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Companion Diagnostics in Personalized Medicine and Cancer Therapy


Publication Date   April 2008
Publisher   TriMark Publications
Product Type   Report
Pages   190
ISBN Number   not applicable
Product Code   TRI083
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Summary


A near-term market opportunity for cancer companion diagnostic tests exists in drug selection for cancer therapy. Co-development of molecular diagnostics and targeted therapeutics has already been proven to be a successful strategy in the development of novel anti-cancer drugs. Adoption of biomarker development in clinical research provides great opportunities to identify patient subpopulations with differential drug responses and to uncover the underlying mechanisms. These data could help to explain if clinical trials of new drugs are adequate, and offer the possibility of creating a clear prescription path based on predictive biomarkers. The purpose of this TriMark Publications report is to describe the specific segment of the diagnostics market that develops new technology platforms for evaluating the metabolism of therapeutic agents, or for evaluating which therapeutic regimes are most effective for a particular type of disease. The term companion diagnostic means that the particular diagnostic test under evaluation is specifically linked to a known therapeutic drug. This linkage could be important in the therapeutic application and clinical outcome of a drug (personalized medicine), or an important component of the drug development process. This report focuses on the former linkage, i.e., the use of companion diagnostic tests in personalized medicine.

Content


  • 1 Overview
    • 1.1 Statement of Report
    • 1.2 About This Report
    • 1.3 Scope of the Report
    • 1.4 Objectives
    • 1.5 Methodology
    • 1.6 Executive Summary
  • 2 Companion Diagnostics and Personalized Medicine
    • 2.1 Scope of this Section
    • 2.2 Introduction to Companion Diagnostics and Personalized Medicine
    • 2.3 Drug Metabolism and Companion Diagnostics and Personalized Medicine
    • 2.4 Examples of Personalized Medicine and Companion Diagnostic Tests
    • 2.5 Personalized Medicine and Companion Diagnostic Testing Product Pipeline
    • 2.6 The Personalized Medicine Coalition (PMC)
    • 2.7 Regulatory Trends and Guidelines in the Personalized Medicine Space
      • 2.7.1 The Changing Regulatory Landscape for Personalized Medicine
    • 2.8 Companion Diagnostics Play an Increasing Role in Cancer Care
    • 2.9 Specific Examples of Clinical Situations Where Companion Diagnostics Are Being Deployed
      • 2.9.1 Epidermal Growth Factor Receptor (EGFR) Assay
      • 2.9.2 Individualized Warfarin Therapy
      • 2.9.3 UGT1A1 Molecular Assay for Camptosar
      • 2.9.4 Response to Gleevec in GIST
      • 2.9.5 LabCorp, ARCA Personalized Medicine Deal for Cardiovascular Diseases
      • 2.9.6 Osmetech Licenses Epidauros Biotechnologie AG CYP2D6 Biomarker to Enter Companion Diagnostics
    • 2.10 Diagnostic Tests for Personalized Analysis of Cancer Therapy Effectiveness
  • 3 Companion Diagnostics: Qualitative and Quantitative Market Analysis
    • 3.1 Market Analysis of Molecular Diagnostics and Companion Diagnostics
    • 3.2 Costs of Companion Diagnostics in Healthcare Expenditures
    • 3.3 Molecular Diagnostic Market
    • 3.4 Molecular Diagnostics Technology Platforms and Their Impact on Clinical Medicine
    • 3.5 Snapshot of Companion Diagnostics Industry Structure
    • 3.6 The Case for Theranostics
    • 3.7 Companion Diagnostics Market Analysis-Market Survey Data Characterizing the Qualitative and Quantitative Industry Parameters
  • 4 Trends and Overview
    • 4.1 Companion Diagnostics: Industry SWOT Analysis
    • 4.2 Macro Trends in Companion Diagnostics
    • 4.3 Challenges for Companion Diagnostics Development
    • 4.4 Timeline for Impact of Various Segments in Companion Diagnostics
    • 4.5 Use of Proteomics to Develop Individualized Tests
    • 4.6 The Market Problem: Finding Value with Diagnostics for Personalized Medicine
  • 5 Biomarker Tests Co-developed with Cancer Therapeutics as Companion Diagnostics
    • 5.1 Sector Overview
      • 5.1.1 Impact of New Technology Platforms
      • 5.1.2 Impact on Drug Discovery
      • 5.1.3 Biomarkers as Endpoints in Drug Discovery
      • 5.1.4 Targeted Therapy
    • 5.2 Companion Diagnostics on the Market
    • 5.3 Epidermal Growth Factor Receptor Companions
      • 5.3.1 Bevacizamab (Avastin)
      • 5.3.2 EGFR for Colorectal Cancer and Camptosar (Irinotecan)
      • 5.3.3 EGFR Express and Erbitux (Cetuximab)
      • 5.3.4 HER2 and Heceptin (Trastuzumab)
      • 5.3.5 Irressa and Tarceva Companion Test
      • 5.3.6 Tykerb (GSK), and Vectibix (Amgen) Companion Tests
      • 5.3.7 EGFRx Assay
      • 5.3.8 Monogram eTag
      • 5.3.9 Veripath OncoDiagnostics EGFR PharmDX
    • 5.4 Myriad's TheraGuide 5-FU
    • 5.5 Companions for Tyrosine Kinase Inhibitors: Erlotinib and Gefitinib
      • 5.5.1 TheraScreen: EGFR29
      • 5.5.2 The K-RAS Mutation Detection Kit
    • 5.6 Irinotecan and UGT1A1
    • 5.7 Gleevec (Imatinib) Companions
      • 5.7.1 DakoCytomation's c-Kit (9.7) pharmDx
    • 5.8 Companion Diagnostics Involving Metabolizing Enzymes
      • 5.8.1 Companions for TMPT, CYP2C9, and UGT1A1 Enzymes
      • 5.8.2 Companions for Aromatase Inhibitors
      • 5.8.3 Companions for Actos and Avandia
    • 5.9 Drivers and Barriers to Companion Diagnostics
    • 5.10 Partnerships with Pharma Companies to Identify Therapeutic Targets
    • 5.11 Circulating Tumor Cell Assay: Prognostic and Predictive Factors for Breast Cancer
    • 5.12 Companion Diagnostics Used by Clinical Service Laboratories
    • 5.13 New Technologies and Products under Development
      • 5.13.1 OncoMethylome
    • 5.14 Blood-Based Technologies
      • 5.14.1 Oncotech
    • 5.15 Monogram Biosciences HIV Personalized Plaftorm
    • 5.16 Wako LBAAFP Test for Liver Cancer
    • 5.17 Future Developments for Companion Diagnostics
  • 6 Business and Regulatory Trends in the Companion Biomarker Testing Sector
    • 6.1 Industry Consolidation
    • 6.2 Breath of Product Offering and Pricing
    • 6.3 Government Regulation of Medical Devices
      • 6.3.1 FDA Guidance on Drug Test Co-development
      • 6.3.2 Device Classes
      • 6.3.3 Investigational Use of IVDM Assays
      • 6.3.4 Post-market Requirements
    • 6.4 Strategic Business and Marketing Considerations
    • 6.5 Commercial Opportunities in Companion Markers
    • 6.6 Moderators of Growth
      • 6.6.1 Roadblocks to Integrating Companion Biomarkers into Clinical Practice
      • 6.6.2 Management of Targeted Therapeutics by Third-Party Payers
    • 6.7 Biotechnology Industry Trends
    • 6.8 Pharmaceutical Industry Trends
    • 6.9 Acquisition, License Agreement, Partnerships
    • 6.10 Legal Developments
    • 6.11 Sales and Marketing Strategies for Tumor Marker Tests
      • 6.11.1 International Markets
    • 6.12 Product Commercialization
    • 6.13 Reimbursement
    • 6.14 Self-Referral Rules
    • 6.15 Health Insurance Portability and Accountability Act
    • 6.16 Clinical Laboratory Improvement Amendments (CLIA)
    • 6.17 In Vitro Diagnostic Directive (IVDD) and Medical Device Regulations
    • 6.18 FDA's Quality System Regulation (QSR)
    • 6.19 FDA'S OIVD on IVDMIAs
    • 6.20 FDA's Qualification of Cancer Biomarkers
      • 6.20.1 Regulatory Perspectives of Biomarker Validation
    • 6.21 Genetic Tests and Medical Records
      • 6.21.1 Laws against Genetic Discrimination
    • 6.22 Medicare Reimbursement
      • 6.22.1 Medicare Part B Spending Trends
    • 6.23 Global Drivers of Clinical Laboratory Testing
    • 6.24 Global Outlook
    • 6.25 Oncology Biomarker Qualification Initiative
    • 6.26 FDA Critical Path
    • 6.27 Biomarkers and FDA's Voluntary Genomic Data Submission
    • 6.28 From Personalized to Predictive Medicine
    • 6.29 Analysis of Cost-Effectiveness at the Individual Level
    • 6.30 The Patient and Advocate Perspective: An Evolution of Influence
    • 6.31 Real-World Experiences Translating the Vision of Personalized Medicine into Practice
  • 7 Companies Entering the Companion Diagnostics Market
    • 7.1 Industry Overview
    • 7.2 Representative Companion Diagnostic Development Companies
      • 7.2.1 20/20 GeneSystems
      • 7.2.2 Abbott Diagnostics
      • 7.2.3 Affymetrix
      • 7.2.4 Agendia BV
      • 7.2.5 Agensys
      • 7.2.6 Almac Group
      • 7.2.7 AMDL
      • 7.2.8 Arcturus Bioscience
      • 7.2.9 Aureon Biosciences
      • 7.2.10 Beckman Coulter
      • 7.2.11 Biocode S.A
      • 7.2.12 BioCurex
      • 7.2.13 Biomarker Technologies
      • 7.2.14 Biomedical Diagnostics
      • 7.2.15 Biomerica
      • 7.2.16 bioMrieux
      • 7.2.17 Biomira
      • 7.2.18 BioModa
      • 7.2.19 Bruker Daltonics
      • 7.2.20 Byk Gulden
      • 7.2.21 Cangen Biotechnologies
      • 7.2.22 Caprion Proteomics
      • 7.2.23 Celera Diagnostics
      • 7.2.24 Cepheid
      • 7.2.25 Claros Diagnostics
      • 7.2.26 Clinical Data: PGxHealth and Cogenics
      • 7.2.27 Ciphergen Biosystems
      • 7.2.28 Clarient
      • 7.2.29 Correlogic Systems
      • 7.2.30 Cytogen
      • 7.2.31 Cytyc Corporation
      • 7.2.32 Dako
      • 7.2.33 DiaDexus LLC
      • 7.2.34 Digene Corporation
      • 7.2.35 DiagnoCure
      • 7.2.36 Diagnostic Systems Laboratories
      • 7.2.37 DRG International
      • 7.2.38 DxS
      • 7.2.39 EDP Biotech
      • 7.2.40 Epigenomics
      • 7.2.41 Exact Sciences Corporation
      • 7.2.42 Exagen Diagnostics
      • 7.2.43 Gene Logic
      • 7.2.44 Genesis Genomics
      • 7.2.45 Genomic Health
      • 7.2.46 Gen-Probe
      • 7.2.47 Health Discovery Corporation
      • 7.2.48 Ikonisys
      • 7.2.49 Immunicon
      • 7.2.50 Immunomedics
      • 7.2.51 Incyte Pharmaceuticals
      • 7.2.52 InterGenetics
      • 7.2.53 Ipsogen
      • 7.2.54 LabCorp
      • 7.2.55 Matritech
      • 7.2.56 Miraculins
      • 7.2.57 Mitsubishi Kagaku Medical
      • 7.2.58 Molecular Diagnostics (CytoCore)
      • 7.2.59 Monogram Biosciences
      • 7.2.60 Myriad Genetics
      • 7.2.61 NimbleGen Systems
      • 7.2.62 Northwest Biotherapeutics
      • 7.2.63 Oncotech
      • 7.2.64 Orion Genomics
      • 7.2.65 Oxford Genome Sciences
      • 7.2.66 Panacea Pharmaceuticals
      • 7.2.67 Perlegen Sciences
      • 7.2.68 Polymedco
      • 7.2.69 Power3 Medical Products
      • 7.2.70 Prometheus
      • 7.2.71 Proteome Systems
      • 7.2.72 Qiagen
      • 7.2.73 Sanko Junyaku
      • 7.2.74 SensiGen
      • 7.2.75 SuperArray Bioscience
      • 7.2.76 Third Wave Technologies
      • 7.2.77 Tosoh Medics
      • 7.2.78 TrimGen
      • 7.2.79 TriPath Imaging
      • 7.2.80 Upstream Biosciences
      • 7.2.81 Ventana Medical Systems
      • 7.2.82 Veridex
    • Appendix 1: FDA Guidance for Industry: Pharmacogenomic Data Submission (March 2005)
    • Appendix 2: Histochemical Markers for Cancer
  • List Of Tables
    • Table 2.1: Timeline for Development of Companion Diagnostics
    • Table 2.2: Personalized Medicine at the Nexus Point
    • Table 2.3: Percentage of Non-Responders in Various Drug Classes
    • Table 2.4: High-Profile Drug Withdrawals from the Marketplace
    • Table 2.5: Metabolism of Drugs by Hepatic Enzymes
    • Table 2.6: Drug Metabolism Drives Drug Efficacy/Toxicity
    • Table 2.7: Population Frequency of the Various Cytochromes
    • Table 2.8: Selected List of Personalized Medicine Tests
    • Table 2.9: Personalized Medicine Product Pipeline
    • Table 2.10: Marketed Personalized Therapies in 2006
    • Table 2.11: Typical Response Rates in Therapeutic Areas
    • Table 2.12: Prevalence of People Taking Medications Metabolized by Liver Enzymes
    • Table 2.13: UGT1A1 Helps to Determine Risks Associated with Irinotecan
    • Table 2.14: Current Product Labels: Enzyme Metabolism
    • Table 3.1: Timeline for Impact of Various Molecular Diagnostics Technologies on Personalized Medicine
    • Table 3.2: Impact of Molecular Diagnostics Technologies on Therapeutic Areas in Personalized Medicine
    • Table 3.3: Challenges of Various Molecular Diagnostics Technology Platforms in Personalized Medicine
    • Table 3.4: FDA Classification of Diagnostics by Risk
    • Table 4.1: Personalized Medicine Industry SWOT Analysis
    • Table 4.2: Market Opportunities in Personalized Medicine
    • Table 4.3: Challenges for Market Adoption of Various Personalized Medicine Tests
    • Table 4.4: Hurdles to Personalized Medicine and Companion Diagnostics Development
    • Table 4.5: Timeline of Impact in Areas of Personalized Medicine
    • Table 4.6: Impact of Personalized Medicine on Various Therapeutic Areas
    • Table 5.1: Potential Benefits of Biomarkers as Companion Diagnostics
    • Table 5.2: Utility of Biomarker as Companion Diagnostics to Drug Development
    • Table 5.3: ASCO-CAP Guidelines for HER2 Testing in Breast Cancer: How to Interpret Test Results
    • Table 5.4: Device Submission Elements for the FDA
    • Table 6.1: List and Discounted Prices for Abbott Tumor Marker Tests
    • Table 6.2: Medicare Spending on Clinical Lab Services, 1996 to 2005
    • Table 6.3: Hospital Laboratory Share of Part B Medicare Spending, 1996 to 2005
    • Table 6.4: Medicare Part B Lab Spending Per Medicare Enrollee, 1998 to 2005
    • Table 6.5: Summary of Biomarker Use in the Commercialization of Novel Oncology Pharmacotherapeutics
    • Table 6.6: Pharmacoeconomic Challenges to the Implementation of Biomarkers as Companion Diagnostic Tests
    • Table 7.1: Major Players in Companion Diagnostic Sector
    • Table 7.2: Tumor Diagnosis Immunoassay
    • Table 7.3: Tumor Diagnosis Radioimmunoassay
    • Table 7.4: Summary of Matritech's Product Development Programs
  • List Of Figures
    • Figure 2.1: Personalizing Drug Treatment
    • Figure 2.2: Approaches to Personalized Medicine
    • Figure 2.3: The Phase I and II Processes of Drug Metabolism
    • Figure 2.4: Hepatic Distribution of Human CYP450
    • Figure 2.5: Relative Contribution of CYP450 Enzymes to Drug Metabolism
    • Figure 2.6: Genetic Components Determine Drug Metabolism
    • Figure 2.7: Personalized Medicine Drugs in Development
    • Figure 3.1: From Genetic Content to Personalized Medicine
    • Figure 3.2: Impact of Diagnostic Testing on Healthcare Decision Making
    • Figure 3.3: Impact of Diagnostic Testing on Healthcare Spending
    • Figure 3.4: Breakout of the Molecular Diagnostics Marketplace by Country
    • Figure 3.5: Breakout of the Molecular Diagnostics Marketplace by Vendor
    • Figure 3.6: Molecular Diagnostics Market Segmentation
    • Figure 3.7: Molecular Diagnostics Market Segmentation by Technology
    • Figure 3.8: Market Survey Respondent Demographics
    • Figure 3.9: Breakout of the Respondent Pool by Affiliation
    • Figure 3.10: Segmentation of the Personalized Medicine Market
    • Figure 4.1: Personalized Medicine Market Drivers
    • Figure 4.2: Challenges in the Personalized Medicine Space
    • Figure 5.1: Carcinogenesis Is a Multi-Step Process
    • Figure 5.2: ASCO-CAP Guidelines for HER2 Testing in Breast Cancer: Equivocal Results with IHC
    • Figure 5.3: ASCO-CAP Guidelines for HER2 Testing in Breast Cancer: Results by FISH
    • Figure 5.4: MGMT Methylation Status Correlates to Survival Rate
    • Figure 6.1: Part B Spending on Clinical Lab Services, 1991 to 2005