Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthfull adult r/r B-cell ALL

A Biologics License Application (BLA) for this indication is under FDA priority review; if approved, CTL019 could become very first CAR-T cell therapy available

Positive ODAC recommendation is latest milestone for CTL019 program that commenced through collaboration with the University of Pennsylvania

Basel, July 12, 2017 – Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthful adult patients with B-cell acute lymphoblastic leukemia (ALL).

“The panel’s unanimous recommendation in favor of CTL019 moves us closer to potentially delivering the first-ever commercially approved CAR-T cell therapy to patients in need,” said Bruno Strigini, CEO, Novartis Oncology. “We’re very proud to be expanding fresh frontiers in cancer treatment by advancing immunocellular therapy for children and youthfull adults with r/r B-cell ALL and other critically ill patients who have limited options. We look forward to working with the FDA as they finish their review.”

Acute lymphoblastic leukemia comprises approximately 25% of cancer diagnoses among children under fifteen years old and is the most common childhood cancer in the US[1]. Effective treatment options for patients with r/r ALL are limited. In pediatric and youthful adult patients with B-cell ALL that have relapsed numerous times or become refractory to treatment, the five-year disease-free survival is less than 10-30%[Two],[Trio],[Four].

The ODAC recommendation is based on review of the CTL019 r/r B-cell ALL development program, which includes the Novartis-led ELIANA investigate (NCT02435849), the very first pediatric global CAR-T cell therapy registration trial. Findings from a US multicenter trial and a single site trial examining the safety and efficacy of CTL019 among pediatric and youthful adult patients with r/r B-cell ALL also supported the recommendation and the Biologics License Application (BLA)[Five].

CTL019 was very first developed by the University of Pennsylvania (Penn) and uses the 4-1BB costimulatory domain in its chimeric antigen receptor to enhance cellular responses as well as persistence of CTL019 after it is infused into the patient, which may be associated with long-lasting remissions in patients. In 2012, Novartis and Penn entered into a global collaboration to further research, develop and commercialize CAR-T cell therapies, including CTL019, for the investigational treatment of cancers. Children’s Hospital of Philadelphia (CHOP) was the very first institution to investigate CTL019 in the treatment of pediatric patients and led the single site trial.

“It is encouraging to see the FDA panel’s recommendation and continued momentum behind this innovative therapy, which has potential to help youthfull patients with relapsed/refractory B-cell ALL,” said the Penn team’s leader, Carl June, MD, the Richard W. Vague Professor of Immunotherapy, director of the Center for Cellular Immunotherapies in Penn’s Perelman School of Medicine and director of the Parker Institute for Cancer Immunotherapy at Penn. “We look forward to continuing to work with Novartis to help make a lasting influence on the way this disease is treated.”

“We know firsthand from treating children and youthfull adults with relapsed/refractory B-cell ALL that they despairingly need innovative medicines that provide a fresh treatment to managing this aggressive disease,” said Stephan Grupp, MD, PhD, the Yetta Deitch Novotny Professor of Pediatrics at the Perelman School of Medicine at Penn, Director of the Cancer Immunotherapy Frontier Program and Chief of the Section of Cellular Therapy and Transplant at CHOP. “Today’s vote in favor of CTL019 is a positive step and we appreciate Novartis’ commitment to pediatric patients.”

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first subordination by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis proceeds to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

Novartis plans extra filings for CTL019 in the US and EU later this year, including applications with the FDA and European Medicines Agency (EMA) for the treatment of adults with r/r diffuse large B-cell lymphoma (DLBCL).

About CAR-T and CTL019

CAR-T is different from typical puny molecule or biologic therapies because it is manufactured for each individual patient using their own cells. During the treatment process, T cells are drawn from a patient’s blood and reprogrammed in the manufacturing facility to create T cells that are genetically coded to express a chimeric antigen receptor to recognize and fight cancer cells and other B-cells voicing a specific antigen.

ELIANA (NCT02435849) is the very first pediatric global CAR-T cell therapy registration trial, with explore enrollment having occurred across twenty five centers in the US, Canada, EU, Australia and Japan.

Because CTL019 is an investigational therapy, the safety and efficacy profile has not yet been established. Access to investigational therapies is available only through cautiously managed and monitored clinical trials. These trials are designed to better understand the potential benefits and risks of the therapy. Because of the uncertainty of clinical trials, there is no ensure that CTL019 will ever be commercially available anywhere in the world.

About CTL019 Manufacturing

The Novartis leukapheresis process using cryopreservation permitted for manufacturing and treatment of patients from around the world. Cryopreserved leukapheresis involves removing white blood cells from a patient’s blood and preserving them at very low temperatures. Cryopreserved leukapheresis gives physicians the plasticity to schedule apheresis at a time that is in the best interest of their patients. Novartis commercial manufacturing for CTL019 proceeds to build on its practice in its Morris Plains, Fresh Jersey facility, which has already manufactured CTL019 for hundreds of patients in global clinical trials. Novartis believes that practice is significant in cell therapy manufacturing, and the practice gained at the Morris Plains, Fresh Jersey facility will be a foundation for commercial manufacturing of CAR-T therapies. Novartis has made and proceeds to make investments in manufacturing.

This press release contains forward-looking statements, including “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “look forward,” “believe,” “committed,” “investigational,” “pipeline,” “launch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, fresh indications or labeling for CTL019 and the other investigational products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forward in the forward-looking statements. There can be no assure that CTL019 or the other investigational products described in this press release will be submitted or approved for sale or for any extra indications or labeling in any market, or at any particular time. Neither can there be any ensure that Novartis will successfully implement and maintain commercial manufacturing for CTL019 or the other investigational products described in this press release, or successfully build a network of treatment centers to suggest CTL019 or the other investigational products described in this press release. Nor can there be any ensure that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and extra analysis of existing clinical data; regulatory deeds or delays or government regulation generally; our capability to successfully implement and maintain commercial manufacturing and build a network of treatment centers; our capability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures; general economic and industry conditions, including the effects of the persistently feeble economic and financial environment in many countries; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of fresh information, future events or otherwise.

Novartis provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, cost-saving generic and biosimilar pharmaceuticals and eye care. Novartis has leading positions globally in each of these areas. In 2016, the Group achieved net sales of USD 48.Five billion, while R&D via the Group amounted to approximately USD 9.0 billion. Novartis Group companies employ approximately 118,000 full-time-equivalent associates. Novartis products are sold in approximately one hundred fifty five countries around the world. For more information, please visit http://www.novartis.com.

For Novartis multimedia content, please visit www.novartis.com/news/media-library

For questions about the site or required registration, please contact [email protected]

[1] Howlader, N., Noone, A.. M, Krapcho, M., et al. SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, April 2013; Section 28.9 (12).

[Two] Oudot, C. Auclerc, F. Levy, V., et al. Prognostic Factors for Leukemia Induction Failure in Children With Acute Lymphoblastic Leukemia and Outcome After Salvage Therapy: The FRALLE ninety three Investigate. Journal of Clinical Oncology, March 2008; Volume twenty eight (9).

[Trio] Chessels, J., Veys, P., Kempski, H., et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. British Journal of Hematology, 2003; one hundred twenty three (Trio).

[Four] Reismuller, B., Peters, C., Dworzak, M., et al. Outcome of children and adolescents with a 2nd or third relapse of acute lymphoblastic leukemia (ALL): a population-based analysis of the Austrian ALL-BFM (Berlin-Frankfurt-Münster) Examine Group. Journal of Pediatric Hematology/Oncology. July 2013; thirty five (Five).

[Five] Novartis CTL019 ODAC Briefing Document.

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthfull adult r

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r/r B-cell ALL

A Biologics License Application (BLA) for this indication is under FDA priority review; if approved, CTL019 could become very first CAR-T cell therapy available

Positive ODAC recommendation is latest milestone for CTL019 program that embarked through collaboration with the University of Pennsylvania

Basel, July 12, 2017 – Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthfull adult patients with B-cell acute lymphoblastic leukemia (ALL).

Acute lymphoblastic leukemia comprises approximately 25% of cancer diagnoses among children under fifteen years old and is the most common childhood cancer in the US[1]. Effective treatment options for patients with r/r ALL are limited. In pediatric and youthfull adult patients with B-cell ALL that have relapsed numerous times or become refractory to treatment, the five-year disease-free survival is less than 10-30%[Two],[Trio],[Four].

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first conformity by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis proceeds to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

About CAR-T and CTL019

CAR-T is different from typical petite molecule or biologic therapies because it is manufactured for each individual patient using their own cells. During the treatment process, T cells are drawn from a patient’s blood and reprogrammed in the manufacturing facility to create T cells that are genetically coded to express a chimeric antigen receptor to recognize and fight cancer cells and other B-cells voicing a specific antigen.

Because CTL019 is an investigational therapy, the safety and efficacy profile has not yet been established. Access to investigational therapies is available only through cautiously managed and monitored clinical trials. These trials are designed to better understand the potential benefits and risks of the therapy. Because of the uncertainty of clinical trials, there is no assure that CTL019 will ever be commercially available anywhere in the world.

About CTL019 Manufacturing

This press release contains forward-looking statements, including “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “look forward,” “believe,” “committed,” “investigational,” “pipeline,” “launch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, fresh indications or labeling for CTL019 and the other investigational products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forward in the forward-looking statements. There can be no ensure that CTL019 or the other investigational products described in this press release will be submitted or approved for sale or for any extra indications or labeling in any market, or at any particular time. Neither can there be any assure that Novartis will successfully implement and maintain commercial manufacturing for CTL019 or the other investigational products described in this press release, or successfully build a network of treatment centers to suggest CTL019 or the other investigational products described in this press release. Nor can there be any assure that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and extra analysis of existing clinical data; regulatory deeds or delays or government regulation generally; our capability to successfully implement and maintain commercial manufacturing and build a network of treatment centers; our capability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures; general economic and industry conditions, including the effects of the persistently feeble economic and financial environment in many countries; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of fresh information, future events or otherwise.

For Novartis multimedia content, please visit www.novartis.com/news/media-library

For questions about the site or required registration, please contact [email protected]

[1] Howlader, N., Noone, A.. M, Krapcho, M., et al. SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, April 2013; Section 28.9 (12).

[Two] Oudot, C. Auclerc, F. Levy, V., et al. Prognostic Factors for Leukemia Induction Failure in Children With Acute Lymphoblastic Leukemia and Outcome After Salvage Therapy: The FRALLE ninety three Examine. Journal of Clinical Oncology, March 2008; Volume twenty eight (9).

[Three] Chessels, J., Veys, P., Kempski, H., et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. British Journal of Hematology, 2003; one hundred twenty three (Trio).

[Four] Reismuller, B., Peters, C., Dworzak, M., et al. Outcome of children and adolescents with a 2nd or third relapse of acute lymphoblastic leukemia (ALL): a population-based analysis of the Austrian ALL-BFM (Berlin-Frankfurt-Münster) Investigate Group. Journal of Pediatric Hematology/Oncology. July 2013; thirty five (Five).

[Five] Novartis CTL019 ODAC Briefing Document.

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthfull adult r/r B-cell ALL

A Biologics License Application (BLA) for this indication is under FDA priority review; if approved, CTL019 could become very first CAR-T cell therapy available

Positive ODAC recommendation is latest milestone for CTL019 program that began through collaboration with the University of Pennsylvania

Basel, July 12, 2017 – Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthfull adult patients with B-cell acute lymphoblastic leukemia (ALL).

Acute lymphoblastic leukemia comprises approximately 25% of cancer diagnoses among children under fifteen years old and is the most common childhood cancer in the US[1]. Effective treatment options for patients with r/r ALL are limited. In pediatric and youthfull adult patients with B-cell ALL that have relapsed numerous times or become refractory to treatment, the five-year disease-free survival is less than 10-30%[Two],[Trio],[Four].

The ODAC recommendation is based on review of the CTL019 r/r B-cell ALL development program, which includes the Novartis-led ELIANA examine (NCT02435849), the very first pediatric global CAR-T cell therapy registration trial. Findings from a US multicenter trial and a single site trial examining the safety and efficacy of CTL019 among pediatric and youthfull adult patients with r/r B-cell ALL also supported the recommendation and the Biologics License Application (BLA)[Five].

“It is encouraging to see the FDA panel’s recommendation and continued momentum behind this innovative therapy, which has potential to help youthful patients with relapsed/refractory B-cell ALL,” said the Penn team’s leader, Carl June, MD, the Richard W. Vague Professor of Immunotherapy, director of the Center for Cellular Immunotherapies in Penn’s Perelman School of Medicine and director of the Parker Institute for Cancer Immunotherapy at Penn. “We look forward to continuing to work with Novartis to help make a lasting influence on the way this disease is treated.”

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first obedience by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis proceeds to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

About CAR-T and CTL019

ELIANA (NCT02435849) is the very first pediatric global CAR-T cell therapy registration trial, with examine enrollment having occurred across twenty five centers in the US, Canada, EU, Australia and Japan.

Because CTL019 is an investigational therapy, the safety and efficacy profile has not yet been established. Access to investigational therapies is available only through cautiously managed and monitored clinical trials. These trials are designed to better understand the potential benefits and risks of the therapy. Because of the uncertainty of clinical trials, there is no assure that CTL019 will ever be commercially available anywhere in the world.

About CTL019 Manufacturing

This press release contains forward-looking statements, including “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “look forward,” “believe,” “committed,” “investigational,” “pipeline,” “launch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, fresh indications or labeling for CTL019 and the other investigational products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forward in the forward-looking statements. There can be no assure that CTL019 or the other investigational products described in this press release will be submitted or approved for sale or for any extra indications or labeling in any market, or at any particular time. Neither can there be any assure that Novartis will successfully implement and maintain commercial manufacturing for CTL019 or the other investigational products described in this press release, or successfully build a network of treatment centers to suggest CTL019 or the other investigational products described in this press release. Nor can there be any ensure that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and extra analysis of existing clinical data; regulatory deeds or delays or government regulation generally; our capability to successfully implement and maintain commercial manufacturing and build a network of treatment centers; our capability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures; general economic and industry conditions, including the effects of the persistently feeble economic and financial environment in many countries; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of fresh information, future events or otherwise.

Novartis provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, cost-saving generic and biosimilar pharmaceuticals and eye care. Novartis has leading positions globally in each of these areas. In 2016, the Group achieved net sales of USD 48.Five billion, while R&D across the Group amounted to approximately USD 9.0 billion. Novartis Group companies employ approximately 118,000 full-time-equivalent associates. Novartis products are sold in approximately one hundred fifty five countries around the world. For more information, please visit http://www.novartis.com.

For Novartis multimedia content, please visit www.novartis.com/news/media-library

For questions about the site or required registration, please contact [email protected]

[1] Howlader, N., Noone, A.. M, Krapcho, M., et al. SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, April 2013; Section 28.9 (12).

[Two] Oudot, C. Auclerc, F. Levy, V., et al. Prognostic Factors for Leukemia Induction Failure in Children With Acute Lymphoblastic Leukemia and Outcome After Salvage Therapy: The FRALLE ninety three Explore. Journal of Clinical Oncology, March 2008; Volume twenty eight (9).

[Three] Chessels, J., Veys, P., Kempski, H., et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. British Journal of Hematology, 2003; one hundred twenty three (Three).

[Four] Reismuller, B., Peters, C., Dworzak, M., et al. Outcome of children and adolescents with a 2nd or third relapse of acute lymphoblastic leukemia (ALL): a population-based analysis of the Austrian ALL-BFM (Berlin-Frankfurt-Münster) Explore Group. Journal of Pediatric Hematology/Oncology. July 2013; thirty five (Five).

[Five] Novartis CTL019 ODAC Briefing Document.

Novartis CAR-T Cell Therapy CTL019 Unanimously (10-0) Recommended for Approval by FDA Advisory Committee to Treat Pediatric, Youthful Adult r

Kymriah

Update: Kymriah (tisagenlecleucel) Now FDA Approved – August 30, 2017

Novartis CAR-T Cell Therapy CTL019 Unanimously (10-0) Recommended for Approval by FDA Advisory Committee to Treat Pediatric, Youthful Adult r/r B-Cell ALL

Basel, July 12, two thousand seventeen – Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthful adult patients with B-cell acute lymphoblastic leukemia (ALL).

“The panel’s unanimous recommendation in favor of CTL019 moves us closer to potentially delivering the first-ever commercially approved CAR-T cell therapy to patients in need,” said Bruno Strigini, CEO, Novartis Oncology. “We’re very proud to be expanding fresh frontiers in cancer treatment by advancing immunocellular therapy for children and youthful adults with r/r B-cell ALL and other critically ill patients who have limited options. We look forward to working with the FDA as they accomplish their review.”

The ODAC recommendation is based on review of the CTL019 r/r B-cell ALL development program, which includes the Novartis-led ELIANA probe (NCT02435849), the very first pediatric global CAR-T cell therapy registration trial. Findings from a US multicenter trial and a single site trial examining the safety and efficacy of CTL019 among pediatric and youthful adult patients with r/r B-cell ALL also supported the recommendation and the Biologics License Application (BLA)[Five].

“We know firsthand from treating children and youthful adults with relapsed/refractory B-cell ALL that they despairingly need innovative medicines that provide a fresh treatment to managing this aggressive disease,” said Stephan Grupp, MD, PhD, the Yetta Deitch Novotny Professor of Pediatrics at the Perelman School of Medicine at Penn, Director of the Cancer Immunotherapy Frontier Program and Chief of the Section of Cellular Therapy and Transplant at CHOP. “Today’s vote in favor of CTL019 is a positive step and we appreciate Novartis’ commitment to pediatric patients.”

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first obedience by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis resumes to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

About CAR-T and CTL019

ELIANA (NCT02435849) is the very first pediatric global CAR-T cell therapy registration trial, with investigate enrollment having occurred across twenty five centers in the US, Canada, EU, Australia and Japan.

Because CTL019 is an investigational therapy, the safety and efficacy profile has not yet been established. Access to investigational therapies is available only through cautiously managed and monitored clinical trials. These trials are designed to better understand the potential benefits and risks of the therapy. Because of the uncertainty of clinical trials, there is no assure that CTL019 will ever be commercially available anywhere in the world.

About CTL019 Manufacturing

This press release contains forward-looking statements, including “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “look forward,” “believe,” “committed,” “investigational,” “pipeline,” “launch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, fresh indications or labeling for CTL019 and the other investigational products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forward in the forward-looking statements. There can be no assure that CTL019 or the other investigational products described in this press release will be submitted or approved for sale or for any extra indications or labeling in any market, or at any particular time. Neither can there be any assure that Novartis will successfully implement and maintain commercial manufacturing for CTL019 or the other investigational products described in this press release, or successfully build a network of treatment centers to suggest CTL019 or the other investigational products described in this press release. Nor can there be any ensure that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and extra analysis of existing clinical data; regulatory deeds or delays or government regulation generally; our capability to successfully implement and maintain commercial manufacturing and build a network of treatment centers; our capability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures; general economic and industry conditions, including the effects of the persistently powerless economic and financial environment in many countries; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of fresh information, future events or otherwise.

About Novartis

Novartis provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, cost-saving generic and biosimilar pharmaceuticals and eye care. Novartis has leading positions globally in each of these areas. In 2016, the Group achieved net sales of USD 48.Five billion, while R&D across the Group amounted to approximately USD 9.0 billion. Novartis Group companies employ approximately 118,000 full-time-equivalent associates. Novartis products are sold in approximately one hundred fifty five countries around the world. For more information, please visit http://www.novartis.com.

[Two] Oudot, C. Auclerc, F. Levy, V., et al. Prognostic Factors for Leukemia Induction Failure in Children With Acute Lymphoblastic Leukemia and Outcome After Salvage Therapy: The FRALLE ninety three Explore. Journal of Clinical Oncology, March 2008; Volume twenty eight (9).

[Three] Chessels, J., Veys, P., Kempski, H., et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. British Journal of Hematology, 2003; one hundred twenty three (Trio).

[Five] Novartis CTL019 ODAC Briefing Document.

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthfull adult r

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r/r B-cell ALL

A Biologics License Application (BLA) for this indication is under FDA priority review; if approved, CTL019 could become very first CAR-T cell therapy available

Positive ODAC recommendation is latest milestone for CTL019 program that commenced through collaboration with the University of Pennsylvania

Acute lymphoblastic leukemia comprises approximately 25% of cancer diagnoses among children under fifteen years old and is the most common childhood cancer in the US[1]. Effective treatment options for patients with r/r ALL are limited. In pediatric and youthfull adult patients with B-cell ALL that have relapsed numerous times or become refractory to treatment, the five-year disease-free survival is less than 10-30%[Two],[Three],[Four].

The ODAC recommendation is based on review of the CTL019 r/r B-cell ALL development program, which includes the Novartis-led ELIANA examine (NCT02435849), the very first pediatric global CAR-T cell therapy registration trial. Findings from a US multicenter trial and a single site trial examining the safety and efficacy of CTL019 among pediatric and youthful adult patients with r/r B-cell ALL also supported the recommendation and the Biologics License Application (BLA)[Five].

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first obedience by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis resumes to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

About CAR-T and CTL019

About CTL019 Manufacturing

This press release contains forward-looking statements, including “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “look forward,” “believe,” “committed,” “investigational,” “pipeline,” “launch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, fresh indications or labeling for CTL019 and the other investigational products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forward in the forward-looking statements. There can be no assure that CTL019 or the other investigational products described in this press release will be submitted or approved for sale or for any extra indications or labeling in any market, or at any particular time. Neither can there be any ensure that Novartis will successfully implement and maintain commercial manufacturing for CTL019 or the other investigational products described in this press release, or successfully build a network of treatment centers to suggest CTL019 or the other investigational products described in this press release. Nor can there be any assure that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and extra analysis of existing clinical data; regulatory deeds or delays or government regulation generally; our capability to successfully implement and maintain commercial manufacturing and build a network of treatment centers; our capability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures; general economic and industry conditions, including the effects of the persistently feeble economic and financial environment in many countries; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of fresh information, future events or otherwise.

Novartis provides innovative healthcare solutions that address the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, cost-saving generic and biosimilar pharmaceuticals and eye care. Novartis has leading positions globally in each of these areas. In 2016, the Group achieved net sales of USD 48.Five billion, while R&D across the Group amounted to approximately USD 9.0 billion. Novartis Group companies employ approximately 118,000 full-time-equivalent associates. Novartis products are sold in approximately one hundred fifty five countries around the world. For more information, please visit http://www.novartis.com.

For Novartis multimedia content, please visit www.novartis.com/news/media-library

For questions about the site or required registration, please contact [email protected]

[1] Howlader, N., Noone, A.. M, Krapcho, M., et al. SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, April 2013; Section 28.9 (12).

[Two] Oudot, C. Auclerc, F. Levy, V., et al. Prognostic Factors for Leukemia Induction Failure in Children With Acute Lymphoblastic Leukemia and Outcome After Salvage Therapy: The FRALLE ninety three Probe. Journal of Clinical Oncology, March 2008; Volume twenty eight (9).

[Trio] Chessels, J., Veys, P., Kempski, H., et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. British Journal of Hematology, 2003; one hundred twenty three (Three).

[Four] Reismuller, B., Peters, C., Dworzak, M., et al. Outcome of children and adolescents with a 2nd or third relapse of acute lymphoblastic leukemia (ALL): a population-based analysis of the Austrian ALL-BFM (Berlin-Frankfurt-Münster) Probe Group. Journal of Pediatric Hematology/Oncology. July 2013; thirty five (Five).

[Five] Novartis CTL019 ODAC Briefing Document.

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthfull adult r

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News Release

Basel, July 12, 2017 – Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthfull adult patients with B-cell acute lymphoblastic leukemia (ALL).

“The panel’s unanimous recommendation in favor of CTL019 moves us closer to potentially delivering the first-ever commercially approved CAR-T cell therapy to patients in need,” said Bruno Strigini, CEO, Novartis Oncology. “We’re very proud to be expanding fresh frontiers in cancer treatment by advancing immunocellular therapy for children and youthful adults with r/r B-cell ALL and other critically ill patients who have limited options. We look forward to working with the FDA as they finish their review.”

The ODAC recommendation is based on review of the CTL019 r/r B-cell ALL development program, which includes the Novartis-led ELIANA probe (NCT02435849), the very first pediatric global CAR-T cell therapy registration trial. Findings from a US multicenter trial and a single site trial examining the safety and efficacy of CTL019 among pediatric and youthfull adult patients with r/r B-cell ALL also supported the recommendation and the Biologics License Application (BLA)[Five].

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first obedience by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis resumes to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

Because CTL019 is an investigational therapy, the safety and efficacy profile has not yet been established. Access to investigational therapies is available only through cautiously managed and monitored clinical trials. These trials are designed to better understand the potential benefits and risks of the therapy. Because of the uncertainty of clinical trials, there is no assure that CTL019 will ever be commercially available anywhere in the world.

About CTL019 Manufacturing

The Novartis leukapheresis process using cryopreservation permitted for manufacturing and treatment of patients from around the world. Cryopreserved leukapheresis involves removing white blood cells from a patient’s blood and preserving them at very low temperatures. Cryopreserved leukapheresis gives physicians the plasticity to schedule apheresis at a time that is in the best interest of their patients. Novartis commercial manufacturing for CTL019 resumes to build on its practice in its Morris Plains, Fresh Jersey facility, which has already manufactured CTL019 for hundreds of patients in global clinical trials. Novartis believes that practice is significant in cell therapy manufacturing, and the practice gained at the Morris Plains, Fresh Jersey facility will be a foundation for commercial manufacturing of CAR-T therapies. Novartis has made and proceeds to make investments in manufacturing.

This press release contains forward-looking statements, including “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “look forward,” “believe,” “committed,” “investigational,” “pipeline,” “launch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, fresh indications or labeling for CTL019 and the other investigational products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forward in the forward-looking statements. There can be no assure that CTL019 or the other investigational products described in this press release will be submitted or approved for sale or for any extra indications or labeling in any market, or at any particular time. Neither can there be any assure that Novartis will successfully implement and maintain commercial manufacturing for CTL019 or the other investigational products described in this press release, or successfully build a network of treatment centers to suggest CTL019 or the other investigational products described in this press release. Nor can there be any assure that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and extra analysis of existing clinical data; regulatory deeds or delays or government regulation generally; our capability to successfully implement and maintain commercial manufacturing and build a network of treatment centers; our capability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures; general economic and industry conditions, including the effects of the persistently powerless economic and financial environment in many countries; safety, quality or manufacturing issues, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of fresh information, future events or otherwise.

For Novartis multimedia content, please visit www.novartis.com/news/media-library

For questions about the site or required registration, please contact [email protected]

[1] Howlader, N., Noone, A.. M, Krapcho, M., et al. SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, April 2013; Section 28.9 (12).

[Two] Oudot, C. Auclerc, F. Levy, V., et al. Prognostic Factors for Leukemia Induction Failure in Children With Acute Lymphoblastic Leukemia and Outcome After Salvage Therapy: The FRALLE ninety three Probe. Journal of Clinical Oncology, March 2008; Volume twenty eight (9).

[Trio] Chessels, J., Veys, P., Kempski, H., et al. Long-term follow-up of relapsed childhood acute lymphoblastic leukaemia. British Journal of Hematology, 2003; one hundred twenty three (Trio).

[Four] Reismuller, B., Peters, C., Dworzak, M., et al. Outcome of children and adolescents with a 2nd or third relapse of acute lymphoblastic leukemia (ALL): a population-based analysis of the Austrian ALL-BFM (Berlin-Frankfurt-Münster) Probe Group. Journal of Pediatric Hematology/Oncology. July 2013; thirty five (Five).

[Five] Novartis CTL019 ODAC Briefing Document.

Novartis Car-T Cell Therapy Ctl019 Unanimously (10-0) Recommended for Approval by Fda Advisory Committee to Treat Pediatric, Youthfull Adult r

Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r/r B-cell ALL

Recommendation based on review of CTL019 r/r B-cell ALL development program, including the pivotal Phase II global ELIANA trial

A Biologics License Application (BLA) for this indication is under FDA priority review; if approved, CTL019 could become very first CAR-T cell therapy available

Positive ODAC recommendation is latest milestone for CTL019 program that embarked through collaboration with the University of Pennsylvania

– Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor`T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthfull adult patients with B-cell acute lymphoblastic leukemia (ALL).

“The panel`s unanimous recommendation in favor of CTL019 moves us closer to potentially delivering the first-ever commercially approved CAR-T cell therapy to patients in need,” said Bruno Strigini, CEO, Novartis Oncology. “We`re very proud to be expanding fresh frontiers in cancer treatment by advancing immunocellular therapy for children and youthful adults with r/r B-cell ALL and other critically ill patients who have limited options. We look forward to working with the FDA as they accomplish their review.”

Acute lymphoblastic leukemia comprises approximately 25% of cancer diagnoses among children under fifteen years old and is the most common childhood cancer in the US. Effective treatment options for patients with r/r ALL are limited. In pediatric and youthful adult patients with B-cell ALL that have relapsed numerous times or become refractory to treatment, the five-year disease-free survival is less than 10-30% , , .

The ODAC recommendation is based on review of the CTL019 r/r B-cell ALL development program, which includes the Novartis-led ELIANA probe (NCT02435849), the very first pediatric global CAR-T cell therapy registration trial. Findings from a US multicenter trial and a single site trial examining the safety and efficacy of CTL019 among pediatric and youthfull adult patients with r/r B-cell ALL also supported the recommendation and the Biologics License Application (BLA) .

CTL019 was very first developed by the University of Pennsylvania (Penn) and uses the 4-1BB costimulatory domain in its chimeric antigen receptor to enhance cellular responses as well as persistence of CTL019 after it is infused into the patient, which may be associated with long-lasting remissions in patients. In 2012, Novartis and Penn entered into a global collaboration to further research, develop and commercialize CAR-T cell therapies, including CTL019, for the investigational treatment of cancers. Children`s Hospital of Philadelphia (CHOP) was the very first institution to investigate CTL019 in the treatment of pediatric patients and led the single site trial.

“It is encouraging to see the FDA panel`s recommendation and continued momentum behind this innovative therapy, which has potential to help youthful patients with relapsed/refractory B-cell ALL,” said the Penn team`s leader, Carl June, MD, the Richard W. Vague Professor of Immunotherapy, director of the Center for Cellular Immunotherapies in Penn`s Perelman School of Medicine and director of the Parker Institute for Cancer Immunotherapy at Penn. “We look forward to continuing to work with Novartis to help make a lasting influence on the way this disease is treated.”

“We know firsthand from treating children and youthful adults with relapsed/refractory B-cell ALL that they despairingly need innovative medicines that provide a fresh treatment to managing this aggressive disease,” said Stephan Grupp, MD, PhD, the Yetta Deitch Novotny Professor of Pediatrics at the Perelman School of Medicine at Penn, Director of the Cancer Immunotherapy Frontier Program and Chief of the Section of Cellular Therapy and Transplant at CHOP. “Today`s vote in favor of CTL019 is a positive step and we appreciate Novartis` commitment to pediatric patients.”

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first subjugation by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis proceeds to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

About CAR-T and CTL019

CAR-T is different from typical petite molecule or biologic therapies because it is manufactured for each individual patient using their own cells. During the treatment process, T cells are drawn from a patient`s blood and reprogrammed in the manufacturing facility to create`T cells that are genetically coded to express a chimeric antigen receptor to recognize and fight cancer cells and other B-cells voicing a specific antigen.

Because CTL019 is an investigational therapy, the safety and efficacy profile has not yet been established. Access to investigational therapies is available only through cautiously managed and monitored clinical trials. These trials are designed to better understand the potential benefits and risks of the therapy. Because of the uncertainty of clinical trials, there is no assure that CTL019 will ever be commercially available anywhere in the world.

About CTL019 Manufacturing

The Novartis leukapheresis process using cryopreservation permitted for manufacturing and treatment of patients from around the world. Cryopreserved leukapheresis involves removing white blood cells from a patient`s blood and preserving them at very low temperatures. Cryopreserved leukapheresis gives physicians the plasticity to schedule apheresis at a time that is in the best interest of their patients. Novartis commercial manufacturing for CTL019 resumes to build on its practice in its Morris Plains, Fresh Jersey facility, which has already manufactured CTL019 for hundreds of patients in global clinical trials. Novartis believes that practice is significant in cell therapy manufacturing, and the practice gained at the Morris Plains, Fresh Jersey facility will be a foundation for commercial manufacturing of CAR-T therapies. Novartis has made and proceeds to make investments in manufacturing.

Novartis: CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r

Novartis : CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r/r B-cell ALL

Novartis International AG / Novartis CAR-T cell therapy CTL019 unanimously (10-0) recommended for approval by FDA advisory committee to treat pediatric, youthful adult r/r B-cell ALL . Processed and transmitted by Nasdaq Corporate Solutions. The issuer is solely responsible for the content of this announcement.

Basel, July 12, 2017 – Novartis announced today that the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) unanimously (10-0) recommended approval of CTL019 (tisagenlecleucel), an investigational chimeric antigen receptor T cell (CAR-T) therapy, for the treatment of relapsed or refractory (r/r) pediatric and youthfull adult patients with B-cell acute lymphoblastic leukemia (ALL).

“The panel’s unanimous recommendation in favor of CTL019 moves us closer to potentially delivering the first-ever commercially approved CAR-T cell therapy to patients in need,” said Bruno Strigini, CEO, Novartis Oncology. “We’re very proud to be expanding fresh frontiers in cancer treatment by advancing immunocellular therapy for children and youthful adults with r/r B-cell ALL and other critically ill patients who have limited options. We look forward to working with the FDA as they finish their review.”

Acute lymphoblastic leukemia comprises approximately 25% of cancer diagnoses among children under fifteen years old and is the most common childhood cancer in the US[1]. Effective treatment options for patients with r/r ALL are limited. In pediatric and youthfull adult patients with B-cell ALL that have relapsed numerous times or become refractory to treatment, the five-year disease-free survival is less than 10-30%[Two],[Three],[Four].

Earlier this year, Novartis submitted a BLA for CTL019 to the FDA, marking the very first subordination by Novartis for a CAR-T cell therapy. CTL019 previously received FDA Breakthrough Therapy designation and is under Priority Review by the FDA. The FDA will consider the vote as it reviews the BLA, albeit it is not obligated to go after the recommendation. Novartis resumes to invest in the necessary infrastructure for the potential commercialization of CTL019, including manufacturing and the establishment of a network of certified treatment centers.

About CAR-T and CTL019

About CTL019 Manufacturing

The Novartis leukapheresis process using cryopreservation permitted for manufacturing and treatment of patients from around the world. Cryopreserved leukapheresis involves removing white blood cells from a patient’s blood and preserving them at very low temperatures. Cryopreserved leukapheresis gives physicians the plasticity to schedule apheresis at a time that is in the best interest of their patients. Novartis commercial manufacturing for CTL019 resumes to build on its practice in its Morris Plains, Fresh Jersey facility, which has already manufactured CTL019 for hundreds of patients in global clinical trials. Novartis believes that practice is significant in cell therapy manufacturing, and the practice gained at the Morris Plains, Fresh Jersey facility will be a foundation for commercial manufacturing of CAR-T therapies. Novartis has made and resumes to make investments in manufacturing.