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Cancer Drug Discoveries: What the Future Holds: Non-Small Cell Lung Cancer Chapter


Description: Non-small cell lung cancer (NSCLC) is one of the leading causes of death, resulting in the worst survival rates for all cancers and killing more patients than breast, colon and prostate cancer together, accounting for nearly 30% of all cancer deaths. According to the WHO, NSCLC affects more than 1.2 million patients a year, with around 1.1 million deaths annually and around 500,000 in the US, Europe and Japan.

The NSCLC market was estimated to be worth US$3.7 billion in 2006 with a growth rate of 14% YoY. According to PhRMA it is one of the most actively researched cancers with nearly 100 drugs in the US being evaluated in clinical trials during 2006.

As researchers begin to understand the processes involved in NSCLC formation several new targeted therapies have evolved which modulate growth factor pathways. Two small-molecular tyrosine kinase inhibitors, Iressa (AstraZeneca) and Tarceva (Roche/Genentech/OSI Pharmaceuticals), and the anti-angiogenic vascular endothelial growth factor inhibitor, Avastin (Roche/Genentech/Chugai), are gaining credence in third-line therapy and are beginning to migrate to second-line therapy.

By 2012, we anticipate at least four new chemotherapeutic agents will be launched including sanofi-aventis’ Eloxatin, Hana Biosciences’ Talvesta, Cell Therapeutics/Novartis’ Xyotax and AstraZeneca/Abraxis BioScience's Abraxane. These may have been approved to be used in combination with existing treatment protocols and in some cases may replace older products.

Key questions answered include:
The addressable NSCLC market will increase by 17% by 2012 – what are the factors driving this?
By 2012, products yet to be launched will account for over 50% of global NSCLC drug sales. What are they, who’s developing them and when are they expected to launch?
What are the prospects for CancerVax, Biomira, Alfacell, Transgene and others in the hotly contested NSCLC vaccine market?
How will the newer cytotoxics such as Eloxatin (sanofi-aventis) and satraplatin (GPC Biotech/ Pharmion/Spectrum Pharmaceuticals) fare against currently available therapies?
CURRENT PRODUCTS EVALUATED AND FORECAST
CHEMOTHERAPY
Taxotere (sanofi-aventis)
Taxol (BMS)
Navelbine (GSK)
Gemzar (Eli Lilly)
Alimta (Eli Lilly)

TARGETED THERAPIES
Iressa (AstraZeneca)
Tarceva (Roche/Genentech)
Avastin (Roche/Genentech/Chugai)

UP AND COMING PRODUCTS EVALUATED
PHASE III
Recentin (AstraZeneca)
Eloxatin (sanofi-aventis)
Erbitux (BMS/Merck Serono/ImClone Systems)
PF-3,512,676 (Pfizer/Coley Pharmaceutical)
Stimuvax (Merck Serono/ Biomira)
Talabostat (Point Therapeutics)
Xyotax (Novartis/Chugai/Cell Therapeutics)
Zactima (AstraZeneca)

PHASE II
Abraxane (AstraZeneca/
Abraxis BioScience)
EP-2101 (IDM Pharma)
Matuzumab (Merck Serono/ Takeda)
Onconase (Alfacell)
Satraplatin (GPC Biotech/Pharmion/Spectrum Pharmaceuticals)
Talvesta (Hana Biosciences)
TG4010 (Transgene)
¨ Velcade (J&J/Millennium Pharmaceuticals).


Contents: NON-SMALL CELL LUNG CANCER
EXECUTIVE SUMMARY

THE FACTS
What is NSCLC and how does it affect patients?
Figure 41: Schematic of the Lung
Stages of the disease
Table 41: Stages of NSCLC and Survival Rates
PATIENT STATISTICS
Incidence, diagnosis rates and treatment; now and in the future
Figure 42: Estimates New Cancer Deaths (2006E)*
Table 42: European prevalence of NSCLC
Table 43: Japanese prevalence of NSCLC
PATIENT MODEL
The addressable NSCLC market will increase by 15% by 2012
Table 44: Summary of Global NSCLC Patient Population Forecasts In Top 7 Countries (2005A-2012E)
Figure 43: Tobacco Use in the US 1900-2002
DRUG GROWTH DRIVERS
DRUG GROWTH RISKS/DAMPENERS

GLOBAL CANCER MARKET
Figure 46: Global Cancer Drug Sales (including Supportive Care) in 2006 (US$472 billion)
Figure 47: Global Cancer Sales 2004A-2012E

THE NSCLC MARKET
GLOBAL NSCLC SALES SPLIT
Figure 48: Global NSCLC Market By Region (2006)
Figure 49: Global NSCLC Market By Therapy Class (2006)
Figure 410: Global NSCLC Market by Region (2012E)
Figure 411: Global NSCLC Market by Therapy Class (2012E)
US market
Figure 412: NSCLC US Drugs Sales Split (2006)
European market
Figure 413: NSCLC European Drugs Sales Split (2006)
Japanese market
Figure 414: NSCLC Japanese Drugs Sales Split (2006)
THE PLAYERS
Figure 415: Market Share of NSCLC Players By Sales (2006)
Players and Products in 2006
Players and products in 2012
CURRENT TREATMENTS
SURGERY
RADIATION
CHEMOTHERAPY
Table 45: Standard NSCLC therapy
Table 46: Platinum-Based Regimens
Table 47: FDA-Approved Regimens for Advanced NSCLC
Table 48: Doublet Regimens
Leading Brands
Current Products’ Patent Exposure
Table 49: Patent Exposure of Leading Brands
ANALYSIS OF LEADING BRANDS
Chemotherapies
Taxotere (sanofi-aventis)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Figure 417: Summary of pivotal clinical trial data with Taxotere
Figure 418: TAX317 Survival Kaplan-Meier Curves – Taxotere 75mg/m2 vs Best Supportive Care
Figure 419: TAX320 Survival Kaplan-Meier Curves – Taxotere 75mg/m2 vs Vinorelbine or Ifosfamide Control
Figure 420: Taxotere-treated patients as % of patient potential (Top 7)
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Taxol (Bristol-Myers Squibb)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Figure 420: Efficacy Parameters in Phase III Trials
Management/clinical expertise
Figure 421: BMS Developmental Product Pipeline
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Navelbine (GlaxoSmithKline)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Gemzar (Eli Lilly)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Alimta (Eli Lilly)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Novel Targeted Therapies
Targeting EGFR
Figure 424: EGFR Signal Transduction in Tumour Cells
Table 410: EGFR Expression In Solid Tumours
Targeting VEGF
Figure 425: Angiogenesis is the Formation of New Blood Vessels
Figure 426: Agents Targeting the VEGF Pathway
Current Products Patent Exposure
Table 411: Patent Exposure of Leading Brands
ANALYSIS OF LEADING BRANDS
Novel targeted therapies
Iressa (AstraZeneca)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Table 412: Clinical Development of Iressa
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Tarceva (Roche/Genentech/OSI Pharmaceuticals)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Figure 427: Tarceva Lung Cancer Development Programme
Figure 428: Key Combination Targeted Therapy Programmes
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Table 413: Tarceva Filings and Indications
Sales forecasts and assumptions
Competitor Ratio Analysis
Avastin (Roche/Genentech/Chugai)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Figure 429: Avastin Lung Cancer Development Programme
Figure 430: Key Combination Targeted Therapy Programmes
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Table 414: Proposed Filing of New Indication for Avastin
Sales forecasts and assumptions
Competitor Ratio Analysis
Sales Forecast of Current NSCLC Drugs
Table 415: Global NSCLC Sales of New Products 2005A-2012E (US$ millions)

RESEARCH & DEVELOPMENT OF NSCLC DRUGS
Figure 431: 2006 Survey: Medicines in Development for Cancer
Table 415: Products in Clinical Development for the Treatment of NSCLC
ANALYSIS OF PHASE III DRUGS
Table 416: New Drugs in Phase III Development to Treat NSCLC
Recentin (AstraZeneca)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Eloxatin (sanofi-aventis)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Erbitux (Bristol-Myers Squibb/Merck Serono/ImClone Systems)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Table 417: Clnical developmental programme for Erbitux
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
PF-3,512,676 (Pfizer/Coley Pharmaceutical)
Novelty/rationale for mechanism of action
Figure 432: PF-3,512,676 Mechanism of Action Through TLR Modulation
Proof of concept/clinical data
Figure 433: Survival benefit of TLR-9 monotherapy in NSCLC
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Stimuvax (Merck Serono/Biomira)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Talabostat (Point Therapeutics)
Novelty/rationale for mechanism of action
Figure 434: Schematic of Talabostat’s mechanism of action
Proof of concept/clinical data
Figure 435: Point Therapeutics Pipeline December 2006
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Xyotax (Novartis/Chugai/Cell Therapeutics)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Zactima (AstraZeneca)
Novelty/rationale for mechanism of action
Figure 436: Zactima’s Triple Mechanism of Action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Figure 437: Schematic of Zactima’s Pivotal Trial Programme 2006-2008
Sales forecasts and assumptions
Competitor Ratio Analysis
Another Phase III drug of interest
Telcyta (Telik)
GLOBAL SALES FORECASTS OF PHASE III NSCLC DRUGS 2006E – 2012E
Table 418: Sales Forecasts of Phase III Developmental NSCLC Drugs (US$ million)
Model assumptions
ANALYSIS OF PHASE II DRUGS
Table 419: New Drugs in Phase II Development to Treat NSCLC
Abraxane (AstraZeneca/Abraxis BioScience)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
EP-2101 (IDM Pharma)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Matuzumab (Merck Serono/Takeda)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Onconase (Alfacell)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Satraplatin (GPC Biotech/Pharmion/Spectrum Pharmaceuticals)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Talvesta (Hana Biosciences)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Figure 438: Talvesta’s Developmental Status
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions numbers are the same as last time
Competitor Ratio Analysis
TG 4010 (Transgene)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Figure 439: Transgene Product Pipeline
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Figure 440: TG 4010 Development Timeline
Sales forecasts and assumptions
Competitor Ratio Analysis
Velcade (Johnson & Johnson/Millennium Pharmaceuticals)
Novelty/rationale for mechanism of action
Proof of concept/clinical data
Management/clinical expertise
Competition within the marketplace/gaining share of voice
Risks associated with developing a drug within a therapeutic class
Filings and approval
Sales forecasts and assumptions
Competitor Ratio Analysis
Other Interesting Phase II Drugs
Asentar (sanofi-aventis/Novacea)
Phase I/II
Axitinib (Pfizer)
HGS-ETR2 (Human Genome Sciences Inc/Cambridge Antibody Technology)
Phase I/II
Ispinesib (Cytokinetics/GlaxoSmithKline)
KRX-0401 (Keryx Oncology/AEterna Zentaris)
Phase I/II
LEP-ETU (NeoPharm)
MAGE-A3 vaccine (GlaxoSmithKline)
Nexavar (Bayer Schering Pharma/Onyx Pharmaceuticals)
Phase I/II
Omnitarg (Roche/Genentech/Chugai Pharmaceutical)
Triapine (Vion Pharmaceuticals)
Phase I/II
Targretin (Ligand Pharmaceuticals)
Torisel (Wyeth)
GLOBAL SALES FORECASTS OF PHASE II NSCLC DRUGS 2006A – 2012E
Table 420: Sales Forecasts of Phase II Developmental NSCLC Drugs (US$ millions)
Model assumptions
Sales Forecast of New NSCLC Drugs
Table 421: Global NSCLC Sales of New Products 2006A-2012E (US$ millions)
COMPETITOR RATIO ANALYSIS - PRODUCTS
Table 422: Rating Score for Clinical Rating
Figure 441: CR Analysis of NSCLC Agents Approved by 2012 – Based on Drug Class
COMPETITOR RATIO ANALYSIS - COMPANIES
Figure 442: CR Analysis of NSCLC Agents Approved by 2012 – Based on Company
WINNERS & LOSERS
Table 423: Summary of Key Companies and Drugs in the NSCLC Market by 2012
Winners (alphabetical)
Losers
DISCONTINUATION OF NSCLC DRUGS
Table 424: NSCLC Drugs Discontinued During Development
Appendix 1
Patient Model
Table 425: Summary of US NSCLC Patient Population Forecasts
Appendix 2
Patient Model
Table 426: Summary of Europe (Top 5) NSCLC Patient Population Forecasts
Appendix 3
Patient Model
Table 427: Summary of Japan NSCLC Patient Population Forecasts
Appendix 41
Table 428: Global NSCLC Drugs Sales 2005A-20012E
APPENDIX 5
Phase transition probability
Table 429: Probability of Launch
Appendix 6
Competitor Ratio Analysis Criteria
Table 430: Key NSCLC Drugs on the Market by 2012
BIBLIOGRAPHY
GLOSSARY
Acronyms
Table of Contents


Summary: Lung cancer affects more than 1.2 million patients a year, with around 1.1 million deaths annually and 500,000 in the US, Europe and Japan. Find out more about market developments in this chapter of Cancer Drug Discoveries.




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