Colorectal Cancer

Pharmacor -- May 2007

  Introduction:

Colorectal cancer (CRC) is the second-leading cause of cancer death in the world. Clear unmet need remains for a novel targeted agent with efficacy and tolerability superior to that of bevacizumab (Genentech/Roche/Chugai’s Avastin) that can increase survival in the adjuvant and metastatic settings.

  Questions Answered in This Report:

Increasing screening rates will result in earlier diagnosis of CRC. This trend, together with more-efficacious adjuvant treatments, will result in fewer patients presenting at or progressing to the metastatic stage. How will this shift affect the numbers of patients available for drug treatment? What impact will these factors have on the size of the market? Which drugs and regimens are going to dominate in the adjuvant setting?

Despite a busy pipeline, only one new agent will launch for CRC during the study period. Which drug will launch? For which patient population will it be used and how will it fair against current biologics?

Thought leaders tell us that the future for drug treatment over the next five years lies in investigating new combinations of existing drugs. Which drugs will be combined to create which regimens and for which patients?

Several major drugs will lose their patent protection and face aggressive generics erosion within our study period. What will be the impact, and what will fill the void?

  Scope:

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.

Primary research: 22 country-specific interviews with thought-leaders.

Epidemiology: Stage I, II, III, and IV colon cancer and stage I, II, III, and IV rectal cancer.

Population segments in market forecast: Stage II and III colon cancer, stage II and III rectal cancer, stage IV first-, second-, and third-line CRC.

Emerging therapies: Phase II: 10 drugs; Phase III: 3 drugs; preregistration: 0 drugs; registered: 0 drugs. Three select preclinical and Phase I products.

Market forecast features: Using a proprietary patient-flow model incorporating mortality, we forecast population sizes and drug sales for all patient segments through 2016.

Alternative market scenarios: (1) panitumumab does not launch in Europe, (2) approval of biogeneric versions of bevacizumab and cetuximab, (3) higher uptake of panitumumab because of its lower price compared with that of cetuximab, (4) final results of CRYSTAL trial are not as compelling as anticipated, (5) primary end points in the NSABP C-08 and AVANT trials are not met, (6) primary end points in the PETACC-8 trial are not met, (7) cediranib demonstrates equivalent or better efficacy and safety compared with bevacizumab in mCRC.