The Present and Future Role of Biomarkers in Clinical Development A Partnership Journey towards Precision Medicine Presented by Sponsored by Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Welcome & Introductions Moderators • Robert A. Lindberg, PhD, RAC Senior Director, Technology Transfer and Entrepreneur Programs • MaryAnne Rizk, PhD Global VP, CRO Business Partnerships & Alliances, Oracle Health Sciences Speakers • Jeffrey Shuster, PhD - General Manager at the Biomarker Factory • Thomas Turi, PhD - Vice President of Science & Technology for Covance Central Laboratory Services • Thomas Povsic, M.D., PhD - Associate Professor of Medicine at Duke University Medical Center • James Streeter – Global Vice President, Life Science Strategy Copyright Oracle © Confidential 2015, Oracle – Internal/Restricted/Highly and/or its affiliates. All rights Restricted reserved. | 2 The Present and Future Role of Biomarkers in Clinical Development • Importance of Biomarkers in Clinical Trials and Precision Medicine – Cost to Develop New Pharmaceutical Drug Now Exceeds $2.5B – Fit-for-Purpose: How Biomarkers Can Be Leveraged to Improve Return on Investment (ROI) in Drug Development • Getting Precise on Precision Medicine – Patient Stratification • The Collaboration & Partnership Journey – Innovation Solutions to accelerate Drug Development – Leveraging CROs and Sponsor Engagement Strategies Copyright Oracle © Confidential 2015, Oracle – Internal/Restricted/Highly and/or its affiliates. All rights Restricted reserved. | 3 Cost of drug development has increased in recent years According to PhRMA1: • –In 1970, the average cost to develop a drug (including failures) was $140M • –In late 1990s, the cost was $800M • –In early 2000s, cost was $1.2B • 10-15 years from discovery to the marketplace According to a 2013 article in FORBES2: • –The cost to develop a drug is as high as $5B 1 http://www.phrma.org/sites/default/files/pdf/PhRMA%20Profile%202013.pdf 2 http://www.forbes.com/sites/matthewherper/2013/08/11/how-the-staggering-cost-of-inventing-new-drugs-is-shaping-the-future-of-medicine/ Copyright Oracle © Confidential 2015, Oracle – Internal/Restricted/Highly and/or its affiliates. All rights Restricted reserved. | 4 Why is the cost of drug development going up? High failure rate – 5,000 to 10,000 compounds enter the pipeline for every 1 FDA-approved medicine1 – Even medicines that reach clinical trials have only a 16% chance of being approved. 2 Clinical trials are becoming more complex, less likely to succeed. • Personalized medicine and accompanying diagnostics development • more procedures, more data, more numerous and complex eligibility criteria for enrollment, longer study duration. 3 Difficulty recruiting volunteers extends the original timeline of phase 2 to 4 trials by nearly double on average across all therapeutic areas.4 – 1 http://www.phrma.org/sites/default/files/pdf/PhRMA%20Profile%202013.pdf – 2 Tufts Center for the Study of Drug Development. “Large Pharma Success Rate for Drugs Entering Clinical Trials in 1993–2004: 16%.” – Impact Report 2009; 11(4 – 3 K.A. Getz, R.A. Campo, and K.I. Kaitin. “Variability in Protocol Design Complexity by Phase and Therapeutic Area.” Drug Information Journal 2011; 45(4): 413–420. – 4 Tufts Center for the Study of Drug Development. “89% of Trials Meet Enrollment, but Timelines Slip, Half of Sites Under-Enroll.” Impact Report 2013; 15(1). Copyright Oracle © Confidential 2015, Oracle – Internal/Restricted/Highly and/or its affiliates. All rights Restricted reserved. | 5 Reduced profits after approval • Fierce competition reduces revenue after approval • After FDA approval, the average effective patent life of a brand name medicine is about 12 years • Only 2 of every 10 brand name medicines earn sufficient revenues to recoup average R&D costs 1 H.G. Grabowski, et al. “Evolving Brand-name and Generic Drug Competition may Warrant a Revision of the Hatch-Waxman Act.” Health Affairs 2011; 30(11): 2157–2166. 2 J.A. Vernon, J.H. Golec, and J.A. DiMasi. “Drug Development Costs When Financial Risk is Measured Using the Fama-French Three-factor Model.” Health Economics 2009; 19(8): 1002–1005. Copyright Oracle © Confidential 2015, Oracle – Internal/Restricted/Highly and/or its affiliates. All rights Restricted reserved. | 6 How can use of biomarkers increase ROI? • “Biomarker” = a laboratory measurement that reflects the activity of a disease process1 • Quantitatively correlates with disease progression. • Examples include: – – – – Blood pressure Cholesterol Fasting glucose Positron emission tomography (PET) • –Magnetic resonance imaging (MRI) 1 Russell Katz, Biomarkers and Surrogate Markers: An FDA Perspective, NeuroRx, Apr 2004; 1(2): 189–195. doi: 10.1602/neurorx.1.2.189 Copyright Oracle © Confidential 2015, Oracle – Internal/Restricted/Highly and/or its affiliates. All rights Restricted reserved. | 7 Importance of Biomarkers in Clinical Trials and Precision Medicine Bringing Biomarkers to Clinical Practice Jeffrey Shuster, PhD jshuster@biomarkerfactory.com Translational Medicine in Diagnostics A diagnostic is of use if it changes clinical practice. Biomarkers in Clinical Practice Utilities of Biomarkers Disease diagnosis Prognosis, for selection of treatment Predictive, for optimizing therapy Companion diagnostics Studies must identify and validate biomarkers in clinical materials Specimen obtainment and assay technology must be suitable for use in clinical practice Areas of Interest for Biomarkers Chronic disease Cardiovascular Diabetes Mental health Cancer Arthritis Autoimmune diseases Health Acute illness Nutrition Aging Microbiomes Immune system functions Performance training Cardiovascular events Infectious disease Cancer Toxicology Trauma Translational Medicine in Diagnostics Biomarker Study Components Four Questions 1. Clinical need What is the medical need for a new test over and above current clinical practice? 2. Patient population to be tested What patient criteria will a physician use to order the test? 3. Actionable in clinical practice Based on the test result, what will the physician do differently than he/she does today? 4. Number of patients How many patients are estimated to be tested and how often? Bringing Biomarkers to Clinical Practice A diagnostic is of use if it changes clinical practice. A focus on the utility of the biomarker Diagnostic, prognostic, predictive, or companion Screening in the general population Screening in at risk populations Diagnosis in symptomatic patients Patient stratification to prescribe drug treatment Drug efficacy Drug side effects/toxicity One biomarker may have more than one utility and can be used in multiple tests and product lines. Example - Focus on the utility of the biomarker Prostate-Specific Antigen (PSA) Biomarker for Prostate Cancer 1979: Discovery of PSA (Wang et al., Invest. Urol. 17:159-63) 1980: PSA levels in serum as a biomarker of prostate cancer (Kuriyama et al., Cancer Res. 40:4658-62) 1986: FDA approval for PSA test as a monitoring test for patients already diagnosed with prostate cancer 1994: FDA approval for PSA test (with DRE) as a screening test for prostate cancer in asymptomatic men Experimental Design Have the right specimens, and have enough of them Pre-define the target patient population Do not settle for samples of convenience o You cannot make a good test with bad specimens Make sure you understand all possible confounding variables Understand the possible limitations of retrospective studies Quality assurance for all samples in experimental design Understand potential regulatory affairs issues up front In translational work, very careful attention to detail is necessary in sourcing specimens Example - Experimental Design Attention to detail is necessary in sourcing specimens Biomarkers for Early Detection of Ovarian Cancer Discovery Experimental Design, Case-control, Cancer vs. non-cancer* Test Utility for Early Detection, ≤ 12 months before Diagnosis** Reported Reported Sensitivity Specificity Study 1 100.0 95.0 Study 2 86.5 93.0 Study 3 95.3 99.4 Study 4 74.0 97.0 Petricoin et al., Lancet. 2002, 359(9306):572-7 2. Gorelik et al., Cancer Epidemiol Biomarkers Prev. 2005, 14(4):981-7 3. Visintin et al., Clin Cancer Res. 2008, 14(4):1065-72 4. Zhang et al. Cancer Res. 2004, 64(16):5882-90 *1. Sensitivity at 95% Specificity CA125 64.6 95.0 Panel A 32.8 95.0 Panel B 64.6 95.0 Panel C 25.4 95.0 Panel D 52.3 95.0 **ref. Cancer Prev Res 2011;4 (3) Consider Design Options Early Enlist biostatisticians throughout the discovery phase Plan biomarker discovery as close to clinical specimens as possible If the test will need clinical parameters Include the clinical parameters in the discovery phase Does the new test out-perform current state of care Sensitivity, specificity, PPV, NPV ROC analysis, area under the curve Calibration, reclassification Costs of false positive and false negative results Test Performance Gold Standard Positive Negative Sensitivity = TP / (TP+FN) Specificity = TN / (TN+FP) TP FP PPV = TP / (TP+FP) NPV = TN / (TN+FN) Negative Test Result Positive FN TN Rule In test [high specificity] Rule Out test [high sensitivity] Test performance requirements are based on the medical need. What is the consequence of a false positive test ? Of a false negative? Sensitivity, Specificity, and Positive and Negative Predictive Values If the test has PPV - NPV > 20 years of age Diabetes screening in patients 1.00 0.95 95% sensitivity 0.90 1.20 0.85 0.80 95% specificity Ovarian cancer screening in asymtomatic womenPPV age 50NPV 1.10 0.75 0.70 1.00 0.65 0.55 Positive Predictive Value = 0.70 0.80 0.50 0.70 0.45 0.40 0.60 0.35 0.30 0.50 0.25 0.40 0.20 0.15 Positive Predictive Value = 0.004 0.30 0.10 0.05 0.20 100% 95% 90% 85% NPV 0.0100 PPV 80% 75% 70% 65% 60% 55% 50% 45% 35% 30% 25% 40% Prevalence 0.0010 0.0001 0.00 20% 10% 0.10 15% 0.00 5% or like this: 0.90 0.60 0% it looks like this: Biomarkers in Clinical Trials A Few Preliminary Questions on the Use of Biomarkers in Clinical Trials At what stage of your clinical trial would you use a biomarker? Would you use a non-validated biomarker in a clinical trial? Would you not use a validated biomarker in a clinical trial? Clinical Trials with Biomarkers Some metrics Year first received Trials with "biomarker" 2015 (to June 30, 2015) 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 Trials 1035 2100 1835 1685 1616 1625 1618 1341 1092 860 795 178 124 115 96 91 Percent with "biomarker" 11598 8.9% 23270 9.0% 20444 9.0% 19639 8.6% 18228 8.9% 17736 9.2% 17156 9.4% 17020 7.9% 13397 8.2% 10932 7.9% 12907 6.2% 1797 9.9% 1664 7.5% 1589 7.2% 1349 7.1% 1986 4.6% In 2005, the International Committee of Medical Journal Editors (ICMJE) began to require trial registration as a condition of publication. (data from clinicaltrials.gov, 08/07/2015) Biomarkers in Clinical Trials Integral, Integrated, or Exploratory Integral: Required for trial to proceed Patient inclusion/exclusion criteria Assignment to specific trial arm Continue/discontinue treatment Integrated Validation of biomarker to be used in future trials Experimental design and statistical analysis pre-specified Exploratory Biomarker discovery/ mechanistic studies/ hypothesis generation Which Biomarker Technology? Provides Best and Economic Use and Suitable with Regulatory Requirements Film image Digital imaging Digital image analysis Gene-by-gene Gene panels Genome sequencing Western blot ELISA Mass Spectrometry Microarray H&E RT-qPCR IHC RNA-seq FISH and... Biomarkers in Clinical Trials Use of Analytically Validated Assays Accuracy and Precision Sample obtainment and processing Defined and obtainable standards Qualified reagents Analytical sensitivity Analytical specificity Stability Example: Biomarkers in Clinical Trials Use of Analytically Validated Assays Validation of a multiplex assay for simultaneous quantification of amyloid-β peptide species in human plasma with utility for measurements in studies of Alzheimer's disease therapeutics Lachno et al., J Alzheimers Dis. 2012;32(4):905-18 Abstract.The The aim of this study was to validate the INNO-BIA plasma(Aβ) amyloid-β (Aβ)forforms assay for Abstract. aim of this study was to validate the INNO-BIA plasma amyloid-β forms assay quantification of Aβ1-40 and Aβ1-42 according to regulatory guidance for bioanalysis and demonstrate its fitness for clinical trial quantification of Aβ1-40 and Aβ1-42 according to regulatory guidance for bioanalysis and demonstrate applications. Validation were evaluated by repeated testing were of human EDTA-plasma pools. Intesting 6 separate its fitness for clinicalparameters trial applications. Validation parameters evaluated by repeated of estimates, intra-assay coefficients variation (CV) forcoefficients repeated testing of 5 plasma pools human EDTA-plasma pools. In 6 separateofestimates, intra-assay of variation (CV) for were≤9% relative (RE) varied –35% and +22%. error Inter-assay (n = 36) rangedand from 5% to repeated and testing of 5error plasma pools between were≤9% and relative (RE) variedCV between –35% +22%. Inter-assay CV (nfrom = 36) ranged from 5% to 17%linearity and RE varied from –17% to +8%. Dilutional linearity 17% and RE varied –17% to +8%. Dilutional was not demonstrated for either analyte using was not demonstrated for either analyte using diluent buffer,gave but results dilution with20% immuno-depleted diluent buffer, but dilution with immuno-depleted plasma by 1.67-fold within of target. Analyte plasma by 1.67-fold gave results within 20% of target. Analyte stability was demonstrated in plasma at stability was demonstrated in plasma at 2–8◦C for up to 6 h. Stability during frozen storage up to 2–8◦C for and up to 6 h. Stability during frozen storage todemonstrated 12 months and through 3 freeze-thaw cycles 12 months through 3 freeze-thaw cycles at ≤–70◦C wasup also in 5 of 6 individuals but deteriorated at ≤–70◦CNeither was also demonstrated in 5 of 6interfered individuals deteriorated thereafter. Neither thereafter. semagacestat nor LY2811376 with but the assay but solanezumab at 500 mg/L reduced semagacestat nor LY2811376 interfered with the assay butvolunteer solanezumab 500 mg/L reduced recovery of Aβ1-42 by 53%. Specimens from a Phase I human study ofatthe β-secretase inhibitorrecovery of Aβ1-42were by 53%. from Phase up I human volunteer study of the β-secretase inhibitor LY2811376 testedSpecimens at baseline and at a intervals to 12 h after single oral doses, demonstrating a clear treatment LY2811376 were tested at baseline and at intervals up to 12 h after single oral doses, demonstrating a effect. During 1,041 clinical assay runs from semagacestat studies over 10 months, the CV for plasma quality clear treatment effect. During 1,041 clinical assay runs from semagacestat studies over 10 months, the control pools at three levels were≤15% and RE were <10%. In conclusion, the INNO-BIA plasma assay was CV for plasma quality control pools at three levels were≤15% and RE were <10%. In conclusion, the successfully validated and qualified for use in clinical research. INNO-BIA plasma assay was successfully validated and qualified for use in clinical research. Example: Integral Biomarkers in Oncology Clinical Trials BRAF V600E mutation in melanoma Vemurafinib and Dabrafenib Example: Integral Biomarkers in Oncology Clinical Trials Vemurafenib Phase 1 - NCT00405587, Solid Tumors Paired melanoma biopsies must have a V600E+ BRAF mutation Phase 2 - NCT00949702, Melanoma BRAF V600E positive mutation (by Roche CoDx BRAF mutation assay) Phase 3 - NCT01006980, Melanoma positive for BRAF V600E mutation Phase 4 - NCT01307397: Melanoma BRAF V600 mutation determined by Cobas 4800 BRAF Mutation Test Dabrafenib Phase 1 - NCT01262963, Solid Tumors BRAF mutation-positive tumor (V600 E/K mutation) as determined via relevant genetic testing Phase 2 - NCT01153763, Melanoma BRAF mutation-positive (V600 E/K) as determined via central testing with a BRAF mutation assay Phase 2 -NCT01336634, Lung Cancer. BRAF V600E mutation confirmed in a CLIA-certified laboratory (or equivalent) Phase 3 - NCT01584648, Melanoma BRAF V600E/K mutation-positive using the bioMerieux (bMx) investigational use only (IUO) THxID BRAF Assay (IDE: G120011). A Few Additional Questions If a biomarker result is required for use of a drug and If biomarker positive patients respond to a drug, and If biomarker negative patients are harmed by a drug What is the consequence of a false positive test ? Of a false negative? Example: Integral and Integrated Biomarkers in Immuno-oncology Clinical Trials PD-1 Antibodies in Oncology Pembrolizumab and Nivolumab Example: Integral and Integrated Biomarkers in Immuno-oncology Clinical Trials Pembrolizumab in lung cancer* Biomarker Response *from Garon et al., Pembrolizumab for the treatment of non-small-cell lung cancer N Engl J Med. 2015 May 21;372(21):2018-28. Example: Integral and Integrated Biomarkers in Immuno-oncology Clinical Trials Nivolumab in melanoma* Biomarker / Response "In the subgroup with positive PD-L1 status, the objective response rate was 52.7% (95% CI, 40.8 to 64.3) in the nivolumab group" "In the subgroup with negative or indeterminate PD-L1 status, the objective response rate was 33.1% (95% CI, 25.2 to 41.7) in the nivolumab group" *from Robert et. al., Nivolumab in Previously Untreated Melanoma without BRAF Mutation N Engl J Med. 2015 Jan 22;372(4):320-30 Immuno-oncology PD-1 Antibodies Questions for consideration: If 40-50% of biomarker positive patients respond to a drug, and If 10-20% of biomarker negative patients respond to a drug, How would this test be useful in future clinical trials? In clinical practice? What is the consequence of a false positive/negative test ? Example: Alzheimer's Disease Integral and Integrated Biomarkers in Clinical Trials Biomarkers in Alzheimer's Disease Bapineuzumab Phase 1 - NCT00397891 Total plasma amyloid-beta (x-40) was determined using a validated ELISA method Phase 3 - NCT00575055 Bapineuzumab in Patients With Mild to Moderate Alzheimer's Disease (ApoE4 Carrier) Phase 3 - NCT00574132 Bapineuzumab in Patients With Mild to Moderate Alzheimer's Disease (ApoE4 Non-Carrier) Solanezumab Phase 3 - NCT00905372: Progression of Alzheimer's Disease Change from baseline to endpoint in plasma A Beta Phase 3 - NCT00904683: Progression of Alzheimer's Disease Change from Baseline to Week 80 in Plasma Amyloid Beta Levels Importance of Biomarkers in Clinical Trials and Precision Medicine Summary Focus on Biomarker Utility • • • • • Diagnostic, Prognostic, Predictive, and/or Companion Drug Efficacy: On Target, Clinical Response Drug Side Effects/Toxicity Patient Stratification Integral, Integrated, or Exploratory Some Questions in the Use of Biomarkers in Clinical Trials 1. At what stage of your clinical trial would you use a biomarker? 2. Would you use a non-validated biomarker in a clinical trial? 3. Would you not use a validated biomarker in a clinical trial? 4. If a high percentage of biomarker positive patients respond to a drug, and a low percentage of biomarker negative patients respond to a drug, How would this test be useful in clinical trials? In clinical practice? 5. What is the consequence of a false positive test ? Of a false negative? Importance of Biomarkers in Clinical Trials and Precision Medicine Bringing Biomarkers to Clinical Practice Jeffrey Shuster, PhD jshuster@biomarkerfactory.com Oracle Health Sciences Strategic Vision for Precision Medicine James Streeter Global Vice President Life Sciences Strategy October 16th, 2015 @OracleHealthSci #PrecisionMedicine Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Safe Harbor Statement The following is intended to outline our general product direction. It is intended for information purposes only, and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle’s products remains at the sole discretion of Oracle. Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | 40 Oracle Health Sciences Strategic Vision for Precision Medicine James Streeter Global Vice President Life Sciences Strategy October 16th, 2015 @OracleHealthSci #PrecisionMedicine Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Safe Harbor Statement The following is intended to outline our general product direction. It is intended for information purposes only, and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle’s products remains at the sole discretion of Oracle. Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | 42 Industry Trends Significant reduction in cost of Increase in real world data Cost Will you use secondary health data within the next 2 years? 70% 61% Provider Pharma Aggregation and analysis of Big Data 54% Payer Time More than half of clinical trials already have a molecular biomarker component Patient stratification to identify population subsets most likely to respond to a therapy are enhancing R&D collaboration Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Results Formulated To Accelerated Drug Discovery Through Biomarkers Imatinib (Gleevec) First in class targeted cancer therapeutic Targets the BCR-ABL protein only occurring in Chronic Myelogenous Leukemia (CML) Now considered standard of care for Myelogenous Leukemia (CML) Crizotinib (Xalkori) Ivacaftor (Kalydeco) Targets ALK protein, mutated in 7% of lung cancers Targets CFTR G551D mutation, present in 5% of cystic fibrosis patients FDA approved from a trial of only 255 patients with the biomarker Phase-III trial approval based on 161 subjects (Placebo 78; Ivacaftor 83) Indication expanded to Gastrointestinal 3 years from biomarker mutation Stromal Tumors (GIST) with KIT mutations discovery to approval 10.5% mean absolute improvement in lung function Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Biomarker Uses in Drug Development Discover Develop Deliver Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Requirements for Incorporating Molecular Analytics a Systematic way to manage genomic data generated in a clinical trial Integrates with EDC Individual Clinical Trial Genomic profile and analysis reporting Single study and cross-study analysis of biomarkers Integrates with well-established public domain data for joint analysis with your own data Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Oracle Products enabling Precision Medicine Specimen Doctor / Nurse Clinical Data InForm AMA (Advance Molecular Analysis) Genomic profiling Molecular data analysis for statisticians FDA submission Molecular measurements Enrolled Patient InForm/DMW (Study Data) IRT Laboratory (Enrollment Decisions) Cohort Explorer (Data Analysis) Data Warehouse Purchased or Public Domain Data (Data Models) Big Data (Prescription, Institutional, Government, etc.) Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Case Studies from Leading Molecular Data Initiatives • To power Center for Individualized Medicine (CIM) • Translational Research & Clinical use of 100k genomes • $100M personalized medicine effort • UPMC strategy – Science Driven, Patient-centric Care • To power Moon Shots program • To change 8 cancer types from terminal to chronic diseases • To support Total Cancer Care program • 19 hospitals, 10 states, 90k cancer patients Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | MD Anderson CASE STUDY Background / Needs Moon Shots initiative to cure 6 cancers in 5 years Single platform for clinical and genomic data aggregation and analysis Scalability to address data growth Results With Oracle In less than 6 months, deployed a reporting environment that contains in excess of 1 million patients many thousands with genomic tests Reduced time to run complex cohort identification queries from weeks to minutes in self service mode One source of truth for all data Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Strategic Vision for Precision Medicine A world wide Genomic/Biomarker data warehouse Patient consent and biomarker collection is standard of care and industry shared Increase tools and data linkage to increase the precision Post linked and processed data is also warehoused and openly available Patients provides additional life long device data Is standard for Drug Discovery and Clinical Trials and Submission Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | healthsciences_ww_grp@oracle.com +1.800.633.0643 www.oracle.com/healthsciences Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | Copyright © 2015, Oracle and/or its affiliates. All rights reserved. | The Present and Future Role of Biomarkers in Clinical Development A Partnership Journey towards Precision Medicine Presented by Sponsored by Copyright © 2015, Oracle and/or its affiliates. All rights reserved. |