| New York | April 2, 2011 |
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| 1. | Adherex requires and OCT agrees to perform following additional Services: |
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|   | 1.1. | Open 2 (two) additional sites for its Clinical Trial, carried in Russia by OCT; |
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|   | 1.2. | Perform safety activities for the Clinical Trial; |
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| 2. | MSA dated August 16, 2010 shall be amended by adding Exhibit 2 PSA “Additional Services Budget” dated March 09, 2011 enclosed hereto. |
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| 3. | The Total Cost of the Services listed in Article 1 above and PTCs associated with Services is 150.078,00 (one hundred fifty thousand seventy eight) USD  as detailed in Exhibit 2 PSA “Additional Services Budget” dated March 09, 2011. |
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| 4. | Exhibit 1 PSA dd. Aug. 16, 2010 shall be amended as follows: |
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|   | 4.1. | Section Warehouse of Exhibit 1 PSA dated Aug. 16, 2010 shall be considered null and void by the Parties as of March 09, 2011 and shall be replaced in full by Section Vendor Warehouse dd. March 09, 2011 attached hereto. |
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| 5. | The Parties agree on the following invoicing procedure for the Additional Services stipulated in Article 1 above: |
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|   | 5.1. | The Total Cost of Services associated with opening of the 2 additional sites (55185 USD) shall be invoiced at the fulfillment of the milestones as set forth below: |
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|   | a)  | Within 30 calendar days from the effective date of this Amendment # 1, Adherex agrees to make an advance payment to OCT in the amount of 25% of the Total Service cost; |
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|   | b)  | 10% of the cost of the Services – 25% patients enrolled |
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|   | c)  | 5%  of the cost of the Services -  50% patients enrolled |
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|   | d)  | 5% of the cost of the Services – 75% patients enrolled |
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|   | e)  | 15% of the cost of the Services – 100% patients enrolled |
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|   | f)  | 5% of the cost of the Services – 25% of patients completed treatment, case report forms monitored and queries resolved. |
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|   | g)  | 5% of the cost of the Services – 50% of patients completed treatment, case report forms monitored and queries resolved. |
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|   | h)  | 10% of the cost of the Services – 75% of patients completed treatment, case report forms monitored and queries resolved. |
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|   | i)  | 10% of the cost of the Services – 100% of patients completed treatment, case report forms monitored and queries resolved. |
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|   | j)  | 5% of the cost of the Services - Database Lock |
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|   | k)  | 5% All Sites Closed |
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|   | 5.2. | Total Cost for the Safety Activities (67655 USD) shall be invoiced together with the milestones listed above based on the amount of the Safety services actually performed within the course of the corresponding milestone. |
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|   | 5.3. | PTCs associated with Services as well as the Warehouse expenses shall be invoiced as set forth by Clause 6.3. of the MSA. |
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|   | 6. | Currency of the MSA and all Exhibits is USD. |
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|   | 7. | This Amendment has the following attachments incorporated herein: |
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|   | 7.1. | Exhibit 2 PSA “Additional Services Budget” dated March 09, 2011 |
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|   | 7.2. | Vendor Warehouse dd. March 09, 2011 |
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| OCT Group, LLC        |                | Adherex Technologies, Inc. |
|-----------------------|---------------------|----------------------------|
|                  |                |                       |   |   |
| Signature   | ss                  |                       | Signature   | ss |
|  Name            |  Dmitry Sharov |                       |  Name |  Robert Andrade |
|  Title           |  President     |                       |  Title | CFO |
|  Date            | April 2, 2011       |                       |  Date | April 2, 2011 |

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