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Description

It extends median survival by only approximately 2 to 3 months, a benefit that many patients and clinicians consider limited in the face of a rapidly progressive disease (27)

The Merck group continued to utilize the spiroindanyl piperidine core and examined positions 3 and 4 off the spiroindane phenyl group with additional substitutions off of the spiroinanyl piperidine, and pyrrolidine amine substitutions ( 11 , Figure 3)