Overview
In a market currently valued around US$42 billion, cancer chemotherapies are on course for staggering growth potential and may revolutionize cancer treatments over the next 10 years according to Spectra’s expert cancer report. “The chemotherapy market is currently the fastest growing in the pharmaceutical industry, driven by the explosion of potential therapeutic targets revealed by the molecular genetic assessments of cancer biology and fuelled by the magnitude of the disease worldwide, which shows every indication of increased incidence and sustained mortality rates over the next decade” says report author Dr Sarah Crawford PhD, Director of Experimental Chemotherapy at Southern Connecticut State University, USA and Associate Professor of Biology.
With more than 25 million people affected by cancer globally, and an estimated 5 million people dying each year as a result of cancer, new treatments are clearly needed to curtail these high mortality statistics despite the availability of effective cancer drugs such as Herceptin and Avastin. Dr Crawford cautions however that although there are very exciting and promising novel cancer therapeutics on the horizon with limitless potential, enthusiasm must be tempered by the need to identify those chemotherapy approaches that may have the greatest potential for therapeutic success and suggests that there is a need to distinguish important new entries to the cancer therapeutics market from those therapy approaches that may not fare as well on the world market.
Chemotherapy Market Insights, 2006-2016: A Critical Analysis of Cancer Research, Treatments, Pipelines, and Commercial Opportunities, provides an in-depth assessment and analysis of the global cancer therapy market. Included in this study are critical analyses of key therapeutic areas, epidemiological, aetiological, and healthcare data, R&D programs, and innovating companies and products. The reader will benefit from authoritative critical review, market forecasts to 2016, pooled knowledge of recent industrial activities and events, and from analytical discourse, which is intended to stimulate research and industrial growth, and create new market opportunities.
Report Highlights and Key Findings
- Critical assessment of the challenges to the development of better, more efficacious cancer treatments with fewer side effects
- Analysis of the problems associated with the use of traditional cancer therapeutics, eg. drug resistance, lack of clinical efficacy, side effects
- Focused analysis of the global prevalence of cancer: incidence, mortality and survival rates as they relate to new directions in cancer research
- Identification of the major classes of cancer drugs currently in research and development using the newest technologies and genetic approaches
- Highlights the most successful cancer therapeutics that may serve as prototypes for the research and development of more effective drugs
Table of Contents
Chapter 1. Introduction to Cancer: Epidemiology, Pathophysiology, Diagnosis, and Treatment
Cancer Epidemiology
Global Epidemiology of Cancer
Global Statistics (World Health Organization - WHO)
Cancer Incidence and Mortality by Geographical Regions Worldwide
Cancer Epidemiology, United Kingdom (Office of National Statistics)
Cancer Incidence and Mortality
United Kingdom: Current Incidence Trends
Incidence by Age Group, United Kingdom
Current Mortality Trends in the United Kingdom
Survival Trends for Most Common Cancers in the United Kingdom
Current Cancer Statistics in the United States - American Cancer Society and
Surveillance, Epidemiology and End Results Program (SEER)
Current Incidence and Mortality Rates for the Most Common Cancers in the United States
Current Cancer Estimates in the United States, 2005
Incidence and Mortality Rates by Racial Group, United States
Aetiology, Pathophysiology, and Diagnosis of Cancer by Type: Europe, United Kingdom and United States
Lung Cancer
Aetiology of Lung Cancer
Risk Factors for Lung Cancer
Pathophysiology of Lung Cancer
Diagnosis of Lung Cancer
Treatment of Lung Cancer
Lung Cancer: Outcome
Colorectal Cancer
Aetiology and Pathophysiology
Risk Factors for Colon Cancer
Diagnosis of Colon Cancer
Treatment of Colon Cancer
Colon Cancer: Outcome
Breast Cancer
Aetiology of Breast Cancer
Risk Factors for Breast Cancer
Pathophysiology of Breast Cancer
Diagnosis of Breast Cancer
Treatment of Breast Cancer
Breast Cancer: Outcome
Prostate Cancer
Aetiology of Prostate Cancer
Pathophysiology of Prostate Cancer
Diagnosis of Prostate Cancer
Treatment of Prostate Cancer
Prostate Cancer: Outcome
Incidence and Mortality Rates for Other Common Cancers: Europe, and
North America
Cancer Staging and Grading: Diagnostic and Therapeutic Criteria
Common Solid Tumour Malignancies
Chemotherapy for Leukaemias and Lymphomas: Standard Treatment Options
Leukaemias
Lymphomas
Chapter 2. Drug Development Challenges
Tumour Biology
Important Discoveries in Tumour Biology: Viruses, Genes and Cancer
Cancer Genetics
Towards a Model on the Genetic Origins of Cancer
Pharmacology
Pharmacology of the Important Groups of Chemotherapeutic Drugs Used in the
Treatment of Cancer
Mechanism of Action of Major Groups Chemotherapy Drugs and Treatment Applications
Antimetabolites
Antibiotics
Alkylating Agents
Vinca Alkaloids
Other Alkaloids
Platinum Compounds
Treatment Resistance
General Parameters of Drug Resistance
Pharmacological Parameters of Chemosensitivity - Drug Delivery Applications
Genetic Components of Drug Resistance Mechanisms
Acquired Drug Resistance Mechanisms
Current Biological and Pharmacological Obstacles to the Successful Treatment
of Cancer
Biological Complexity
Pharmacological Challenges
New Research/Technologies
Gene-Targeted Therapeutic Approaches
Angiogenesis
Apoptosis
Application of New Technologies to Chemotherapy Research and Development
Chapter 3. Chemotherapeutic Treatment Options: Clinical Management and Drug Development Issues
Current Chemotherapies
Chemotherapy Treatment Overview
Treatment Options
Clinical Assessment of Solid Tumours
Organ-Specific Chemotherapy
Lung Cancer
Colorectal Cancer
Breast Cancer
Prostate Cancer
Ovarian Cancer
Testicular Cancer
Cancers of Haematopoetic Origin - The Leukaemias
Leukaemias
Hodgkin’s Disease
Non-Hodgkin’s Lymphoma
Chemotherapy Drugs Approved by the United States Food and Drug Administration
Chemotherapy Side Effects
Clinical Treatment Administration Protocols
Chemotherapy Drugs and Market Opportunities
Chemotherapy Drug Reformulation
Novel Drug Delivery Systems
Chapter 4. The Market for Cancer Chemotherapies
The Market for Chemotherapies
The Global Cancer Market: Trends, Estimates, Economics, and Outlook
Cancer Market: Overview
Best-Selling Oncology Products
Pharmaceutical Product Growth in Oncology
Licensing and Chemotherapy Products
Cancer Treatments and Pharmacoeconomics
Critical Factors Affecting the High Pricing of Patented Cancer Drugs
Generic Erosion
High Costs of the New Super Drugs
Healthcare Costs: United States
Prescription Drug Costs and Coverage
Healthcare Reimbursement Issues: United States
Local Community Health Services
Private Sector Health Programs: Managed Care
Healthcare Purchasing Cooperatives: Federal Employers Health Benefits Program
Uninsured Americans
Current Issues in United States Healthcare Policy
Healthcare Policies: United Kingdom
National Health Service/National Institute for Health and Clinical Excellence
Healthcare Policies: United States versus United Kingdom
Healthcare Costs: Europe
Future Trends in the Cancer Market Based on Cancer Incidence
General Assessment of Future Trends in Cancer Therapeutics
Cancer Incidence, Survival and Mortality Rates: General Trends
Future Trends Based on Successful Treatment Approaches
General Considerations
Market Outlook for New Cancer Drugs
Current Chemotherapies: Product Review and Commercial Outlook
Genentech/Roche: Newly Approved Cancer Drug
Avastin
Tarceva
Rituxan
Herceptin
Genentech Bio-Oncology Market Data: 2004-2005
Roche
American Pharmaceutical Partners: Abraxane
MGI Pharma/Guildford Pharmaceuticals: Aloxi/Gliadel Wafer
Sanofi-Aventis: Taxotere/Eloxatin
Pfizer
Aromasin
Other Drugs in Pfizer’s Portfolio
AstraZeneca
Arimidex
Faslodex
Zoladex
Iressa
Novartis
Gleevec
Zometa
Sandostatin
Femara
Schering-Plough
Temodar
Intron A
GlaxoSmithKline
Zofra
Hycamtin
Bexxar
Arranon
Genzyme
Clolar
Thyrogen
Imclone: Erbitux
3M Pharmaceuticals: Aldara
Supportive Therapies
MGI Pharma
Other Support Therapies
Cancer Market Outlook: Summary
Chapter 5. Chemotherapies in Research and Development
General Trends in Global Oncology Markets Considered to Impact Chemotherapies
in Research and Development
Important Therapeutic Areas Targeted for Research and Development
Promising New Oncology Drugs Poised for Market Entry
Therapeutic Clinical Oncology Candidates: Product Review
Cancer Vaccines: Gardasil (Merck) and Cervarix (GlaxoSmithKline)
Sutent – Pfizer
Sorafenib (BAY43-9006) - Bayer/Onyx
Panitumamab - Amgen/Abgenix
Prospective Oncology Drugs in Research and Development: Challenges for
Drug Development
Promising Cancer Drugs in Late-Stage Clinical Trials
GlaxoSmithKline (GSK): Pipeline Products in Late-Stage Development
Tykerb (Lapatinib)
Eltrombopag
Casopitant
Novartis
Femara
PTKZK
Introgen Therapeutics: Advexin
United Therapeutics: OvaRex
GPC Biotech AG: Satraplatin
Cell Therapeutics: Xyotax
NeoPharm: LEP-ETU
Genta Pharmaceuticals: Genasense
SuperGen: Orathecin
Dendreon: Provenge
Bayer: Sorafenib
Promising Oncology Portfolios in Clinical Development
GlaxoSmithKline
Iboctadekin
Vestipitant
Ispenesib
Pazopanib
Relacatib
Elacridar
Novartis
RAD001
Patupilone
PKC412
ST1571
Gimatecan
AMN107
AEE788
INGN225
INGN241
INGN401
Eisai
Phase-III Products
Phase-II Products
Phase-I Products
Abbott Laboratories
Xinlay (Atrasentan)
Merck
SAHA
Promising Biopharmaceutical Oncology Products in Clinical Development
Market Outlook for New Oncology Products in Late-Stage Development
Chapter 6: Cancer Research - Evaluating Drug Development and Market Opportunities
Current Themes and Trends in Cancer Research
Cancer Therapeutic Approaches in Research and Development
Supportive Therapies
Stem Cell Therapy
Immunotherapy
Emerging Biotechnologies
Recombinant Vaccines
Antisense Technology
Humanized Monoclonal Antibodies
Gene Therapy
Nanoparticle Technology
Current Biotechnological Cancer Therapeutic Approaches
Therapeutic Cellular Vaccines
Antigen/Adjuvant Vaccines
Whole Tumour Vaccines
Viral Vectors and DNA Vaccines
Idiotype Vaccines
Dendritophages
Molecular Targets of Therapeutic Vaccines
Therapeutic Vaccines in Clinical Trials
Passive Immunotherapy: Monoclonal Antibodies
Therapeutic Classes of Monoclonal Antibodies
Anti-CD20 Monoclonal Antibodies
Anti-Epidermal Growth Factor Receptor Monoclonal Antibodies
Cell Death Targets
Small Molecule Targeted Anticancer Agents
Promising Small Molecule Therapeutic Targets in Research and Development
Tyrosine Kinase Inhibitors
Heterodimerization Inhibitors
STAT-3 Inhibitors
Cyclin-Dependent Kinase Inhibitors
Apoptosis Inducers
Hypoxia Inducible Factor-1 Pathway
Dipeptidyl Peptidase Inhibitors
Small Molecule Therapies for Cancer Cachexia
Small Molecule Immunostimulatory Agents
Small Molecule Adhesion Targets
Small Molecule Inhibitors: Resistance Mechanisms
New Chemical Entities - Standard Chemotherapy Approaches
New Investigative and Experimental Oncology Products
Novel Oncology Products: Nontargeted Experimental and Investigational Agents
Novel Drug Delivery Approaches in Research and Development
Novel Molecular Tumour Targets in Research and Development
Antisense Therapeutics
Novel Treatment Approaches in Early Preclinical Stages of Development
General Experimental Approaches
Chemopreventive Approaches
Development Outlook for Investigative/Experimental Oncology Products
General Considerations
Comparison of Therapeutic Treatment Modalities
Standard Chemotherapy
Small Molecule Inhibitors
Monoclonal Antibodies
Therapeutic Vaccines
Novel Treatment Delivery Approaches
Antisense Technologies
Chapter 7. Companies Developing Cancer Drugs
Leading Companies and Oncology Pipelines
Leading Multinational Companies and Oncology Products
Roche/Genentech
Novartis
Sanofi-Aventis
AstraZeneca
Eli Lilly
GlaxoSmithKline
Pfizer
Bristol-Myers Squibb
Schering-Plough
Johnson & Johnson
Other Oncology Focused Multinationals with Promising Pipelines
Abbott Laboratories/TAP Pharmaceutical
Merck & Co.
Takeda
Wyeth
Leading Biopharmaceutical Companies and Oncology Therapeutics
Amgen
Genentech
Genzyme
Serono
Medimmune
Chiron
Millennium Pharmaceuticals
Specialty Oncology Drug Discovery and Development Companies
Antigenics
Antisoma
Celgene
Cell Therapeutics
Ecopia Pharmaceutical Company
Helix Biopharma
ImClone Systems
Immunogen
Immusol
Inovio
Kosan Biosciences
MediGene
Milagen
MorphoSys
Myriad Pharmaceuticals
NeoRx
Protherics
Receptor Biologix
Regeneron Pharmaceuticals
Starpharma
Syrrx
U3 Pharma
Vertex Pharmaceuticals
Viventia Biotech
Xoma
Zymo Genetics
Other Discovery and Development Companies Specializing in Oncology Therapeutics
Reference Sources
List of Tables
Table 1.1 Highest Mortality Rates for Common Cancers
Table 1.2 Common Cancers in the United Kingdom Relative to Gender, 2004
Table 1.3 Incidence Trends for the Common Cancers in the United Kingdom (1990-2001)
Table 1.4 Mortality Rates in the United Kingdom, 2003
Table 1.5 Changes in 5- and 10-Year Survival Rates for Common Cancers, United Kingdom (1971-1999 Diagnosis)
Table 1.6 Incidence Rates for Common Cancers in the United States and United Kingdom
Table 1.7 Incidence and Mortality for Most Prevalent Cancer in the United States, 2005 Estimates for Men and Women
Table 1.8 Trends in Cancer Incidence, 2005 (% Total New Cases)
Table 1.9 Incidence, Mortality, Survival Trends, and Risk Factors for 10 Less Common Cancers in the United States
Table 1.10 Chemotherapy Options for Common Solid Tumour Malignancies by Disease Stage
Table 2.1 Viruses Implicated in Human Cancers
Table 2.2 Genes Most Commonly Identified in Human Cancers
Table 2.3 Genes Most Commonly Implicated in Major Human Cancers
Table 2.4 Chemotherapy Drugs Most Commonly Used to Treat Cancer
Table 3.1 General Staging Criteria Relevant to Chemotherapy Treatment Options in Solid Tumour Malignancies
Table 3.2 Chemotherapy Drugs Most Commonly Used to Treat Lung Cancer
Table 3.3 Most Common Treatment Options for Limited Small Cell Lung Carcinoma
Table 3.4 Most Common Treatment Options for Extensive Small Cell Lung Carcinoma
Table 3.5 Less Common Treatment Protocols for Extensive Small Cell Lung Carcinoma
Table 3.6 Most Common Treatment Protocols for Nonsmall Cell Lung Carcinoma
Table 3.7 Experimental Chemotherapy for Advanced Lung Cancer
Table 3.8 Chemotherapy Drugs Most Commonly Used to Treat Colorectal Cancer
Table 3.9 Breast Cancer Chemotherapy Treatment Options
Table 3.10 Hormonal Therapies Used in the Treatment of Advanced Prostate Cancer
Table 3.11 Chemotherapy Drugs Most Commonly Used to Treat Ovarian Cancer
Table 3.12 Second-Line Treatments for Ovarian Cancer
Table 3.13 First-Line Combined Treatment Options for Advanced Ovarian Cancer
Table 3.14 Second-Line Combined Treatment Options for Resistant Ovarian Cancer
Table 3.15 Combined Chemotherapy Treatment Protocols for Acute Myeloid Leukaemia
Table 3.16 Common Drugs Used to Treat Chronic Myeloid Leukaemia
Table 3.17 Standard Treatment Options for Chronic Lymphocytic Leukaemia
Table 3.18 Standard Treatment Options for Hodgkin’s Disease
Table 3.19 Treatment Options for Advanced Low-Grade Non-Hodgkin’s Lymphoma
Table 3.20 Treatment Options for Early-Stage Fast-Growing Non-Hodgkin’s Lymphoma
Table 3.21 Chemotherapy Drugs Approved by the United States Food and Drug Administration
Table 3.22 Drugs Administered to Combat Dose-Limiting Side Effects of Chemotherapy
Table 4.1 Estimated Global Sales (US$) and Forecasts of Leading Cancer Chemotherapies, 2005-2016
Table 4.2 Approximate 2004 Expenditures for Chemotherapy Treatment of the Most Common Cancers Based on Incidence Rates
Table 4.3 Comparative Assessment of Positive Outcomes and Problems in Healthcare Systems, United States/United Kingdom
Table 4.4 Accessibilty Ratings to New Cancer Drugs in Europe by Country
Table 4.5 Global Incidence and Mortality Ratios for the Most Common Cancers by Gender
Table 4.6 Global Incidence of Cancer by Site, Males and Females
Table 4.7 Estimated Percentage of Cancer Cases by Type in Men and Women, United States, 2005
Table 4.8 Predicted Average Lifetime Risk for Developing Cancer in Men and Women, 1999-2001 Estimates
Table 4.9 Five-Year Relative Survival Rates for the Most Common Cancers, United States, 1995-2000
Table 4.10 Comparison of 5-Year Survival Rates (%) for Most Common Cancers Over Three Time Periods, United States
Table 4.11 Death Rates from the Most Common Cancers in Men and Women, United States, 2005 Estimates
Table 4.12 New Anticancer Drugs with Strong Commercial Outlook Based on Clinical Efficacy
Table 5.1 New Drug Application Submissions (Oncology), United States Food and Drug Administration, 2005
Table 5.2 Comparison of Angiogenesis Inhibitors
Table 5.3 Major Projected Competitors: Oncology Drugs for Advanced Colon Cancer that Target Growth Factor Signal Pathways
Table 5.4 Tykerb: Summary of Clinical Trial Studies
Table 5.5 Late-Stage Oncology Products in Clinical Development Grouped by Mechanism of Action
Table 5.6 GlaxoSmithKline’s Portfolio of Oncology Products in Research and Development
Table 5.7 Histone Deacetylase Inhibitors in Clinical Trials, 2006
Table 5.8 Biotechnological Oncology Products in Clinical Development by Clinical Phase
Table 5.9 Top Prospects for Market Success in the Oncology Pipeline
Table 6.1 United States Federal Drug Administration Approved and Investigational Monoclonal Antibody Therapeutics for Cancer
Table 6.2 Small Molecule Cancer Therapeutics in Research and Development by Clinical Phase
Table 6.3 Novel Druggable Tumour Targets in Research and Development
Table 6.4 Antisense Therapeutics in Research and Development
Table 7.1 The Top 50 Global Pharmaceutical Companies (2004 and 2005 Revenues)
Table 7.2 Global Portfolio Revenues and Market Share of Cancer Chemotherapies, 2005 (US$m)
Table 7.3 Roche`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.4 Novartis` Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.5 Sanofi-Aventis` Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.6 AstraZeneca`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.7 Eli Lilly’s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.8 GlaxoSmithKline`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.9 Pfizer`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.10 Bristol-Myers Squibb`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.11 Schering-Plough`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.12 Johnson & Johnson`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.13 Amgen`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.14 Genentech`s Key Chemotherapy Portfolio and Product Sales, 2005 (US$m)
Table 7.15 Additional Discovery and Development Companies Specializing in Oncology Therapeutics
List of Figures
Figure 1.1 Total Cancer Mortality (Age Standardized Rates)
Figure 1.2 Total Cancer Incidence (Age Standardized Rates)
Figure 1.3 Averaged Incidence of the Most Common Cancers in the United Kingdom for Men and Women
Figure 1.4 Incidence and Mortality of the 10 Most Common Cancers in the United States, 2005 Estimates
Figure 1.5 Lung Cancer Incidence (Age Standardized Rates)
Figure 1.6 Colon Cancer Incidence (Age Standardized Rates)
Figure 1.7 Breast Cancer Incidence/Mortality (Age Standardized Rates)
Figure 1.8 Prostate Cancer Incidence/Mortality (Age Standardized Rates)
Figure 1.9 Bladder Cancer Incidence (Age Standardized Rates)
Figure 1.10 Stomach Cancer Incidence (Age Standardized Rates)
Figure 1.11 Cervical Cancer Incidence/Mortality (Age Standardized Rates)
Figure 1.12 Melanoma Incidence (Age Standardized Rates)
Figure 1.13 Larynx Cancer Incidence (Age Standardized Rates)
Figure 1.14 Hodgkin’s Disease Incidence (Age Standardized Rates)
Figure 1.15 Non-Hodgkin’s Lymphoma Incidence (Age Standardized Rates)
Figure 1.16 Ovarian Cancer Incidence/Mortality (Age Standardized Rates)
Figure 1.17 Chemotherapy Regimens Used to Treat Non-Hodgkin’s Lymphoma
Figure 2.1 Origins of Chemotherapy Resistance
Figure 2.2 Pharmacological Parameters of Drug Resistance
Figure 2.3 Proliferative Cell Cycle: Genes and Drug Targets
Figure 3.1 Factors Associated with Successful Chemotherapy Outcome
Figure 4.1 Best-Selling Chemotherapies, 2005 (US$m)
Figure 4.2 Market Share of the Top 10 Cancer Chemotherapies, 2005 & 2010
Figure 4.3 Growth Rates of Best-Selling Cancer Chemotherapy Drugs, 2005
Figure 4.4 Total Healthcare Costs: % Gross Domestic Product (GDP) by Country (2002)
Figure 4.5 Key Parameters of Cancer Drug Market
Figure 5.1 Therapeutic Classes of Oncology Drugs in the Product Pipeline
Figure 6.1 General Clinical Research Areas in Cancer Therapeutics
Figure 6.2 General Categories Of Therapeutic Enhancement Approaches
Figure 6.3 Biotechnology Approaches to Cancer Therapeutic Research and Development
Figure 6.4 Types of Therapeutic Cancer Vaccines in Clinical Research and Development
Figure 6.5 Tumour Antigen Targets Used in the Development of Therapeutic Cancer Vaccines
Figure 6.6 Monoclonal Antibody Therapeutic Targets
Figure 6.7 Small Molecule Therapy Targets
Figure 6.8 Combined Chemotherapy Treatment Possibilities
Figure 6.9 Cell Targets of Experimental Cancer Therapeutics: Drugs and Delivery Mode
Figure 7.1 Leading Oncology Companies by Chemotherapy Portfolio Revenues, 2005 (US$m)
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