CORPORATE PRESENTATION. March 2017

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1 CORPORATE PRESENTATION March 2017

2 Safe Harbor Statement To the extent that statements contained in this presentation are not descriptions of historical facts regarding TESARO, they are forward-looking statements reflecting the current beliefs and expectations of management made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of Words such as "may," "will," "expect," "anticipate," "estimate," "intend," and similar expressions (as well as other words or expressions referencing future events, conditions, or circumstances) are intended to identify forward-looking statements. Examples of forward-looking statements contained in this press release include, among others, statements regarding the expected timing of the launches of niraparib and VARUBI IV in the U.S., the expected timing of our planned commercial launches of niraparib and oral rolapitant in Europe, the expected launch of our EAP in Europe, the expected timing of finalizing our registration program for niraparib in lung cancer, the expected timing of initiation of our TSR-042 registration program, the expected approval of the rolapitant IV NDA, the expected timing of data from our TOPACIO, AVANOVA and other ongoing clinical trials, our expected cash utilization during the first half of 2017, and our expectation to achieve our various key 2017 corporate objectives. Forward-looking statements in this release involve substantial risks and uncertainties that could cause our research and pre-clinical development programs, clinical development programs, future results, performance, or achievements to differ significantly from those expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others, the uncertainties inherent in the execution and completion of clinical trials, uncertainties surrounding our ongoing discussions with and potential actions by regulatory authorities, uncertainties regarding regulatory approvals, including with respect to the ultimate approval and indication for niraparib, uncertainties regarding certain expenditures, risks related to manufacturing and supply, and other matters that could affect the availability or commercial potential of our drug candidates. TESARO undertakes no obligation to update or revise any forward-looking statements. For a further description of the risks and uncertainties that could cause actual results to differ from those expressed in these forward-looking statements, as well as risks relating to the business of the Company in general, see TESARO's Annual Report on Form 10-K for the year ended December 31,

3 TESARO: Our Vision Global Product Reach Oncology Focus, Small and Large Molecule Approaches The Right Medicine for the Right Patient TESARO Will Be a Leading Oncology-Focused Biopharmaceutical Company 3

4 TESARO: Strong Financial and Strategic Position First Commercial Product Launched Portfolio Addresses Large Markets CINV Ovarian Cancer Breast Cancer Other Tumors ~$786M In Cash & Equiv. as of 12/31/16 Strong Financial Position Proven Management Team Balanced Product Pipeline Early to Late Stage I-O Approaches Small Molecules Biologics 4

5 TESARO: Global Commercial Reach United States Europe Niraparib Launch 1H 2017 VARUBI IV Approval 1H 2017 VARUBY Oral Launch Q Niraparib Launch by YE

6 Nausea and Vomiting are two Distressing and Feared Side Effects of Cancer Chemotherapy Acute nausea and vomiting often occur within the first 24 hours after treatment completion. i Delayed CINV begins more than 24 hours after treatment and can last up to several days after treatment completion. i ONCOLOGISTS AND NURSES COMMONLY UNDERESTIMATE THE INCIDENCE OF DELAYED CINV ii DELAYED NAUSEA HCP perception 31% Actual Patient Experience DELAYED VOMITING HCP perception 18% Actual Patient Experience 32% 54% References: i. Know the basics of CINV. Oncology Nursing Society. Last Accessed December 6, ii. Grunberg, S., et al. Incidence of Chemotherapy-Induced Nausea and Emesis after Modern Antiemetics Cancer. 2004;100(10): Last 6 Accessed December 7,

7 VARUBI (ROLAPITANT): TESARO s FIRST MARKETED PRODUCT Approved by FDA on September 1, Provides protection from CINV for the full delayed risk period ( hours) Single oral dose administration just prior to chemotherapy No dose adjustment for dexamethasone, a CYP3A4 substrate 4 Flexibility to use with any 5-HT3 receptor antagonist 5 6 IV formulation in development to address entire market Included in NCCN Antiemesis Guidelines with a Category 1 Level of Evidence and Consensus for MEC and HEC 7 U.S. CoM until 2023; exclusivity into 2028 with expected Hatch-Waxman CoM: composition of matter 7

8 VARUBI : Commercial Launch Update Commercial Units 9,165 3,431 4,481 5, Q Q Q Q Q Demand for VARUBI Continues to Increase Due to Account Penetration, Technology and Operational Enhancements, and Co-Pay Assistance Programs Data as of Source: Specialty distributor and specialty pharmacy pull through data for Q November 2016; TESARO internal data for December

9 VARUBI : Strategy to Drive Growth Grow NK-1 Market Opportunity Establish IV, Grow Share Establish Oral, Grow Share Volume Year 1 Year 2 Year 3 Year 4 Oral Establishing VARUBI Brand Profile with U.S. Oral Launch Ahead of Planned 2017 IV Launch IV 9

10 TESARO: A Balanced Portfolio of Product Candidates Compound Therapeutic Area Discovery Pre-clinical Ph 1 Ph 2 Ph 3 Registration VARUBI IV VARUBY Oral Niraparib PARP Inhibitor Niraparib + bevacizumab Niraparib + KEYTRUDA (pembrolizumab) TSR-042 Anti-PD-1 mab TSR-022 Anti-TIM-3 mab TSR-033 Anti-LAG-3 mab Anti-LAG-3/PD-1 bi-specific mab Undisclosed small molecule I-O candidates Chemotherapy-Induced Nausea & Vomiting (CINV) Chemotherapy-Induced Nausea & Vomiting (CINV) Ovarian Cancer (NOVA) Ovarian Cancer (PRIMA) Ovarian Cancer Treatment (QUADRA) BRCA+ Breast Cancer (BRAVO) Ovarian Cancer (AVANOVA)* Ovarian Cancer / Triplenegative Breast Cancer (TOPACIO) Various tumor types Various tumor types Various tumor types Various tumor types Various tumor types FDA EMA 1 FDA & EMA 1 CHMP rendered positive opinion for MAA for VARUBY *In collaboration with ENGOT, the European Network for Gynaecological Oncological Trial groups mab: Monoclonal antibody FDA: U.S. Food and Drug Administration EMA: European Medicines Agency 10

11 NIRAPARIB: TESARO s Most Advanced Cancer Therapeutic Candidate 1 Highly selective PARP 1/2 inhibitor; once per day, oral dosing Only PARPi to successfully demonstrate a PFS benefit in a Phase 3 trial in patients with ovarian cancer, regardless of BRCA mutation status Compelling response rates and durations of response in highly pre-treated patients demonstrated in Phase 1 AEs observed in Phase 3 trial were similar to other PARPs (e.g., myelosuppression, N&V, fatigue); most AEs were managed via dose reduction 5 NDA accepted for Priority Review; MAA under review 6 Potential for multiple combination and monotherapy-based approaches 7 U.S. Composition of Matter until 2030 AE: Adverse Event; N&V: Nausea & Vomiting; NDA: New Drug Application; MAA: Marketing Authorisation Application 11

12 NIRAPARIB: The Prevalence and Challenges of Ovarian Cancer Early symptoms are non-specific and difficult to detect: iv,v Bloating Pelvic/Abdominal pain Ovarian cancer is the FIFTH MOST DEADLY cancer in women i,ii ~22,000 new cases will be diagnosed in 2016 in the U.S. ii ~65,000 new cases were diagnosed in Europe in 2012 ii Difficulty eating Urinary issues 61% of women with ovarian cancer are diagnosed in an advanced stage v, when prognosis is poor. i. Siegel, R., J. Ma, Z Zou, and A Jemal Cancer Statistics, CA: A Cancer Journal for Clinicians 64 (1): doi: /caac ii. WHO, IARC GLOBOCAN, Cancer Incidence and Mortality Worldwide in 2008 at Last Accessed September 28, iii. National Cancer Institute Cancer of the Ovary - SEER Stat Fact Sheets. Last Accessed June 23, iv. American Cancer Society Signs and Symptoms of Ovarian Cancer pdf. Last Accessed September 28, v. American Cancer Society Cancer Facts & Figures Atlanta: American Cancer Society. cancerfactsstatistics/ cancerfactsgures2015/. Last Accessed June 23,

13 NIRAPARIB: Despite High Response Rates to Platinum-Based Treatment, Effectiveness Diminishes Over Time EACH ROUND OF CHEMOTHERAPY LEADS TO DIMINISHING EFFECTIVENESS AND A SOBERING REALITY Platinum-Based Chemotherapy Even though most patients with high-grade serious ovarian cancer respond well to standard therapy... For ~85% Of patients, the disease will recur vi Platinum-based chemotherapy becomes less effective ix Progression-free survival becomes shorter ix Cumulative toxicities increase x Up to ~80% of women living with ovarian cancer are afraid of recurrence. vii,viii vi. Birrer, M., et al. Medical Treatment for Relapsed Epithelial Ovarian, Fallopian Tubal, or Peritoneal Cancer: Platinum-Resistant Disease. UpToDate. Last Accessed June 23, vii. Mirabeau-Beale KL, et al. Comparison of the quality of life of early and advanced stage ovarian cancer survivors. Gynecologic Oncology. 2009;114(2): viii. Cesario SK, et al. Sword of Damocles cutting through the life stages of women with ovarian cancer. Oncol Nurs Forum Sep; 37(5): ix. Hanker LC, et al. The impact of second to sixth line therapy on survival of relapsed ovarian cancer after primary taxane/platinum-based therapy. Ann Oncol. 2012;23(10): x. Bell J, Brady MF, Young RC, et al. Randomized phase III trial of three versus six cycles of adjuvant carboplatin and paclitaxel in early stage epithelial ovarian carcinoma: A Gynecologic Oncology Group study. Gynecologic Oncology. 2006;102(3):

14 NIRAPARIB: Niraparib Delivers Anti-Tumor Activity, Selective, Durable, and Near Complete (>90%) PARP Inhibition Product Niraparib Olaparib Rucaparib Talazoparib DNA Repair PARP1 Off-Target Activity of PARP Inhibitors PARP2 PARP3 TNKS1 Multiple Functions (Off Target) TNKS2 PARP6 PARP7 PARP8 PARP10 PARP11 PARP12 PARP14 <10nM nM 100 1µM >1µM PARP15 O NH 2 F O O PARPi Niraparib Olaparib NH N N N Rucaparib H N N H O N F N HN NH PKDM Properties Among PARP Inhibitors O Permeability P app * (10-6 cm/s) Volume of Distribution V/F (L) Bioavail -ability F (%) Half life t 1/2 (h) P-gp a S BCRP S I (+++) b S I (+) c S S There are clear differences in the clinical pharmacology and chemical properties among PARP inhibitors (as supported by pre-clinical data) Talazoparib F O H N N N N N NA 287 NA 40 a NA NA F Clinical Activity of a PARP Inhibitor Should not be Extrapolated Across the Class, Particularly Across a Broad Patient Population * > 10, High Permeability; < 10, Low Permeability a QD dosing; b IC50 ~ 6 µm; c IC50 ~ 100 µm; NA = Not available; S = Substrate; I = Inhibitor 14

15 Niraparib Concentrates in the Tumor to Deliver Sustained anti-tumor Activity in a Patient Derived Ovarian Tumor Model BRCA2 mutant, HRD positive PDX Treatment Regimen Result Niraparib tumor exposure >30- fold higher than olaparib at steady state Tumor regression with niraparib (50mg/kg/day) vs. tumor growth inhibition with olaparib (75mg/kg/day) Tumor Concentration of PARPi (ng/g) 6h post final dose ± SD (Steady State) 24h post final dose ± SD (Steady State) Niraparib 3837 ± ± BJC 2016, 115: Pharm research :37 3. PNAS : Mikule AACR-NCI-EORTC 2016 Abstract B168 Olaparib 123 ± 32 Not determined 15

16 Preclinical Studies Suggest Multi-drug Resistance Pumps Induce Cross Resistance to Taxane, Olaparib and Rucaparib PgP efflux pumps are induced by Taxane and Olaparib treatment and resulted in drug resistance in preclinical studies 1 Olaparib and Taxane resistant tumors are cross-resistant to each other and rucaparib in preclinical studies 1 1. BJC 2016, 115:431 16

17 In Preclinical Studies, Switching From Olaparib To Niraparib Led To Tumor Regression BRCA2 mutant, HRD positive PDX Treatment Regimen Result Daily dosing of 75 mg/kg olaparib slowed tumor growth; did not lead to tumor regression Switch, on Day 44, to 50 mg/kg daily niraparib resulted in tumor regression Data on file 17

18 Preclinical Data Suggests Niraparib Distribution and Anti-Tumor Activity May Not Be Limited by Multidrug Resistance Pumps PgP effects on niraparib are limited, in part due to high permeability of niraparib across biomembranes 1. Niraparib readily distributes to and maintains active brain concentrations associated with anti-tumor activity. 2 Multidrug resistance pumps markedly limit brain accumulation and activity of other PARPi in the brain in preclinical models 2,3,4 1. Zhi-Yi Zhang et al 20 th North American ISSX Mikule AACR-NCI-EORTC 2016 Abstract B Pharm Res :37 4. Olaparib nonclinical overview, NDA 18

19 Preclinical Data Suggests Niraparib Anti-tumor Activity is Sustained and not Limited by Platinum Resistance BRCA wild type, HRD positive tumor, PDx model Treatment Regimen Single 30mg/kg carboplatin dose on day 1 in mice bearing an established tumor No platinum response Daily niraparib 50 mg/kg treatment (day 8 day 114) Niraparib treated tumors did not regrow during 48 day observation period, even in absence of niraparib dosing Result Niraparib dosing stopped Data on File 19

20 Preclinical Data Suggests Niraparib Treatment Results in Durable Inhibition of Tumor PARP Durable PARP inhibition in tumors following treatment with niraparib Anti-tumor activity was durable, lasting beyond the dosing period MDA-MB-436 (BRCA1-mut) Residual PARP Activity in MDA-MB-436 (BRCA1-mut) Tumors Following Niraparib Treatment Tumor Volume (mm 3 ) 1,600 1,400 1,200 1, Vehicle MK mpk QDx1Week MK mpk QDx2Weeks MK mpk QDx3Weeks MK mpk QDx4Weeks % PARP Activity Days MK-4287 = niraparib 0 Hrs Post-dose Vehicle 100 mpk 50 mpk 20

21 NIRAPARIB: NOVA Study Design and PFS Analysis Phase 3 NOVA Trial Two cohorts (gbrcamut and nongbrcamut) were independently powered for 1 o endpoint (PFS) analysis High-Grade Serous Ovarian Cancer, Relapsed Response to Platinum Treatment n=490 Assessed PFS in gbrcamut cohort (p<0.05) >90% power to detect a HR=0.50 Niraparib 300 mg gbrcamut 180 planned Placebo Endpoint Assessment Non-gBRCAmut / HRDpos 310 planned 2:1 Randomization 2:1 Randomization Niraparib 300 mg Placebo Endpoint Assessment Assessed PFS in non-gbrcamut cohort using hierarchical testing First, assessed PFS in HRDpos subset >90% power to detect a HR=0.50 Then assessed PFS for the entire cohort >90% power to detect a HR=0.50 Primary Endpoint PFS; >90% power to detect 4.8 month improvement (HR 0.50 in both cohorts) Assumption: 4.8 month PFS for control arms Prospectively defined statistical analysis of PFS in the HRD population >90% power PFS: Progression free survival; HRD: Homologous recombination deficiency 21

22 NIRAPARIB: Progression-free Survival: Non-gBRCAmut Cohort Progression free Survival (%) Niraparib Placebo Treatment Niraparib (N=234) Placebo (N=116) PFS Median (95% CI) (Months) Hazard Ratio (95% CI) p-value 9.3 (7.2, 11.2) 0.45 (0.338, 0.607) p< (3.7, 5.5) % of Patients without Progression or Death 12 mo 18 mo 41% 30% 14% 12% Time Since Randomization (months) The most common ( 10%) treatment-emergent grade 3/4 adverse events in the niraparib arm were thrombocytopenia (33.8%), anemia (25.3%), and neutropenia (19.6%) with treatment discontinuation for these events of 3.3%, 1.4% and 1.9%, respectively Thrombocytopenia was not associated with grade 3/4 bleeding events. The majority of these hematological laboratory abnormalities occurred within the first three cycles; following dose modifications the incidence of these lab abnormalities decreased and thrombocytopenia and neutropenia were infrequent beyond cycle 3 The rates of MDS/AML in the niraparib (1.4%) and control (1.1%) arms were similar. There were no deaths among patients during study treatment CI: Confidence Interval Data presented at ESMO

23 NIRAPARIB: Progression-free Survival: gbrcamut Cohort Progression free Survival (%) Niraparib Placebo Treatment Niraparib (N=138) Placebo (N=65) PFS Median (95% CI) (Months) Hazard Ratio (95% CI) p-value 21.0 (12.9, NR) 0.27 (0.173, 0.410) p< (3.8, 7.2) % of Patients without Progression or Death 12 mo 18 mo 62% 50% 16% 16% Time Since Randomization (months) PFS was analyzed using a 2-sided log-rank test using randomization stratification factors, and summarized using the Kaplan-Meier methodology Hazard ratios with 2-sided 95% confidence intervals were estimated using a stratified Cox proportional hazards model, with the stratification factors used in randomization NR: Not Reached CI: Confidence Interval Data presented at ESMO

24 NIRAPARIB: PFS2 Minus PFS1 Showed Niraparib Had No Impact on the Effectiveness of Subsequent Chemotherapy Platinum Niraparib Chemo <8 weeks PFS PFS2 minus PFS1 PFS-2 *Immature data: <50-70% of events across treatment arms Details presented at SGO Data presented at ICGS

25 Niraparib Had No Impact on the Efficacy of Next-Line Therapy 1 Platinum Niraparib or placebo Chemo Chemo PFS1 PFS2 PFS1 PFS2 (PFS2 PFS1) in the Pooled gbrcamut and Non-gBRCAmut Cohorts Note: The numbers at the bottom of the display represent number at risk for niraparib (top row) and placebo (bottom row). CI=confidence interval. Data presented at SGO Mirza et al. N Engl J Med. 2017;376:

26 NIRAPARIB: Expanded Access Program Now Open for U.S. Patients With Ovarian Cancer Some patients with serious or immediately life-threatening disease may not be eligible for any of our clinical trials nor have other treatment options. In these cases, TESARO may provide access to Niraparib outside of the clinical trials process, before it has been approved by the FDA, through an expanded access program (EAP). WHO IS ELIGIBLE? Women with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer following a complete or partial response to platinum-based chemotherapy for whom niraparib is considered an appropriate therapy. For further details: U.S.-based doctors who may have eligible patients may contact Idis Managed Access niraparibuseap@clinigengroup.com A list of Frequently Asked Questions is available at 26

27 NIRAPARIB PIPELINE: A Portfolio of Opportunities Compound Therapeutic Area Discovery Preclinical Ph 1 Ph 2 Ph 3 Registration Recurrent Ovarian Cancer (NOVA) 1 FDA & EMA Niraparib Ovarian Cancer Treatment (QUADRA) 1L Ovarian Cancer (PRIMA) BRCA+ Breast Cancer (BRAVO) Niraparib + KEYTRUDA (pembrolizumab) Triple Negative Breast & Ovarian Cancers Niraparib Ovarian Cancer + bevacizumab (AVANOVA) 2 Global collaboration and license agreement with Janssen to develop and commercialize niraparib specifically for prostate cancer announced in April Priority Review Granted; PDUFA date is June 30, In collaboration with ENGOT, the European Network for Gynaecological Oncological Trial groups 27

28 NIRAPARIB: Comprehensive Development Program in Ovarian Cancer Recurrent Ovarian NOVA Trial Phase 3 trial complete PFS benefit demonstrated in ovarian cancer patients, regardless of biomarker status NDA and MAA under review Ovarian Treatment QUADRA Trial ORR primary endpoint Efficacy analyses in prespecified gbrca mut and HRD+ subgroups Registrational phase 2 trial ongoing Data expected in 2H st Line Ovarian PRIMA Trial PFS primary endpoint Will enroll all patients, regardless of biomarker status Efficacy analyses in prespecified gbrca mut and HRD+ subgroups Phase 3 trial ongoing AVANOVA Combination Trial Niraparib plus bevacizumab PFS primary endpoint Efficacy analyses in gbrca mut and non-gbrca / HRD+ patients Phase 2 trial ongoing TOPACIO Combination Trial Niraparib plus KEYTRUDA Patients with ovarian or triplenegative breast cancer Phase 2 trial ongoing PFS: Progression free survival ORR: Overall response rate HRD: Homologous recombination deficiency 28

29 NIRAPARIB: Potential to Combine with an Anti-PD-1 mab Objectives Phase 1/2 TOPACIO Trial Niraparib + Pembrolizumab Triple-negative breast cancer (TNBC) and Recurrent, Platinum-Resistant Ovarian Cancer Phase 1 Cohorts: OC and TNBC; up to 36 Patients DL2: 6 patients N: 300 mg d1-21 P: 200 mg d1 DL1: 6 patients N: 200 mg d1-21 P: 200 mg d1 DL-1: 6 patients N: 200 or 300 mg d1-14 P: 200 mg d1 DL-2: 6 patients N: 200 or 300 mg d1-7 P: 200 mg d1 Recommended Phase 2 Dose Phase 2 Study: 42 Ovarian Pts 48 TNBC pts Phase 1: Evaluate DLTs and establish Phase 2 dose Phase 2: Response rate by RECIST Exploratory biomarker work planned SABC 2 J Clin Oncol 32:5s, 2014 (suppl; abstr 5511) 3 Rucaparib package insert; Gelmon, Lancet Oncol.,2011 Sep;12(9): PARPi have the potential to promote a tumor microenvironment that complements I-O approaches to result in broader and more durable responses than monotherapy <20% of triple negative breast (TNBC) and ovarian cancer (OC) patients respond to anti-pd- 1 therapy 1,2 Patients with platinum resistant ovarian cancer and non-biomarker selected TNBC patients are less sensitive to PARPi 3 Promising initial combination activity observed in TOPACIO Safety/tolerability and RP2D established Phase 2 is ongoing Data to be presented at a future medical meeting Potential for applicability in other tumors sensitive to anti-pd-1 therapy (lung, bladder, head and neck) 29

30 NIRAPARIB: Potential to Combine with Bevacizumab Phase 1/2 AVANOVA Trial Niraparib + Bevacizumab Recurrent, platinum-sensitive epithelial ovarian, fallopian tube, or primary peritoneal cancer w/high-grade serous/endometrioid histology Phase 1, N = 12 Phase 2, N=94 Stratify on HRD and PFI (>6-12 months or 12+ months) Potentially synergistic activity via simultaneously inhibition of anti-angiogenesis and DNA repair Goal to improve PFS with bevacizumab or niraparib monotherapy Supported by VEGFi + PARPi exploratory work (Avastin and others) Promising initial combination activity observed in AVANOVA Safety/tolerability established in Phase 1 Niraparib: 300mg Bevacizumab: 15mg/kg Niraparib: 300mg 4 HRD+ (3 BRCAmut) (75% CR/PR + 1 SD) 5/12 (42%) ORR Median duration of treatment in all patients 41.7weeks (91% of patients without progression; ASCO 2016) Objectives Phase 1: Safety and tolerability of bevacizumabniraparib combination Phase 2: Progression-Free Survival (PFS) in Niraparib vs. niraparib + bevacizumab Phase 2 is ongoing 80% power for HR 0.57 (8 vs. 14 months) Data to be presented at a future medical meeting Potential applicability in ovarian, CRC. GBM Initial data presented at ASCO 2016, abstract 5555 AVANOVA is an Investigator Sponsored Trial (IST) 30

31 Advancing Our Early Stage I-O Pipeline Compound Indication Discovery Preclinical Ph 1 Ph 2 Ph 3 Registration TSR-042 Anti-PD-1 mab TSR-022 Anti-TIM-3 mab TSR-033 Anti-LAG-3 mab Anti-LAG-3/PD-1 dual reactive mab Undisclosed small molecule I-O candidates Various tumor types Various tumor types Various tumor types Various tumor types Various tumor types 31

32 IMMUNO- ONCOLOGY: TESARO s Vision & Strategy TESARO s I-O portfolio: Three known checkpoint inhibitors PD-1, TIM-3 and LAG-3 Small molecule collaboration with MD Anderson Immune modulators are likely to treat many tumor types Checkpoint expression correlates with a loss of T cell activity May be most effective when used in combination therapy Potential to combine with TESARO pipeline molecules Establish collaborations with other companies that have complementary approaches Bi Specific Antibody Anti- PD-1/LAG-3 32

33 IMMUNO- ONCOLOGY: Treatment with TSR-042 Prevents Tumor Growth in a Humanized Mouse Model A549 tumors, 200 µg/ mouse; IP twice weekly; dosing started at tumor sizes of mm 3 Anti-tumor activity after repeat dosing of TSR-042 Anti-tumor activity was associated with decreased T reg infiltration 15 Isotype control TSR-042 %CD * 0 Treg P rolif T reg Srimoyee Ghosh PhD 33

34 IMMUNO- ONCOLOGY: TSR-042 (anti-pd-1): Dose Escalation and Expansion Goal: Execute on Fastest Path to Approval Part 1: DLT Based Dose Escalation all comers N~30 Expansion Cohorts with Registration Intent <1/3 DLT <1/3 DLT 3mg/kg* 3 enrolled 10mg/kg 12 enrolled Part 2a Fixed dose safety cohorts (all comers) 500 mg Q3W 1000 mg Q6W N=12 Dec/Jan 2016 Phase 1 Dose Escalation (n=21 evaluable) Complete through 10 mg/kg Q2W, Clinical activity observed in 5 patients including at lowest dose level Based on the PK and PD, dose and schedule was selected 500 mg Q3W for 12 weeks followed by 1000 mg Q6W 1mg/kg 6 enrolled At RP2D, predicted trough concentration exceeds the lowest concentration where full receptor occupancy was observed in the periphery 34

35 IMMUNO- ONCOLOGY: PD-1/L1 Inhibitors Are Effective Across Multiple Indications Key Indications in Late-Stage Development chl CRC- MSI-H Melanoma NSCLC Renal HNC Bladder Gastric HCC SCLC Ovarian Breast ORR Range 65-70% 25-57% 30-40% 20-30% 25% 13-18% 16-30% 15-22% 19% 13% 11-15% 10-18% A large unmet need still exists for those who don t respond to PD1 blockade 35 Approved Indications Incidence of resistance is rapidly increasing, e.g. in melanoma, 30% of patients progressing at 2 yrs Goal is to improve responses and duration via combination approaches

36 IMMUNO- ONCOLOGY: Loss of T cell Function Associated with Progressive Expression of Checkpoint Molecules Elimination of antigen CTL IFNγ IL-2 TNFα Poly-functional memory cell PD-1 Tim-3 PD-1 LAG-3 Tim-3 PD-1 CTL Prolife ration IFNγ IL-2 TNFα IFNγ Exhausted Naïve CD8 T cell Persistent stimulation + inflammation Progressive acquisition of checkpoints associated with reduced functionality PD-1 is one of several checkpoints associated with exhausted T-cells with e.g. reduced proliferative and cytokine releasing capacity Wherry, Nat Immunol. 2011; Wherry et al., Immunity, 2007; Blackburn et al., Nat Immunol., 2009; Paley et al., Science,

37 IMMUNO- ONCOLOGY: Multiple Factors Drive Resistance to Immune Mediated Tumor Killing Acquired mutations Induce T cell infiltration Deficit of immune infiltrates Checkpoint multiplicity Suppressive TME Relieve suppressive TME Checkpoint pathway modulation Lack of MHC/productive neoantigen presentation Indiscriminate immune activation limits dose / efficacy Enhance antigenic recognition Limit dose limiting side effects 37

38 IMMUNO- ONCOLOGY: TIM-3 is a key immune checkpoint and a next generation cancer immunotherapy target Tim-3 biology has been implicated in T cell exhaustion AND immune suppression mediated by regulatory T cells and myeloid cells CD4/8+ T cell exhaustion Myeloid cells TIM-3 is expressed on macrophages and can also influence MDSC activity in TME* Dendritic cells Regulatory T cells T-cell TIM-3 negatively regulates T cell activation and is a marker of exhausted T cells TIM-3 is expressed on regulatory T cells and promotes survival and suppressive activity TIM-3 is expressed on tumor associated dendritic cells and may negatively regulate DC activation *TME = tumor microenvironment Adapted from Anderson, A. Cancer Immunology 38 Research. 2014

39 IMMUNO- ONCOLOGY: A subset of CD8 + PD-1 + T cells express high levels of TIM-3 in NSCLC % (CD45+CD3+) CD8+ Full exhaustion Partial exhaustion PD-1+ PD-1+, TIM-3+ PD-1+, TIM-3+, LAG-3+ Adenocarcinoma Squamous cell 39

40 IMMUNO- ONCOLOGY: TIM-3 Expression on CD8+ T cells Correlates with Exhaustion Expression on tumor infiltrating immune cells in multiple tumor types Expression on CD8+ T cells correlates with exhausted phenotype Reduced ability to proliferate or secrete immunoactive cytokines HNSCC Patient TILs PD-1+Tim-3+ Cells Cannot Proliferate CD8 Proliferation Tim-3+ Cells Are Functionally Impaired CD8 IFNγ Production PD-1 Hi Tim-3 - PD-1 Int PD-1 - PD-1 + PD-1 - Tim-3 - Tim-3 + Tim-3 + Tim-3 - PD-1 Hi Tim-3 - PD-1 Int PD-1 - PD-1 + PD-1 - Tim-3 - Tim-3 + Tim-3 + Tim-3 - Shayan, G. et al. (Ferris), SITC 2015 abstract 40

41 IMMUNO- ONCOLOGY: Tumor Infiltrating T regs Express TIM-3 and Suppress T cell Proliferation T regulatory TILS Express CTLA-4, TIM-3, and PD-1 and expression correlates with increased suppressive activity CTLA-4 TIM-3 PD-1 1:1 1:.025 Jie, H-B, Ferris, RL et al. BJC 2013 CFSE 41

42 IMMUNO- ONCOLOGY: Treatment with anti-tim-3 enhances anti-tumor response of anti-pd1 therapy GEMM Tumor Model (EGFR TL) Anti-PD-1 treatment increases expression of TIM-3 Resistance to anti-pd1 treatment is correlated with expression of TIM-3 on CD8+ T cells Treatment with anti- PD1 and anti-tim3 increases survival in mouse tumor model CD8 T Cells TIM-3 and PD-1 Blockade Enhance T Cell Activity and Survival Koyama, S et al. Nature Communications

43 IMMUNO- ONCOLOGY: TSR-022: Anti-TIM-3 antibody Enhances the activity of anti-pd-1 TSR-022 enhances MLR response from T cells as monotherapy and in combination with anti-pd1 IL-2 Concentration (pg/ml) ng/ml anti-pd ng/ml anti-pd [Antibody] (µg/ml) Lead antibody IL-2 Concentration (pg/ml) ng/ml anti-pd ng/ml anti-pd [Antibody] (µg/ml) Reference Ab (2E2) 43

44 IMMUNO- ONCOLOGY: TSR-022: Phase 1 Dose Escalation as Monotherapy and in Combination Setting Dose escalation: monotherapy Starting dose: 0.03 mg/kg 4 week DLT period <1/3 DLT DL1: 0.03mg/kg n=3+3 <1/3 DLT DL2: 0.1mg/kg n=3+3 <1/3 DLT DL3: 0.3mg/kg n=3+3 <1/3 DLT DL4: 1.0 mg/kg n=3+3 <1/3 DLT DL5: 3.0 mg/kg n=3+3 DL6: 10.0 mg/kg n=3+3 <1/3 DLT CDL1: TSR anti-pd-1 n=3+3 <1/3 DLT CDL2: TSR anti-pd-1 n=3+3 Dose escalation: combination with anti-pd-1 Initiate combination at TSR-022 dose after 6 patients have been treated at monotherapy dose or 2 dose levels below cleared monotherapy dose 6 week DLT period CDL3: TSR anti-pd-1 n=3+3 Part 2: Expansion Cohorts 44

45 IMMUNO- ONCOLOGY: Near-Term Milestones Co-inhibition of Checkpoint Molecules May Be Required to Produce Optimal Clinical Activity in the Greatest Number of Patients Identified a dose and schedule for TSR-042 (anti-pd-1 mab) Identify the first clinical candidate within the MD Anderson collaboration in 1H 2017 Submit IND for TSR-033 (anti-lag- 3 mab) in 2Q 2017 Initiate a registration program for TSR-042 in 1H 2017 Identify dose and schedule for TSR- 022 (anti-tim-3 mab) Initiate a Phase 1 clinical trial of TSR-022 in combination with an anti-pd-1 antibody in mid-2017 Activation signal TCR Ag MHC Exhausted T cell Inhibitory signal APC or Tumor Cell PD-1 LAG-3 TIM-3 Reinvigorated T cell Activation signal TCR Ag MHC αpd-1 APC or Tumor Cell Cytokines Effector mechanisms αtim-3 αlag-3 mab: Monoclonal antibody IND: Investigational New Drug application 45

46 TESARO: Corporate Goals VARUBI (rolapitant) Launch VARUBI IV into the U.S. market in mid-2017, pending FDA approval Launch VARUBY oral in Europe in 2Q 2017, pending EMA approval Niraparib I-O Platform Continue commercial preparations in support of the launches of niraparib in the U.S. in 1H 2017 and Europe by year-end 2017, pending regulatory approvals Report initial data from TOPACIO trial at upcoming medical meeting Finalize a potential lung cancer registration strategy in 1H 2017 and initiate development program Report QUADRA data in 2H 2017 Report Phase 3 BRAVO data in 2H 2017 Report AVANOVA data in 2H 2017 Determine the potential registration strategy for niraparib plus TSR-042 in ovarian cancer and other cancers in 2H 2017 Continue to enroll Phase 3 PRIMA trial throughout 2017 Identify the first clinical candidate within the MD Anderson collaboration in 1H 2017 Submit IND for TSR-033 (anti-lag-3 mab) in 2Q 2017 Finalize the TSR-042 registration strategy and initiate a registration program in 1H 2017 Identify a dose and schedule for TSR-022 (anti-tim-3 mab) by mid-2017 Initiate a Phase 1 clinical trial of TSR-022 in combination with an anti-pd-1 mab in mid-2017 FDA: U.S. Food and Drug Administration EMA: European Medicines Agency IV: Intravenous mab: Monoclonal antibody 46

47 CORPORATE PRESENTATION March 2017

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