FDA’s CBER Gone Fishing While Men Gone Wishing

Read it here http://www.nowpublic.com/health/fdas-cber-gone-fishing-while-men-gone-wishing 

Popularity: 20%

Seems there is no moving forward without moving backwards, as much as moving forward would be the right thing for everyone to do. The FDA won’t allow us to move forward so we must forever walk them through the sins of the past. The FDA dooms themselves to forever be walked through events of the past, events of the present, and events of the future.

While they have the power to end it happily like good old Ebenezer, and to help Tiny Tim (Teddy), they choose to let it end without redemption for themselves. Ebenezer Scrooge epitomizes the current FDA.

http://www.youtube.com/watch?v=qY2TT_aj_Fw&feature=fvsr

First, today, we visit the Provenge of May’s gone past.

As you know shortly after the FDA announced that they were not going to approve Provenge in May 2007 advocates met with then commissioner Andrew von Eschenbach to discuss the mistake the FDA had made in denying the BLA for Provenge and not allowing late stage prostate cancer patients to have Provenge.

It appeared that absent from the group of advocates at that meeting was anyone from the Prostate Cancer Foundation. However, unbeknownst to the advocates there meeting with Dr. von Eschenbach, the Prostate Cancer Foundation was in fact there. The problem was they were there on the other side.

The Prostate Cancer Foundation had and has the ear of former commissioner Andrew von Eschenbach. It is now crystal clear that if they would have gone they would have been sitting on von Eschenbach’s side of the table. Since the Commissioner has left the FDA, CareToLive has requested his help and he has declined (that request was renewed after the data came in).

The advocates at the advocacy meeting might not have seen it in Andy’s eyes but in them were, Michael Milken, Jonathan Simons and Stuart Holden all from the PCF.

They had and have the ear of Dr. von Eschenbach. What good could it do for the advocates to meet with Andy von Eschenbach when the largest prostate cancer patient advocacy group was absent and was in fact telling von Eshenbach to do the opposite that the advocates at the meeting were advocating for? Did those advocates know that they were speaking to the commissioner and the PCF? It’s kind of like the old poker adage; if you are sitting at a poker table and you don’t know who the sucker is, it’s you. The chair that spoke loudest was the chair that sat empty. When is the PCF going to pull up its chair to the right side of the table?

Thy enemy has shown thyself and that enemy is within the advocacy groups themselves. In deference to Michael’s love for baseball: Does anyone doubt that if the PCF would just step up to the plate and call for accelerated approval they could hit a home run.

In September of 2007 on behalf of CareToLive I sent a letter to Michael Milken by regular U.S. mail seeking his support for the effort to make Provenge available to late stage prostate cancer patients. That letter was never responded to.

Aren’t Mr. Milken and his groups in favor of speedier approval and access to treatments for late stage disease when the patients are without good alternatives?

Michael Milken founded the group Faster Cures which has shown no indication that it is in fact willing to support getting treatments such as Provenge to the patients faster.

Mike Milken says:

FasterCures

This Washington, D.C.-based think tank is removing barriers to progress against all life-threatening diseases.

The FasterCures team is dedicated to saving lives by saving time.
Milken Institute

Mike and his Faster Cures both remain MIA!!

More importantly, the greatest scientific achievement in late stage prostate cancer treatment in modern history and the PCF does nothing to help groups like CareToLive and others to try and speed it to the patients. If not now when? They have no right to call themselves prostate cancer patient advocates. Since the new data was announced CareToLive again sought the assistance of the multimillion dollar funded Prostate Cancer Foundation. These requests have repeatedly been made by CareToLive and they have repeatedly been ignored by the largest, most powerful and influential prostate cancer advocacy group first made in 2007 and then later made by request at the April 24th 2009 PCF round table in Washington D.C. and then later made by e-mails and finally culminating in the open letter sent by e-mail and regular U.S. mail to PCF CEO Jonathan Simons.

Soon after the advocates meeting with Dr. von Eschenbach after the Provenge denial in 2007 came this event:

Los Angeles, 2007 Milken Institute Global Conference
Building a Food and Drug Administration for the 21st Century

Moderator:
Greg Simon, President, FasterCures/The Center for Accelerating Medical Solutions

Panelists:
David Gratzer, Senior Fellow, Center for Medical Progress, Manhattan Institute
Andrew von Eschenbach, Commissioner, U.S. Food and Drug Administration

Greg Simon, President of FasterCures/The Center for Accelerating Medical Solutions and panel moderator began by asking how we can take the FDA we have today and get to the one we need for the 21st century. Andrew von Eschenbach, Commissioner of the FDA said, “in essence, the FDA is an information management business, and the world around us is changing fast and the data is changing also.” Personalized medicine will fundamentally change how the FDA approaches its work and how it is organized and the types of skill sets employees need. Dr. von Eschenbach talked about how science has crossed the threshold where diseases can be viewed through a molecular prism. “This doesn’t have to be about the science of safety or efficacy, with new molecular medicine we can have both,” he pointed out.

Balancing patient safety with access will be critical. “We have these discussions and a lot of time is spent on safety but we need to be sure we have an innovative drug market,” offered David Gratzer, Senior Fellow at the Manhattan Institute. Moving towards a “lifecycle approach” at the FDA that balances safety and access is critical and was a key message of the 2006 Institute of Medicine study on drug safety.

Beth Seidenberg, Partner at Kleiner Perkins Caufield & Byers pointed out that the future is now. Programs at the FDA like the Critical Path Initiative need even more support and resources. “We need to give the FDA the tools, people, and money to ensure the agency can take advantage of these scientific advances.” A system of integrated medical information based on electronic health records and data sharing will allow for more streamlined post-marketing surveillance and will get the FDA away from paper to electronic files. Resources and systems change are needed to advance these IT systems at the agency. “We need to get around the proprietary relationship to data and see that having access to large population data sets is the only way to advance.”

When Greg Simon asked each panelist to name the most important next step for the agency two themes emerged: getting the agency more resources and the creation of a creative strategic plan that embraces the possibility of how personalized medicine can change how we currently approve drugs.

Andy also says:
http://www.mikemilken.com/videos.taf?video=6&type=wmp

Mr. Milken and the PCF: Today there are an estimated 10 million cancer survivors just in America alone — men and women who in many cases have life expectancies measured in months, not years. “Many would gladly enlist as foot soldiers in an effort to help cure a disease that in many cases will be genetically passed on to their children and grandchildren.”

* “Cancer researchers, clinicians, and patient advocates rarely speak with one voice on any subject related to the disease. They fight over funding priorities; they squabble over treatment options; they joust over the relevance of biological discoveries. But virtually everyone agrees that Milken deserves an enormous share of the credit for the progress made against this major killer. ‘Mike’s done more for prostate cancer research than anyone in America,’ says one of the nation’s best-known prostate surgeons, Patrick Walsh, head of urology at Johns Hopkins.”
* ” ‘Michael Milken changed the culture of [medical] research,’ says Andrew von Eschenbach, director of the National Cancer Institute. ‘He created a sense of urgency that focused on results and shortened the timeline. It took a business mindset to shake things up. What he’s done is now the model.’”

* ” ‘Michael is always thinking creatively,’ says [Dr. Leroy] Hood, sounding like a convert. ‘He transformed how you do research in the field of prostate cancer and how you think about aggressively going after a disease. It has been a real revolution.’ ”

Mr. Milken, Mr. Simons we want to speak with one voice, why won’t you return our call?

Why won’t you respond to our e-mails?

Why won’t you help us to help late stage cancer patients now?

Where is the disagreement with regards to Provenge and WHY won’t you help?

So you backed the wrong horse but there is still time to change your bets, still time to turn the cart upright, still time to wipe that egg off your face and move forward.

HELP!!!!!

Here is what the PCF as a group says:

Although there has been dramatic progress in finding better treatments, the impending increase in incidence makes the need greater than ever. Fortunately, recent advances in science have made the opportunities greater than ever as well. With your support, we will be able to pursue more of these opportunities and hasten the day when prostate cancer is merely a sad memory.

Hey PCF, why won’t you give us a straight answer on our call for helping Provenge get to the patients sooner?

It’s bad enough that you have been MIA these past 2 years but now you simply have no excuse.

Teddy needs Provenge now!

Ebenezer Scrooge said of Tiny Tim, “If he is going to die he should do it and decrease the surplus population”.

I hate to be so grim on a Sunday but I have no patience for the FDA’s lack of humanity and no tolerance for the PCF’s non-support of quicker approval of Provenge because they are afraid if they do that it may bruise their ego.

Even Scher and Coffey at the PCF round table said they would rally behind Provenge if the data was there on April 28th…where is the rally?

Really, where is the rally?

Lets go!

No more free pass.

Popularity: 23%

Harry Markopolos, at the Bernie Madoff Ponzi Scheme Congressional Investigation.

Congressman Alan Grayson: Are you familiar with the concept of capture when you are talking about regulation? What is that? Do you know that concept?

Harry Markopolos: Yes. It’s basically when the regulator is in bed with the industry they purport to regulate and do not regulate the industry. In fact, they consider the industry the client, not the public citizens.

Congressman Alan Grayson: And have you seen that in action.

Harry Markopolos: Yes. At the Food and Drug Administration and at the SEC.

Excerpt starts at 14:14  http://www.cnbc.com/id/15840232?video=1021435842

Popularity: 32%

The Citizen Petition filed with the FDA by CareToLive has now been pending for decision with the FDA for 556 days. The Petition which asked the FDA to reconsider its decision to deny a license to Provenge, was followed up by 200 positive comments in the months following that filing, by patients, families of patients, physicians, scientists, researchers and other fine citizens.

The petition process is the only formal way for patients and their advocates to ask the FDA to consider and address their wishes.

It has been 384 days since CBER head Jesse Goodman wrote to CareToLive and said that they needed some additional time to decide the petition.

It has been approximately 372 days since a CBER employee told CareToLive counsel that a committee had been formed and they were actively reviewing the petition.

It has been approximately 365 days since counsel for the CBER division of the FDA told counsel for CareToLive that they took the petition very seriously and that while she could not say who was on the committee considering the petition, she could make the assurance that they were in fact actively reviewing it.

God bless all the patients that watch and wait. Stay strong!

Kerry M. Donahue
6295 Emerald Parkway
Dublin, Ohio 43016

Popularity: 29%

It’s the Citizens that the currently unfriendly FDA are there to serve, a fact long forgotten by the current FDA. Also, TIMELY access to innovative new treatments for patients with late stage disease where there are no good alternative treatments available, which was important enough to encompass within the revised FDA mission statement, must be a priority. That mission was not accomplished under our current FDA chief.

The next FDA commissioner needs to remember the mission of the FDA is to protect and serve the Citizens and to speed innovative, safer new treatments to them. The next commissioner should stop ignoring the pleas of the citizens! In the current FDA the Citizens have no voice and nobody at the top levels of the FDA has shown any inclination towards being caring or sensitive to patient rights.

Currently, Citizens do not have a voice in the FDA. The Citizen Petition process at the FDA is broken. The FDA is completely unresponsive to filed Petitions. The FDA’s consideration of the opinions of patient advocates, and even their own hired expert’s opinions at Advisory Committee hearings, are given mere lip service.

The public is given no rights, no voice, and no way to express its concerns to the Agency. There is very little support left for the agency in its current decayed state. Even the staunchest of supporters, such as Peter Barton Hutt, former FDA Counsel, who went before the Energy and Commerce Committee in January 2008 to ask for more funds for the agency, when current commissioner Andrew von Eschenbach would not do so,(as he was afraid to anger/upstage President Bush), now admits that the agency is broken. “This is a fundamentally broken agency,” Hutt stated earlier this year, “and it needs to be repaired.” Mr. Hutt has laid out some basic principles for sound government regulatory policy. They are:

Continue Reading THE NEXT FDA COMMISSIONER »

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While the FDA continues to tow the untenable line they have chosen and while they continue to refuse to admit to their mistakes, much less take any action to fix them, Patients including CareToLive members continue to suffer.

This recent note was received from a very loved member of CareToLive:

“Just a note to thank everyone who has worked so hard over the past year and a half to oppose the FDA’s reckless disregard of cancer patients. I think it was Stalin who said: “A single death is a tragedy; a million deaths is a statistic.

That’s how I feel. Today my PSA is 300+ and doubling every 2 months. I did participate in a NCI Prostvac study in Bethesda. It slowed my disease for a while but I was recently dropped from the study due to disease progression in bone scans. The NCI doc recommended I get taxotere ASAP and did mention some past research suggesting following vaccine therapy with chemo enhances the effect of chemo. I’ll keep a happy thought, but what really maddens me was the study doc’s analysis that I simply had too much tumor mass for the vaccine treatments to overcome. I can only think of what might have been the outcome if I could have had Provenge treatments a year ago May when my PSA was moving through the 12 to 18 range. The latest interim report that a 20% survival improvement doesn’t quite cut it felt like a stake through the heart. Statistics rule.

Out of options, I’ll try the taxotere and hope for the best. I’m frustrated, tired, and out of energy for fighting the FDA, BUT I want you to know that I believe that God has a special place in heaven for you and your friends who put so much fight into representing people like me.”

We at CareToLive are humbled that a patient that is fighting for his very life would take the time to thank us. Tonight before you go to bed everyone say a prayer for all those men who are currently suffering from this dreaded disease.

It is for him and others like him and the patients of the future that we continue the fight. We just completed our writ for the Supreme Court which can be found here (Word document) or here (PDF document).

While I have no illusions about the chance that the Supreme Court will grant our writ of certiorari if by chance they did grant it then I am confident we would win it. The argument put forth is legally sound. The Court was wrong to dismiss the case on jurisdictional grounds.

Such a writ is basically a request that the Supreme Court review the matter. If they grant cert it would mean that they have agreed to review the case and invite the parties to submit briefs and make oral argument. If they deny cert then they do not review it.

Meanwhile, while CBER head Jesse Goodman has the power to reconsider Provenge based on the Citizens Petition filed by CareToLive he seemingly lacks the courage and the fortitude to do so, even though it is clearly the humane thing to do. Instead he chooses to ignore the citizens and he chooses not to respond to the numerous letters and e-mails sent to him from CareToLive since his January 2008 response that said: they are still actively considering the petition, but need more time. CBER, anyone home, hello, hello!

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http://youtube.com/watch?v=6Q0uQAL_YDA

Video of Care To Live member Ted Girgus taken at our nationwide protest in Seattle. Ted has stage IV prostate cancer, that has metastacized to his bones. Ted and his doctor, want him on Provenge NOW!

* * * * *

Here is a Video of the 2007 Rally

http://www.youtube.com/watch?v=UqAx7uZAS90

MAY 30, 2008 NATIONWIDE PROSTATE CANCER PROTEST

* * * * *

20% of 42,000 Lives = 8,400 Lives & Counting

Money is very important to most people yet nobody can measure how many dollars one life is worth. There is no amount of money, no matter how much, that is worth trading for one single life. If one life is so very valuable to one family, then how much are 8,400 lives worth?

Ever since the FDA delayed getting Provenge to men with late stage prostate cancer over 42,000 men have died. If they were on Provenge since May 2007, at least 20% would still be alive. That is over 8,400 men that would have benefited.

In other words the FDA would have approved Provenge if it saved 9,240 people, but because it only saved 8,400 people’s lives, they won’t let us have it. The bureacracy must be using artificial intelligence to come up with their faulty conclusion to delay. The FDA already told us the agency is too broken to keep up with the science.

There are currently 90,000 to 100,000 men with Androgen Independent Prostate Cancer (AIPC), or are hormone refractory. That’s 18,000 to 20,000 people. AT LEAST THEY COULD BE SAVED, according to interim data just released. Keep in mind that the final data will even be more impressive.

CareToLive has again written to Dr. Jesse Goodman, the Director of the Center for Biologics Evaluation and Research (CBER) at the Food and Drug Administration (FDA). CareToLive sent Dr. Goodman a Citizens Petition on July 27, 2007, to reconsider the denial of a license for Provenge, an immunotherapy treatment for men with late stage prostate cancer. The petition was sent to the FDA over a year ago and as per Federal Regulation CareToLive should have received an answer within 180 days after receipt. We are still waiting.

Additional data for Provenge has recently been evaluated and has shown what we at CareToLive have been saying all along. Provenge is safe and Provenge shows a survival benefit. An outside firm has just confirmed that 20% of the men in the Provenge trials survived over placebo, due to the Provenge treatment. It is time for the FDA to grant approval, even if only conditional while more data is gathered, so that men with late stage prostate cancer can begin receiving Provenge NOW!

Link to CareToLive’s Citizen’s Petition http://caretolive.com/caretolivepetition.pdf

Here is the letter CareToLive sent to Dr. Jesse Goodman:

Jesse L. Goodman, M.D., M.P.H.
Director
Food and Drug Administration
Center for Biologics Evaluation and Research
1401 Rockville Pike
Rockville, MD 20852-1448

Re: Docket No. 2007P-0297/CP1

Dear Dr. Goodman,

I am requesting that the FDA reconsider our CareToLive Citizens Petition docket number 2007P-0297/CP1 filed in July 2007, concerning the FDA delay of Provenge licensure for men with late stage prostate cancer. To date we have never received a proper answer and have only received one letter from you, stating that our petition is still pending. Enclosed is additional data obtained from the Independent Data Monitoring Committee (IDMC) from the Interim look, proving that the survival is real. Provenge clearly demonstrated a 20% reduction in the risk of death in the Provenge arm relative to placebo.

My husband Mike Kearney and I both spoke to Paul Richards of the FDA Consumer Affairs CBER Department, whom your office directed us to. He is supposed to be working for Consumer Affairs but he obviously does not have the consumer in mind. Mr. Richards stated that he himself looked at the data and did not see the survival. This is shocking, seeing that even Dr. Maha Hussain, of “leaked letter” fame said at the meeting that she saw the survival. She wanted to make sure it could be attributed to Provenge. This additional IDMC data proves that the survival is indeed due to Provenge. Mr. Richards refused to answer our question as to whether Provenge is safe. The IDMC clearly states that Provenge is safe, and the FDA Advisory Commmitee voted unanimously that Provenge is safe, so that should not be an issue, despite Mr. Richards refusal to admit Provenge’s safety profile. Mr Richards told us that the minority panelists swayed the FDA decision to delay Provenge. Another of the minority panelists, Dr. Howard Scher, also of “leaked letter” infamy, had many undisclosed conflicts of interest, including running a competitior’s trial for prostate cancer with Novacea’s Asentar, a trial that was stopped midstream due to the high number of deaths, possibly caused by Dr. Scher’s trial design, which caused an abundance of toxicity to the poor patients enrolled.

Our Citizens Petition, which is also attached, addressed the shenanigans that took place during the FDA Provenge BLA process. The FDA correctly granted Provenge Fast Track Status and Priority Review since it is a treatment for a life threatening disease where no viable alternatives exist. Regardless of what took place in the past, in light of the corroborating scientific evidence seen at the Interim, it is time to to reconsider our Petition concerning the denial of a license for Provenge for men with late stage prostate cancer.

To date, over 42,000 men have died without the benefit of Provenge. A 20% improvement in survival means that more than 8000 of them might still be alive if given the right to fight for their lives. It is a travesty that the FDA, which is sworn to protect the public health, has instead ignored these men in their battle with prostate cancer.

The FDA can fix this by allowing the 96,000 men who are eligible for Provenge right now, the chance to fight for their lives. Please restore the American people’s faith in the FDA, and in light of the new data, honor that Fast Track Status and Priority Review. Please reconsider the CareToLive Citizens Petition to reconsider the denial of a license for Provenge. This is an emergency!

Thank you for your immediate consideration of this matter.

Very Respectfully,

Rory & Mike Kearney
CareToLive,
a not for profit corporation

Cc: Division of Dockets Management (HFA-305)
Paul Richards, FDA Consumer Affairs
Lanessa Hill, FDA Consumer Affairs
Stephen Ripley, FDA Consumer Affairs

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ctldecision.pdf

The court ruled,

“Appeal Denied”.

Kerry is very sorry we could not win this for the patients suffering with AIPC. “We will take the fight to the Supreme Court but we understand that this is not timely enough for many thousands of suffering men.”

We are unripe. We are in FDA limbo. We haven’t been denied a license, yet you can’t get Provenge, but it is not denied, just delayed a few years. To our fathers, husbands, sons and brothers who have passed away, it is as final as anything can get. The FDA needs to be disbanded and the patients rights given back to the patients and not the corporations, and “venture capitalists.”

Unconscionable!

We fight on!

Next Stop

Kerry Donahue, our lawyer extraordinaire, has incredible fortitude to pursue this fight on behalf of men with late stage prostate cancer. The Courts are passing this hot potato up the hill. Kerry has filed a lawsuit on behalf of CareToLive to try to get men with late stage prostate cancer access to Provenge, a safe, non toxic, non invasive immunotherapy. Somebody needs to get the ear of the right fat cats on the hill, exchange a few suitcases of cash, no, wait a minute, that would be illegal. We have men we love who need Provenge NOW! Approve it because it is the right thing for a civilized society to do. Visions of Soylent Green come to mind.

FEAR NOT!

MOTION TO THE SUPREME COURT TO REVIEW Coming Soon!

Kerry, We LOVE You. You are doing an incredible job. You stand among America’s finest. Your amazing work on behalf of men with late stage prostate cancer is unrivaled!

http://caretolive.com/lawsuit-news/

The courts are part of the system, pushing us aside, shutting off another route to redress. We will stay in their face. What choice do we have.

Ted needs Provenge NOW!

http://www.youtube.com/watch?v=6Q0uQAL_YDA

http://www.youtube.com/watch?v=UqAx7uZAS90

THE CAN CAN
http://www.jibjab.com/starring_you/receipt/2111682

Popularity: 22%

CareToLive has just learned Alison Martin no longer works at NCI. Remember her? She helped Howie Scher write his leaked letter. She now works for the Melanoma Research Alliance. Check out their website. It will be fully up and running on August 19th.

http://www.melanomaresearchalliance.org/

This is a new organization found under the auspices (patronage; support; sponsorship) of the Michael Milken Institute. It intends to support ambitious and innovative projects from both individual scientists and research teams to develop novel diagnostic and therapeutic avenues relevant to pathways governing the behavior and clinical outcome of melanoma.

Skin cancer represents the most commonly diagnosed malignancy, surpassing lung, breast, colorectal and prostate cancer.
Melanoma is a type of skin cancer.
Even though it is rare, malignant melanoma is responsible for 75 % of all skin cancer related death cases

Meanwhile, back at the NCI ranch, we tried to pursue the missing gaps in the FOIA documents, namely, Scher’s “personal” e-mail. Under the rules, we can’t have his personal letter if it has his mother’s maiden name, his social security number, his phone number, home address, etc. Well what we learned is, this e-mail has his personal opinion. Did he say bad things about the Advisory Committee, its panelists, the patients who made public statements, CBER, Dendreon and Provenge? Did he brag how Asentar and GVAX and Abiraterone are better options? We want to know. Personal information and personal opinion are two different things, especially when that opinion influences a decision.

You can view the NCI FOIA documents here:

http://caretolive.com/NCI-FOIA-Response.pdf

Well, NCI tells us that since Alison Martin no longer works there, and since Scher doesn’t work for NCI, they do not have to turn over the e-mail. Can you believe that? What Alison Martin did when she worked for NCI should be fair game. Our tax dollars paid for that “work”. And what Scher, the most conflicted doctor on the Advisory Committee panel, had to say is most relevant in why he fought so hard to stop Provenge from being approved. We are sure he didn’t ask Alison Martin her bra size because it appears she forwarded the e-mails to Howard Streicher. We will continue to pursue this.

Popularity: 31%

On Thursday, 1/17/08, CareToLive received a response to the CTL Citizens Petition filed on July 27, 2007.
Read the FDA response to the CareToLive petition for the FDA to reconsider the decision to delay the approval of the immunotherapy Provenge (click this link)

Today 1/23/08 CTL received a call back from the person at the FDA that had previously faxed us the response to the CTL Citizen Petition.

She indicated that she could not give any kind of timeline on the reconsideration of the failure to approve Provenge. She was asked who could and if anyone else at the FDA could elaborate on the short letter received by CTL from Jesse Goodman, or if anyone could pinpoint a time frame.

She was an extremely nice lady but we sensed that she had strict marching orders.

She stated that “there is a group of people actively reviewing the matter”.

She was asked if the group consisted entirely of people from CBER and she said she was not comfortable answering that.

She was asked if Jesse Goodman was one of the people involved in the group considering the Petition. Again she indicated she was not able to confirm or deny that.

After a few similar type of questions it was sensed that she was very uncomfortable and CTL stated to her that we understood she was in a tough spot and understood that she was not able to tell us more. With that she was thankful.

CTL is sure she was told exactly what to say and not to deviate from what she was specifically told to disclose.

READ OUR PETITION HERE
Petition for the FDA to Reconsider the Failure to Approve Provenge (click this link)

Popularity: 15%