CEO comments

INNOVATION, GROWTh, fOCuS

Despite a challenging business situation, we decided to forge ahead with the development of both our existing and future products. We now feel confident that market conditions will improve and that growth is set to resume.

The past two years have brought major social and economic upheaval all over the world. Re-prioritization of clinical services, where many cancer clinics have postponed their investments, have had a major impact on RaySearch. A clear effect on our operations was that nearly all marketing activities in 2021, including participation in trade fairs, were carried out virtually. We were partly able to offset this by offering a large number of webinars and online workshops. however, we were delighted to see more opportunities for resuming in-person meetings with our customers toward the end of the year. One example was in October, when we were able to meet customers at the 2021 ASTRO Annual Meeting in Chicago, which is the leading conference in our field.

SIGNS OF RECOVERY Despite these challenges, our core product RayStation was sold to 93 new customers during the year. RayStation now has a customer base of just over 800 clinics in 42 countries. In the fourth quarter, a 44-percent increase in order intake was a very positive sign. The first region to show signs of recovery was Asia. In September, for example, National Cancer Centre Singapore (NCCS) placed an order for RayStation for its new proton therapy center and in December, we received a large RayStation order for carbon ion therapy from Chinese Lanzhou Ion Therapy Co. In Europe, the world-class ChuV center in Switzerland placed the first order for RayIntelligence, while also deciding to fully replace its existing oncology information system with RayCare and purchased additional RayStation functionality. Several new agreements were also signed in the uS, with Proton International Arkansas (for uAMS Radiation Oncology Center), Kansas City urology and Atrium health.

The adaptation of sales activities and increased focus on cost control have been important and necessary measures. But our most important strategic decision was to forge ahead with the development of our products, despite the challenging global situation. This is totally in line with our vision to strive for a world where cancer is conquered.

NEW LEADING-EDGE FEATURES The results of these investments were highly favorable in 2021. We released new versions of RayStation with features that are pushing the frontiers of radiation therapy. We also took further steps in our ambition to unify treatment planning and eliminating the complications that arise from using multiple software systems by introducing support for Accuray’s CyberKnife.

The focus for RayCare was enhanced workflows. With the latest version, cancer clinics can now tailor RayCare to their specific needs, which benefits both the clinics and RaySearch now that assistance with configuration is no longer needed. Important progress was also made regarding integration between RayCare and systems from Accuray and Varian. Overall, RayCare displayed a new level of maturity, and interest in the system is considerable.

The RayCommand treatment control system was further developed during the year, mostly in partnership with the cutting-edge MedAustron center in Austria. All of the features that MedAustron needs will be implemented in the latest version of RayCommand when they take the product into clinical use during the spring. Several new versions of RayIntelligence were released with features such as enhanced functionality for analyzing and comparing treatment plans.

It is worth noting that this successful development in all material respects took place remotely, with limited opportunities for the spontaneous meetings and random discussions between employees that are crucial for spurring creativity. We can see already how these types of interactions have become more common since the restrictions were eased and in December, we also relocated our head office to new premises in the life science cluster in hagastaden in Stockholm. We are now settling in to these state-of-the-art premises, which have been fully adapted to our needs, and are delighted to be welcoming more and more customers to user meetings and training.

WELL-EQUIPPED FOR THE NEXT PHASE All in all, the enhancements in all of our four products have positioned us for the next phase of market development. The need for

digital oncology workflows has increased over the past two years. Despite the long-term rise in cancer cases, one effect of the COVID-19 pandemic is that the number of patients receiving cancer treatment has fallen. According to statistics from the Swedish National Board of health (December 2021), about 6 percent fewer cancer cases were diagnosed during the pandemic compared with the average for the three preceding years, and the European Cancer Organisation (May 2021) estimates that as many as one million patients in Europe may have missed a cancer diagnosis during the pandemic due to the restrictions. Cancer clinics and their care teams will subsequently need all available tools to diagnose, treat and manage the inevitable wave of post-COVID cancer cases on a large scale, and as efficiently as possible. RaySearch’s products are well-suited to meeting these needs.

In 2022, we will continue to develop our products and focus on costs. Since we are expecting significantly improved market conditions, partly due to better access to existing and potential customers, but also due to the growing need for efficient cancer care faced by cancer clinics all over the world, we are well positioned to resume growth in 2022. however, the war in ukraine and the complex geopolitical situation that has emerged in the world could once again change these conditions. While RaySearch has no customers in either ukraine or Russia and we see no effects on our business operations at present, we are obviously monitoring the situation closely. The humanitarian crisis in ukraine is catastrophic and we are hoping for a speedy return to peace and a reconstruction of the ukrainian state. finally, I would like to thank all our employees for the flexibility, creativity and dedication you have continued to show in the second year of this pandemic. While these past two years have been challenging, the most difficult times seem to be over and we are looking ahead with confidence.

April 2022

Johan Löf CEO and founder