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Therapeutic Report Series: The Cancer Outlook to 2007 by Steve Birch Report Summary Although many of the gold standard cancer therapies currently used have been marketed for over a decade, the market remains far from mature. The poor efficacy of therapies available and high incidence of disease means that many major pharmaceutical companies see the cancer market as being a key future revenue growth driver. The biopharmaceutical industry has recognised this potential and, in response to this opportunity, has invested heavily in R&D resulting in over 1,000 innovative compounds currently in clinical development. Many of these are now reaching, or about to reach the market, fuelling further expansion in the sector. The new management report, The Cancer Outlook to 2007, from , is a single source of all the key epidemiological, market, licensing and R&D data which will provide you with a detailed analysis of the current and future dynamics within the cancer market. Its future focus provides an important decision making support for executives across biotechnology and pharmaceutical companies. Steve Birch Steve Birch has extensive experience as a consultant in the healthcare and pharmaceutical industries. Steve has a degree in Economics from Durham University. During his career in consultancy, he has provided advice and analysis on disease markets, drug development and strategic issues within the pharmaceutical industry Table of Contents The Cancer Outlook to 2007 Executive Summary 10 Patient potential 10 Global market analysis 11 Global players in the cancer market 12 Market forecasts 13 Chapter 1 Patient Potential 16 Summary 16 Introduction 17 DTC advertising 18 Global epidemiology data 20 Lung cancer 22 Diagnosis of lung cancer 22 Treatment of lung cancer 24 The epidemiology of lung cancer 25 Prostate cancer 27 Diagnosis of prostate cancer 28 Treatment of prostate cancer 29 The epidemiology of prostate cancer 30 Breast cancer 33 Diagnosis of breast cancer 33 Treatment of breast cancer 35 The epidemiology of breast cancer 36 Colorectal cancer 39 Diagnosis of colorectal cancer 40 Treatment of colorectal cancer 41 The epidemiology of colorectal cancer 42 Ovarian cancer 45 Diagnosis of ovarian cancer 46 Treatment of ovarian cancer 47 The epidemiology of ovarian cancer 48 Leukemia 50 Diagnosis of leukemia 50 Treatment of leukemia 54 The epidemiology of leukemia 58 Chapter 2 Global Market Analysis 62 Summary 62 Introduction 63 Global analysis 63 Hormonal therapies 65 Introduction 65 Market overview 67 LHRH agonists 70 Drug analysis 71 Anti-androgens 73 Drug analysis 73 Anti-estrogens 75 Drug analysis 76 Aromatase inhibitors 78 Drug analysis 79 Progestagens 81 Drug analysis 82 Cytotoxics 83 Introduction 83 Market overview 85 ‘Other’ cytotoxics 88 Drug analysis 89 Antimetabolites 93 Drug analysis 95 Cytotoxic antibiotics 98 Drug analysis 99 Alkylating agents 101 Drug analysis 102 Vinka alkaloids and etoposide 104 Drug analysis 105 Innovative cancer therapies 107 Market overview 108 Cytokines 111 Drug analysis 111 Monoclonal antibodies 114 Drug analysis 115 Therapeutic vaccines and photodynamic therapy 118 Drug analysis 118 Adjunct therapies 125 Market overview 127 Anti-emetics 130 Drug analysis 130 Bisphosphonates 132 Drug analysis 133 HGFs 134 Drug analysis 134 Chapter 3 Global Players in the Cancer Market 140 Summary 140 Introduction 141 BMS 143 BMS’ cancer R&D program 146 Key products in development 146 AstraZeneca 148 AstraZeneca’s cancer R&D program 151 Key products in development 151 Novartis 153 Novartis’ cancer R&D program 156 Key products in development 157 Aventis 157 Aventis’ cancer R&D program 160 Key products in development 160 Roche 162 Roche’s cancer R&D program 165 Key products in development 165 Pharmacia 167 Pharmacia’s cancer R&D program 170 Key products in development 170 Chapter 4 Market Forecasts 174 Summary 174 Introduction 175 The hormonal therapy market 176 LHRH agonists 178 Anti-androgens 179 Anti-estrogens 180 Aromatase inhibitors 181 Progestagens 182 Cytotoxics 182 ‘Other’ cytotoxics 184 Antimetabolites 185 Cytotoxic antibiotics 187 Cytotoxic antibiotics 188 Vinka alkaloids and etoposide 189 Innovative therapies 190 Cytokines 193 Monoclonal antibodies 194 Therapeutic vaccines 195 Angiogenesis inhibitors 196 Gene therapy 198 Other therapies 199 Adjunct therapies 200 Anti-emetics 202 Bisphosphonates 202 HGFs 203 Chapter 5 Appendix 206 Sales data 206 R&D data 206 References 207 Index 208 List of Figures Figure 1.1: Comparison of five year cancer prevalence across the major pharmaceutical markets, 2001 20 Figure 1.2: Growth in the prevalence of key tumor types in the major pharmaceutical markets, 2001–2007 21 Figure 1.3: Lung cancer stage breakdown, 2001 26 Figure 1.4: Prostate cancer stage breakdown, 2001 31 Figure 1.5: Breast cancer stage breakdown, 2001 38 Figure 1.6: Colorectal cancer stage breakdown, 2001 44 Figure 1.7: Ovarian cancer stage breakdown, 2001 49 Figure 1.8: Leukemia type breakdown, 2001 59 Figure 2.9: The global cancer market, 1997–2001 64 Figure 2.10: Competitive drug class dynamics in the global cancer market 65 Figure 2.11: Evolution of the hormonal drug therapy market, 1970–2000 66 Figure 2.12: Market share of the leading hormonal therapies, 2001 69 Figure 2.13: Evolution of the cytotoxic drug therapy market, 1940–2000 84 Figure 2.14: Market share of the leading cytotoxics, 2001 88 Figure 2.15: Evolution of the innovative cancer drug market, 1986-1999 108 Figure 2.16: Market share of the leading innovative cancer drugs, 2001 110 Figure 2.17: Market share of the leading adjunct therapy drugs, 2001 129 Figure 3.18: Market share of the global cancer players, 2001 143 Figure 3.19: BMS’ competitive positioning in the cancer market 145 Figure 3.20: AstraZeneca’s competitive positioning in the cancer market 150 Figure 3.21: Novartis’ competitive positioning in the cancer market 156 Figure 3.22: Aventis’ competitive positioning in the cancer market 159 Figure 3.23: Roche’s competitive positioning in the cancer market 164 Figure 3.24: Pharmacia’s competitive positioning in the cancer market 169 Figure 4.25: Forecast global cancer market, 2001–2007 176 List of Tables Table 1.1: Lung cancer incidence, 2001–2007 25 Table 1.2: Lung cancer prevalence, 2001–2007 27 Table 1.3: Prostate cancer incidence, 2001–2007 30 Table 1.4: Prostate cancer prevalence, 2001–2007 32 Table 1.5: Breast cancer incidence, 2001–2007 37 Table 1.6: Breast cancer prevalence, 2001–2007 39 Table 1.7: Colorectal cancer incidence, 2001–2007 43 Table 1.8: Colorectal cancer prevalence, 2001–2007 45 Table 1.9: Ovarian cancer incidence, 2001–2007 48 Table 1.10: Ovarian cancer prevalence, 2001–2007 49 Table 1.11: Leukemia incidence, 2001–2007 59 Table 1.12: Leukemia prevalence, 2001–2007 60 Table 2.13: The global cancer market, 1997–2001 63 Table 2.14: Expected patent expiry on key hormonal therapies 67 Table 2.15: The hormonal therapy market, 1999–2001 68 Table 2.16: The cytotoxics market, 1999–2001 87 Table 2.17: The innovative cancer drug market, 1999–2001 109 Table 2.18: The adjunct therapy market, 1999–2001 128 Table 3.19: Key players in the global cancer market, 1999–2001 142 Table 3.20: BMS’ cancer portfolio, 1999–2001 144 Table 3.21: BMS’ late stage cancer R&D pipeline, 2002 146 Table 3.22: AstraZeneca’s cancer portfolio, 1999–2001 148 Table 3.23: AstraZeneca’s late stage cancer R&D pipeline, 2002 151 Table 3.24: Novartis’ cancer portfolio, 1999–2001 154 Table 3.25: Novartis’ late stage cancer R&D pipeline, 2002 157 Table 3.26: Aventis’ cancer portfolio, 1999–2001 158 Table 3.27: Aventis’ late stage cancer R&D pipeline, 2002 160 Table 3.28: Roche’s cancer portfolio, 1999–2001 162 Table 3.29: Roche’s late stage cancer R&D pipeline, 2002 165 Table 3.30: Pharmacia’s cancer portfolio, 1999–2001 168 Table 3.31: Pharmacia’s late stage cancer R&D pipeline, 2002 170 Table 4.32: Forecast global cancer market, 2001–2007 175 Table 4.33: The hormonal therapy market, 2001–2007 177 Table 4.34: The cytotoxics market, 2001–2007 183 Table 4.35: The innovative therapy market, 2001–2007 192 Table 4.36: The adjunct therapy market, 2001–2007 201