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Bladder Cancer - High Recurrence Rates, Targeted Therapy to Stem the Flow?


Description: Introduction


The incidence of bladder cancer is set to increase by 11% in the seven major pharmaceutical markets between 2004 and 2012. Current therapy yields notable response rates yet 80% of patients with superficial bladder cancer will relapse and there has been no advance in patient survival in the last decade. This brief examines current treatment issues and future directions in the bladder cancer market.





Scope


Overview of disease including epidemiology, biology of bladder cancer, staging and prognostic variables


Current treatment options and clinical controversies


Key recommendations in the areas of greatest unmet need, including superficial and invasive bladder cancer


Profiles of key bladder cancer agents in late-stage development. Opinions from key bladder cancer specialists


Highlights


There have been no improvements in patient survival over the last decade. In the setting of advanced disease combination regimens using Eli Lillys Gemzar are set to replace the current gold standard M-VAC, but this is likely to be due to an improved toxicity profile rather than increased efficacy.





We believe that the integration of new, targeted therapies in combination with chemotherapy may hold promise for preventing the progression to invasive bladder cancer. The most appropriate combination remains to be defined.





Optimal treatment will be dependant on an accurate assessment of disease prognosis. Thus the development of molecular markers which can predict patients at greatest risk of progression will be pivotal to improving patient survival.





Reasons to Purchase


Identify future market opportunities by examining current unmet needs and how current therapy fails to improve survival for bladder cancer patients


Understand the epidemiology and current clinical treatments in bladder cancer


Plan new product development based on an understanding of physician expectation of molecular- targeted therapy for bladder cancer


Contents: TABLE OF CONTENTS
Key findings 6
CHAPTER 1 INTRODUCTION 8
Epidemiology 9
Risk factors 10
Symptoms 12
Diagnosis 13
CHAPTER 2 TREATMENT AND PROGNOSIS BY STAGE 14
Staging and grading 14
Staging 14
Grading 15
Treatment and prognosis by stage 15
Stage 0 (T0a, N0, M0) 16
Stage 0is (Tis, N0, M0) 17
Stage I (T1 N0 M0) 18
Stage II (T2a, N0, M0; T2b, N0, M0) 19
Stage III (T3a, N0, M0; T3b, N0, M0; T4a, N0; M0) 20
Stage IV (T4b, N0, M0; Any T, N1, M0; Any T, N2, M0: Any T, N3, M0: Any T, Any N, M1) 21
CHAPTER 3 CURRENTLY USED DRUG REGIMES 22
Therapeutic BCG 22
Therapy for patients refractory to BCG 24
Chemotherapy agents used for intravesical chemotherapy 26
Combination therapy for invasive bladder cancer 29
CHAPTER 4 UNMET NEEDS 32
Major challenges in superficial bladder cancer 32
Major challenges in invasive bladder cancer 33
Agents with increased tolerability 33
Clinical trial design 34
CHAPTER 5 PIPELINE PRODUCTS AND NOVEL THERAPIES IN BLADDER CANCER 36
Phase III trials 39
Gemcitabine 39
Celecoxib 44
Mycobacterium cell-wall complex (MCC) 46
Modified KLH 47
Phase II trials 48
Alimta (pemetrexed disodium) 48
Targeted therapy in bladder cancer 49
Iressa (gefitinib) 49
Erbitux (cetuximab) 51
Tarceva (erlotinib) 51
Other novel therapies in bladder cancer 53
Velcade (bortezomib) 53
APPENDIX 55
References 55




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Bladder Cancer - High Recurrence Rates, Targeted Therapy to Stem the Flow?
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