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DATAMONITOR HEALTHCARE CONTACT DETAILS EXECUTIVE SUMMARY Scope Datamonitor insight into the lung cancer market Currently marketed cytotoxics form the mainstay of lung cancer treatment, accounting for $1.2bn of sales and 100% of the lung cancer market in 2001. Despite the patent expiries of key agents between 2001 and 2004, the sales of these cytotoxic drugs will remain stable due to the lack of efficacious alternatives, and the fact that many of the pipeline drugs in development are expected to be used in combination with existing cytotoxics. With newer cytotoxic agents expected to be launched in the next seven years, the whole class will grow steadily and is expected to remain the dominant force in the lung cancer market. Of the three new drug classes expected to enter the lung cancer market in the next seven years, Datamonitor believes that the angiogenesis inhibitor class will achieve the best performance in terms of sales and clinical uptake. In particular, Iressa has generated considerable interest among the medical communities, fueled not only by AstraZeneca’s marketing but also driven by its pre-launch competition with Imclone’s Erbitux. As a result, Datamonitor predicts Iressa to achieve sales of nearly $630m by 2008 and become the main driver of the lung cancer market. The development of gene therapies and immunotherapies was meant to herald a new era in cancer treatment, providing a higher standard of care to patients through high specificity and low toxicity. However, this has not yet been realized and trial results, so far, have been disappointing. As a result, only three drugs in these classes are expected to be launched into the lung cancer market in the next seven years, with each achieving only modest sales. Datamonitor believes that second and third generation immunotherapies and gene therapies are likely to offer improved efficacy and thus achieve higher sales over current products in development. Key metrics TABLE OF CONTENTS DISEASE OVERVIEW Definition of lung cancer Types of lung cancer Non-small cell lung cancer Small cell lung cancer Malignant mesothelioma Classification of lung cancer Current treatment of lung cancer Classification of pipeline drugs Cytotoxic drug class definitions Alkylating agents Antimetabolites Vinca alkaloids and etoposide Other cytotoxics Angiogenesis inhibitors Immunotherapies Gene therapies Clinical endpoints in disease Survival Toxicity Quality of life Response rates Multiple end points Unmet needs in lung cancer Survival Reduced toxicity Metastatic disease Second line therapy Older patients Screening Prevention Cost LUNG CANCER PIPELINE ANALYSIS Pipeline analysis by development strategy Key drug discovery strategies in lung cancer Key R&D protocol strategies in lung cancer Key dug delivery strategies in lung cancer Key licensing strategies in lung cancer Pipeline analysis by class Pipeline analysis by region Pipeline analysis by company type Pipeline analysis by individual company DRUG ANALYSIS Cytotoxics Alimta (pemetrexed disodium) Tirazone (tirapazamine) Navelbine (vinorelbine) Aptosyn (exisulind) DX 8951f (exatecan) BMS 184476 Hycamtin (topotecan) Calsed (amrubicin) Anti-angiogenesis Neovastat Avastin (bevacizumab/ rhuMab VEGF) Iressa (ZD 1839) Gene therapies ISIS 3521 Onconase (ranpirnase) Immunotherapies Mitumomab SRL172 Others Targretin Drugs in phase II development Key phase II drugs Erbitux (Cetuximab/IMC-C225) Squalamine PG-TXL INGN 201 ABX-EGF ET-743 Discontinued pipeline drugs Marimastat Drugs in phase I/II development Drugs in phase I development COMPARATIVE ANALYSIS Comparison by class Survival Toxicity Elderly patients Second-line therapy Marketing factors Comparative analysis of cytotoxic class Comparative analysis of angiogenesis inhibitors Comparative analysis of immunotherapies Comparative analysis of gene therapies FUTURE FOCUS IN LUNG CANCER Market drivers in lung cancer Future trends in the incidence and prevalence of lung cancer Prospective drug launches in lung cancer Launch forecast methodology Forecast launches in lung cancer from 2001 to 2008 Lung cancer market forecast Key trends in the global lung cancer market Key R&D product forecasts APPENDIX Research methodology Global highest stage of development References LIST OF TABLES