Introduction:
With a five-year survival rate of less than 5%, pancreatic
cancer (PC) is one of the most lethal carcinomas. In a drug development
pipeline characterized by a paucity of late-stage drugs, immunotherapies, in
particular vaccines, offer the most promise of improving survival rates in the
short- to medium-term, while epidermal growth factor receptor (EGFR) inhibitors
may bolster combination therapy regimens. Most of the emerging therapies in
development for advanced PC are being investigated in combination with agents
already approved for use in PC--primarily gemcitabine (Eli Lilly’s Gemzar).
Given the severity of disease, oncologists are desperate for a novel therapy
that can demonstrate a significant increase in patient survival. Addressing
this area of unmet need could mean significant earnings for a new therapy.
Questions Answered in This Report:
*
A drug’s performance on at least three efficacy end points,
including overall survival and progression free survival, is important for drug
approval and physician use.
What are the key primary and secondary clinical
trial end points with which new therapies are evaluated? How do oncologists
weight efficacy measures and other drug attributes in their prescribing
decisions for advanced pancreatic cancer?
*
Despite the potential launch of several emerging therapies
in the advanced pancreatic cancer market over the next ten years,
gemcitabine/erlotinib will remain the gold standard therapy in our drug
comparator model.
On what clinical attributes is gemcitabine/erlotinib most
differentiated from its competitors? What are the weaknesses of this therapy
upon which emerging therapies can capitalize? Which emerging therapies, if any,
pose the great threat to gemcitabine/erlotinib as well as the other key current
therapies?
*
The gemcitabine (Eli Lilly’s Gemzar) plus oxaliplatin
(Sanofi-Aventis’s Eloxatin/Eloxatine, Yakult’s Elplat, generics) regimen is the
2006 major-market sales leader for advanced pancreatic cancer.
How will gemcitabine
plus oxaliplatin and other current regimens fare against emerging therapies?
Will emerging therapies offer improvements in the efficacy end points and drug
attributes that are most influential in physician prescribing decisions? If so,
which drugs will suffer the most from entry of these new agents?Scope:
Key drug development opportunity tested in our target
product profiles for advanced pancreatic cancer: An emerging therapy that improves
median overall survival better than the gemcitabine plus erlotinib regimen for
the treatment of advanced pancreatic cancer.
Physicians surveyed for this study: 63 U.S. oncologists.
Comprehensive List of Therapies Included in Our Research and
Modeling
Current therapies:
- Gemcitabine/oxaliplatin (Eli Lilly’s Gemzar)/(Sanofi-Aventis’s Eloxatin; Yakult Honsha’s Elplat)
- Gemcitabine standard dose (Eli Lilly’s Gemzar)
- Gemcitabine/erlotinib (Eli Lilly’s Gemzar)/(Genentech/OSI/Roche/Chugai’s Tarceva)
- Gemcitabine/cisplatin (Eli Lilly’s Gemzar)/(Bristol-Myers Squibb’s Platinol-AQ, generics).
- Gemcitabine/capecitabine (Eli Lilly’s Gemzar)/(Roche/Chugai’s Xeloda)
Emerging therapies:
- GV-1001 (Pharmexa)
- GVAX (Cell Genesys)
- Irinotecan (Pfizer/Yakult’s Campto/Camptosar, Daiichi Sankyo’s Topotecin)
About DecisionBase
Pancreatic Cancer (Advanced): Physicians Desperate for a
Drug that Shows a Significant Increase in Survival is a DecisionBase 2008 study
from Decision Resources. DecisionBase 2008 combines market forecasts with
clinical and commercial end points to assess market share projections in 35
indications. These outputs are driven by quantitative and qualitative primary
research. DecisionBase 2008 provides detailed market share, patient share, and
price-per-day projections for emerging drugs in development. The market share
projections are based on prescriber surveys that compare physicians’
expectations of a potential target product profile with an emerging product
profile of the leading drugs in development.