INDIANAPOLIS, Dec. 16, 2014 /PRNewswire/ -- Eli Lilly and
Company (NYSE: LLY) has received its third U.S. Food and Drug
Administration (FDA) approval for CYRAMZA®
(ramucirumab).
Specifically, CYRAMZA is now also indicated in combination with
docetaxel, for the treatment of patients with metastatic non-small
cell lung cancer (NSCLC) with disease progression on or after
platinum-based chemotherapy. Patients with epidermal growth factor
receptor (EGFR) or anaplastic lymphoma kinase (ALK) genomic tumor
aberrations should have disease progression on FDA-approved therapy
for these aberrations prior to receiving CYRAMZA. This latest
approval of CYRAMZA was received on December
12, 2014.
This approval of CYRAMZA (ramucirumab injection 10 mg/mL
solution) marks the first FDA-approved medicine for use in
combination with docetaxel in the second-line treatment of
metastatic NSCLC, including nonsquamous and squamous
histologies.
"Lilly is determined to meet the challenge of delivering new
treatments for people with difficult-to-treat cancers, such as
non-small cell lung cancer," said Sue Mahony, Ph.D., senior
vice president and president, Lilly Oncology. "We are pleased with
this approval and excited for the therapeutic advantage that
CYRAMZA in combination with docetaxel can bring to second-line,
metastatic NSCLC patients. It truly builds on Lilly's continued
commitment to discovering potential treatment options for people
fighting lung cancer."
The REVEL Phase III trial compared CYRAMZA plus docetaxel to
placebo plus docetaxel, and included people with nonsquamous and
squamous forms of NSCLC. Efficacy endpoints in the trial included
the major efficacy outcome measure of overall survival and the
supportive efficacy outcome measures of progression-free survival
and objective response rate.i The labeling for CYRAMZA
contains a Boxed Warning regarding increased risk of hemorrhage,
including severe and sometimes fatal hemorrhagic events. CYRAMZA
should be permanently discontinued in patients who experience
severe bleeding. See the Important Safety Information at the end of
this press release and the Prescribing Information.
Lung cancer is the leading cause of cancer death in the U.S. and
most other countries, and NSCLC accounts for about 85 percent
of all lung cancer cases.ii,iii,iv Approximately half of
patients with metastatic NSCLC who begin first-line therapy will
move on to second-line treatment.v Despite currently
available therapies, there continues to be a need for new
second-line treatment options for patients with
NSCLC.i
Lilly is committed to offering patient assistance programs for
eligible patients receiving CYRAMZA treatment. Patients,
physicians, pharmacists or other healthcare professionals with
additional questions about CYRAMZA should contact The Lilly Answers
Center at 1-800-LillyRx (1-800-545-5979) or
visit www.lilly.com. Healthcare professionals may also find
additional product information on CYRAMZA at www.CYRAMZA.com.
About CYRAMZA®
(ramucirumab)
CYRAMZA® (ramucirumab) is
approved in combination with docetaxel (a type of chemotherapy) as
a treatment for people with metastatic non-small cell lung cancer
(NSCLC) whose cancer has progressed on or after platinum-based
chemotherapy; it is also approved as a single agent or in
combination with paclitaxel (a type of chemotherapy) as a treatment
for people with advanced or metastatic gastric (stomach) or
gastroesophageal junction (GEJ) adenocarcinoma whose cancer has
progressed on or after prior fluoropyrimidine- or
platinum-containing chemotherapy.
CYRAMZA is an antiangiogenic therapy. It is a vascular
endothelial growth factor (VEGF) Receptor 2 antagonist that
specifically binds and blocks activation of VEGF Receptor 2 by
blocking the binding of VEGF receptor ligands VEGF-A, VEGF-C, and
VEGF-D. CYRAMZA inhibited angiogenesis in an in vivo animal
model.
About Angiogenesis
Angiogenesis is the process
of making new blood vessels. In a person with cancer, angiogenesis
creates new blood vessels that give a tumor its own blood supply,
allowing it to grow and spread.
Some tumors create proteins called VEGF. These proteins attach
to the VEGF receptors of blood vessel cells causing new blood
vessels to form around the tumors, enabling growth. Blocking the
VEGF protein from linking to the blood vessels helps to inhibit
tumor growth by slowing angiogenesis and the blood supply that
feeds tumors. Of the three known VEGF receptors, VEGF Receptor 2 is
linked most closely to VEGF-induced tumor angiogenesis.
About REVEL
REVEL was a global, randomized,
double-blinded Phase III study of CYRAMZA plus docetaxel compared
to placebo plus docetaxel in people with metastatic NSCLC whose
cancer had progressed on or after prior platinum-based chemotherapy
for locally advanced or metastatic disease. In total, 1,253
patients – including people with nonsquamous (73%) and squamous
(26%) forms of NSCLC – were randomized in 26 countries over six
continents.i REVEL is the first positive Phase III study
of a biologic in combination with chemotherapy to demonstrate
improved overall survival compared to chemotherapy alone in
second-line metastatic NSCLC.
In the trial, CYRAMZA plus docetaxel achieved a statistically
significant improvement in overall survival (the primary endpoint),
progression-free survival and objective response rate (secondary
endpoints). CYRAMZA plus docetaxel significantly extended median
overall survival compared to placebo plus docetaxel (10.5 months
[95% confidence interval (CI): 9.5, 11.2] vs. 9.1 months [95% CI:
8.4, 10.0], respectively; hazard ratio 0.86 [95% CI: 0.75, 0.98];
P=0.024). Furthermore, CYRAMZA plus docetaxel significantly
delayed disease progression (progression-free survival of 4.5
months for CYRAMZA plus docetaxel [95% CI: 4.2, 5.4] vs. 3.0 months
for placebo plus docetaxel [95% CI: 2.8, 3.9]; hazard ratio 0.76
[95% CI: 0.68, 0.86]; P<0.001). The percentage of
deaths at the time of analysis was 68% (428 patients) and 73% (456
patients) in the CYRAMZA-plus-docetaxel and placebo-plus-docetaxel
arms, respectively. The progression-free survival number of events
was 558 (89%) and 583 (93%) for CYRAMZA-plus-docetaxel and
placebo-plus-docetaxel treatment arms, respectively. Significantly
more patients responded to CYRAMZA combined with docetaxel than
with placebo plus docetaxel (23% [95% CI: 20, 26] for CYRAMZA plus
docetaxel vs. 14% [95% CI: 11, 17] for placebo plus docetaxel;
P<0.001).
The labeling for CYRAMZA contains a Boxed Warning for hemorrhage
and additional Warnings and Precautions for arterial thromboembolic
events, hypertension, infusion-related reactions, gastrointestinal
perforations, impaired wound healing, clinical deterioration in
patients with Child-Pugh B or C cirrhosis, and reversible posterior
leukoencephalopathy syndrome. In the REVEL trial, the most common
adverse reactions (all grades) observed in patients treated with
CYRAMZA plus docetaxel at a rate of ≥30% and ≥2% higher than
placebo were neutropenia (low white blood cell count) (55% vs.
46%), fatigue/asthenia (weakness) (55% vs. 50%) and
stomatitis/mucosal inflammation (37% vs. 19%). The most common
serious adverse events with CYRAMZA were febrile neutropenia (fever
and potentially other infection signs along with low white blood
cell count) (14%), pneumonia (6%), and neutropenia (5%); 42% of
patients treated with CYRAMZA plus docetaxel received granulocyte
colony-stimulating factors (treatment for low white blood cells)
vs. 37% of patients who received placebo plus docetaxel. See the
Important Safety Information at the end of this press release and
the Prescribing Information.
About Lung Cancer
Lung cancer is the leading cause of
cancer death in the U.S. and most other countries, killing nearly
1.6 million people worldwide each year.ii In the U.S.,
lung cancer is responsible for approximately 27 percent of all
cancer deaths, more than those from breast, colon and prostate
cancers combined.iv Stage IV NSCLC is a very
difficult-to-treat cancer and the prognosis is poor for metastatic
NSCLC.vi NSCLC is much more common than other
types of lung cancer, and accounts for about 85 percent of all lung
cancer cases. For those people affected by NSCLC, about 70 percent
have nonsquamous cell carcinoma, while about 30 percent have
squamous cell carcinoma.iii Approximately half of
patients with metastatic NSCLC who begin first-line therapy will
move on to second-line treatment.v Despite currently
available therapies, there continues to be a need for new
second-line treatment options for patients with
NSCLC.i
Lilly PatientOne
The Lilly PatientOne program
addresses financial and coverage issues for qualified uninsured,
underinsured and insured patients who are prescribed a Lilly
Oncology product. Lilly PatientOne provides reimbursement
assistance for eligible patients who are prescribed a Lilly
Oncology product, such as information about coding and billing,
prior authorization, benefits investigation, and denied claim
appeals, as well as operating a patient assistance program. To
learn more, visit www.LillyPatientOne.com or call 1-866-4PatOne
(1-866-472-8663).
Indication
CYRAMZA (ramucirumab) is used with a
chemotherapy called docetaxel to treat metastatic non-small cell
lung cancer (NSCLC) in patients whose cancer has progressed on or
after being treated with other initial types of chemotherapy.
Patients with epidermal growth factor receptor (EGFR) or anaplastic
lymphoma kinase (ALK) genomic tumor aberrations should have disease
progression on FDA-approved therapy for these aberrations prior to
receiving CYRAMZA.
CYRAMZA is also approved as a single agent or in combination
with paclitaxel (a type of chemotherapy) as a treatment for people
with advanced or metastatic gastric (stomach) or gastroesophageal
junction (GEJ) adenocarcinoma whose cancer has progressed on or
after prior fluoropyrimidine- or platinum-containing
chemotherapy.
IMPORTANT SAFETY INFORMATION FOR CYRAMZA
WARNING:
HEMORRHAGE CYRAMZA
increased the risk of hemorrhage, including severe and sometimes
fatal hemorrhagic events. Permanently discontinue CYRAMZA in
patients who experience severe bleeding.
|
Warnings and Precautions
Hemorrhage
- CYRAMZA increased the risk of hemorrhage and gastrointestinal
hemorrhage including severe and sometimes fatal hemorrhagic events.
In Study 1, which evaluated CYRAMZA as a single agent in advanced
gastric cancer, the incidence of severe bleeding was 3.4% for
CYRAMZA and 2.6% for placebo. In Study 2, which evaluated CYRAMZA
plus paclitaxel in advanced gastric cancer, the incidence of severe
bleeding was 4.3% for CYRAMZA plus paclitaxel and 2.4% for placebo
plus paclitaxel. Patients with gastric cancer receiving
nonsteroidal anti-inflammatory drugs (NSAIDs) were excluded from
enrollment in Studies 1 and 2; therefore, the risk of gastric
hemorrhage in CYRAMZA-treated patients with gastric tumors
receiving NSAIDs is unknown. In Study 3, which evaluated CYRAMZA
plus docetaxel in metastatic non-small cell lung cancer (NSCLC),
the incidence of severe bleeding was 2.4% for CYRAMZA plus
docetaxel and 2.3% for placebo plus docetaxel. Patients with NSCLC
receiving therapeutic anticoagulation or chronic therapy with
NSAIDs or other antiplatelet therapy other than once-daily aspirin
or with radiographic evidence of major airway or blood vessel
invasion or intratumor cavitation were excluded from Study 3;
therefore, the risk of pulmonary hemorrhage in these groups of
patients is unknown. Permanently discontinue CYRAMZA in patients
who experience severe bleeding.
Arterial Thromboembolic Events
- Serious, sometimes fatal, arterial thromboembolic events (ATEs)
including myocardial infarction, cardiac arrest, cerebrovascular
accident, and cerebral ischemia occurred in clinical trials
including 1.7% of 236 patients who received CYRAMZA as a single
agent for gastric cancer in Study 1. Permanently discontinue
CYRAMZA in patients who experience a severe ATE.
Hypertension
- An increased incidence of severe hypertension occurred in
patients receiving CYRAMZA as a single agent (8%) as compared to
placebo (3%), in patients receiving CYRAMZA plus paclitaxel (15%)
as compared to placebo plus paclitaxel (3%), and in patients
receiving CYRAMZA plus docetaxel (6%) as compared to placebo plus
docetaxel (2%). Control hypertension prior to initiating treatment
with CYRAMZA. Monitor blood pressure every 2 weeks or more
frequently as indicated during treatment. Temporarily suspend
CYRAMZA for severe hypertension until medically controlled.
Permanently discontinue CYRAMZA if medically significant
hypertension cannot be controlled with antihypertensive therapy or
in patients with hypertensive crisis or hypertensive
encephalopathy.
Infusion-Related Reactions
- Prior to the institution of premedication recommendations
across clinical trials of CYRAMZA, infusion-related reactions
(IRRs) occurred in 6 out of 37 patients (16%), including 2 severe
events. The majority of IRRs across trials occurred during or
following a first or second CYRAMZA infusion. Symptoms of IRRs
included rigors/tremors, back pain/spasms, chest pain and/or
tightness, chills, flushing, dyspnea, wheezing, hypoxia, and
paresthesia. In severe cases, symptoms included bronchospasm,
supraventricular tachycardia, and hypotension. Monitor patients
during the infusion for signs and symptoms of IRRs in a setting
with available resuscitation equipment. Immediately and permanently
discontinue CYRAMZA for Grade 3 or 4 IRRs.
Gastrointestinal Perforations
- CYRAMZA is an antiangiogenic therapy that can increase the risk
of gastrointestinal perforation, a potentially fatal event. Four of
570 patients (0.7%) who received CYRAMZA as a single agent in
advanced gastric cancer clinical trials experienced
gastrointestinal perforation. In Study 2, the incidence of
gastrointestinal perforation was 1.2% for CYRAMZA plus paclitaxel
as compared to 0.3% for placebo plus paclitaxel. In Study 3, the
incidence of gastrointestinal perforation was 1% for CYRAMZA plus
docetaxel as compared to 0.3% for placebo plus docetaxel.
Permanently discontinue CYRAMZA in patients who experience a
gastrointestinal perforation.
Impaired Wound Healing
- CYRAMZA has not been studied in patients with serious or
nonhealing wounds. CYRAMZA is an antiangiogenic therapy with the
potential to adversely affect wound healing. Withhold CYRAMZA prior
to surgery. Resume CYRAMZA following the surgical intervention
based on clinical judgment of adequate wound healing. If a patient
develops wound healing complications during therapy, discontinue
CYRAMZA until the wound is fully healed.
Clinical Deterioration in Child-Pugh B or C Cirrhosis
- Clinical deterioration, manifested by new onset or worsening
encephalopathy, ascites, or hepatorenal syndrome, was reported in
patients with Child-Pugh B or C cirrhosis who received single-agent
CYRAMZA. Use CYRAMZA in patients with Child-Pugh B or C cirrhosis
only if the potential benefits of treatment are judged to outweigh
the risks of clinical deterioration.
Reversible Posterior Leukoencephalopathy Syndrome
(RPLS)
- RPLS has been reported at a rate of <0.1% in clinical
studies with CYRAMZA. Confirm the diagnosis of RPLS with MRI and
discontinue CYRAMZA in patients who develop RPLS. Symptoms may
resolve or improve within days, although some patients with RPLS
can experience ongoing neurologic sequelae or death.
Most Common Adverse Reactions—Single Agent
- The most commonly reported adverse reactions (all grades; Grade
3/4) occurring in ≥5% of patients receiving CYRAMZA and ≥2% higher
than placebo in Study 1 were hypertension (16% vs 8%; 8% vs 3%),
diarrhea (14% vs 9%; 1% vs 2%), headache (9% vs 3%; 0% vs 0%), and
hyponatremia (6% vs 2%; 3% vs 1%).
- Treatment discontinuation due to adverse reactions occurred
more frequently in CYRAMZA plus docetaxel-treated patients (9%)
than in placebo plus docetaxel-treated patients (5%). The most
common serious adverse events with CYRAMZA in Study 1 were anemia
(3.8%) and intestinal obstruction (2.1%). Red blood cell
transfusions were given to 11% of CYRAMZA-treated patients vs 8.7%
of patients who received placebo.
- Clinically relevant adverse reactions reported in ≥1% and
<5% of CYRAMZA-treated patients vs placebo in Study 1 were:
neutropenia (4.7% vs 0.9%), epistaxis (4.7% vs 0.9%), rash (4.2% vs
1.7%), intestinal obstruction (2.1% vs 0%), and arterial
thromboembolic events (1.7% vs 0%).
- Across clinical trials of CYRAMZA administered as a single
agent, clinically relevant adverse reactions (including Grade ≥3)
reported in CYRAMZA-treated patients included proteinuria,
gastrointestinal perforation, and infusion-related reactions. In
Study 1, according to laboratory assessment, 8% of CYRAMZA-treated
patients developed proteinuria vs 3% of placebo-treated patients.
Two patients discontinued CYRAMZA due to proteinuria. The rate of
gastrointestinal perforation in Study 1 was 0.8% and the rate of
infusion-related reactions was 0.4%.
Most Common Adverse Reactions—Combination With
Paclitaxel
- The most commonly reported adverse reactions (all grades; Grade
3/4) occurring in ≥5% of patients receiving CYRAMZA plus paclitaxel
and ≥2% higher than placebo plus paclitaxel in Study 2 were
fatigue/asthenia (57% vs 44%; 12% vs 6%), neutropenia (54% vs 31%;
41% vs 19%), diarrhea (32% vs 23%; 4% vs 2%), epistaxis (31% vs 7%;
0% vs 0%), hypertension (25% vs 6%; 15% vs 3%), peripheral edema
(25% vs 14%; 2% vs 1%), stomatitis (20% vs 7%; 1% vs 1%),
proteinuria (17% vs 6%; 1% vs 0%), thrombocytopenia (13% vs 6%; 2%
vs 2%), hypoalbuminemia (11% vs 5%; 1% vs 1%), and gastrointestinal
hemorrhage events (10% vs 6%; 4% vs 2%).
- The most common serious adverse events with CYRAMZA plus
paclitaxel in Study 2 were neutropenia (3.7%) and febrile
neutropenia (2.4%); 19% of patients treated with CYRAMZA plus
paclitaxel received granulocyte colony-stimulating factors.
- Adverse reactions resulting in discontinuation of any component
of the CYRAMZA plus paclitaxel combination in 2% or more patients
in Study 2 were neutropenia (4%) and thrombocytopenia (3%).
- Clinically relevant adverse reactions reported in ≥1% and
<5% of the CYRAMZA plus paclitaxel-treated patients in Study 2
were sepsis (3.1% for CYRAMZA plus paclitaxel vs 1.8% for placebo
plus paclitaxel) and gastrointestinal perforations (1.2% for
CYRAMZA plus paclitaxel vs 0.3% for placebo plus paclitaxel).
Most Common Adverse Reactions—Combination With
Docetaxel
- The most commonly reported adverse reactions (all grades; Grade
3/4) occurring in ≥5% of patients receiving CYRAMZA plus
docetaxel and ≥2% higher than placebo plus docetaxel in Study 3
were neutropenia (55% vs 46%; 49% vs 40%), fatigue/asthenia (55% vs
50%; 14% vs 11%), stomatitis/mucosal inflammation (37% vs 19%; 7%
vs 2%), epistaxis (19% vs 7%; <1% vs <1%), febrile
neutropenia (16% vs 10%; 16% vs 10%), peripheral edema (16% vs 9%;
0% vs <1%), thrombocytopenia (13% vs 5%; 3% vs <1%),
lacrimation increased (13% vs 5%; <1% vs 0%), and hypertension
(11% vs 5%; 6% vs 2%).
- The most common serious adverse events with CYRAMZA plus
docetaxel in Study 3 were febrile neutropenia (14%), pneumonia
(6%), and neutropenia (5%). The use of granulocyte
colony-stimulating factors was 42% in CYRAMZA plus
docetaxel-treated patients versus 37% in patients who received
placebo plus docetaxel.
- Treatment discontinuation due to adverse reactions occurred
more frequently in CYRAMZA plus docetaxel-treated patients (9%)
than in placebo plus docetaxel-treated patients (5%). The most
common adverse events leading to treatment discontinuation of
CYRAMZA in Study 3 were infusion-related reaction (0.5%) and
epistaxis (0.3%).
- Clinically relevant adverse reactions reported in ≥1% and
<5% of CYRAMZA plus docetaxel-treated patients in Study 3 were
hyponatremia (4.8% CYRAMZA plus docetaxel versus 2.4% for placebo
plus docetaxel) and proteinuria (3.3% CYRAMZA plus docetaxel versus
0.8% placebo plus docetaxel).
Drug Interactions
- No pharmacokinetic (PK) interactions were observed between
ramucirumab (CYRAMZA) and paclitaxel or between ramucirumab
(CYRAMZA) and docetaxel.
Use in Specific Populations
- Pregnancy Category C: Based on its mechanism of action, CYRAMZA
may cause fetal harm. Advise females of reproductive potential to
avoid getting pregnant, including use of adequate contraception,
while receiving CYRAMZA and for at least 3 months after the last
dose of CYRAMZA. Animal models link angiogenesis, VEGF and VEGF
Receptor 2 to critical aspects of female reproduction, embryofetal
development, and postnatal development. There are no adequate or
well-controlled studies of ramucirumab in pregnant women. If this
drug is used during pregnancy, or if the patient becomes pregnant
while taking this drug, apprise the patient of the potential hazard
to a fetus.
- Nursing Mothers: It is recommended to discontinue nursing or
discontinue CYRAMZA due to the potential risks to the nursing
infant.
- Females of Reproductive Potential: Advise females of
reproductive potential that CYRAMZA may impair
fertility.
For more information about CYRAMZA, including Boxed Warning
for hemorrhage, please see full Prescribing Information at
http://pi.lilly.com/us/cyramza-pi.pdf.
RB-P HCP ISI 16DEC2014
About Lilly Oncology
For more than fifty years, Lilly
has been dedicated to delivering life-changing medicines and
support to people living with cancer and those who care for them.
Lilly is determined to build on this heritage and continue making
life better for all those affected by cancer around the world. To
learn more about Lilly's commitment to people with cancer, please
visit www.LillyOncology.com.
About Eli Lilly and Company
Lilly is a global
healthcare leader that unites caring with discovery to make life
better for people around the world. We were founded more than a
century ago by a man committed to creating high-quality medicines
that meet real needs, and today we remain true to that mission in
all our work. Across the globe, Lilly employees work to discover
and bring life-changing medicines to those who need them, improve
the understanding and management of disease, and give back to
communities through philanthropy and volunteerism. To learn more
about Lilly, please visit us at www.lilly.com and
newsroom.lilly.com/social-channels.
P-LLY
RB93109 12/2014 © Lilly USA,
LLC 2014. ALL RIGHTS RESERVED.
CYRAMZA® is a registered trademark of Eli Lilly and
Company.
This press release contains forward-looking statements about
the potential of CYRAMZA (ramucirumab) as a treatment of advanced
non-small cell lung cancer and reflects Lilly's current beliefs.
However, as with any pharmaceutical product, there are substantial
risks and uncertainties in the process of development and
commercialization. There can be no guarantee that future study
results and patient experience will be consistent with the study
findings to date. There can also be no guarantee that CYRAMZA will
receive regulatory approval for any future indications or that it
will prove to be commercially successful. For further discussion of
these and other risks and uncertainties that could cause actual
results to differ from Lilly's expectations, please see the
company's latest Forms 10-K and 10-Q filed with the U.S. Securities
and Exchange Commission. Except as required by law, Lilly
undertakes no duty to update forward-looking statements.
i Garon EB, et al. Ramucirumab plus docetaxel versus
placebo plus docetaxel for second-line treatment of stage IV
non-small-cell lung cancer after disease progression on
platinum-based therapy (REVEL): a multicentre, double-blind,
randomised phase 3 trial. Lancet. 2014;384:665-73.
ii International Agency for Research on Cancer. GLOBOCAN
2012. Lung Cancer Estimated Incidence, Mortality and Prevalence
Worldwide in 2012. http://globocan.iarc.fr. Accessed December 2, 2014.
iii American Cancer Society. What is non-small cell lung
cancer? http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-what-is-non-small-cell-lung-cancer.
Updated November 10, 2014. Accessed
December 2, 2014.
iv American Cancer Society. What are the key statistics
about lung
cancer? http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-key-statistics.
Updated November 10, 2014. Accessed
December 2, 2014.
v Stinchcombe TE, Socinski MA. Considerations for
Second-Line Therapy of Non-Small Cell Lung Cancer.
Oncologist. 2008;13:28-36.
vi American Cancer Society. Learn about cancer:
Non-small cell lung cancer survival rates by stage
http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-survival-rates.
Updated November 10, 2014. Accessed
December 2, 2014.
Refer
To:
|
Tracy Henrikson
(Lilly Oncology); (609) 240-3902 (mobile);
tracy.henrikson@lilly.com
|
|
Mary Coyle (TogoRun);
(212) 453-2089 (office); (917) 975-6615 (mobile);
m.coyle@togorun.com
|
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