beat, and for me as CEO and founder it is extremely rewarding to see the RaySearch family grow and spread throughout the world.

We welcomed 50 new team members last year and we all help our new colleagues to quickly feel at home in the company and become part of our common mission – to continue to advance cancer treatment through innovative software solutions that save lives and improve quality of life.

2015 WAS A FANTASTIC YEAR FOR RAYSEARCH AND MANY OF MY HIGH EXPECTATIONS WERE EXCEEDED. WE LAUNCHED GROUNDBREAKING NEW FEATURES IN THE LATEST VERSION OF RAYSTATION, INCREASED SALES SUBSTANTIALLY, RECEIVED PRESTIGIOUS RECOGNITION FROM SEVERAL OF THE WORLD’S LEADING CANCER CLINICS, AND TOOK MAJOR STEPS IN THE DEVELOPMENT OF RAYCARE, THE NEXT-

GENERATION ONCOLOGY INFORMATION SYSTEM (OIS).

2 3LETTER FROM THE CEO LETTER FROM THE CEO

ACCESS TO RADIATION THERAPY

FOR THE MASSESRADIATION THERAPY IS CRUCIAL FOR COMPREHENSIVE CANCER TREATMENT AND CARE. IT IS A COST-EFFECTIVE METHOD THAT CAN BENEFIT HALF OF ALL CANCER PATIENTS. HOWEVER, THERE IS A WORLDWIDE SHORTAGE OF RADIATION THERAPY SERVICES – PARTICULARLY IN LOW-INCOME AND MIDDLE-INCOME COUNTRIES

WHERE THERE IS AN ACUTE LACK OF RESOURCES.

4 5THE CANCER CHALLENGE THE CANCER CHALLENGE

There is strong evidence that investments in radiation therapy not only enable the treatment of a large number of cancer cases, but also bring about economic benefits to a society.

CANCER INCIDENCE IS INCREASINGEach year, more than 14 million new cases of cancer are reported globally, and this number is projected to reach over 24 million by 2030. Cancer is now the leading cause of premature death worldwide. More than 8 million cancer deaths are currently reported every year and the figure is expected to rise to 13 million in 2030.

Without doubt, the fight against cancer will continue to be one of the greatest challenges facing medical science for the foreseeable future. However, global efforts to control cancer using current knowledge and technology are still inadequate.

RADIATION THERAPY FUNDAMENTAL FOR EFFECTIVE CANCER TREATMENTRadiation therapy is fundamental for effective cancer treatment and control. It is estimated that about half of all cancer patients would benefit from radiation therapy for the treatment of localized disease, local control and pallia-tion. Yet this crucial component of the response to cancer has been largely absent from global health discourse. As a consequence, funding is inadequate, both on a local and global level.

Currently, there are some 8,000 radiation therapy cen-ters around the world. Their distribution varies greatly between geographical areas. In North America, which is leading the development in the field, around 60 percent of all cancer patients are treated with radiation therapy. In Europe, the rate varies between 30 and 50 percent from country to country, and only 25 percent of cancer patients are treated with radiation in Japan.

In low-income and middle-income countries, there is an acute lack of resources. These countries carry 80 per-cent of the global cancer burden but have only access to 5 percent of the healthcare resources. This is the biggest driver behind the worldwide shortage of radiation therapy services. The growing incidence of cancer cases will place increased demand on the already scarce global radiation therapy resources. However, when planning and building treatment capacity for cancer, radiation therapy is fre-quently the last resource to be considered, according to a report recently published by The Lancet Oncology Commis-sion. Consequently, worldwide access to radiation therapy is unacceptably low.

THE “25 BY 25” TARGETIn 2013, World Health Organization (WHO) member states agreed on global targets to reduce premature mortality from cardiovascular and chronic respiratory diseases, cancers and diabetes by 25 percent by 2025, compared to 2010 levels. To achieve this so called “25 by 25” target, at least 1.5 million deaths from cancer will need to be pre-vented each year.

Meeting this challenge requires both effective preventive measures and healthcare systems that provide accurate diagnosis and high-quality multimodality treatment. This includes radiation therapy, surgery, drugs and access to palliative and supportive care. However, persistent underin-vestment in radiation therapy resources, which ultimately results in unnecessary premature deaths, highlights the fact that this clinical service is frequently overlooked when planning new cancer centers.

AN INVESTMENT THAT PAYS OFFRadiation therapy is considered to be a complex treatment that is often considered to be unfeasible in poorer nations. However, nothing could be further from the truth – radiation therapy can be effectively standardized and delivered in low-income and middle-income countries.

The Lancet Oncology Commission has recently stated in a report that there are substantial health and economic benefits to be gained by investing more in radiation ther-apy. In an efficiency model presented by the Commission, scaling up radiation therapy capacity by a worldwide invest-ment close to US$ 100 billion over the period 2015–2035, will result in substantial benefits.

In low-income and middle-income countries, it is estimated that almost 27 million life years could be saved over the lifetime of patients who receive treatment. In addition, the economic benefits of investment in radiation therapy are calculated to be around $365 billion. According to the Lan-cet Oncology Commission, investments in radiation therapy not only enable the treatment of a large number of cancer cases, but also bring positive economic benefits.

SOFTWARE IS KEYThe development of linear accelerators (linacs) has been fundamental for the progress of radiation therapy, and is still ongoing. But hardware for radiation therapy is increas-ingly becoming a commodity, which is manifested by the entry of new manufacturers that are producing and selling linacs for the low- and middle-income markets. There is also an increasing market for refurbished linacs, as perfectly functional linacs are being replaced and resold after 10 years in many high-income countries.The key component that is yet to be properly addressed is treatment planning software. There is a strong need for a modern, user-friendly and fast treatment planning system to be made available to these markets. Based on the same core technologies as RayStation, RayPlan has been devel-oped to fill this space.

RAYPLAN RayPlan is a trimmed version of RayStation. It provides licensing options that are adapted to clinics that are de di-cated to the most commonly available treatment tech-niques, 3D-CRT and IMRT. Through RayPlan, more clinics will have the opportunity to access RaySearch treatment planning technology and it will play an important role in making efficient radiation therapy more available. Clinics that have chosen RayPlan will have the option to upgrade to RayStation in order to get access to additional features such as VMAT, deformable registration and scripting. RayPlan will initially be available in China.

80% 5% OF THE HEALTHCARE

RESOURCES

THEY HAVE ACCESS TO ONLYOF ALL CANCER PATIENTS

ARE FROM LOW/MIDDLE INCOME COUNTRIES


“We have built a strong relationship with RaySearch in a short time. Due to the multi-modal and diverse techno logy that we offer in our clinics, RayStation is a universal so lution for us to be able to compare tech-no logy platforms, create efficiency and focus more on adaptive planning. Our visions strongly align for developing a patient-centered care model through the development of RayCare, and aligns with UCSF vision for a more integrated platform with EPIC, our hospital information system. We believe this will be a transformative partnership on many levels.”CATHERINE PARK, M.D. PROFESSOR AND CHAIR, UCSF, HELEN DILLER COMPREHENSIVE CANCER CENTER, DEPARTMENT OF RADIATION ONCOLOGY, SAN FRANCISCO, USA


About 100 leading clinics and hospitals chose RayStation as their treatment planning system during 2015. With 292 RayStation centers in 23 countries in March 2016, the system is now firmly established in all major markets around the world.

A GROWING SHARE OF A GROWING MARKETThe global radiation therapy devices market is expected to grow by 9 percent annually to reach a value of approxi-mately $3.6 billion by 2018. This estimate is driven by the increasing cancer incidences worldwide combined with extensive healthcare investments in emerging markets and the transition to new treatment technologies.

At the beginning of 2016 – as RayStation entered its sev-enth year on the market – there were 292 RayStation cen-ters established in 23 countries. RayStation’s track-record as a fast, user-friendly and innovative system is leading to customers increasingly choosing to make a complete transition to RayStation directly, rather than opting to start with a few licenses as a complement to their existing software. Also, current users are ordering more licenses. Sales from existing customers represented 25 percent of all RayStation revenues in 2015, which is twice as much as in 2014.

Today, there are approximately 8,000 clinics and hospi-tals worldwide that provide radiation therapy. RaySearch’s ambition is a market share of over 30 percent in the not too distant future.

A SHIFT OF FOCUS The development of linacs has been important for the prog-ress of radiation therapy, and is still ongoing. But hardware for radiation therapy is becoming a commodity. Clinics are realizing that improvements in patient care are relying on software to a larger extent, while linacs represent a far greater cost.

Spending more time, effort and resources on selecting the best and most flexible treatment planning software is key. By doing so, clinics can achieve a higher quality of care and a better overall patient flow.

WELL-POSITIONED IN ASIA Asia is one of the most interesting markets for radiation therapy in many ways. 60 percent of the world’s population lives in Asia, yet only 30 percent of all linacs are found there. This lack of capacity combined with the rapid expan-sion of healthcare systems indicates a sharp growth in the field of cancer treatment.

There is currently also a lot of activity in Asia in the area of particle-beam radiation therapy using protons or carbon ions. RaySearch is the market leader in proton treatment planning and is the only provider of carbon planning. We are in close partnerships with equipment manufacturers, many of them based in Asia, to develop new and better solutions in the field of particle therapy.

To support our expansion in Asia, we have established an office in Singapore. The office is headed by Vivien Li who is responsible for sales in Southeast Asia and Taiwan, and for supporting regional radiation therapy clinics throughout Asia. With its own staff in place, RaySearch will be able to increase brand recognition in the region and take advan-tage of the increasing demand for efficient radiation therapy software. We are also planning to open our own offices in Japan, South Korea and China.

In Japan, RaySearch started a distribution partnership with Hitachi Medical Corporation during 2014 and this collaboration has led to over 30 Japanese clinics invest-ing in RayStation during the first years of the partnership. That makes Japan the second largest country after the US in terms of installed base.

In South Korea, a large national plan to extend cancer therapy is expected to be realized in the coming years. RaySearch has established a local cooperation to capitalize on this. In Taiwan, a new distributor agreement was signed in early 2016 and, as in Thailand and Australia, sales are expected to take off in 2016.

CHINA: A PROMISING MARKET China is currently the world’s second-largest market for radiation treatment and the market is expected to continue to grow rapidly – twice as fast as in the US.

Today, China has a growing elderly population with around 130 million individuals currently over 65 years of age, which will lead to an increasing number of cancer patients. In line with this, the country is currently investing heavily in its healthcare resources. Extended and improved cancer treatment is an important part of this significant investment.

China has less than one linac per million inhabitants – compared with the WHO recommendation of four per million inhabitants. But the situation is changing and capacity is being rapidly built-up. Several Chinese companies are now producing and selling linacs for the lower and mid-market segments in China.

THE GLOBAL MARKET FOR RADIATION THERAPY IS EXPANDING AT A STEADY PACE. AT THE SAME TIME, THE SALES MOMENTUM OF RAYSTATION

CONTINUES TO BE MUCH STRONGER THAN THE MARKET GROWTH.

A STRONG MARKET MOMENTUM

10 11MARKET DEVELOPMENT MARKET DEVELOPMENT

If the capabilities of the linacs from local hardware manu-facturers are to be fully utilized, they need to be supported by innovative and efficient software, such as RayStation.

This link-up poses large potential for RaySearch, as an independent software vendor, to compete. Since the build-up of the country’s resources for cancer treatment is progressing according to a long-term plan, the outlook for the coming years is very promising.

In line with this, we plan to establish an office in China in the near future to further explore the great opportunities in this market.

NORTH AMERICA STILL THE HIGH-END MARKET North America accounts for over 50 percent of the global market in radiation therapy and is a fiercely competitive market. The efficiency requirements are often emphasized in US clinics, which is beneficial to RayStation. For histori-cal reasons, the US clinics are also accustomed to buying treatment planning systems from independent suppliers, rather than buying packages from one manufacturer.

In 2015, the market remained strong in North America. The year represented a milestone for RayStation as the soft-ware was chosen by some of the most recognized clinics in the world, such as The University of Texas MD Anderson Cancer Center where RayStation was selected after a long and thorough evaluation process against major compet-itors. Other significant achievements in the US included orders from The University of Florida Health Proton Therapy Institute, The University of North Carolina, Texas Center for Proton Therapy and The US Oncology Network.

A STRONG BASE OF REFERENCE CLINICS IN EUROPE The sales process in Europe is more formalized than in the US, partly because most clinics are run by the public sector and are regulated by EU procurement rules.

Last year, the European market continued to be stable with a trend towards improving efficiency. RayStation is well positioned in this respect and as a result sales more than doubled in Europe in 2015. Several major contracts were won, including Gustave Roussy in France, one of the ten leading cancer centers worldwide. Gustave Roussy chose RayStation as its main treatment planning system with the aim to develop the best possible care protocols, to ensure that its patients gain access to the most effective and innovative treatments.

AMERICAS

110

EUROPE

86

++

=292 ASIA

96

RaySearch has a strong local European presence with local offices in the UK, France, Belgium and Germany, and dis-tributors in Spain and Italy. RayStation reference clinics are now established in most of the major European markets. This significantly enhances the opportunities for increased sales, as new clients want to visit a reference clinic, and preferably one in their own country, as part of evaluating a new treatment planning supplier.

At the beginning of 2016, there were 292 RayStation centers in 23 countries. Since the introduction six years ago, the development has been rapid.

RaySearch Offices

RaySearch Distributors

12 13MARKET DEVELOPMENT MARKET DEVELOPMENT

THE ART OF TREATMENT PLANNING

RAYSTATION REPRESENTS THE NEXT GENERATION OF TREATMENT PLANNING SYSTEMS WITH A SUPERIOR USER EXPERIENCE AND INNOVATIVE FEATURES, SUCH AS ADVANCED SUPPORT FOR ADAPTIVE RADIATION THERAPY, AUTO-MATED WORKFLOWS AND UNIQUE MULTI-CRITERIA OPTIMIZATION. EARLY IN 2016 WE LAUNCHED RAY STATION 5, A NEW VERSION OF THE SOFTWARE WITH

SEVERAL GROUNDBREAKING FEATURES.

14 15FEATURING RAYSTATION FEATURING RAYSTATION

A WORLD OF ENDLESS POSSIBILITIESRayStation is an advanced and flexible system with end-less possibilities for treatment planning regardless of hardware and treatment technique. The software offers outstanding opportunities to radically improve both plan-ning and delivery processes. All techniques can be used since RayStation includes algorithms for optimizing both traditional 3D-CRT and newer techniques such as IMRT, VMAT and ion beam therapy. RayStation provides state-of-the-art tools to design and optimize treatment plans, as well as to automate parts of the planning process. Full support for four-dimensional adaptive radiation therapy is also included. This offers the opportunity to take into account anatomical changes in the patient on a daily basis and represents the next step in cancer treatment.

A COMPLETELY NEW TAKE ON AUTOMATED PLANNING RayStation 5 features Plan Explorer, a tool that drastically changes the treatment planning process. It is based on the capability to automatically generate a large number of treatment plans for an individual patient that spans defined combinations of treatment techniques and machines based on given clinical goals. It also provides efficient means to filter and browse among plan candidates to find the most desired one. This means that the user can focus on selecting plans that are best suited and compare them to find the most appropriate candidate for each patient, instead of spending time on manually designing plans. If an automatically generated plan needs further refinement, all the regular plan optimization tools can still be applied.

Plan Explorer enables clinicians to explore more of the solution space to ensure that every radiation treatment is delivered with the highest possible efficiency – with an optimal combination of treatment technique and machine. This would be too time consuming for the clinic to achieve with the current manual workflow. The best treatment setup for a given patient is not known beforehand but clinics now have the opportunity to find it for every patient in their everyday routine.

Plan Explorer also enhances resource optimization, since the system automatically generates plans for different techniques and different treatment machines.

LEADING THE WAY IN ION BEAM THERAPYAs the most innovative and advanced treatment planning system on the market, RayStation is leading the way in pro-ton and carbon ion therapy. For proton therapy treatment planning, RayStation currently has a 30 percent market share worldwide. For carbon ion therapy, RayStation 5 is the only commercial treatment planning system.

Ion beam therapy is the most advanced method of radi-ation therapy. Compared to conventional radiation therapy, where the tumor is irradiated using photons, the energy deposition of the ion beams can be controlled more effec-tively. This means that the radiation dose can be deliv-ered even more precisely, which lowers unwanted doses to healthy tissues and leads to a reduction in treatment- related side effects. In addition, radiation therapy with car-bon ions can be used to target tumors with low levels of oxygen, so called hypoxic tumors, for which conventional radiation therapy has limited effect.

Carbon ions have an increased relative biological effec-tiveness (RBE) compared with other types of radiation. An important part of the support for carbon ion treatment planning in RayStation 5 is the precise modeling of RBE, which has been developed in collaboration with the GSI Helmholtzzentrum für Schwerionenforschung in Darm-stadt, Germany. RBE modeling is one of several examples of technologies that will also be applicable to other types of treatment planning in RayStation. The first clinics to adopt this new planning technology are MedAustron in Austria and Centro Nazionale di Adroterapia Oncologica (CNAO) in Italy.

LONG-TERM AGREEMENTS WITH CERN AND INFNThe carbon ion module in RayStation 5 is based on long-term license agreements with CERN (the European Organi-zation for Nuclear Research) and INFN (the Italian Institute

of Nuclear Physics) concerning the FLUKA Monte Carlo code. It is developed and maintained by CERN and INFN and is a general purpose tool for the calculation of particle transport and interaction. The code is used in a wide variety of applications, including radiation therapy.

At RaySearch, the FLUKA code now is an essential tool for research and development in the field of ion beam therapy. During 2015, data generated by the FLUKA code has been integrated into RayStation’s algorithms.

WORLD-LEADING CARBON ION CENTERS USE RAYSTATION Two of the world’s leading carbon ion centers have chosen RayStation as their treatment planning system – MedAustron in Austria and CNAO in Italy. Cooperation with these clinics has had a major impact on the development of the ion beam functionality in RayStation 5.

In particular, requirements from MedAustron have provided guidance on which features to implement, both

for the proton and carbon ion modules, as MedAustron is a dual-mode particle therapy facility. The center has co- developed its cyclotron with CERN, and RayStation has been adapted to facilitate this unique technology. When asked about the collaboration with RaySearch on this long-term project, Gabriele Kragl, medical physicist, responsible for the treatment planning implementation, has only praise. According to her, some of the successfully handled key challenges were the machine integration, the dose calculation, collaboration with the robotic and OIS provider for the collision avoidance, and the deliverability of the plans.

HIGH PACE OF DEVELOPMENT AND INNOVATIONThe first version of RayStation was launched in January 2010. Since then, a new version has been released every year. These frequent updates enable RayStation to stay at the forefront in terms of both technology and usability.

In 2016, we are proud to present RayStation 5. This new version of the software features carbon ion treatment planning, which represents the most advanced form of radiation therapy, and Plan Explorer, a groundbreaking planning tool that allows clinics to maximize delivery efficiency and plan quality for every individual patient treatment.

TREATMENT ROOM AT MEDAUSTRON, WIENER NEUSTADT, AUSTRIA.


“We are extremely impressed by the flexibility and the dedication RaySearch has shown to implement our requirements in RayStation in such a short time. A great advantage when working with RaySearch has been their collaborative spirit and willingness to let us test, review and evaluate the system con-tinuously. This has helped us define our priorities and contributed to a good learning process that ultimate ly led into a tailor-made proton and carbon ion treatment planning system.”GABRIELE KRAGL, MEDICAL PHYSICIST, MEDAUSTRON, WIENER NEUSTADT, AUSTRIA


ALWAYS AT HAND TO SUPPORT

CUSTOMER SERVICE IS A KEY FUNCTION AT RAYSEARCH. ANY-ONE WHO USES OUR SYSTEM CAN FEEL CONFIDENT OF RECEIVING THE SUPPORT NEEDED TO MAKE BEST USE OF THE

INHERENT OPPORTUNITIES OF THE RAYSTATION SYSTEM.

20 21CUSTOMER SERVICE CUSTOMER SERVICE

We offer everything from extensive installation support and effective in-depth training to ongoing assistance and guidance. RayStation users can also share experiences and enhancement requests via a dedicated online com-munity and through regular user meetings.

TAKING FULL ADVANTAGE OF RAYSTATIONRayStation is a leading-edge product that takes treatment planning to new levels. But the system cannot fulfill its full potential without specific training, which is why RaySearch’s customer service plays such an important role.

All the professionals using RayStation – medical phys-icists, dosimetrists and oncologists – have two things in common: they are dedicated to achieving the best outcome for their patients and they have chosen an advanced treat-ment planning system to help them in their work. Their chal-lenge is to make optimum use of the RayStation system, and RaySearch’s Customer Service is committed to helping them succeed.

MEETING CUSTOMER NEEDSThe number of RayStation users is rapidly growing. Con-sequently, our support capabilities have been rapidly expanded in recent years and are continually strength-ened. We currently have dedicated in-house support spe-cialists in Benelux, France, UK, Italy, Singapore, Sweden

and in the US. In addition, RayStation distributors in several regions of the world have dedicated application specialists to support customers.

We are therefore always at hand to help when users are faced with issues or simply require guidance. Our ambition is to be available for customers at any time of the day and to ideally support them in their preferred language.

DEDICATED TRAINING COURSESWe work systematically to develop our customer service operations, including installation training, advanced edu-cation and ongoing support.

All customers also have the opportunity to participate in advanced training sessions if they wish to further develop their capabilities. Advanced training is conducted in dedi-cated training centers in Stockholm and New York.

The courses also offer the opportunity for customers to meet other RayStation users and build a personal network of peers. This transparent exchange of experiences with participating clinics and the opportunity to meet some of RaySearch’s top developers is usually highly appreciated by participants.

INTERACTIVE USER MEETINGSWe organize annual major user meetings in Europe, USA and Asia. These two-day sessions are highly appreciated and the number of attendees increases each year. Local meetings are also arranged depending on market need.

At these meetings, customers get the opportunity to interact with each other and express their views on the soft-ware to our development team. We collect enhancement requests where customers describe what improvements and adjustments they would like to see in the system. Listening to our customers is an important part of our development work. Each meeting also includes a selected number of customer presentations that demonstrate how they use the system at their specific clinic.

SMOOTH TRANSITIONInitial customer contact with our customer service staff typically occurs at the sales stage. When a clinic is consid-ering implementing RayStation, we demonstrate the unique capabilities of the system and show how its user-friendly tools can speed up and facilitate the delivery of high quality radiation treatments.

We do everything to make the transition to RayStation as smooth and convenient as possible for our customers. Our involvement covers all aspects of working with RayStation. We assist with installation and conduct the necessary training, either on site at the customer’s premises or at our offices. In the initial stages of an installation, customers are usually provided with a dedicated RayStation delivery team consisting of three experts: an application specialist, a service physicist and an IT specialist. Depending on their specific queries, our customers always have access to the appropriate specialist.

OPEN LINES OF COMMUNICATIONCustomers can contact us at any time by e-mail, via our community website or by phone, whichever is most conve-nient. We can usually resolve issues and queries remotely, and guide customers to take advantage of the full potential of RayStation rather than only solving problems.

“ We have been very pleased with the RayStation installation from RaySearch. Issues with the performance of our 21 servers were immediately address ed by RaySearch to everyone’s satis-faction. Planning related questions were also promptly answered by RaySearch’s support staff.

We are overall extremely satisfied with RayStation and RaySearch’s support of our clinical vision to provide high quality patient plans.”

SHIVA K. DAS, PH.D., DABR, PROFESSOR AND DIRECTOR OF MEDICAL PHYSICS, UNIVERSITY OF NORTH CAROLINA, USA

IN 2015, RAYSEARCH INAUGURATED MODERN AND CUSTOMIZED TRAINING FACILITIES FOR UP TO 20 PARTICIPANTS AT THE STOCKHOLM HEADQUARTERS.

The RayStation community website, our users club, is becoming an increasingly important feature of our customer support. A modern and more user-friendly version of the community website was launched in early 2016. With it came a new video streaming service that allows us to share webinars on specific topics as well as tutorials with our customers. The community website allows users to par-ticipate in public discussions with other users or experts, as well as logging a case or browsing the solution database.

The rapidly expanding number of RayStation users is an asset in bringing new functionalities to the system and in further advancing cancer treatment.


“We were able to transfer all our planning over to RayStation on the same week we received training. This would not have been possible without the excellent support from the service team at RaySearch. We see very positive and measurable effects of the use of the system in our department. Our optimization and dose computation time declined from around 20 minutes to 1 minute. We have been able to automate our planning process thanks to the scripting capabilities and the speed of the system allows us to spend the saved time on optimizing further for better plan quality.”ANDREAS JOHANSSON, MEDICAL PHYSICIST, MÄLARSJUKHUSET, ESKILSTUNA, SWEDEN


DEDICATION AT WORK RAYSEARCH OFFERS A FANTASTIC OPPORTUNITY TO WORK ON THE FRONTLINE OF THE FIGHT AGAINST CANCER. THE DEDICATION AND PRIDE IN CONTRIBUTING TO THE GREATER GOOD IS THE VERY SOUL OF OUR COMPANY. OUR EMPLOYEES POSSESS A NOTABLY HIGH LEVEL OF SCIEN-TIFIC KNOWLEDGE AND TECHNICAL SKILLS, AS WELL AS AN INNOVATIVE MINDSET. THIS UNIQUE COMBINATION ALLOWS US TO BE AT THE CUTTING

EDGE OF SOFTWARE DEVELOPMENT.

26 27WORLD-CLASS KNOW-HOW WORLD-CLASS KNOW-HOW

RaySearch’s vision is to improve the chances of survival and quality of life for cancer patients by providing innova-tive software to clinics for more effective cancer radiation therapy. This is the driving force behind everything we do. Our employees consider their job to be meaningful, working for a good cause at the forefront of technology. RaySearch is a world leader in the field of advanced soft-ware development for radiation therapy, and the role of our employees is to carry this vision forward in their day-to-day work. The rapidly growing number of leading clinics and hospitals that are using RayStation is proof of their success.

AN INSPIRING WORKING ENVIRONMENTOur office, in the heart of Stockholm, is the global hub of software development in radiation therapy. Our company boasts an impressive CV of scientific expertise. Almost all employees hold at least one university or college degree, and a significant proportion has a PhD.

RaySearch has a modern and innovative spirit and we recognize that the creative minds and dedication of our employees are crucial for success. Therefore we are always prepared to go that extra mile for them.

Teamwork is key and our work environment promotes close interaction and collaboration. Decision-making is streamlined by our flat organizational structure where feed-back is highly valued. At RaySearch, employees can grow and excel by working together with the best talent in the industry. We also believe that motivation and performance are enhanced by a fun and social atmosphere. Our daily breakfast and numerous social activities provide opportu-nities for our staff to interact in different settings, which also stimulates creative thinking, reflection and problem solving in their work.

Achieving a good work-life balance is essential for us at RaySearch as we recognize that a happy and healthy per-sonal life is a prerequisite for excellent work performance.

With optimization at our core, solving the life-puzzle comes naturally at every level of our organization. This results in strikingly low staff turnover and sick leave frequency, and creates a continuity that is important for a fast-moving company such as RaySearch.

COMBINING CUTTING-EDGE COMPETENCERaySearch engineers are divided into teams that each work on a dedicated assignment. Some projects are short-term and driven by current customer challenges, whereas others have long-term objectives. The teams are cross-functional with members from several different areas of expertise.

Physicists dedicated to the details of dosimetry work alongside specialists in algorithms, the core technology of RaySearch. Specialists in visualization and image pro-cessing and system testers are also incorporated into the teams. To gain clinical insights, application specialists and user experience designers are involved to translate the algorithms into a user-friendly interface. This effective com-bination of cutting-edge competencies drives RaySearch ahead as an industry leader.

The development of the new RayCare oncology infor-mation system requires new competencies to strengthen our current teams, such as web application development capabilities. Our approach to combine different expertise is crucial for the efficient development of RayCare and to ensure that it works seamlessly with RayStation.

DIVERSITY, LEADERSHIP & INNOVATIONRaySearch currently has 180 employees located in four conti-nents. In 2015, we welcomed more than 50 new team members into the company. This year, we expect to employ an additional 35–40 specialists with a variety of expertise.

Diversity is important to us – our employees represent 19 different nationalities and we work systematically to achieve a good gender balance. We also emphasize the importance of effective and inspiring leadership in order to motivate our employees, and we believe in personal and professional devel-opment for all.

Our managers have an important role in this to create a work environment that encourages growth and innovation.

CLOSE TO THE CLINICAL WORLD All RaySearch employees are encouraged to meet with custom-ers to gain an insight into the clinical world. The online customer community offers opportunities for RaySearch employees to communicate with customers and bring in their expertise. At conferences, developers have the opportunity to demonstrate the software and its latest features while gathering feedback for potential improvements. Members of the development team also attend user meetings to hear how customers experience the product and to gather improvement requests. By working closely with our users, we continuously advance the capabili-ties and possibilities of cancer therapy.


“Our decision to purchase RayStation was based on thorough investigation, comparison and follow-up over a five-year period. I feel confident that we made the right decision and we strongly believe that RayStation will become one of the leading global treatment planning systems. RayStation fully meets our needs and will contribute to the future develop-ment of our oncology department and our research.”DR BAI, DIRECTOR OF MEDICAL PHYSICS, WEST CHINA HOSPITAL, SICHUAN UNIVERSITY, CHINA


THE NEXT GENERATION

OISA RADIATION THERAPY CLINIC NEEDS TWO SOFTWARE PLATFORMS FOR ITS CORE ACTIVITIES: A TREATMENT PLANNING SYSTEM AND

AN ONCOLOGY INFORMATION SYSTEM.

RaySearch has already contributed to more effective cancer treatment through the innovative treatment planning software RayStation. Now, we are taking the next step by developing a unique system for effective and modern information management. In 2017 we will launch the next generation OIS: RayCare.

THE USER IN FOCUSRayCare is designed to meet the demand from clinics for a more user-friendly and workflow-oriented information system that can support the future of radiation therapy.

The system is therefore developed from the ground to meet the logistical challenges in modern radiation therapy. The software connects the advanced radiation therapy algorithms contained in RayStation to advanced features for clinical resource optimization, workflow automation, adaptive radiation therapy and clinical analytics.

OPTIMIZATION OF RESOURCESWhen conducting radiation therapy, several treatment options in terms of choice of treatment techniques and machines could be considered for each patient. How-ever, today it is not feasible to explore more than one or two options, since that would involve a great amount of time-consuming manual work. Now this is made possible with Plan Explorer in RayStation (see page 16). With Ray-Care, we will bring this a step further and take advantage of the multiple treatment options to optimize the clinic’s schedule and resources to improve the plan quality for the total population of patients in a clinic.

WORKFLOW AUTOMATION FREES UP TIMERayCare will offer a user-friendly interface and support for automated workflows. The advanced tools for automation of the treatment planning process that RayStation provides, will be extended to RayCare to support configurable, auto-mated workflow management and analysis. The insights gained from the analysis can be used to adapt the clinic workflow.

SUPPORT FOR ADAPTIVE THERAPYThe adoption of adaptive therapy by clinics has been slowed down due to the lack of support by the OIS currently avail-able on the market. The clinic needs to be able to easily manage the image data flow and keep track of changes made in the plan in order to fully implement adaptive radi-ation therapy. Today, RayStation provides complete sup-port for adaptive planning through advanced algorithms, dose-tracking and adaptive re-planning. RayCare will use those algorithms and will also allow the automation and management of the complex flow of information in adaptive radiation therapy.

RAYCARE WILL HELP INCREASE THE ADOPTION OF ADAPTIVE RADIATION THERAPY LEADING TO BETTER CARE.

RAYCAREREFERRAL

CONSULTATION & ORDINATION

SETUP & IMAGING

TREATMENT PLANNING

TREATMENT DELIVERYTREATMENT FOLLOW-UP

TREATMENT SCHEDULING

32 33LOOKING AHEAD LOOKING AHEAD

RayCare will be configured to support both offline and online dose tracking and adaptive decision making. Offline dose tracking means that, once a treatment fraction has been completed, a series of automatic calculations can be performed to obtain the aggregated delivered treatment dose based on an up-to-date view of the patient’s condi-tion. When the treatment is at risk to move outside the action levels, RayCare will be alerted and will then create an adapted treatment. The system will also support online dose tracking and adaptations, which will document all cal-culations and decisions that occur during the treatment session rather than between sessions. This requires near real-time calculations and dedicated interfaces for review and approval. A type of online adaptive treatment called “plan of the day” will also be supported, which features multiple pre-prepared plans that account for likely varia-tions in patient anatomy. When the patient is positioned for treatment one of the plans can be selected based on the patient’s current situation.

ENHANCED POSSIBILITIES FOR DATA ANALYSISRayCare stores all clinical data acquired during planning, treatment and follow-up in a structured and accessible for-mat that is suitable for data analysis. This enables advanced automated follow-up of treatment outcome and opens the door to further analysis and refined treatment methods.

The ability to collect and analyze data will be extremely important for the future, as the entire healthcare industry is undergoing a shift toward more personalized medicine.

STATE-OF-THE-ART USABILITYRayCare will not only offer a variety of innovative and in- demand features, it will also be easy to use, with an intu-itive and modern interface. Usability experts are involved in every step of the process and our development team collects continuous feedback from partner clinics regarding design and usability.

The system will have a visual presentation of data, simple illustration of complex flows, and a modern and innovative design. The aim is also to only display the data that is rele-vant at that moment.

CLOSE COLLABORATION WITH LEADING CLINICSRayCare is being developed in close partnership with clinics in Europe and in the US. The collaboration involves analyz-ing the workflows of clinics and adapt RayCare to fit those needs. In return, the partners continuously provide their feedback on the system to our development team. Read more about our partnerships on page 37.

There has been a great interest in RayCare to date, both from clinics and from other companies within the indus-try. The development will continue according to plan with expanded staffing during 2016. A lot of work remains before the system is ready for launch, but we have already received tremendously positive feedback on our current version.

RAYCARE KEY FEATURES INCLUDE:

• RESOURCE OPTIMIZATION

• WORKFLOW AUTOMATION

• INDIVIDUALIZED TREATMENT ADAPTATION

• ADVANCED DECISION SUPPORT

• THE SYSTEM IS DESIGNED TO PROVIDE:

– A user-friendly, everyday workflow

– Easy configuration for the clinic’s specific needs

– Modernized versions of standard OIS features

34 35LOOKING AHEAD LOOKING AHEAD

KEY PARTNERSHIPS PAVE THE WAYFOR SUCCESS

RAYSEARCH HAS RESEARCH COLLABORATIONS AND PARTNERSHIPS WITH A NUMBER OF UNIVERSITIES, CLINICS AND COMPANIES THAT ARE LEADING THE WAY IN RADIATION THERAPY. AS A SPIN-OFF FROM THE KAROLINSKA INSTITUTE, RAYSEARCH IS KNOWN FOR ITS DEEP UNDER-STANDING OF THE ACADEMIC COMMUNITY. THIS COMBINED WITH 15 YEARS OF CLINICAL INNOVATION MAKES US AN ATTRACTIVE PARTNER

WITH WHOM TO SHAPE THE FUTURE OF RADIATION THERAPY.

Close collaboration is essential for the development of the oncology information system RayCare. The strategy is to partner with many clinics from different parts of the world to get a representative picture of the market needs in terms of OIS. In early 2016, we are proud to count on three prestigious partner clinics in both Europe and the US, and we expect to establish additional collaborations during the year. All partners are actively involved in the development of RayCare and are frequently in contact with our development team.

With The University Medical Center in Groningen (UMCG), Netherlands, we have a strong common vision to develop RayCare to fully support adaptive treatment techniques. In addition, we have focused on the workflow management and patient logistics in the clinic, as this is an area where UMCG excels. The large amount of user feedback we have received from UMCG has been of tremendous value for the development of RayCare.

In the USA, we are collaborating with The University of California San Francisco (UCSF). This partnership is intended to develop a comprehensive approach to provide data gathering infrastructure for the individualization of cancer care within radiation oncology. Sufficiently struc-tured data can help discover new causal relationships, such as between genomic profile, delivered dose and outcome. The intention is that RayCare will become a key component in collecting and structuring treatment data and enable the pooling of data and analysis using other systems.

Our third partner is Iridium Kankernetwerk in Antwerpen, Belgium. Iridium is a network of seven hospitals and the largest radiotherapy center in Belgium, as well as one of the largest in Europe. In collaboration with Iridium, RaySearch will develop features in RayCare to support collaboration within a cancer network. Iridium is a network of hospitals with coordinated cancer care efforts and we see great opportunities to develop functions to efficiently manage patients, communicate securely between clinicians and share information across the network.

PARTNERING WITH ACCURAY FOR BOTH RAYSTATION AND RAYCAREDuring 2015, we signed an agreement with Accuray to co-market the RayCare system. This will give Accuray the opportunity to offer RayCare in several major radiation ther-apy markets. A fully-integrated solution with their Tomo-Therapy® and CyberKnife®System systems will be made available. The intention is that RayCare will help to enhance the integration of Accuray’s technologies in the customers’ oncology department workflow. This will facilitate the hand-ling of large volumes of clinical data and streamline patient radiation treatments.

The partnership with Accuray also encompasses that RayStation will support treatment planning for Accuray’s unique systems TomoTherapy and CyberKnife.

The collaboration also means that, for the first time ever, treatment planning for both of the Accuray systems as well as conventional linacs, will be available in one integrated treatment planning system. This will entail significant gains in efficiency for clinics that have several machine types.

Accuray has an installed base of more than 500 Tomo-Therapy Systems and more than 300 CyberKnife Systems worldwide. Treatment planning support for TomoTherapy Systems in RayStation is targeted for release during 2016 and support for CyberKnife Systems for release during 2017.

RadiotherapieMedische OncologieHematologie

36 37PARTNERS PARTNERS

“My role is to work closely with clinicians to identify clinical needs and define new innovative functiona -lity for RayCare, our next generation OIS, and to share that input with our development teams. I’m confident we are building a great product that will bring great value to our customers.”JONAS ANDERSSON, SCRUM PRODUCT OWNER, RAYSEARCH LABORATORIES AB, STOCKHOLM, SWEDEN

38 39PARTNERS PARTNERS

THE UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER, is one of the world’s most respected cancer centers. The center signed a purchase agreement in August 2015 with RaySearch for new treatment planning soft-ware (TPS). With RayStation, the center sees the potential to benefit from a modern working environment, to improve optimization speed and to investigate new technologies such as multi-criteria optimization and adaptive planning.

They will implement approximately 30 licenses throughout the Department of Radi-ation Oncology – 20 for clinical use and 10 for research – to fully investigate which technolo-gies are of the greatest benefit to its practice.

THE UNIVERSITY OF FLORIDA HEALTH PROTON THERAPY INSTITUTE, was the first treatment center in the Southeast US to offer proton therapy. It has the capacity to treat 150 can-cer patients a day with the most advanced technology available. The selection of the RayStation treatment planning system was made to support both their photon planning needs, as well as the advanced requirements of intensity modulated proton therapy (IMPT).

Dr. Zuofeng Li, Director and Professor at the University of Florida College of Medicine, explains: “We found RayStation to have supe-rior planning tools for IMPT in terms of effi-ciency and quality of plans, as well as other new technologies that could help our photon planning teams. We believe features such as multi-criteria optimization (MCO), fallback planning, deformable registration and adap-tive therapy will all have a significant impact on our daily planning workflow. These bene-fits, combined with ultrafast calculation speed, made RayStation the best choice for us.”

GUSTAVE ROUSSY, located in Villejuif, France, is one of the ten leading cancer centers in the world. The facility is an integral part of a large network of satellite centers and partners, both nationally in France and internationally as a member of the Cancer Core Europe consortium.

In the context of an international develop-ment project during 2015–2020, the center has upgraded its radiation therapy department with state-of-the-art technologies. In order to develop the best possible care protocols to ensure its patients gain access to the most effective, innovative treatments, Gustave Roussy’s radiation oncology team has selected RayStation for its treatment planning.

THE UNIVERSITY OF NORTH CAROLINA (UNC), has a longstanding and well-established re putation of leadership and innovation in the field of radiation oncology. UNC serves as the specialty oncology referral center for the entire state of North Carolina with seven treatment centers. UNC has recently replaced its treatment planning system, developed in-house and in use since 1985, with Ray Station. The selection process for a new TPS was an intense and scientific effort, with many of the UNC staff involved in performing test plans to fully assess the competing sy stems.

Dr. Shiva Das, Chief Medical Physicist at UNC who led the project, says: “Our own treatment planning system has served the center well for several decades. With programmers employed by us, we had the opportunity to customize the software to fit our workflow and planning needs. However, we also saw the future of treatment planning placing more demands on the TPS. In order to continue to provide the highest level of care to our patients, we know we needed to team up with a partner that was forward-thinking and had more resources. We are very confident that RaySearch is that partner.”

GHENT UNIVERSITY HOSPITAL, BELGIUM, is one of the largest and most specialized hospitals in Flanders, with a capacity of over 3,000 patients and almost 6,000 employees. Its radiation oncology department has a track record of developing innovative radiation ther-apy delivery techniques. It greatly contributed to the development of IMRT and currently plays a leading role in clinical and physics research on dose painting by numbers.

Ghent University Hospital radiation oncology department has a multi-vendor linac config-uration from Elekta and Varian. The hospital required treatment planning software that could easily integrate with their current sys-tems and streamline their planning workflow. The RayStation treatment planning system from RaySearch, which offers high compati-bility with all commercial linear accelerators, fully met these requirements. RayStation will be used for all the hospital’s clinical treatment planning.

Prof. Dr. Yolande Lievens, Chair of the radi-ation oncology department, says: “With RayStation, we foresee the advantages of much quicker and more efficient daily plan-ning that will allow us to choose the optimal plan for each individual patient.

LOPBURI CANCER HOSPITAL, THAILAND, is one of the leading cancer hospitals in central Thai-land and treats patients from 12 provinces in the country. Lopburi has been identified by the Thai government to become one of the centers of excellence for the Province of Lopburi and the surrounding provinces.

The hospital selected RayStation as its treatment planning system in 2015, largely due to its industry-leading automated breast planning capabilities and unique multi- criteria optimization features. To date, the system has not only facilitated the clinic’s workflow, but has also enhanced efficiency by speeding up calculations and by producing high-quality treatment plans.

During 2015, about 100 leading clinics and hospitals around the world selected RayStation as their treatment planning system. The year also marked a significant mile-stone in that the software was chosen by many frontrun-ners in the field of radiation oncology. Here you can read about how some of the most recognized clinics in the world are relying on RayStation to take their pioneering work further still.

THE FRONTRUNNER’S CHOICE

40 41MAJOR ORDERS MAJOR ORDERS

RAYSEARCH IN SUMMARY

On the preceding pages, you’ve been able to read about our company, our products and our views on different subjects. This double spread provides a quick guide to RaySearchand to the topics treated in this review. On following pages you will find a summary of the most important facts and figures about RaySearch.

SOFTWARE LEADS INNOVATIONAdvances in radiation therapy have long been dependent on the development of linacs, but hardware for radiation therapy is more and more becoming a commodity. Clinics are realizing that improvements in patient care are increasingly related to the treatment planning software.

Spending more time, effort and resources on selecting the best and most flexible treatment planning software is key. By doing so, clinics can achieve a higher quality of care and a bet-ter overall patient flow.

RaySearch has won market recognition with RayStation, an advanced and flexible treatment planning system with endless pos-sibilities, for all treatment techniques. A radi-ation therapy clinic essentially requires two software platforms: an information system and a treatment planning system. To offer a complete and integrated solution, RaySearch is currently developing a unique oncology information system for effective and modern information management – RayCare.

Read more about RayStation and RayCare on pages 14 and 32 respectively.

GREATER ACCESS TO RADIATION THERAPYWith over 14 million new cases of cancer reported each year, the fight against cancer remains one of the world’s greatest medical challenges. However, global efforts to treat cancer are still inadequate.

Radiation therapy is a cost-effective treat-ment method that is crucial for comprehen-sive cancer care. There is strong evidence that investments in radiation therapy not only enable the treatment of a large number of cancer cases, but also bring about economic benefits to a society. However, when building treatment capacity for cancer, radiation ther-apy is often the last resource to be considered. Consequently, worldwide access to radiation therapy is unacceptably low, particularly in low- and middle-income countries. Access to easy-to-use and efficient software is funda-mental to help increase the use of this efficient treatment method.

There is a huge need for a modern treatment planning system suitable for low- and middle- income countries. To meet this demand, RaySearch has developed RayPlan, a trimmed version of RayStation.

Read more about Access to Radiation Therapy on page 4.

STRONG FOCUS ON ASIAAsia is the engine for the rapid global growth in cancer therapy. 60 percent of the world’s population lives in Asia, yet only 30 percent of all linacs are found there. The lack of capacity combined with a rapid expansion of health-care systems has led to a sharp growth in the cancer treatment market.

RaySearch has established an office in Singapore. It is headed by Vivien Li who is responsible for sales in Southeast Asia and Taiwan, and for supporting regional radiation therapy clinics throughout Asia. With our own staff in place, we are able to take advantage of the increasing market demand for efficient treatment planning software.

China is currently the second-largest mar-ket for radiation treatment in the world and the market is expected to continue to grow rapidly. The country has less than one linac per million inhabitants and is investing heavily in health-care. We plan to strengthen our presence in China with a dedicated office during 2016.

Through distribution partnerships, RaySearch is established in several other markets in Asia, such as Japan, South Korea and Thailand.

Read more about Market Development on page 10.

GROUNDBREAKING TREATMENT PLANNINGRayStation represents the next generation of treatment planning systems with a superior user experience and innovative features. In 2016, we launched RayStation 5, a new version that features carbon ion treatment planning, and Plan Explorer, a groundbreaking planning tool that allows clinics to maximize delivery efficiency and plan quality.

Plan Explorer is based on the capability to automatically generate a large number of treatment plans for an individual patient. It also provides efficient means to filter and browse among plan candidates. The benefits are many – improved general plan quality, enhanced resource optimization and time savings.

RayStation is also leading the way in proton and carbon ion therapy, the most advanced methods of radiation therapy. RayStation 5 is the only commercial treatment planning sys-tem for carbon ion therapy.

RayStation has been chosen by two of the world’s leading carbon ion centers – MedAus-tron in Austria and CNAO in Italy – which also have had a major role in the development of the ion beam functionality in RayStation 5.

Read more about RayStation on page 14.

DEDICATION AND TEAMWORK FIGHTS CANCERThe dedication of contributing to the greater good is the very soul of RaySearch. Our employees take pride in working for a good cause, and their expertise and innovative mindset allows us to be at the cutting edge of software development.

At RaySearch, teamwork is key, decision- making is streamlined and feedback is highly valued. Our staff work in cross- functional teams with members from several different areas of expertise, and employees can thrive by working with the best talent in the industry.

The creative minds and dedication of our employees are crucial for success. Therefore achieving a good work-life balance is essen-tial and our strikingly low staff turnover and sick leave frequency create a continuity that is important for a fast-moving company such as RaySearch. In addition, numerous social activities provide opportunities to interact in different settings, which also stimulates cre-ative thinking, reflection and problem solving.

Read more about our World-class Know-how on page 26.

42 43FACTS & FIGURES FACTS & FIGURES

NET REVENUE

RETURN ON EQUITY, %

0

50

100

150

200

250

300

350

400

20152014201320122011

SEK M

CAGR 32%

205 M

398 M

126 M

183 M

285 M

%

0

5

10

15

20

25

30

20152014201320122011

CONSOLIDATED INCOME STATEMENTS

SEK 000s 2015 2014

Net sales 397,600 285,217

Cost of goods sold –23,690 –11,627

Gross profit 373,910 273,590

Selling expenses –138,360 –78,433

Administrative expenses –43,240 –30,736

Research and development expenses –101,514 –95,069

Other operating income/expenses 4,548 10,008

Operating profit/loss 95,344 79,360

Net financial items –1,854 –659

Profit/loss before tax 93,490 78,701

Tax –23,281 –18,869

Profit/loss for the period 70,209 59,832

Of total sales of SEK 398 M in 2015, the share for RayStation was 300 M. This means RayStation now accounts for close to 76 percent of total sales, compared to 15 percent in 2011. In 2015 total net sales grew almost 40 percent compared to 2014.

In 2015 return on equity was close to 25 percent. At the end of 2015 total shareholders’ equity amounted to SEK 320 M, or SEK 9.32 per share.

RAPID SALES AND EARNINGS GROWTH

SALES AT RAYSEARCH HAVE GROWN RAPIDLY. THE COMPOUND ANNUAL GROWTH RATE SINCE 2011 AMOUNTS TO MORE THAN 33 PERCENT. TOTAL SALES IN 2015 ROSE TO SEK 397 M, WITH RAYSTATION AS THE KEY GROWTH DRIVER. EARNINGS GROWTH HAS FOLLOWED. THE 2015 OPERATING PROFIT

WAS SEK 95 M, A LARGE IMPROVEMENT ON THE PREVIOUS YEAR.

PARTNER SALES 85%

PARTNER SALES 24%

RAYSTATION 15%

RAYSTATION 76%

20112015

Sales SEK 126 M

Sales SEK 398 M


66%EQUITY/ASSET RATIO

CONSOLIDATED STATEMENT OF FINANCIAL POSITION

SEK 000s 2015 2014

ASSETS

Intangible fixed assets 195,114 164,081

Other fixed assets 41,817 12,951

Total fixed assets 236,963 177,032

Total current assets 247,559 212,721

TOTAL ASSETS 484,490 389,753

SHAREHOLDERS’ EQUITY AND LIABILITIES

Shareholders’ equity attributable to Parent Company stakeholders 319,517 251,548

Liabilities 164,973 138,205

TOTAL SHAREHOLDERS’ EQUITY AND LIABILITIES 484,490 389,753

EQUITY/ASSET RATIO

0

20

40

60

80

100

20152014201320122011

%

75 % 74 %

66 % 66 % 66 %

SHARE PRICE 2011–2015

SEK

0

30

60

90

120

150

20152014201320122011

RaySearch is listed for trading in the Mid Cap segment on the NASDAQ OMX Nordic Exchange in Stockholm. The chart shows the share price for RaySearch from January 2011 up to and including the quote of SEK 122.5 on December 2015. In the last year the share price has appreciated a full 131 percent.

At the end of 2015 RaySearch’s share capital amounted to SEK 17,1 M. The total number of shares was 34,3 M, of which 10,3 M were Class A shares and 24,0 M were Class B shares. The number of shareholders was 5,435. Each Class A share has 10 votes and each Class B share 1 vote. The Class A shares are primarily owned by members of Management and the Board of Directors.

A STRONG FINANCIAL BASE

CONTINUOUS DEVELOPMENT OF NEW, IMPROVED PRODUCTS HAS PROVED A SUCCESS FACTOR FOR RAYSEARCH SINCE ITS INCEPTION, THEREFORE THE COMPANY HAS ALWAYS REINVESTED A LARGE PORTION OF ITS SALES REVENUES IN RESEARCH AND DEVELOPMENT. A PREREQUISITE FOR THE STRATEGY’S SUCCESS HAS BEEN THE COMPANY’S STRONG FINANCIAL BASE.

Being a stable and resourceful company is important in several ways. One is in attracting, recruiting and retaining the highly skilled key employees needed for multi-year development projects like RayStation. At the end of 2015 RaySearch had an equity/asset ratio of 66 percent and has shown equally high numbers throughout its 15-year existence.


HENRIK FRIBERGER DIRECTOR OF DEVELOPMENT

VICTORIA SÖRVINGGENERAL COUNSEL

BJÖRN HÅRDEMARK DEPUTY CEO

JOHAN LÖFPRESIDENT AND CEO

NICLAS BORGLUND DIRECTOR OF SERVICE

MEET OUR MANAGEMENT TEAM

LARS JORDEBYDIRECTOR OF SALES,

ASIA & PACIFIC

PETER KEMLINDIRECTOR OF SALES

AND MARKETING

KJELL ERICSSONCHEF SCIENCE OFFICER

PETER THYSELLCHIEF FINANCIAL OFFICER

48 49

RAYSEARCH LABORATORIES AB (PUBL)Sveavägen 44, SE-103 65 Stockholm, SwedenTel: +46 (0)8 510 530 [email protected] Pr

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