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Aranesp(R) DAHANCA 10 Study Results Presented at ECCO Annual Meeting



    Amgen (NASDAQ:AMGN) today announced the analysis of the Aranesp(R)
    (darbepoetin alfa) Danish Head and Neck Cancer (DAHANCA) 10 study
    presented by investigators from the DAHANCA study group in the
    Presidential Session at the 14th European Cancer Conference (ECCO) in
    Barcelona, Spain. As previously communicated, the trial was stopped on
    Nov. 28, 2006, due to futility following an interim analysis, which
    showed low likelihood that the Aranesp arm would demonstrate improved
    outcomes.

    This independent, investigator-sponsored study is a component of
    Amgen's ongoing Aranesp pharmacovigilance program and was designed to
    evaluate the experimental circumstance of whether using Aranesp to
    maintain hemoglobin (Hb) levels between 14.0 to 15.5 g/dL results in
    better outcomes for patients with squamous cell carcinoma of the head
    and neck (HNSCC) by allowing more oxygen to reach the tumor, making it
    more sensitive to radiotherapy. Aranesp is not indicated for
    concomitant treatment with radiotherapy alone and the Hb targets in
    this study exceeded the current approved labeling in both Europe and
    the U.S.

    The study investigators completed their analysis of the data in
    July 2007 and have concluded that patients with primary HNSCC who were
    treated with Aranesp had significantly poorer tumor control after
    radiotherapy. Of 515 patients eligible for analysis, the results
    demonstrated a poorer outcome with Aranesp treatment in 5-year
    loco-regional control (56 percent with Aranesp versus 69 percent for
    the control group; RR: 1.44 (1.06-1.96), p=0.02), the primary endpoint
    for the study.

    There were no significant differences in overall survival (RR:
    1.28 (0.98-1.68), p=0.08), the risk of developing distant metastases
    or in non-cancer related deaths. There was also no enhanced risk of
    cardiovascular events observed in the Aranesp arm. Systematic imaging
    was not applied in this study. Instead, the study relied on clinical
    methodology for detection of disease persistence or recurrence. This
    method is not the U.S. or European regulatory standard for assessing
    disease progression in HNSCC.

    The study was conducted by the independent DAHANCA study group,
    and thus Amgen did not have control over the study conduct or data
    analysis. Amgen has not had the opportunity to validate the assessment
    of the raw data. In early December 2006, Amgen shared with regulatory
    agencies, including the European Agency for the Evaluation of
    Medicinal Products (EMEA) and the U.S. Food and Drug Administration
    (FDA), the preliminary interim data report that was posted on the
    DAHANCA study group's Web site.

    The boxed warning section of the U.S. labeling for
    erythropoiesis-stimulating agents (ESAs) was updated in March 2007 to
    include information about the DAHANCA 10 preliminary results.

    "Aranesp is approved to treat anemic patients receiving
    chemotherapy, and is not approved for use by the FDA or EMEA for the
    experimental indication investigated in this trial," said Willard
    Dere, M.D., Amgen senior vice president and international chief
    medical officer. "Amgen continues to recommend the use of Aranesp to
    treat patients with anemia only in accordance with its approved
    product labeling, and remains committed to providing patients and
    their physicians with the most accurate information to make informed
    treatment decisions."

    About Aranesp

    Aranesp is a recombinant erythropoietic protein (a protein that
    stimulates production of red blood cells, which carry oxygen). Amgen
    revolutionized the treatment of anemia with the development of
    recombinant erythropoietin, Epoetin alfa. Building on this heritage,
    Amgen developed Aranesp, a unique erythropoiesis stimulating protein,
    which contains two additional sialic acid-containing carbohydrate
    chains compared to the epoetin alfa molecule and remains in the
    bloodstream longer than epoetin alfa as demonstrated by its longer
    half-life.

    Aranesp was granted marketing authorization by the European
    Commission in 2001 for the treatment of anemia associated with chronic
    renal failure (CRF), also known as chronic kidney disease (CKD), in
    adults and pediatric subjects 11 years of age or older. In 2002, the
    European Commission approved Aranesp for the treatment of anemia in
    adult cancer patients receiving chemotherapy with solid tumors. This
    patient population was subsequently expanded in 2003 to include
    treatment of symptomatic anemia in adult cancer patients with
    non-myeloid malignancies receiving chemotherapy. Approval was granted
    in 2004 for extended dosing intervals of once-every-three-weeks in the
    treatment of anemia in adult cancer patients with non-myeloid
    malignancies who are receiving chemotherapy and up to once-per-month
    Aranesp administration in the treatment of anemia in CKD patients not
    on dialysis. In 2006, the Aranesp label was updated to allow CKD
    patients on dialysis to switch from rHuEPO one to three times a week
    to Aranesp every two weeks. In 2007, the Aranesp label was updated to
    allow for treatment of anemia associated with CRF, in all European
    pediatric patients on dialysis or not on dialysis.

    Aranesp was approved by the U.S. Food and Drug Administration
    (FDA) in September 2001 for the treatment of anemia associated with
    CRF for patients on dialysis and patients not on dialysis. In July
    2002, the FDA approved weekly dosing of Aranesp for the treatment of
    anemia caused by concomitantly administered chemotherapy in patients
    with nonmyeloid malignancies and in March 2006, the FDA approved
    every-three-week dosing in these patients.

    Important EU Aranesp Safety Information

    Aranesp is contraindicated in patients with uncontrolled
    hypertension. Erythropoietic therapies may increase the risk of
    thrombotic and other serious events; regional guidelines should be
    referred to for target and maximum hemoglobin levels, and dose
    adjustment rules should be performed in line with regional prescribing
    information.

    The most commonly reported side effects in clinical trials were
    arthralgia, edema, injection site pain, and thromboembolic event
    reactions. Prescribers are recommended to consult regional prescribing
    information before prescribing Aranesp, including side-effects,
    precautions and contra-indications.

    Important U.S. Aranesp Safety Information

    Use the lowest dose of Aranesp(R) that will gradually increase the
    hemoglobin concentration to the lowest level sufficient to avoid the
    need for red blood cell transfusion.

    Aranesp(R) and other erythropoiesis-stimulating agents (ESAs)
    increased the risk for death and for serious cardiovascular events
    when administered to target a hemoglobin of greater than 12 g/dL

    Cancer Patients: Use of ESAs

    -- Shortened the time to tumor progression in patients with
    advanced head and neck cancer receiving radiation therapy when
    administered to target a hemoglobin of greater than 12 g/dL,

    -- Shortened overall survival and increased deaths attributed to
    disease progression at 4 months in patients with metastatic
    breast cancer receiving chemotherapy when administered to
    target a hemoglobin of greater than 12 g/dL,

    -- Increased the risk of death when administered to target a
    hemoglobin of 12 g/dL in patients with active malignant
    disease receiving neither chemotherapy or radiation therapy.
    ESAs are not indicated for this population.

    Patients receiving ESAs pre-operatively for reduction of
    allogeneic red blood cell transfusions: A higher incidence of deep
    venous thrombosis was documented in patients receiving Epoetin alfa
    who were not receiving prophylactic anticoagulation. Aranesp(R) is not
    approved for this indication.

    Aranesp is contraindicated in patients with uncontrolled
    hypertension.

    About Amgen

    Amgen discovers, develops and delivers innovative human
    therapeutics. A biotechnology pioneer since 1980, Amgen was one of the
    first companies to realize the new science's promise by bringing safe
    and effective medicines from lab, to manufacturing plant, to patient.
    Amgen therapeutics have changed the practice of medicine, helping
    millions of people around the world in the fight against cancer,
    kidney disease, rheumatoid arthritis, and other serious illnesses.
    With a deep and broad pipeline of potential new medicines, Amgen
    remains committed to advancing science to dramatically improve
    people's lives. To learn more about our pioneering science and our
    vital medicines, visit www.amgen.com.

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