Technical Development Update

8 September 2020

ADVANCED ONCOTHERAPY PLC

("Advanced Oncotherapy" or the "Company")

Technical Development Update

Advanced Oncotherapy (AIM: AVO), the developer of next-generation proton therapy systems for cancer treatment, today provides an update on recent progress and achievements made with regards to its LIGHT system.

Technical development of the LIGHT system

The LIGHT system includes innovative linear accelerators which are integrated with a fully functional treatment room system and operated through a suite of software components.

As previously announced, as a result of the impact of COVID-19, Advanced Oncotherapy shifted its focus to documentation and software development. The Company has made strong progress to support the timely delivery of all technical files for the certification process.

All of the high-precision accelerating structures, which include: (i) the proton source; (ii) the radio-frequency quadrupole; (iii) the side-coupled drift tube linacs and; (iv) the coupled cavity linacs, have been delivered to the Daresbury assembly site and the hardware required for the patient positioning system (PPS) has been manufactured and passed factory acceptance testing.

Most notable developments achieved since the update provided at the time of the Company's results in June 2020 when the assembly activity resumed include:

Assembly of the first and subsequent machines

·     Site preparation at Daresbury is ready to support the ultra-high vacuum tests and the high-voltage conditioning of the accelerating structures, to (i) prepare them for use in delivering the proton beams, and (ii) assemble additional LIGHT systems based on the production schedule set by the Company.

·      The first beam diagnostic test benches have been installed at Daresbury.

·   The powering sources for the RFQ (inductive output tubes) have been successfully tested and delivered to Daresbury.

·   The first series of the magnets, which steer the accelerator beam towards the treatment room, have been delivered in accordance with the operational plan of the Company. These include dipole and quadrupole electromagnets for the high energy beam transfer line and permanent magnet quadrupoles for the medium energy beam transfer line.

·      Production of the modulators-klystrons by Scandinova is progressing according to the operational plan.

Patient treatment and LIGHT installation at customer sites

·   Building requirements and building interfaces for the patient treatment area, located at the assembly site in Daresbury, have been finalised.

·      Work on the safety systems for connecting the patient treatment area with the LIGHT system is ongoing.

·   The machine installation process has been optimised which will reduce the start-up time for future LIGHT systems.

·    P-Cure, the supplier of the PPS, and the Company have enhanced key documentation to support the efficient installation and use of future systems, enabling quicker system start-up and commissioning.

Software development

·      Upgraded versions of the oncology information system and the treatment session manager have been received.

·      The upgraded version of the treatment planning system (TPS) software has been installed and is operational for LIGHT proton therapy treatments using the PPS.

The Notes for Editors set out below provide further details of the key technical components and software requirements for the LIGHT system. In addition, further information on LIGHT and its design can be found at: https://www.avoplc.com/en-gb/Technology/Overview-of-the-LIGHT-System

Partnering developments

The Company has continued to carry out clinical use discussions with the University Hospitals Birmingham NHS Foundation Trust ("UHB"), the London Clinic and the Mediterranean Hospital with regards to the installation of their LIGHT systems. UHB is preparing to install LIGHT beam data into its TPSs and is cooperating with the Company to plan for the initial Daresbury patient indications. Cleveland Clinic has now installed the LIGHT TPS software and has commenced a two-year study to evaluate the target conformity of proton mini-beams in comparison with X-ray stereotactic body radiation therapy and stereotactic radiosurgery.

Nicolas Serandour, CEO of Advanced Oncotherapy, commented:

"Assembly activities in Daresbury have recently resumed with the view of assembling our first machine and having the infrastructure in place to cater for future demand. As a result, we have received all the bespoke and high-precision accelerating structures now and we are expecting the delivery of further supporting equipment to be in line with our operational plan for completion. We are grateful for the support of our team and suppliers who have shown greater flexibility during the pandemic and the support of our financing partners, such as VDL and Nerano Pharma, who have provided the debt facilities to support our continuing work on the LIGHT system."

Advanced Oncotherapy intends to hold an investor day in October 2020. Further details will be provided in due course.

- ENDS -

Notes for Editors

The following section outlines some of the key technical components and software requirements for the LIGHT system (referred in today's announcement):

·      Radio-frequency quadrupole (RFQ)

The RFQ is a copper accelerating structure which focuses, bunches and accelerates protons up to 5MeV. The RFQ sits between the proton source and the side-coupled drift tube linacs.

·      Inductive output tubes (IOT)

IOTs are high power radio-frequency generators used to bring the relevant power to the RFQ.

·      Side-coupled drift tube linacs (SCDTLs)

The LIGHT accelerator includes four SCDTL modules which accelerate protons from 5MeV to 37.5MeV. The SCDTLs sit between the RFQ and the CCLs.

·      Coupled cavity linacs (CCLs)

The CCL structures or "higher speed accelerators" are an essential part of the LIGHT Accelerator. They consist of a series of "cells" which accelerate the protons from 37.5MeV to energies that can be applied usefully to a clinical setting (70MeV to 230MeV). The CCLs sit between the SCDTLs and the high energy beam transfer line.

·      Modulators-klystrons

The modulators are the primary power supply to the accelerating units. The klystrons provide the radio-frequency power, which creates the electrostatic field (or wave) on which protons are accelerated.

·      Dipole and quadrupole electromagnets

Dipole electromagnets, which are magnets with two poles, are used to create a homogeneous magnetic field through which the proton beam travels. The quadrupole electromagnets, which consist of four magnets, are used to bend, steer and focus the proton beam.

·      Permanent magnet quadrupoles (PMQ)

The PMQs, which are used to focus and align the proton beam, are placed along the LIGHT accelerator within the SCDTLs and CCLs (in between acceleration tanks) and also in the MEBTs.

·      Medium energy beam transfer (MEBT) line

The MEBT is the series of components which connects the RFQ and the SCDTLs as well as the SCDTLs and the CCLs.

·      High energy beam transfer (HEBT) line

The HEBT is the series of components which connects the LIGHT accelerator to the treatment room(s).

·      Patient positioning system (PPS)

The purpose of the PPS is to provide a platform to position and immobilise the patient with respect to the radiation beam axis. It includes the diagnostic quality computerised tomography (CT) scanner used to scan patients in a seated position, the real-time X-ray verification system which enables continuous imaging of moving tumour, and the robotic chair which can move and rotate the patient with high accuracy and precision.

·      Treatment session manager (TSM)

The TSM software developed by Raysearch, acts as the control system to connect and manage various sub-systems of the LIGHT system. It allows the management of the daily proton treatment for patient delivery.

·      Treatment planning system (TPS)

The TPS software provides superior functionality for treatment planning, encompassing patient positioning through to treatment solutions. The software is well established and familiar to oncologists.

·      Oncology information system (OIS)

The OIS is the software, developed in partnership with Raysearch, which integrates with the TPS to offer managed workflows and to enable patient treatment to be modified daily.

About Advanced Oncotherapy Plc www.avoplc.com

Advanced Oncotherapy, a UK headquartered company with offices in London, Geneva, The Netherlands and in the USA, is a provider of particle therapy with protons that harnesses the best in modern technology. Advanced Oncotherapy's team "ADAM," based in Geneva, focuses on the development of a proprietary proton accelerator called, Linac Image Guided Hadron Technology (LIGHT). LIGHT's compact configuration delivers proton beams in a way that facilitates greater precision and electronic control.

Advanced Oncotherapy will offer healthcare providers affordable systems that will enable them to treat cancer with innovative technology as well as expected lower treatment-related side effects.

Advanced Oncotherapy continually monitors the market for any emerging improvements in delivering proton therapy and actively seeks working relationships with providers of these innovative technologies. Through these relationships, the Company will remain the prime provider of an innovative and cost-effective system for particle therapy with protons.