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NovoCure Limited

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FY2019 Annual Report · NovoCure Limited
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only the beginning

 20 STORIES AND BUILDING 

N OVO CU R E   201 9   A N N UA L   R EP O R T

NOVOCURE 2019 ANNUAL REPORT

There’s a particular energy at 
Novocure. It doesn’t matter whether 
you’re at our U.S. Operations Center 
in Portsmouth or at our Research 
and Development Center in Haifa, 
Israel, or meeting a colleague  
from the sales team at a meeting in 
Germany—you can feel it.

This energy originates, in part, from a collective drive toward innovation. From the first moment 
of Novocure’s founding to the many significant milestones in the last 20 years, this energy has 
been the source of the big moments and the micro moments that comprise the whole. 

This unifying factor possessed by Novocure colleagues across the globe comes from a joy in 
building. We create from nothing every day because we can see a vision for the future. We start 
from countless blank slates in unchartered territories, moving forward even when it feels 
impossible. After years of work to complete an initiative and in our day-to-day challenges to find 
solutions, we start over. 

This spirit is the hallmark of our company—a dichotomy of making significant progress and 
starting over at the same time. Even after 20 years of innovation after innovation and milestone 
after milestone moving forward on our mission, it is only the beginning.

Please visit the online version of this 
annual report at 2019.novocure.com

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Yoram Palti, Founder and Chief Technology Officer

DEAR FELLOW 
SHAREHOLDERS, 

2019 was a transformative year.

We started Novocure with the novel insight that electric 
fields can be harnessed to disrupt cancer cell division 
selectively and cause cancer cell death. In the 20 years 
since, we have built an organization of more than  
750 colleagues dedicated to delivering Tumor Treating 
Fields therapy to patients with glioblastoma (GBM) or 
mesothelioma and dedicated to advancing clinical 
research and product development programs intended  
to extend survivals in some of the most aggressive cancers. 
We made noteworthy advancements in 2019, and we  
are poised to continue building on this momentum in 
2020 and beyond.

NOVOCURE 2019 ANNUAL REPORT

We believe we are in a virtuous cycle of execution and 
innovation supporting the future growth of our company. 
Tumor Treating Fields therapy is a foundational platform, 
enabling our efforts to make a difference in cancer. We are 
focused on growing our commercial business to bring 
Tumor Treating Fields therapy to as many patients who  
can benefit as possible. Commercial growth provides us 
the financial strength and flexibility to increase investments  
in clinical research and product development programs 
that will help more patients and propel further growth.  
We believe we are just beginning our journey.

Commercial execution drove strengthening financial 
performance.

Our 2019 commercial performance reinforces our 
confidence in the long-term potential of Tumor Treating 
Fields therapy. In 2019, we received FDA approval via the 
Humanitarian Device Exemption (HDE) pathway for the 
treatment of adults with malignant pleural mesothelioma, 
or MPM, our first FDA-approved torso indication. Medicare 
established coverage of Optune for the treatment of adults 
with newly diagnosed GBM. Through our partnership with 
Zai Lab, we developed our foundation in Greater China. 
Notably, we accomplished these milestones while 
generating over $350 million in annual net revenues and 
adding $80 million in cash to our balance sheet.

With more than 14,000 GBM patients treated to date,  
we believe Optune has established its central role in the 
treatment of GBM. As proud as we are of our progress in 
treating GBM, we believe multiple levers remain to drive 
near-term growth. We remain focused on working with 
physicians to expand adoption in our current markets, on 
laying the groundwork for access in new markets, on 
extending the duration of therapy for patients and on 
improving reimbursement for Optune.

Bill Doyle, Executive Chairman

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Asaf Danziger, CEO

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Established 
commercial 
business

Product 
innovation

Tumor 
Treating 
Fields

Financial 
strength

Growing body 
of clinical 
evidence

striving to extend survival  
in some of the most 
aggressive forms of cancer

NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT

3

FDA-APPROVED
INDICATIONS

$326M

CASH ON HAND* 
AS OF DECEMBER 31, 2019

4

180+

INDICATIONS IN 
LATE-STAGE PIPELINE

ISSUED PATENTS AND PENDING 
APPLICATIONS GLOBALLY

*cash, cash equivalents and short-term investments

Beyond GBM, we launched our second commercial 
business in 2019 treating patients diagnosed with MPM. 
Our MPM launch was the first FDA-approved treatment  
for MPM in over 15 years, and our first approved torso 
indication. We believe this is an important harbinger of the 
promise of Tumor Treating Fields in many additional solid 
tumor indications. 

Heading into 2020, our focus is unwavering on growing 
the awareness and acceptance of Tumor Treating Fields 
therapy in our approved indications and driving global 
adoption. With over $320 million of cash on hand at year 
end, we believe we are well positioned to execute our 
strategic objectives. We will not be satisfied until all eligible 
cancer patients are offered an opportunity for long-term 
quality survival.

A growing body of preclinical and clinical evidence 
supports an advancing pipeline.

Tumor Treating Fields therapy selectively targets the 
electrical properties of proteins involved in cancer cell 
division with electric fields tuned to specific frequencies  
to disrupt mitosis.

Tumor Treating Fields therapy is backed by a growing body 
of preclinical and clinical evidence. We believe the 
evidence supports that Tumor Treating Fields’ mechanism 
of action may be broadly applicable to solid tumor cancers. 
Our scientific research spans two decades and in all of our 
preclinical and clinical research to date, Tumor Treating 
Fields has demonstrated a consistent anti-mitotic effect. 
Additionally, research has shown that Tumor Treating Fields 
may have an additive or synergistic effect when combined 

with certain other cancer therapies without evidence of 
any dose-limiting, cumulative toxicity. In 2019, there were 
more than 250 presentations on Tumor Treating Fields at 
key medical congresses, the majority by independent 
researchers, underlining the recognition Tumor Treating 
Fields therapy is gaining in the global oncology community. 

We are executing our strategy to make Tumor Treating 
Fields therapy available in additional indications through 
phase 2 pilot trials and phase 3 pivotal trials and in current 
indications through phase 4 post-marketing studies based 
on a foundation of significant preclinical evidence. 

In 2019, we initiated clinical trials studying Tumor Treating 
Fields in two additional cancers: the INNOVATE-3 trial in 
recurrent ovarian cancer and the EF-31 trial in gastric 
cancer. Now, we have four ongoing randomized, phase 3 
pivotal trials in brain metastases, non-small cell lung 
cancer, pancreatic cancer and ovarian cancer, and two 
phase 2 pilot studies in liver cancer and gastric cancer; 
creating the potential for substantial market expansion 
over the next five years. 

If approved, the indications in our late-stage pipeline will 
create a more than 20-fold increase in our addressable  
U.S. market, alone. We are optimistic about the role  
Tumor Treating Fields may play in oncology, and we are 
determined to provide our therapy to cancer patients  
with a variety of solid tumor types who may benefit from 
the treatment.

Product innovation remains core to our long-term value 
creation strategy.

Courage and focus to pioneer a new modality 
in cancer care.

Beyond our ongoing preclinical and clinical research,  
we believe we have a considerable opportunity to  
improve the efficacy and usability of Optune through 
product innovation. 

A key publication in the Red Journal in April 2019 detailed 
the dose-efficacy dependence of Tumor Treating Fields. 
The dose response of Tumor Treating Fields therapy  
is determined by total energy delivered. Total energy 
delivered is a function of time on therapy and electric  
field intensity. 

The research published in the Red Journal was pivotal in 
guiding our product development programs. We are 
increasing investments in engineering efforts intended 
both to improve time on therapy and to maximize the 
energy delivered to patients’ tumors. Specifically, our 
teams are working to design and develop improvements  
to our transducer arrays and to our transducer array layout 
mapping software intended to increase Tumor Treating 
Fields intensity and, as a result, survival.

We believe innovation has the potential to improve patient 
outcomes and to extend our intellectual property 
protection into the future as we invent enhancements to 
our products. Our commitment to innovation resulted in 
33 new patent applications in 2019, alone. Supported by 
our financial strength, we remain committed to investing 
in clinical research and product development to extend 
survival in our current and future indications and to unlock 
future value for our patients, employees and shareholders. 

Re-imagining the possible is the essential theme of 
Novocure’s story. 

We have a remarkable 20-year history of building 
Novocure from Professor Palti’s vision into an established 
global oncology company. As proud as we are of the 
accomplishments of our first 20 years, the responsibility to 
treat more patients diagnosed with some of the most 
aggressive cancers remains before us. Our mission is 
grounded in this reality. 

Each day, we see our patients for the people they are with 
families, friends, hopes and dreams. Each day, we see the 
physical and emotional pain cancer causes. Each day, we 
do not look away, rather we look forward to work to 
provide access to Tumor Treating Fields therapy to more 
patients in our approved indications, to complete clinical 
research in new indications, and to further improve the 
efficacy of Tumor Treating Fields therapy through product 
development.

Thank you for your continued support.

Asaf Danziger,  
CEO

Bill Doyle,  
Executive Chairman

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NOVOCURE 2019 ANNUAL REPORT

20 STORIES AND 
BUILDING

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NOVOCURE 2019 ANNUAL REPORT

the beginning 

Professor Yoram Palti sets up a laboratory in his basement in 
Haifa, Israel, and founds Novocure in 2000.

More than 20 years ago, Novocure founder Professor Yoram Palti 
had a vision. His vision was grounded in belief —what he knew to 
be true about physics, biology and medicine, and what he knew 
to be possible. He unearthed his PhD thesis on the distribution of 
electric fields in nerve fibers from 40 years prior, and he sought to 
apply it to cancer. 

“I was sort of the odd guy in the medical class that was also 
interested in physics rather than just biology and medicine,” 
Yoram said of the breadth of his scientific interests and expertise. 

With pencil and paper, Yoram began computing how to use 
electric fields to destroy cancer cells. 

“I’m a believer in science and physics, as essential to the progress 
of medicine,” he said. “I came to the conclusion that it’s possible, 
and we set up a laboratory to try to prove it.”

“If you just believe that something is, 
you know that it is working and you 
know all the scientific facts behind 
it, then you just know that you have 
to fight until you get it.”

— Professor Yoram Palti,  

Founder and Chief Technology Officer

Yoram Palti, Founder and Chief Technology Officer

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11NOVOCURE 2019 ANNUAL REPORT

‘going in the right 
direction’

Novocure establishes its preclinical research center.

In his basement laboratory, Yoram and Novocure’s first 
three employees captured a video of alternating electric 
fields killing cancer cells, adding to Yoram’s confidence 
in what would eventually become Novocure’s cancer 
therapy, Tumor Treating Fields. The success of this initial 
experiment and the receipt of Novocure’s first 
investment allowed for the opening of a preclinical 
research center in Haifa, Israel, later in 2000. 

Rosa Shnaiderman, Novocure’s first employee who 
still works at Novocure today as Head of the Biology  
Lab, recalled the move from Yoram’s basement to  
a professional research facility. 

“We had better equipment,” she said. “We had a proper 
microscope. I started to see things better, and I started 
getting results on cells, which showed that it was going 
in the right direction.”

“We had a proper microscope.  
I started to see things better, 
and I started getting results on 
cells, which showed that it was 
going in the right direction.”

— Rosa Shnaiderman, 
Head of Biology Lab

Rosa Shnaiderman, Head of Biology Lab

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Moshe Giladi, Director of Preclinical Research

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2NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT

Yoram Wasserman, Vice President of Engineering

moving from petri dish to patient 

Novocure discovers a ceramic disc to insulate the electrodes that deliver the electric fields in 2003. 

After the initial preclinical experiments began to  
show promise, Novocure worked to discover how to 
take the technology behind Tumor Treating Fields from 
the petri dish to the patient. To deliver the tumor 
treating electric fields from a generator into the body 
efficiently, Novocure believed it needed an insulating 
material with a high dialectic constant for the arrays 
that adhere to the patient’s body.

Yoram Wasserman, Vice President of Engineering, said 
the team worked for about two years to find this 
material, scouring books and the internet, and meeting 
with many scientists and companies to find a solution. 
Through a connection within the scientific community, 
Novocure identified a crystal with the necessary high 
dialectic constant. However, the crystal was expensive, 
and it took weeks to produce a small amount. 

Through the initial discovery of the crystal, the  
team learned from the crystal manufacturer that  
the same high dielectric properties could be 
manufactured at the fraction of the price using 
ceramic sintering technology. This same technology  
is used by Novocure today.

“It was a breakthrough,” Yoram said. “We have done so 
many things, from finding the ceramic and designing 
the arrays, to developing the hardware and software 
for preclinical, clinical and commercial devices. We 
find creative ways to solve problems all of the time.” 

“Everything that I touch,  
I need to understand.” 

— Yoram Wasserman, 

Vice President of Engineering

Components used in the development of the arrays  
that deliver Novocure’s therapy to patients.

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3NOVOCURE 2019 ANNUAL REPORT

confronting glioblastoma

A phase 2 pilot trial begins in one of the most aggressive forms of cancer. 

Dr. Vymazal, the first external researcher to collaborate 
with Novocure on a clinical trial, went on to participate in 
both EF-11 and EF-14, a phase 3 pivotal trial in newly 
diagnosed GBM. He continues to conduct research on 
Tumor Treating Fields today. Dr. Vymazal said he feels lucky 
that he connected with Novocure more than 15 years ago.

“This is one of my life achievements,” he said. “We are  
very proud that we are the first institution to hold  
a clinical trial with Tumor Treating Fields. I am very happy 
and very satisfied that I can share our experience with this 
technology all over the world. I’m extremely happy that  
I have helped some patients.”

Prof. Dr. Josef Vymazal remembers the day that he met 
the Novocure team. Eilon Kirson, Novocure’s former Chief 
Science Officer and Head of Research and Development, 
visited Dr. Vymazal in 2004 at Na Homolce Hospital in 
Prague, where Dr. Vymazal worked as a clinical neurologist 
and radiologist, to discuss running a clinical trial on Tumor 
Treating Fields for glioblastoma (GBM) patients. Earlier in 
his career, including six years at the National Institute of 
Neurological Disorders and Stroke, National Institutes of 
Health, Dr. Vymazal saw many clinical trials in GBM fail. 

“I was quite skeptical because nothing worked at that time,” 
said Dr. Vymazal, Chairman of the Department of 
Radiology at Na Homolce Hospital in Prague, Czech 
Republic. “There were no breakthroughs.”

Dr. Vymazal recalled Eilon’s persistence and diligence 
when they met. He remembered the difficulty that came 
with not having anything additional to offer recurrent GBM 
patients once the standard of care treatments at the time 
failed. Josef decided to take a chance on Tumor Treating 
Fields because of the therapy’s non-invasive nature and 
the in vitro research conducted to date. 

The phase 2 pilot trial EF-07 included 10 patients with 
recurrent GBM, and tested the safety and efficacy of Tumor 
Treating Fields. Several months into the trial, Dr. Vymazal 
said, tumors of some of the patients began to shrink. 

“We were surprised,” he said. “More and more patients  
were surviving longer than the expected survival.  
We started to believe in this technology.”

Victor Kaikov, R&D Electronics Engineer

treating the first patient

Novocure’s first clinical trial patient receives therapy.

In December 2003, Novocure began its first clinical trial  
of Tumor Treating Fields in multiple solid tumor types  
in Switzerland. 

Novocure’s Chief Executive Officer Asaf Danziger recalled 
how he and Eilon Kirson, Novocure’s former Chief Science 
Officer and Head of Research and Development, traveled  
to Ormalingen, a village near Basel, to begin conducting  
the trial. Eilon booked a hotel nearby the patient’s house  
for three weeks. 

“I still remember the name of the patient,” Asaf said. 

The patient had cancer and underwent resective surgery. 
She had reached the dose limit of radiation and had a lesion 
remaining after surgery when she started Tumor Treating 
Fields therapy. 

Asaf and Eilon brought Novocure’s original Tumor Treating 
Fields delivery system to her house, set it up and showed 
her how to administer the therapy. They monitored her 
condition and progress daily. After a couple of weeks of 
treatment, the lesion began to shrink. 

“You could see the lesion on the skin, getting smaller,” Asaf 
said. “It was very exciting, and it was a big achievement.  
I was very proud.” 

“It was very exciting, and  
it was a big achievement.  
I was very proud.”

— Asaf Danziger, 

CEO

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Daniel Torres,  
a GBM clinical trial patient

45publication in a peer-reviewed journal

Proceedings of the National Academy of Sciences (PNAS) publishes preclinical and clinical research  
on Tumor Treating Fields in 2007.

and efficacy of Tumor Treating Fields used to treat cancer 
patients. Prior to the publication in PNAS, Cancer Research 
published Novocure’s earliest preclinical data in 2004. 

“Before the Cancer Research and PNAS publications, there 
was limited knowledge available to the world or scientific 
community regarding the effects of alternating electric 
fields at these ranges and these intensities on biological 
systems,” said Dr. Uri Weinberg, Novocure’s Chief Science 
Officer. “Without such publications, we would not have had 
the ability to step forward to build a company, to build more 
advanced science, to take the basis of the science itself and 
translate it, develop it into a therapy—into something that 
works on humans.” 

After completing several years of preclinical and clinical 
research on Tumor Treating Fields, Novocure believed  
it needed to begin building a strong foundation within the 
scientific community to translate Tumor Treating Fields 
research into an approved and accepted therapy.

To the outside world, research on using alternating electric 
fields at specific frequencies to treat cancer was completely 
new. Novocure believed it had made great strides with its 
research internally and in its first clinical trials. To bring a 
new modality to market, the company would need external 
validation and acceptance.

In 2007, those initial years of persistence and diligence  
in the lab and in the clinic paid off. Novocure’s clinical 
research was published for the first time in a top-tier, peer-
reviewed scientific journal, Proceedings of the National 
Academy of Sciences (PNAS). The publication included 
preclinical results of Tumor Treating Fields research in cell 
culture and animal models, as well as data from EF-07, the 
phase 2 pilot trial of Tumor Treating Fields in recurrent GBM. 
The published results were the first evidence of the safety 

Uri Weinberg, Chief Science Officer

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NOVOCURE 2019 ANNUAL REPORT

Alyssa Vinas, U.S. DSS Manager of New Indications

‘culmination of 10 years’

U.S. Food and Drug Administration approves Tumor Treating Fields in recurrent GBM.

On April 8, 2011, Novocure’s Tumor Treating Fields 
delivery system, then referred to as the NovoTTF-100A 
System and now called Optune®, was approved for 
recurrent GBM patients in the U.S. This milestone marked 
Novocure’s first commercial approval for a cancer 
indication. At the time, Novocure’s Executive Chairman 
Bill Doyle described the approval as “the culmination of 
10 years of research, development and clinical trials 
conducted by an exceptional team of scientists, 
engineers and clinicians, and built on the original insights 
of our founder and Chief Technology Officer Yoram Palti.” 

Alyssa Vinas joined Novocure five years before the FDA 
approval in recurrent GBM as a Device Support Specialist 
(DSS), providing technical support on Novocure’s cancer 
treatment to clinical trial patients and their caregivers. 
Alyssa, who joined Novocure as a recent college graduate 
and built her career at the company, recalled thinking 
about the possibilities for Novocure if it received a first 
FDA approval. 

“I remember feeling when we got that FDA approval, that 
moment of, ‘We've made it,’” said Alyssa, now U.S. DSS 
Manager of New Indications. “We did something truly 
groundbreaking in oncology, in the world of medical 
devices and in brain cancer, specifically. I knew in my 
heart that it was only going to go up from there.”

“We did something truly 
groundbreaking in oncology,  
in the world of medical  
devices and in brain cancer, 
specifically. I knew in my heart 
that it was only going to go  
up from there.”

— Alyssa Vinas, 

U.S. DSS Manager of New Indications

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67Costin Lazaroiu, Associate Director of U.S. Operations, 
interacts with CEO Asaf Danziger at Novocure’s warehouse 
in Root, Switzerland.

8

‘everything flowed through Switzerland’

Novocure creates a supply chain to support a global oncology company.

In summer 2012, on the recommendation of a recruiter, 
Jens Hult met with Novocure’s Chief Operations Officer 
Mike Ambrogi about an open position at Novocure’s Root, 
Switzerland location. He could feel Mike’s energy and 
passion for Novocure while they spoke about the role over 
breakfast, and Jens knew there had to be something 
special about Novocure. 

“Mike told me, ‘I want you to build the supply chain for  
a future successful global oncology company,’” Jens said.  
“I thought that was amazing. For me, within my profession, 
that was the ideal job.” 

Jens, now Vice President of the Global Supply Chain, joined 
the company in May 2013 and set out to accomplish the 
challenge, creating a three- to five-year strategic plan for 
the supply chain and building a warehouse and office in 
Root in his first months on the job.

By the end of 2012, Novocure had roughly 75 patients on 
therapy. With a lower volume of patients, most of 
Novocure’s treatment systems were delivered to patients 
through local decentralized distribution channels relying 
heavily on the involvement of Novocure’s field employees. 

Over the course of 2013, the number of patients grew to 
180. Novocure was preparing for a projected period of 
growth in the coming years, with the EF-14 phase 3 pivotal 
trial in newly diagnosed GBM nearing its interim analysis. 
Novocure needed a global supply chain and central 
warehouse designed to ensure that patients received the 
therapy on time and in a compliant manner, and to support 
anticipated commercial launches in new approved markets 
around the world. 

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To build the global supply  
chain, Jens and the team  
chose global partners from 
Europe, Israel, the U.S.,  
Mexico and China. 

“Everything flowed through the 
warehouse here in Switzerland,” 
Jens said. “All of the equipment 
that ended up with a patient, 
be it in the U.S. or in Japan or 
anywhere in the world, was 
managed here in our Global 
Operations Center.” 

Jens Hult, Vice President 
Global Supply Chain

Jens said the strategic approach to building the supply 
chain and creation of a centralized warehouse in 
Switzerland was designed to ensure a secure supply of 
Novocure’s therapy for patients globally. This involved 
building support systems for product planning, 
procurement, manufacturing, warehousing and distribution, 
and service. 

“As you grow, one of the key pieces is that you trust your 
supply chain to deliver what you need when you need it,” 
Jens said. “That sense of security is what we in the supply 
chain team strived to provide to the business since I started, 
and that’s what we intend to continue to provide to the 
business as we grow. Our number one priority—today and 
in the future—is to ensure that we do not have patients 
going off treatment based on not having product.”

NOVOCURE 2019 ANNUAL REPORT

a trial stopped for early success

Novocure announces the EF-14 phase 3 pivotal clinical trial stopped for early  
success at interim analysis.

Two months later, the trial data were presented by  
Dr. Roger Stupp as a late-breaking abstract at the 2014 
Society for Neuro Oncology Annual Meeting. The EF-14 
results gave Novocure’s leadership team confidence  
that FDA approval would be granted and that a business 
could be established helping patients with newly 
diagnosed GBM.

“We now had superiority data in one of the most difficult  
to treat cancer indications,” Bill said. “This was the 
foundation that allowed us to move forward to build  
the Novocure we know today.”

In 2014, Novocure faced unanswered questions from the 
scientific, medical and investment communities regarding 
the potential of its innovative therapy. That changed when 
Bill Doyle, Novocure’s Executive Chairman, learned that 
the EF-14 Independent Data Monitoring Committee 
recommended the trial be stopped for early success. 

“If I had to put my finger on one really transformational 
moment for the company, I would pick the 
announcement that the EF-14 trial achieved statistical 
significance at the interim analysis and was terminated 
early for success,” Bill said. 

The EF-14 study was designed to test the safety and 
efficacy of adding Tumor Treating Fields to standard  
of care chemotherapy compared to standard of care 
chemotherapy alone in patients with newly diagnosed 
GBM. The trial achieved statistically significant and 
clinically meaningful results in overall survival and 
progression-free survival in a planned interim analysis  
of the first 315 patients enrolled.

Michael Davies, a GBM patient

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‘building for this moment’

The initial presentation of EF-14 data also marked the beginning of a brand.

“I really liked the simplicity of it,” Pritesh said. “It really 
resonated with us in terms of the functionality of what  
we wanted the product to do. It allowed us to capitalize  
on what we believe is really the essence of Tumor  
Treating Fields.” 

The Optune brand also included a color palette of  
blue and orange—with blue representing innovation  
and the trailblazing nature of Novocure, and orange 
representing hope. 

“We wanted to give patients the ability to think about  
a future, to think about another treatment, to have hope  
in an underserved disease,” Pritesh said.

Pritesh Shah, Novocure’s Chief Commercial Officer, 
remembers the conference call when he and the  
team learned in November 2014 that the EF-14 phase 3 
pivotal trial in newly diagnosed GBM was positive and met 
the statistical threshold at the interim analysis. As he 
digested the news, he tried to stay present to allow the 
accomplishment to sink in, yet could not help but allow  
his mind to propel into the future.

“We had been building for this moment for such a long 
time,” he said. “To be a part of it, to watch it unfold play-
by-play in front of my eyes…as much as I wanted the time 
to stand still, I knew that we had so much to do to get  
our therapy in the hands of providers so that it can help 
patients.” 

As Novocure worked toward obtaining FDA approval in 
newly diagnosed GBM, Pritesh and the commercial team 
kicked into gear to develop a brand for Novocure’s therapy 
and to prepare for launch.

Novocure’s device used to treat recurrent GBM was called 
the NovoTTF-100A System. When Pritesh joined in 2012 to 
lead Novocure’s U.S. marketing efforts, he knew the 
therapy needed a name that was easy to say and an 
identity. After conducting research and working through 
branding exercises, the team aligned on Optune. The prefix 
“op” signifies the opportunity to offer patients an innovative 
treatment optimized to target tumors that are difficult to 
treat. The suffix “tune” alludes to a tuning fork for a piano 
and evokes the idea of using the therapy as a tool.

NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT

Bill Doyle, Executive Chairman

a public company

Novocure launches its initial public offering to help fund the company’s future.

The outcome of the EF-14 study in newly diagnosed GBM 
transformed the company 

“Starting with the successful EF-14 interim analysis, 
Novocure delivered a cadence of good news,” recalled  
Bill Doyle, Novocure’s Executive Chairman. By 2015, 
Novocure was building commercial operations on  
three continents and establishing a clinical pipeline  
studying Tumor Treating Fields in multiple additional  
solid tumor indications.

As the business evolved, so did the capital needs of  
the company. 

“In the early R&D days, we would raise funding in rounds  
of $5 million, and then rounds of $10 million,” Bill said.  
“All of a sudden, we needed to raise $100 million to build  
a global oncology company.” 

To meet the capital requirements of commercialization, 
Novocure’s leadership team decided to take the company 
public and began to educate the investor community to 
build support for an initial public offering, or IPO. 

Company-wide preparations culminated in a two-week 
roadshow to meet investors in 10 cities across the U.S. and 
Europe. On October 2, 2015, after months of tremendous 
effort, Novocure went public on the NASDAQ Global Select 
Market with a market capitalization of $1.8 billion, raising 
$165 million in funding for the company. 

“We pulled it off,” Bill said. “We all went to NASDAQ 
headquarters in Times Square and rang the bell.”

Reflecting on 20 years of fundraising to support the 
company’s growth, Bill put the importance of the IPO  
into perspective. 

“For us, the Novocure journey has always been about 
bringing a new cancer therapy to patients,” Bill said. “The 
IPO was pivotal for the company, but it was really just one 
of the tools we used to finance our mission to bring Tumor 
Treating Fields therapy to patients, not an end in itself.”

Pritesh Shah, Chief Commercial Officer

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a smaller and lighter Optune

bigger than glioblastoma

NOVOCURE 2019 ANNUAL REPORT

Novocure’s engineering team develops second generation Optune system to improve patient experience.

In 2005, when Novocure designed its first generation 
Optune system to begin conducting clinical trials, the 
team spearheading the project knew that someday it 
would be possible to advance the technology further. 
Mike Ambrogi, Novocure’s Chief Operating Officer, said 
the next evolution of the device hinged on advancements 
in signal amplification technology. 

Over the next several years, Novocure’s Vice President of 
Engineering Yoram Wasserman kept the idea of a lighter 
and smaller device in mind until signal amplification 
technology had come far enough to make enhancements. 
The advancements would switch Optune from analog 
amplification to digital amplification, which would allow 
for a more efficient system and a dramatic reduction in 
weight and size. Yoram and his team began designing  
the software and hardware for second generation  
Optune system. 

Novocure’s engineers created a system that was half the 
size and less than half the weight of the first generation 
Optune system. Including its battery, the second 
generation Optune system weighs 2.7 pounds, compared 
to the first generation system that weighs 6 pounds.

Novocure started offering second generation Optune 
system to GBM patients in Germany in October 2015  
and then made it available to all new patients in Europe.  
In July 2016, the U.S. FDA approved second generation 
Optune system for GBM patients in the U.S. 

Mike recalled the relief he felt when the project was 
completed.

“The ability to make it smaller and lighter is such a benefit 
to make the treatment more accessible,” Mike said. 
“Second generation Optune system is a symbol of what  
we can do and a precursor of things to come.”

Mike Ambrogi, Chief Operating Officer

23
23
23

In the last several years, Novocure has expanded and bolstered its clinical pipeline by growing its  
clinical operations and establishing clinical partnerships. 

Today, with four phase 3 pivotal trials and two phase 2  
pilot trials under way, Leszek said Novocure’s Clinical 
Operations team continues to adapt and change every  
day to prepare for the future. 

“Almost every day, we do something unique,” he said. 

Leszek said he has felt the support of Novocure’s 
management team from day one in his effort to grow the 
company’s clinical operations. He has also recognized  
the role of each individual on his team.

“I am extremely proud of my team—each and every one of 
them,” he said. “I know how much they put into their work 
and I love that about them.”

After watching a TEDMED Talk on Novocure’s cancer 
therapy by Executive Chairman Bill Doyle, Leszek Bialecki 
wanted to be a part of Novocure. 

Leszek, Novocure’s Senior Director of Global Clinical 
Operations, joined in 2017 with the role of leading clinical 
operations as a department and to prepare for growth of 
the clinical program. Clinical operations is responsible for 
the management of clinical trials.

“We knew that the growing pipeline will require changes  
in the way we work, increase the size of the team,  
and expand geographically,” said Leszek, who works  
at Novocure’s Root, Switzerland, office.

At the time, Novocure had recently begun its phase 3 
pivotal trials in brain metastases and non-small cell lung 
cancer, was planning a phase 3 pivotal trial in pancreatic 
cancer and was wrapping up its registrational trial in 
mesothelioma. Novocure was becoming bigger than GBM.

Leszek took the knowledge from his nearly 20-year career 
working for large pharmaceutical companies and applied  
it to Novocure, mapping out the journey for his team. Over 
the last several years, his team grew from nine employees 
to more than 40. Leszek said it isn’t as simple as hiring 
people with specific qualifications for the role—it takes  
a certain type of person who will succeed as an individual 
and in turn contribute to the success of the organization. 

“We need a specific type of talent that will fit Novocure’s 
culture,” he said. “This is our strength. This is what makes 
us go. We hire people driven by ideas and by purpose.  
This is something that we live by.” 

Novocure has also established external partnerships to 
facilitate clinical trial enrollment and execution and 
continued to expand the pipeline. In 2019, Novocure 
partnered with the European Network for Gynaecological 
Oncological Trial groups (ENGOT) and the GOG 
Foundation, Inc. to run its phase 3 pivotal trial in ovarian 
cancer, INNOVATE-3. In 2019, Novocure collaborated with 
Zai Lab to begin a phase 2 pilot trial of Tumor Treating 
Fields in gastric cancer in Greater China. 

Leszek Bialecki, Senior Director of  
Global Clinical Operations

2424
24

13NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT

Katherine Tiku, Senior Director of Global Medical Affairs Publications

Matt Thaeder, Associate Director of Business Development

championing the story

a pathway to reach more patients

Acceptance of Tumor Treating Fields grows across the scientific community. 

Novocure partners with Zai Lab to bring its innovative therapy to Greater China.

15

With increasing frequency over the last decade,  
Novocure was earning external validation of its science. 
Investigators, authors and conference organizers 
increasingly expressed interest in understanding Tumor 
Treating Fields. This rising acceptance and interest  
helped to amplify Novocure’s message. 

“Our story never changed,” said Katherine Tiku, Senior 
Director of Global Medical Affairs Publications. “What we 
were saying on day one about electric fields’ ability to 
disrupt cancer cell division was the same story we were 
telling more than 10 years later. We gained a number of 
advocates along the way, but suddenly all our 
accomplishments added up into something bigger—and 
people started coming to us to help champion the story.”

Novocure saw examples of increased acceptance of 
Tumor Treating Fields across the global scientific 
community. There were notable publications in peer-
reviewed journals, including JAMA, The Lancet Oncology 

and the Red Journal. Optune was recognized in clinical 
guidelines globally, including the National Comprehensive 
Cancer Network (NCCN) guidelines in the U.S and 
equivalent guidelines in Europe, Japan and China.

“The best science is reproducible, and we didn’t have to 
retract or restate anything,” Katherine said. “As the 
community became more familiar with our data, authors 
began approaching us for input, conference organizers 
started inviting us to speak, and news outlets wanted to 
know more. Tumor Treating Fields had established itself, 
and we were gaining prestige and press in the scientific 
community.”

After years of growing the Optune brand in the U.S.,  
Europe and Japan, it was time to turn attention to China, 
the world’s most populated country. In September 2018, 
Novocure and Zai Lab, a Shanghai-based biopharmaceutical 
company, announced a strategic collaboration to make 
Optune available to the Chinese market. 

“There are certain parts of the world, such as China, where it 
makes sense to have a trusted partner,” said Matt Thaeder, 
Novocure’s Associate Director of Business Development. 

Sharing best practices, Novocure ensured that Zai Lab 
could replicate the high standards of Novocure’s patient-
forward business model. In only three months, Zai Lab was 
treating its first GBM patient in Hong Kong.

“Going from an agreement to treating the first patient with 
Optune in that short amount of time was the moment 
when it finally felt real that this treatment had moved to  
a new part of the world,” Matt said.

It didn't stop with GBM. Together, Novocure and Zai Lab  
are also pursuing clinical development, regulatory approvals 
and treatment expansion to other cancer types with high 
unmet needs.

“Our collaboration with Zai Lab is another way to expand 
patient access,” Matt said. “I think that there's so much 
untapped potential in Tumor Treating Fields, and I feel 
proud that we are moving to a new arch in providing our 
therapy to more patients.” 

“I think that there's so much 
untapped potential in Tumor 
Treating Fields, and I feel proud 
that we are moving to a new 
arch in providing our therapy  
to more patients.”

— Matt Thaeder,  

Associate Director of Business Development

25
25

26

1416

Medicare reimbursement 

A partnership with a patient re-energized Novocure on its journey to obtain coverage for Medicare recipients.

Frank Leonard’s first project after joining Novocure 
became a quest that took nearly a decade to complete. 

In 2010, the year before Novocure received its first FDA 
approval in recurrent GBM, Frank was tasked with 
determining how Novocure would launch a product 
commercially. He zeroed in on the fact that Novocure’s 
cancer therapy did not yet have a classification from a 
reimbursement standpoint. Eventually, Optune and Tumor 
Treating Fields became classified as durable medical 
equipment (DME). This posed a challenge because most 
DME are simple devices like wheelchairs, canes and 
walkers, and decision-makers were not used to evaluating 
advanced therapeutic technologies in the DME space. 

After launching its first commercial product, Novocure 
began working to educate insurers and countries with 
national reimbursement about the value of Novocure’s 
therapy. The company also continued to build its data. 

Over the years, nearly every major health insurer in the 
U.S., along with several governments, began reimbursing 
for Optune. Medicare was the last major healthcare payer 
in the U.S. that did not reimburse for Novocure’s therapy.

“Going back to the beginning, we were approaching 
Medicare to introduce an entirely new concept in 
medicine,” said Frank, Novocure’s Senior Vice President  
of Corporate Strategy and Health Policy. “There was 
definitely a point, maybe five years into the process,  
where it felt like the process may never end.”

In 2016, Frank formed a partnership that helped re-
energize him on his journey. He began working with  
Steve Welhoelter, an Optune patient, to advocate for 
Medicare reimbursement on Capitol Hill by educating 
lawmakers on the importance of Novocure’s therapy. 

“It made it very real to me, that no matter how long the 
process took, we had to get all the way through the 
process to be successful and ensure coverage for our 
patients,” Frank said.

Steve of Ponce Inlet, Florida, had recently retired. Teaming 
up with Novocure gave him a renewed sense of purpose. 
He told his story of living with GBM and receiving Optune 
therapy to lawmakers and to panels of decision-makers. 
Steve said he believed in Novocure’s mission and wanted 
to help ensure the therapy was available to patients who 
needed it. 

“I’m privileged to be a part of a team that cares so much 
about people,” Steve said.

In July 2019, Medicare released a final local coverage 
determination providing coverage of Optune for Medicare 
beneficiaries with newly diagnosed GBM. Frank said it took 
him two weeks to digest the news. 

“Securing Medicare reimbursement was only possible 
because every department at Novocure contributed to the 
mission, we worked as a team, and we partnered with our 
patients,” he said. “Everything had to come together.” 

27

27
27

Frank Leonard, Senior Vice President of Corporate 
Strategy and Health Policy

NOVOCURE 2019 ANNUAL REPORT

Maty Ayal Hershkovitz, Vice President of Global Regulatory Affairs

a platform therapy

In May 2019, the U.S. FDA approved Novocure’s therapy for the treatment of malignant pleural mesothelioma.

From fall of 2018 through spring of 2019, Novocure 
embraced a fast-paced dialogue with the U.S. FDA after 
submitting an application for approval of Optune Lua™, 
originally known as the NovoTTF-100L System, in 
combination with chemotherapy for the treatment of 
malignant pleural mesothelioma (MPM). Optune Lua was 
submitted for approval under the Humanitarian Device 
Exemption (HDE) pathway, which was created by the  
FDA to encourage companies to innovate in rare and 
underserved diseases.

“Whenever FDA had a question, we had the resources, we 
had the data, we had the science to go back and provide  
an answer,” Maty said. “That was incredible because those 
back-and-forth exchanges happened many, many times.”

In May 2019, the FDA approved Optune Lua in combination 
with pemetrexed plus platinum-based chemotherapy for 
the first-line treatment of unresectable, locally advanced or 
metastatic MPM. Optune Lua is the first new treatment for 
MPM in more than 15 years.

Maty Ayal Hershkovitz, Vice President of Global Regulatory 
Affairs, lives and works in Israel, and managed a challenging 
time difference when questions from the  
FDA would come in with a tight timeline for response.

“I couldn't believe it myself, but I was writing emails from  
the supermarket to the FDA,” she said.

As Vice President of Global Regulatory Affairs, Maty oversaw 
the submission of Optune Lua as a treatment for MPM to 
the FDA. The role of regulatory affairs, Maty said, is to tell 
regulatory authorities Novocure’s story per specific device 
and cancer indication. 

“A good story would be something that reflects the fact that 
we did quality work, that we have a quality device, that the 
data are solid, and that what we are offering patients is 
going to be safe and effective,” she said. 

Throughout the approval process, the FDA would ask for 
additional information from Novocure regarding its data in 
MPM and about the device. 

Maty acknowledged the high level of cooperation she 
received from colleagues across functions during the 
approval process. 

“I don't take it for granted that you get that kind of 
cooperation at Novocure,” Maty said. “People understood 
that if FDA had a question, the response had to be  
provided quickly.” 

Throughout her career, Maty has seen many companies 
strive to create a pipeline but their innovations may have 
only been specific to one disease. For Novocure, the FDA 
approval in MPM broadened the potential use of its therapy.

“This was a breakthrough,” Maty said. “The FDA approval in 
MPM made Tumor Treating Fields a platform—a platform to 
our future.”

28
28

17NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT

19

excitement for the next opportunity

Geographical expansion adds an additional lever for growth.

Entering 2019, Novocure had established commercial 
operations in seven active markets: the U.S., Austria, 
Germany, Israel, Japan, Sweden and Switzerland. As proud 
as the team was of the progress made in these seven  
active markets, Novocure believed that a significant number 
of patients remained who could benefit from Optune but  
who could not yet access treatment. In late 2019, Novocure 
announced its expansion into France, Europe’s second 
most populous country. 

Anne Calixte de Lembeye, one of Novocure’s newest 
employees, was hired to lead those efforts. She joined the 
team in January 2020 as the French country manager for 
two reasons: the innovation and the patients. “I really enjoy 
working to bring something new and different to patients 
that’s really needed,” Anne said.

Energized by Novocure’s mission and vision, Anne started 
to educate key stakeholders, building awareness of Optune. 
Anne’s work is fueled positive feedback she received from 
the French scientific and medical communities. 

“We are very enthusiastic about the opportunity,” Anne said. 
“It gives me a lot of energy to go as fast as we can to bring 
Tumor Treating Fields therapy to market in France.”

When asked what she 
hopes to achieve at 
Novocure, Anne said:  
“I will be very proud to put 
Optune on the French 
market for GBM first, and 
then I hope to do the  
same for other indications. 
I will be very proud doing 
that at an organization  
with a lot of tightness  
and cooperation between 
its people, and also one 
with a lot of patience.”

Anne Calixte de Lembeye, 
Country Manager France

Wilco Groenhuysen, Chief Financial Officer

18

’a massive, collective effort’

In October 2019, Novocure became a profitable company.

Reflecting on the past eight years as leader of Novocure’s 
finance organization, Wilco Groenhuysen gestured toward 
to the blank whiteboard in his office. Wilco joined 
Novocure in 2012 with the objective of building a finance 
team and achieving finance excellence.

“The whiteboard was truly white,” Wilco said. “There was 
nothing on it.”

The metaphorical and physical white board in his office  
is still without writing. In his early days at Novocure,  
Wilco felt excited by the opportunity to start with  
a blank slate—an excitement that still drives him today  
as Chief Financial Officer. 

“I knew what a successful finance organization should look 
like, but also wanted to create one that adds value,” he 
said. “I’m a strong believer in hiring superior, highly 
motivated talent that can build their own jobs to some 
extent as long as it fits in the total.”

generated by the GBM business exceeded Novocure’s 
investments in research and development. 

“It took a massive, collective effort,” he said. “Becoming 
profitable from scratch is a remarkable achievement.”

Wilco said Novocure’s financial performance and 
improvement is not the company’s primary objective, 
rather a positive consequence of Novocure’s mission. 

“What's remarkable about Novocure is the fact that its  
sole focus is on helping patients and extending survival  
in some of the most aggressive forms of cancer,” he  
said. “We know if we stay focused and if we execute on 
that well in a disciplined way, financial success will also  
be achieved.”

After nearly a decade at Novocure, Wilco still feels like  
he is starting fresh every day—and wouldn’t have it any 
other way.

In October 2019, Novocure reached a financial milestone: 
profitability. In the years leading up to profitability, Wilco 
said, leadership balanced the desire to become profitable 
with investing profits from the GBM business into 
Novocure’s research and development. Over time, funds 

“We are building a company, going through stages that 
require substantial change,” he said. “What is great today 
might not be good enough two years from now. This is  
a continuum. So you have to wipe the board, accept that 
status quo will be insufficient, and define the future.”

29
29
29

30
30

Danilo Conti, Associate Director of  
Device Support Specialists EMEA

NOVOCURE 2019 ANNUAL REPORT
NOVOCURE 2019 ANNUAL REPORT

more than 14,000 patients

20 years of milestones and progress results in thousands of patients treated to date.

Novocure CEO Asaf Danziger remembers the early days  
of the company when he knew every patient by name.  
At the time, he went to the home of patients to help them 
start Novocure’s therapy. At night, when he wasn’t sleeping, 
he thought about each patient as a person and hoped for 
better outcomes. 

Whenever Novocure reaches a significant milestone, Asaf 
often says when addressing employees that it is only the 
beginning. In those moments of celebration, it’s as if those 
words signal a call to see something greater than what exists 
today. In his time at Novocure, Asaf has seen countless 
beginnings, with every moment building on the ones before.

Today, with more than 14,000 patients treated to date, the 
human connection between Novocure and patients remains 
the same. Asaf said it took many parts coming together at 
the right moments to reach the milestone of treating 
14,000-plus patients.

“It’s a huge machine,” Asaf said of Novocure’s business.  
“The goal is to build it in the same way—it doesn’t matter  
if it’s Tokyo, Nashville or Munich.” 

He said he is proud of this milestone, and the fact that 
Novocure and its employees had the focus and drive to  
take it this far.

“I am lucky that there are very talented, passionate people 
working at Novocure,” Asaf said. “I really mean it. Without 
them, it isn’t going to happen.”

“It’s a real thing right now,” he said. “It’s a real establishment. 
We built something strong and sustainable to move to  
the next level.”

Today, when he’s not sleeping at night, Asaf thinks about the 
number of people impacted by Novocure’s therapy—every 
patient and their family and friends. He thinks about the 
potential future indications and all of the people who may 
one day benefit from Novocure’s cancer treatment. He calls 
on Novocure employees to never lose sight of that and to 
keep moving forward. 

31
31

32
32
32

Asaf Danziger, CEO (left) and  
Roman Pass, Supervisor Logistics Coordinators (right)

SELECTED   
FINANCIALS

Jessica Morris, a GBM patient

Our continued commercial growth drives strengthening 
financial performance that allows us to invest in clinical 
and product development intended to unlock future value 
for our patients, employees and shareholders. 

Since our IPO in 2015, we delivered double-digit or greater revenue growth every year, increased our gross 
margins from the mid-40s to the mid-70s and invested over $250 million in research and development. In 2019, 
we began to generate cash flow from operations and reported our first two quarters of profitability. We believe 
our financial strength positions us well to achieve our strategic objectives, and we remain committed to 
maintaining a balanced focus across growth, profitability and liquidity.

YEAR-OVER-YEAR GROWTH 2019 VERSUS 2018

22%

GROWTH IN 
ACTIVE PATIENTS

56%

GROWTH IN RESEARCH & 
DEVELOPMENT INVESTMENTS

*cash, cash equivalents and short-term investments

42%

GROWTH IN 
NET REVENUES 

$80M

CASH ON HAND* ADDED 
TO THE BALANCE SHEET 

NOVOCURE 2019 ANNUAL REPORT

financial strength funds investments in innovation

¹ SG&A Expense Ratio equals total 
selling, general and administrative 
expenses divided by total net 
 revenues in the period

consolidated statement of operations

U.S. dollars in thousands

Net revenues 

Cost of revenues 

Impairment of field equipment

Gross profit 

Research, development and clinical trials 

Sales and marketing 

General and administrative 

Total operating expenses 

Operating income (loss)

Financial expenses (income), net

Income (loss) before income taxes 

Income tax

Net income (loss)

Basic and diluted net income (loss)  
per ordinary share

Year ended December 31,

2019

2018

2017

2016

$

351,318

$

248,069 

$

177,026 

$

82,888 

88,606 

80,048 

55,609 

–

–

262,712 

168,021 

79,003 

96,675 

87,948 

50,574 

77,663 

73,456 

–

121,417 

38,103 

63,528 

59,114 

39,870 

6,412 

36,606

41,467 

59,449 

51,007 

263,626 

201,693 

160,745 

151,923 

(914)

7,910 

(8,824)

(1,594)

(7,230)

(0.07)

(33,672)

12,270 

(45,942)

17,617 

(63,559)

(0.69)

$

$

$

$

(39,328)

(115,317)

9,169 

6,147 

(48,497)

(121,464)

13,165 

(61,662)

(0.70)

10,381 

(131,845)

(1.54)

$

$

$

$

33
33

34

“What appeals to me about  
Tumor Treating Fields is that it  
is a simple and elegant response  
to a big problem. I’m proud to  
be a part of this journey.”

— Todd Longsworth 
General Counsel

LEADERSHIP

CORPORATE OFFICERS AND EXECUTIVE LEADERSHIP

William F. Doyle 
Executive Chairman

Yoram Palti, M.D., Ph.D. 
Founder

Ely Benaim, M.D. 
Chief Medical Officer

Mike Ambrogi 
Chief Operating Officer

Pritesh Shah 
Chief Commercial Officer 

BOARD OF DIRECTORS

William F. Doyle 
Executive Chairman

David T. Hung

Jeryl Hilleman

Kinyip Gabriel Leung 

Asaf Danziger 
Chief Executive Officer 

Todd Longsworth 
General Counsel

Uri Weinberg, M.D., Ph.D. 
Chief Science Officer 

Wilco Groenhuysen 
Chief Financial Officer

Asaf Danziger 
Chief Executive Officer

Martin J. Madden

Sherilyn D. McCoy 

William A. Vernon

NOVOCURE 2019 ANNUAL REPORT

market price of and dividends on the registrants’ common equity 
and related stockholder matters

The following performance graph is being furnished as part  
of this annual report and shall not be deemed "filed" with the 
SEC or incorporated by reference into any of our filings under 
the Securities Act of 1933, as amended (the "Securities Act"),  
or the Exchange Act, whether made before or after the date 
hereof and irrespective of any general incorporation language  
in any such filing.

The following graph shows the total shareholder return of 
an investment of $100 in cash at market close on October 2, 
2015 (the first day of trading of our ordinary shares) through 

December 31, 2019 for (1) our ordinary shares, (2) the Russell 
2000 Index, and (3) the Nasdaq Biotechnology Index. Pursuant 
to applicable SEC rules, all values assume reinvestment of the 
full amount of all dividends; however, no dividends have been 
declared on our ordinary shares to date. The shareholder return 
shown on the graph below is not necessarily indicative of future 
performance, and we do not make or endorse any predictions 
as to future stockholder returns.

comparison of 15 month cumulative total return*
COMPARISON OF CUMULATIVE TOTAL RETURN
Among NovoCure Ltd, the Russell 2000 Index, and the NASDAQ Biotechnology Index

$ 500

$ 140
$ 450
$ 500
$ 120
$ 400
$ 450
$ 100
$ 350
$ 80
$ 400
$ 300
$ 60
$ 350
$ 40
$ 250
$ 300
$ 20
$ 200
$ 250
$ 0
$ 150
10/2/2015
$ 200
$ 100
$ 150
$ 50
$ 100
$ 0
$ 50

NovoCure Ltd

10/2/15

$ 0

10/2/15

12/31/2015

03/31/2016

06/30/2016

09/30/2016

12/31/2016

NASDAQ Biotechnology Index

Russell 2000 Index

12/15

12/15

12/16

12/16

12/17

12/17

Assumes $100 invested on October 2, 2015
Assumes dividend reinvested
Fiscal year ending December 31, 2015
12/19

12/18

12/18

12/19

COMPARISON OF CUMULATIVE TOTAL RETURN
Among Novocure Ltd, the Russell 2000 Index, and the Nasdaq Biotechnology Index

NASDAQ Biotechnology

NovoCure Ltd

Russell 2000

NovoCure Ltd

Russell 2000

NASDAQ Biotechnology

*$100 invested on 10/2/15 in stock or 9/30/15 in index, including reinvestment of dividends. Fiscal year ending December 31.

Copyright© 2019 Russell Investment Group. All rights reserved.

cumulative total return summary

10/31/2015

Novocure Limited

10/2/15

12/15

3/16

NovoCure Ltd

100.00 122.32

79.21

NASDAQ Biotechnology Index
9/16

12/16

6/16
Assumes $100 invested on October 2, 2015
Assumes dividend reinvested
Fiscal year ending December 31, 2015
46.72

42.94

94.64

44.31

6/17

3/17

63.84

11/30/2015

12/31/2015

Russell 2000 Index
12/17

9/17

3/18

6/18

9/18

12/18

108.59

110.50

119.26

171.23

286.65

183.15

Russell 2000

100.00 103.59 102.02 105.89

115.47

125.67

128.77

131.94

139.42

144.07

143.95

155.11

160.66

128.21

NASDAQ 
Biotechnology

100.00

111.62

89.57

86.95

95.87

89.13

97.75

103.18

112.36

106.14

104.85

107.67

119.92

96.28

$ 140
$ 120
$ 100
$ 80
$ 60
$ 40
$ 20
$ 0
10/2/2015

35
35

36

Optune® and Optune Lua™ indications for use and important safety information

INDICATIONS

WARNINGS AND PRECAUTIONS

Optune is intended as a treatment for adult patients (22 years  
of age or older) with histologically-confirmed glioblastoma 
multiforme (GBM).

Optune and Optune Lua can only be prescribed by a healthcare 
provider that has completed the required certification training 
provided by Novocure®.

Optune with temozolomide is indicated for the treatment of adult 
patients with newly diagnosed, supratentorial glioblastoma following 
maximal debulking surgery, and completion of radiation therapy 
together with concomitant standard of care chemotherapy.

The most common (≥10%) adverse events involving Optune 
in combination with chemotherapy in patients with GBM were 
thrombocytopenia, nausea, constipation, vomiting, fatigue, 
convulsions, and depression.

For the treatment of recurrent GBM, Optune is indicated following 
histologically-or radiologically-confirmed recurrence in the 
supratentorial region of the brain after receiving chemotherapy. The 
device is intended to be used as a monotherapy, and is intended as 
an alternative to standard medical therapy for GBM after surgical and 
radiation options have been exhausted.

Optune Lua is indicated for the treatment of adult patients with 
unresectable, locally advanced or metastatic, malignant pleural 
mesothelioma (MPM) to be used concurrently with pemetrexed  
and platinum-based chemotherapy.

CONTRAINDICATIONS

Do not use Optune in patients with GBM with an implanted medical 
device, a skull defect (such as, missing bone with no replacement), 
or bullet fragments. Use of Optune together with skull defects or 
bullet fragments has not been tested and may possibly lead to tissue 
damage or render Optune ineffective. Do not use Optune Lua in 
patients with MPM with implantable electronic medical devices, such 
as pacemakers or implantable automatic defibrillators, etc.

Use of Optune for GBM or Optune Lua for MPM together with 
implanted electronic devices has not been tested and may lead to 
malfunctioning of the implanted device.

Do not use Optune for GBM or the Optune Lua for MPM in patients 
known to be sensitive to conductive hydrogels. Skin contact with the 
gel used with Optune or Optune Lua may commonly cause increased 
redness and itching, and may rarely lead to severe allergic reactions 
such as shock and respiratory failure.

The most common (≥10%) adverse events related to Optune 
treatment alone in patients with GBM were medical device site 
reaction and headache. Other less common adverse reactions 
were malaise, muscle twitching, and falls related to carrying the 
device.

The most common (≥10%) adverse events involving Optune Lua 
in combination with chemotherapy in patients with MPM were 
anemia, constipation, nausea, asthenia, chest pain, fatigue, device 
skin reaction, pruritus, and cough.

Other potential adverse effects associated with the use of Optune 
Lua include: treatment related skin toxicity, allergic reaction to  
the plaster or to the gel, electrode overheating leading to pain  
and/or local skin burns, infections at sites of electrode contact  
with the skin, local warmth and tingling sensation beneath the 
electrodes, muscle twitching, medical site reaction and skin 
breakdown/skin ulcer.

If the patient has an underlying serious skin condition on the 
treated area, evaluate whether this may prevent or temporarily 
interfere with Optune or Optune Lua treatment. Do not prescribe 
Optune or Optune Lua for patients that are pregnant, you think 
might be pregnant or are trying to get pregnant, as the safety  
and effectiveness of Optune and Optune Lua in these populations 
have not been established.

Please go to Optune.com to see the Optune Instructions For Use 
(IFU) for complete information regarding the device's indications, 
contraindications, warnings, and precautions.

Please go to OptuneLua.com to see the Optune Lua IFU 
for complete information regarding the device's indications, 
contraindications, warnings, and precautions. 

forward-looking statements

In addition to historical facts or statements of current condition, this 
press release may contain forward-looking statements. Forward-
looking statements provide Novocure’s current expectations or 
forecasts of future events. These may include statements regarding 
anticipated scientific progress on its research programs, clinical 
trial progress, development of potential products, interpretation of 
clinical results, prospects for regulatory approval, manufacturing 
development and capabilities, market prospects for its products, 
coverage, collections from third-party payers and other statements 
regarding matters that are not historical facts. You may identify 
some of these forward-looking statements by the use of words in 
the statements such as “anticipate,” “estimate,” “expect,” “project,” 
“intend,” “plan,” “believe” or other words and terms of similar meaning. 
Novocure’s performance and financial results could differ materially 
from those reflected in these forward-looking statements due to 

37

general financial, economic, regulatory and political conditions 
as well as issues arising from the COVID-19 pandemic and other 
more specific risks and uncertainties facing Novocure such as 
those set forth in its Annual Report on Form 10-K filed on  
February 27, 2020 and Quarterly Report on Form 10-Q filed on 
April 30, 2020 with the U.S. Securities and Exchange Commission. 
Given these risks and uncertainties, any or all of these forward-
looking statements may prove to be incorrect. Therefore,  
you should not rely on any such factors or forward-looking 
statements. Furthermore, Novocure does not intend to update 
publicly any forward-looking statement, except as required by  
law. Any forward-looking statements herein speak only as of the 
date hereof. The Private Securities Litigation Reform Act of 1995 
permits this discussion.

NOVOCURE 2019 ANNUAL REPORT

Lynn Oxenberg, an Optune patient

38

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