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Emerging Therapeutics in the U.S. Colorectal Cancer Markets
Frost & Sullivan, April 2005


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Difficulty Finding Optimal Combination of Drugs Prevents Success of Individual Drugs
Developing drugs for the U.S. colorectal cancer market is a complicated task due to the complexity of the treatment process, which often involves the use of three or more drugs at a time. As a result, biotechnology companies struggle to determine the best possible combination with which they should test their drugs. Identifying this combination is crucial not only for extended survival of patients, but also for generating higher revenues, since a first-line therapy holds better revenue potential than one that is relegated to second- or third-line treatment status. The targeted therapy Avastin is a case in point - despite having enjoyed great success in combination with the IFL regimen during its critical Phase III trial, it is the FOLFOX regimen that remains the definitive first-line of care. Since every company’s drug ultimately relies on other companies’ drugs to achieve success, the impact of this challenge is expected to continue to be significant.
This Frost & Sullivan research service tracks the use of pharmaceuticals in treating colorectal cancer patients and examines two distinct market segments: cytotoxic therapy and targeted therapy. The study provides detailed patient growth forecasts by stage. Additional forecasts by line of therapy provide an understanding of the revenue potential of each line and can aid companies in making strategic plans for the development of a particular drug.

Success of Targeted Therapies Increases Market Size
Following the success of targeted therapies such as Avastin and Erbitux in extending patients’ lives, companies are now more confident that their targeted drugs will do equally well in the colorectal cancer market. Avastin and Erbitux are anticipated to contribute to the success of targeted drugs by increasing penetration rates of the first- and second-line of therapy.
However, the market success of these drugs is unusual given that they do not typically replace other drugs. Avastin is added to first-line therapy and Erbitux is usually added to second-line therapy. Targeted drugs add to the value of the colorectal cancer market by being a whole new class of products, remarks the analyst of this research service. Therapies are increasing from one or two to three drugs and this is helping drive market growth.

Strength of Targeted Therapies not enough to Counter Decline of Cytotoxic Market
The total U.S. colorectal cancer market is expected to peak in 2006 and 2007 before drastically declining soon after. Two key drugs in the cytotoxic market, Eloxatin and Camptosar, are expected to lose patent exclusivity around this time and this is likely to cause the downward spiral of the market. In such a situation, it is unlikely that even the growth of targeted therapies will be enough to counterbalance the rapid decline of the cytotoxic market.
However, Frost & Sullivan believes that the continued growth of all drugs will combine to create a market worth over $2.58 billion in 2006, says the analyst. The adjuvant therapy market is expected to contribute to this growth, moving from the generic 5-FU drug to the use of Eloxatin and Xeloda instead.




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