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EXECUTIVE SUMMARY Scope Datamonitor insight into the lung cancer market In Europe, and particularly in the UK, under-referral is a common and important factor limiting the patient potential of lung cancer pharmacotherapeutics. Companies must devise more physician- and patient-based initiatives to encourage referral to oncologists. Irinotecan in combination with cisplatin will become the first line gold standard treatment regimen for SCLC, and possibly NSCLC, in Japan within the next two years. In Western markets, irinotecan is likely to supplant topotecan as the standard second line therapy of lung cancer. Its use as a component of first line therapy is the subject of much interest and debate within the scientific and prescribing community. The use of BMS’ paclitaxel in NSCLC within Europe has been limited by its toxicity and high price point. Furthermore, physicians regard paclitaxel’s rival, Aventis’ docetaxel as the only cytotoxic likely to change prescribing habits, should it gain approval for the treatment of first line NSCLC. However, the imminent arrival of cheaper, generic alternatives of paclitaxel will reduce physicians’ concerns over cost, whereas docetaxel’s patented price point will remain prohibitive. Nevertheless, Datamonitor believes docetaxel’s sales will benefit considerably from incoming trial data, if intelligently marketed. Physicians’ interest in new and innovative products, such as AstraZeneca’s Iressa, for the treatment of lung cancer, is high. Principally, physicians believe that such therapies, having such specific modalities, are best used in combination with established, broad-acting cytotoxics. Thus, for companies with aging products, data supporting the use of dual innovative/conventional drug regimes should be a research focus, if older cytotoxics are to remain competitive as lung cancer therapy moves into the age of innovation. Key metrics COMPARATIVE ANALYSIS The Lungs The types of lung cancers Risk factors Smoking Radon Asbestos Pollution Lung disease Genetic predisposition Diagnosis and staging of lung cancer The symptoms of lung cancer The diagnosis of lung cancer Patient segmentation by tumor type Staging of lung cancer Patient segmentation by disease stage Treatment of lung cancer Treatment of SCLC Treatment of NSCLC US MARKET Introduction Key findings Treatment trees Treatment of lung cancer in the US Treatment of SCLC in the US Second line treatment of SCLC in the US Treatment of NSCLC in the US Second line treatment of NSCLC in the US Follow up treatment for lung cancer in the US Drug therapy regimens Changing prescribing decisions in the US Drug therapy side effects Unmet need in lung cancer treatment in the US JAPANESE MARKET Introduction Key findings Treatment Trees Treatment of lung cancer in Japan Treatment of SCLC in Japan Second line treatment of SCLC in Japan Treatment of NSCLC in Japan Second line treatment of NSCLC in Japan Follow up treatment for lung cancer in Japan Drug therapy regimens Changing prescribing decisions in Japan Drug therapy side effects Unmet need in lung cancer treatment in Japan FRENCH MARKET Introduction Key findings Treatment Trees Treatment of lung cancer in France Treatment of SCLC in France Second line treatment of SCLC in France Treatment of NSCLC in France Second line treatment of NSCLC in France Follow up treatment for lung cancer in France Drug therapy regimens Changing prescribing decisions in France Drug therapy side effects Unmet need in lung cancer treatment in France GERMAN MARKET Introduction Key findings Treatment Trees Treatment of lung cancer in Germany Treatment of SCLC in Germany Second line treatment of SCLC in Germany Treatment of NSCLC in Germany Second line treatment of NSCLC in Germany Follow up treatment for lung cancer in Germany Drug therapy regimens Changing prescribing decisions in Germany Drug therapy side effects Unmet need in lung cancer treatment in Germany ITALIAN MARKET Introduction Key findings Treatment Trees Treatment of lung cancer in Italy Treatment of SCLC in Italy Second line treatment of SCLC in Italy Treatment of NSCLC in Italy Second line treatment of NSCLC in Italy Follow up treatment for lung cancer in Italy Drug therapy regimens Changing prescribing decisions in Italy Drug therapy side effects Unmet need in lung cancer treatment in Italy SPANISH MARKET Introduction Key findings Treatment Trees Treatment of lung cancer in Spain Treatment of SCLC in Spain Second line treatment of SCLC in Spain Treatment of NSCLC in Spain Second line treatment of NSCLC in Spain Follow up treatment for lung cancer in Spain Drug therapy regimens Changing prescribing decisions in Spain Drug therapy side effects Unmet need in lung cancer treatment in Spain UK MARKET Introduction Key findings Treatment Trees Treatment of lung cancer in the UK Treatment of SCLC in the UK Second line treatment of SCLC in the UK Treatment of NSCLC in the UK Second line treatment of NSCLC in the UK Follow up treatment for lung cancer in the UK Drug therapy regimens Changing prescribing decisions in the UK Drug therapy side effects Unmet need in lung cancer treatment in the UK DRUG TREATMENT DATA Introduction US drug treatment data US drug treatment data for NSCLC US drug treatment data for SCLC Japanese drug treatment data Japanese drug treatment data for NSCLC Japanese treatment data for SCLC French drug treatment data French drug treatment data for NSCLC French drug treatment data for SCLC German drug treatment data German drug treatment data for NSCLC German drug treatment data for SCLC Italian drug treatment data Italian drug treatment data for NSCLC Italian drug treatment data for SCLC Spanish drug treatment data Spanish drug treatment data for NSCLC Spanish drug treatnment data for SCLC UK drug treatment data UK drug treatment data for NSCLC UK drug treatment data for SCLC APPENDIX Datamonitor’s Cancer Business Unit Contributing experts Table of Tables Table of figures Bibliography Physician research methodology Introduction Hypothesis formulation Physician recruitment Hypothesis testing Validation and quality control Epidemiological Data Glossary Questionnaire How to contact experts in your industry