1-Oxa-2,7-diazaspiro[4.4]non-2-ene-8-carboxamide,N-[(1S)-1-[2-[(3R)-3-(acetylamino)-1-pyrrolidinyl]-2-oxoacetyl]butyl]-3-(3-chlorophenyl)-7-[(2S)-2-[(2-cyclohexylacetyl)amino]-3,3-dimethyl-1-oxobutyl]-, (5S,8S)-