On September 7, 2018 Exelixis, Inc. (NASDAQ:EXEL) reported that the National Comprehensive Cancer Network (NCCN) updated its Clinical Practice Guidelines to include new recommendations for CABOMETYX (cabozantinib) tablets (Press release, Exelixis, SEPT 7, 2018, View Source;p=irol-newsArticle&ID=2366537 [SID1234529348]). With the updates, CABOMETYX is recommended by the NCCN for the treatment of advanced renal cell carcinoma (RCC) regardless of patient risk status (favorable-, intermediate-, and poor-risk).

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Key CABOMETYX-related highlights from the updated NCCN Clinical Practice Guidelines for Kidney Cancer include:1

CABOMETYX is the only preferred tyrosine kinase inhibitor (TKI) treatment option for first-line patients in the poor- and intermediate-risk groups (Category 2A)
CABOMETYX is a recommended first-line treatment option for favorable-risk patients (Category 2B)
CABOMETYX is the only preferred TKI treatment option for previously treated patients (Category 1)
"CABOMETYX is the only TKI indicated for the treatment of advanced kidney cancer with NCCN-preferred status for intermediate- and poor-risk groups in the first-line setting and the only TKI with preferred status for patients who have progressed on prior therapy," said Michael M. Morrissey, Ph.D., President and Chief Executive Officer of Exelixis. "We welcome these updated recommendations, which recognize the significance of the CABOSUN trial data included in our label as an important advance in the care of patients with this disease."

The NCCN Clinical Practice Guidelines are the recognized standard for clinical policy in cancer care and are developed through review of evidence and recommendations from physicians and oncology researchers. The NCCN kidney cancer panel’s decision to include CABOMETYX as a Category 2A preferred option for the treatment of patients with previously untreated advanced RCC with poor- or intermediate-risk disease was based on the results of the phase 2 CABOSUN trial.

Additionally, in its recent update to the Clinical Practice Guidelines for Hepatobiliary Cancers, the NCCN added cabozantinib as a Category 1 option for the treatment of patients with hepatocellular carcinoma (HCC) (Child-Pugh Class A only) who have been previously treated with sorafenib.2 CABOMETYX is not FDA-approved for previously treated advanced HCC. On May 29, 2018, the U.S. FDA accepted the supplemental New Drug Application for CABOMETYX in previously treated advanced HCC and assigned it a Prescription Drug User Fee Act (PDUFA) action date of January 14, 2019.

Please see Important Safety Information below and full U.S. prescribing information at View Source

About the CABOSUN Study

On May 23, 2016, Exelixis announced that the phase 2 CABOSUN study met its primary endpoint, demonstrating a statistically significant and clinically meaningful improvement in PFS compared with sunitinib in patients with advanced intermediate- or poor-risk RCC as determined by investigator assessment. The CABOSUN study was conducted by The Alliance for Clinical Trials in Oncology and was sponsored by the National Cancer Institute-Cancer Therapy Evaluation Program (NCI-CTEP) under the Cooperative Research and Development Agreement with Exelixis for the development of cabozantinib. These results were first presented by Dr. Toni Choueiri at the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) 2016 Congress, and published in the Journal of Clinical Oncology (Choueiri, JCO, 2016).3 In June 2017, a blinded independent radiology review committee (IRC) confirmed that cabozantinib provided a clinically meaningful and statistically significant improvement in the primary efficacy endpoint of investigator-assessed PFS. Results from the IRC review were presented by Dr. Toni Choueiri at the ESMO (Free ESMO Whitepaper) 2017 Congress.

CABOSUN was a randomized, open-label, active-controlled phase 2 trial that enrolled 157 patients with advanced RCC determined to be intermediate- or poor-risk by the IMDC criteria. Patients were randomized 1:1 to receive cabozantinib (60 mg once daily) or sunitinib (50 mg once daily, 4 weeks on followed by 2 weeks off). The primary endpoint was PFS. Secondary endpoints included overall survival, objective response rate and safety. Eligible patients were required to have locally advanced or metastatic clear-cell RCC, ECOG performance status 0-2 and had to be intermediate- or poor-risk per the IMDC criteria (Heng, JCO, 2009).4 Prior systemic treatment for RCC was not permitted.

About Advanced Renal Cell Carcinoma

The American Cancer Society’s 2018 statistics cite kidney cancer as among the top ten most commonly diagnosed forms of cancer among both men and women in the U.S.5 Clear cell RCC is the most common type of kidney cancer in adults.6 If detected in its early stages, the five-year survival rate for RCC is high; for patients with advanced or late-stage metastatic RCC, however, the five-year survival rate is only 12 percent, with no identified cure for the disease.7 Approximately 30,000 patients in the U.S. and 68,000 globally require treatment, and an estimated 14,000 patients in the U.S. each year are in need of a first-line treatment for advanced kidney cancer.7

The majority of clear cell RCC tumors have lower than normal levels of a protein called von Hippel-Lindau, which leads to higher levels of MET, AXL and VEGF.8,9 These proteins promote tumor angiogenesis (blood vessel growth), growth, invasiveness and metastasis.10,11,12,13 MET and AXL may provide escape pathways that drive resistance to VEGF receptor inhibitors.9,10

About HCC

Liver cancer is the second-leading cause of cancer death worldwide, accounting for more than 700,000 deaths and nearly 800,000 new cases each year.14 In the U.S., the incidence of liver cancer has more than tripled since 1980.5 HCC is the most common form of liver cancer, making up about three-fourths of the estimated nearly 42,000 new cases in the U.S. in 2018.5 HCC is the fastest-rising cause of cancer-related death in U.S.15 Without treatment, patients with advanced HCC usually survive less than 6 months.16

About CABOMETYX (cabozantinib)

CABOMETYX tablets are approved in the United States for the treatment of patients with advanced RCC. CABOMETYX tablets are also approved in the European Union, Norway, Iceland, Australia, Switzerland and South Korea for the treatment of advanced RCC in adults who have received prior VEGF-targeted therapy, and in the European Union for previously untreated intermediate- or poor-risk advanced RCC. In March 2017, the FDA granted orphan drug designation to cabozantinib for the treatment of advanced HCC. On March 28, 2018, Ipsen announced that the European Medicines Agency validated its application for a new indication for cabozantinib as a treatment for previously treated advanced HCC in the European Union. In 2016, Exelixis granted Ipsen exclusive rights for the commercialization and further clinical development of cabozantinib outside of the United States and Japan. In 2017, Exelixis granted exclusive rights to Takeda Pharmaceutical Company Limited for the commercialization and further clinical development of cabozantinib for all future indications in Japan.

U.S. Important Safety Information

Hemorrhage: Severe and fatal hemorrhages have occurred with CABOMETYX. In two RCC studies, the incidence of Grade ≥ 3 hemorrhagic events was 3% in CABOMETYX-treated patients. Do not administer CABOMETYX to patients that have or are at risk for severe hemorrhage.
Gastrointestinal (GI) Perforations and Fistulas: In RCC studies, fistulas were reported in 1% of CABOMETYX-treated patients. Fatal perforations occurred in patients treated with CABOMETYX. In RCC studies, gastrointestinal (GI) perforations were reported in 1% of CABOMETYX-treated patients. Monitor patients for symptoms of fistulas and perforations, including abscess and sepsis. Discontinue CABOMETYX in patients who experience a fistula which cannot be appropriately managed or a GI perforation.
Thrombotic Events: CABOMETYX treatment results in an increased incidence of thrombotic events. In RCC studies, venous thromboembolism occurred in 9% (including 5% pulmonary embolism) and arterial thromboembolism occurred in 1% of CABOMETYX-treated patients. Fatal thrombotic events occurred in the cabozantinib clinical program. Discontinue CABOMETYX in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.
Hypertension and Hypertensive Crisis: CABOMETYX treatment results in an increased incidence of treatment-emergent hypertension, including hypertensive crisis. In RCC studies, hypertension was reported in 44% (18% Grade ≥ 3) of CABOMETYX-treated patients. Monitor blood pressure prior to initiation and regularly during CABOMETYX treatment. Withhold CABOMETYX for hypertension that is not adequately controlled with medical management; when controlled, resume CABOMETYX at a reduced dose. Discontinue CABOMETYX for severe hypertension that cannot be controlled with anti-hypertensive therapy. Discontinue CABOMETYX if there is evidence of hypertensive crisis or severe hypertension despite optimal medical management.
Diarrhea: In RCC studies, diarrhea occurred in 74% of patients treated with CABOMETYX. Grade 3 diarrhea occurred in 11% of patients treated with CABOMETYX. Withhold CABOMETYX in patients who develop intolerable Grade 2 diarrhea or Grade 3-4 diarrhea that cannot be managed with standard antidiarrheal treatments until improvement to Grade 1; resume CABOMETYX at a reduced dose.
Palmar-Plantar Erythrodysesthesia (PPE): In RCC studies, palmar-plantar erythrodysesthesia (PPE) occurred in 42% of patients treated with CABOMETYX. Grade 3 PPE occurred in 8% of patients treated with CABOMETYX. Withhold CABOMETYX in patients who develop intolerable Grade 2 PPE or Grade 3 PPE until improvement to Grade 1; resume CABOMETYX at a reduced dose.
Reversible Posterior Leukoencephalopathy Syndrome (RPLS), a syndrome of subcortical vasogenic edema diagnosed by characteristic finding on MRI, occurred in the cabozantinib clinical program. Perform an evaluation for RPLS in any patient presenting with seizures, headache, visual disturbances, confusion or altered mental function. Discontinue CABOMETYX in patients who develop RPLS.
Embryo-fetal Toxicity may be associated with CABOMETYX. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during CABOMETYX treatment and for 4 months after the last dose.
Adverse Reactions: The most commonly reported (≥25%) adverse reactions are: diarrhea, fatigue, nausea, decreased appetite, hypertension, PPE, weight decreased, vomiting, dysgeusia, and stomatitis.
Strong CYP3A4 Inhibitors: If concomitant use with strong CYP3A4 inhibitors cannot be avoided, reduce the CABOMETYX dosage.
Strong CYP3A4 Inducers: If concomitant use with strong CYP3A4 inducers cannot be avoided, increase the CABOMETYX dosage.
Lactation: Advise women not to breastfeed while taking CABOMETYX and for 4 months after the final dose.
Hepatic Impairment: In patients with mild to moderate hepatic impairment, reduce the CABOMETYX dosage. CABOMETYX is not recommended for use in patients with severe hepatic impairment.

On September 6, 2018 Twentyeight-Seven Therapeutics (28-7), a biotechnology company focused on modulating non-coding RNA (ncRNA) biology to develop treatments for cancer and other diseases, reported the successful completion of its $65 million Series A financing (Press release, Twentyeight-Seven Therapeutics, SEPT 6, 2018, View Source [SID1234529351]). Founding investor MPM Capital and Novartis Venture Fund co-led the financing. They were joined by additional investors including Johnson & Johnson Innovation – JJDC, Inc., Vertex Ventures HC, Longwood Fund, and Astellas Venture Management. The funding will be used to advance 28-7’s lead program, aimed at the discovery and development of small molecules that increase the levels of the tumor suppressor microRNA (miRNA), Let-7, into serious cancer indications.

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"This strong financing round was achieved thanks to the new biological understanding and impressive scientific data around non-coding RNA produced by our four scientific founders and the progress the 28-7 team has made since it was founded two years ago," said Kazumi Shiosaki, Ph.D., founding President and Chief Executive Officer, 28-7. "Our experienced investors realize the promise in this new field of therapeutics and in the robust leads produced by our founders, who have made many of the seminal discoveries in this field, and by the exceptional scientists within the company."

In addition, 28-7 announced that Shomir Ghosh, Ph.D., has joined as its Chief Scientific Officer. Most recently CSO and a founding scientist at IFM Therapeutics, Dr. Ghosh has 25 years of scientific research, drug discovery and development experience in biotech and large pharma, and has successfully delivered multiple compounds into preclinical and clinical development in the immunology, oncology and CNS therapeutic areas.

"I am incredibly excited to join 28-7 and support the advancement of its lead program," said Dr. Ghosh. "I look forward to working with Kazumi and our accomplished team and Board as we discover new ways to fight cancer and grow our operations."

28-7’s initial focus is on modulating miRNAs, which are short ncRNAs that inhibit target gene expression by suppressing mRNA translation and/or promoting mRNA decay. It is now well recognized that miRNAs are directly involved in cancer initiation, progression, and metastasis. 28-7’s technology does not focus on directly targeting the RNA itself or on developing oligonucleotides, but rather targets RNA modulating proteins (RMPs), enabling the use of small molecule drug candidates with broader access to cells and tissues. Let-7 is an miRNA that suppresses the translation of oncogenes in cells, and low levels of this miRNA are correlated with greater cancer aggressiveness. The company’s leading protein target is Lin28, an RMP that reduces the levels of Let-7, and has been shown to be an oncogene, promoting cellular transformation and tumorigenesis. 28-7 is developing first-in-class drugs that inhibit Lin28’s activity and thus raise levels of Let-7 for treatment of various cancers.

The company’s core technology comes from its four founding scientists, all leading researchers in RNA biology and cancer:

George Daley, M.D., Ph.D. ─ Dean of the Faculty of Medicine and Professor of Medicine, Biological Chemistry and Molecular Pharmacology, Harvard Medical School
Richard Gregory, Ph.D. ─ Professor of Biological Chemistry and Molecular Pharmacology, and Pediatrics, Harvard Medical School
Frank Slack, Ph.D. ─ Professor of Pathology, Harvard Medical School, Professor of Pathology and Director of Institute of RNA Medicine, Beth Israel Deaconess Medical Center
Piotr Sliz, Ph.D. ─ Associate Professor of Pediatrics and of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
This founding group has been collaborating for years and has made substantial contributions to the science of ncRNA biology, including elucidating the role of ncRNAs in disease and identifying new RMP targets for drug discovery programs.

"Our founders have made important scientific contributions to the field of ncRNA biology, including the discovery of the Lin28/Let-7 pathway and its role in normal development, metabolism, and malignancy. Overall, our studies have established Lin28/Let-7 as a major regulatory pathway in stem cells and cancer," said George Daley, M.D., Ph.D., 28-7’s co-founder and Chairman of the company’s Scientific Advisory Board, and Dean and Professor of Medicine and Biological Chemistry and Molecular Pharmacology, Harvard Medical School. "We felt that the time was right to move these insights from the laboratory to pharmaceutical development, and we are very pleased by the progress the company achieved in the first two years of its existence. With this impressive round of funding and our continued support, 28-7 will unlock the therapeutic potential of our work."

In addition to Dr. Shiosaki, several investors will join 28-7’s Board of Directors, including:

· Luke Evnin, Ph.D. ─ Managing Director and co-founder, MPM Capital

· Briggs Morrison, M.D. ─ Executive Partner, MPM Capital and CEO of Syndax Pharmaceuticals, Inc.

· Carolyn Ng, Ph.D. ─ Principal, Vertex Ventures HC

· Michal Silverberg, M.B.A. ─ Managing Director, Novartis Venture Fund

On September 6, 2018 Checkpoint Therapeutics, Inc. ("Checkpoint") (NASDAQ: CKPT), a clinical-stage immuno-oncology biopharmaceutical company focused on the acquisition, development and commercialization of novel treatments for patients with solid tumor cancers, reported positive preliminary safety and efficacy data from an ongoing Phase 1/2 clinical trial of CK-101 (also known as RX518), a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) being evaluated in advanced non-small cell lung cancer (NSCLC) (Press release, Checkpoint Therapeutics, SEP 6, 2018, View Source [SID1234529736]). The data will be presented on Monday, Sept. 24, at 10:30 a.m. ET in a late-breaking oral presentation at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer in Toronto.

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"These preliminary data demonstrate CK-101 is well-tolerated at the doses tested while also demonstrating encouraging anti-tumor activity, particularly in treatment-naïve EGFR mutation-positive lung cancer patients," said Melissa L. Johnson, M.D., Associate Director, Lung Cancer Research, Sarah Cannon Research Institute at Tennessee Oncology, PLLC, and study chair of the Phase 1/2 trial.

"The data to date demonstrate CK-101’s potential to be a highly effective mutant-selective EGFR inhibitor with the potential for a differentiated safety profile," said James F. Oliviero, President and Chief Executive Officer of Checkpoint Therapeutics. "We look forward to continuing to advance CK-101 towards a pivotal Phase 3 trial next year, positioning CK-101 to potentially be only the second third-generation EGFR inhibitor to enter the market."

The first-in-human, multicenter trial is evaluating CK-101 in NSCLC patients with EGFR mutations and other advanced malignancies (NCT02926768). Following dose escalation ranging from 100 mg to 1,200 mg/day in patients with any solid tumor where targeted EGFR was deemed reasonable, a first doseexpansion cohort was enrolled at 400 mg twice daily in patients with a confirmed diagnosis of either (1) EGFR mutation-positive advanced or metastatic NSCLC without prior exposure to EGFR-TKI therapy, or (2) T790M-positive advanced or metastatic NSCLC with disease progression on previous EGFR-TKI therapy. There was no limit on the number of prior lines of systemic therapy patients received prior to entering the study.

Key Data from the Abstract
As of June 2018, 37 patients had been treated with CK-101 in dose escalation and dose-expansion cohorts
and were evaluable for safety.
• No dose limiting toxicities (DLTs) or treatment
• The most common drug-related treatment-emergent adverse events (>10%) included nausea
(16%), diarrhea (14%), lacrimation increased (14%) and vomiting (11%).
In dose-expansion, 19 EGFR mutation-positive NSCLC patients were treated with CK-101 at a dose of 400
mg twice daily and were evaluable for response (RECIST v1.1). Eight patients achieved a partial response
(7 confirmed, 1 pending). Additional efficacy findings include:
• In eight treatment-naïve patients, six patients (75%) achieved a partial response.
• In six patients with brain metastases present at baseline, three patients achieved a partial
response.
• Higher drug exposures were associated with a higher response rate with a confirmed objective
response rate (ORR) of 55% (6/11) in patients achieving a maximum serum concentration (Cmax)
greater than 400 ng/mL.
• 100% (19/19) disease control rate was observed, with 84% (16/19) of patients experiencing target
lesion reduction versus baseline.
• Median duration of response and progression-free survival were not reached as of the data cutoff.
Enrollment in the trial is ongoing to identify the optimal dose to maximize therapeutic effect.

Oral Presentation
Details of the oral presentation at the IASLC 19th World Conference on Lung Cancer are as follows:
Title: CK-101 (RX518), a Third Generation Mutant-Selective Inhibitor of EGFR in NSCLC: Results of
an Ongoing Phase I/II Trial
Date / Time: Monday, Sept. 24, 2018 at 10:30am
Session: Novel Therapies in ROS1, HER2 and EGFR
Presenter: Melissa L. Johnson, M.D., Associate Director, Lung Cancer Research, Sarah Cannon
Research Institute at Tennessee Oncology, Nashville, Tenn.

The full abstract can be found on the conference website and is also available on the Publications page in
the Pipeline section of Checkpoint’s website, www.checkpointtx.com.

About CK-101
CK-101 (also known as RX518) is an oral, third-generation, irreversible kinase inhibitor against selective mutations in the EGFR gene. Activating mutations in the tyrosine kinase domain of EGFR, such as L858R and exon 19 deletion, are found in approximately 20 percent of patients with advanced non-small cell lung cancer (NSCLC).

Compared to chemotherapy, first-generation EGFR inhibitors significantly improved objective response rate and progression-free survival in previously untreated NSCLC patients carrying EGFR mutations. However, tumor progression could develop due to resistance mutations, often within months of treatment with first-generation EGFR inhibitors. The EGFR T790M "gatekeeper" mutation is the most common resistance mutation found in patients treated with first-generation EGFR inhibitors. The mutation decreases the affinity of first-generation inhibitors to EGFR kinase domain, rendering the drugs ineffective. Second-generation EGFR inhibitors have improved potency against the T790M mutation, but have not provided meaningful benefits in NSCLC patients due to toxicity from also inhibiting wild-type EGFR. Third-generation EGFR inhibitors are designed to be highly selective against both EGFR-TKIsensitizing and resistance mutations, with minimal activity on wild-type EGFR, thereby improving tolerability and safety profiles.

Checkpoint Therapeutics is developing CK-101 for the treatment of NSCLC patients carrying the susceptible EGFR mutations. These include the EGFR T790M mutation in second-line NSCLC patients, as well as the EGFR L858R and exon 19 deletion mutations in first-line NSCLC patients. Checkpoint holds an exclusive worldwide license (except with respect to certain Asian countries) to CK‐101, which it acquired from NeuPharma, Inc., in 2015.

On September 6, 2018 Zai Lab Limited ("Zai Lab" or the "Company") (NASDAQ:ZLAB), a Shanghai-based innovative biopharmaceutical company, reported the pricing of its underwritten public offering of $150,000,000 of American Depositary Shares ("ADSs") representing ordinary shares of the Company (Press release, Zai Laboratory, SEP 6, 2018, View Source;p=RssLanding&cat=news&id=2366260 [SID1234530327]).

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Zai Lab sold 7,500,000 ADSs at a price of US$20.00 per ADS. Each ADS represents one ordinary share of Zai Lab. The gross proceeds to Zai Lab from the offering, before deducting underwriting discounts and commissions and other offering expenses, are expected to be approximately $150,000,000. In addition, Zai Lab has granted the underwriters a 30-day option to purchase up to an additional 1,125,000 ADSs at the public offering price, less underwriting discounts and commissions. The offering is expected to close on September 10, 2018, subject to customary closing conditions.

J.P. Morgan, Citigroup, Jefferies and Leerink Partners are acting as joint book-running managers for the offering.

A registration statement on Form F-1 relating to the securities sold in this offering has been filed with, and declared effective by, the U.S. Securities and Exchange Commission. Copies of the registration statement related to this offering can be accessed through the SEC’s website at www.sec.gov.

This offering is being made only by means of a prospectus. A final prospectus, when available, may be obtained from: (i) J.P. Morgan Securities LLC, Attention: Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717, telephone: 1-866-803-9204 or email: [email protected], (ii) Citigroup Global Markets Inc., c/o Broadridge Financial Solutions, 1155 Long Island Avenue, Edgewood, NY 11717 or telephone: 1-800-831-9146 (iii) Jefferies LLC, Attention: Equity Syndicate Prospectus Department, 520 Madison Avenue, 2nd Floor, New York, NY 10022, by telephone at 1-877-821-7388, or by email at [email protected] or (iv) Leerink Partners LLC, Attention: Syndicate Department, One Federal Street, 37th Floor, Boston, MA 02110, telephone: 1-800-808-7525 ex. 6132 or email: [email protected].

This press release does not constitute an offer to sell or the solicitation of an offer to buy ADSs or any other securities, nor shall there be any sale of ADSs in any state or jurisdiction in which such an offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction.

On September 6, 2018 Oncolytics Biotech Inc. (NASDAQ: ONCY) (TSX: ONC), currently developing REOLYSIN (pelareorep), an intravenously delivered immuno-oncolytic virus turning cold tumors hot, reported that it has entered into a Master Clinical Supply Agreement (Agreement) with F. Hoffmann-La Roche Ltd (Roche) to supply atezolizumab (Tecentriq) for use in the company’s clinical development program (Press release, Oncolytics Biotech, SEP 6, 2018, View Source [SID1234534182]).

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"The supply agreement enables us to further investigate pelareorep’s impact on cancer treatments in combination with atezolizumab," said Dr. Matt Coffey President and CEO of Oncolytics Biotech. "We plan on incorporating this anti-PD-L1 cancer immunotherapy into our clinical program immediately. Data from these studies will broaden our experience with this drug class as we look to demonstrate the impact of pelareorep with checkpoint inhibitors."

Under this five-year Master Clinical Supply Agreement, Roche will supply atezolizumab for the proposed clinical trial with both parties having access to the clinical data.