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Stakeholder Insight: Prostate Cancer
A Prostrate Market Waiting for Innovations
Publication Date October 2005
Publisher Datamonitor
Product Type Report
Pages 312
ISBN Number not applicable
Product Code DAT382
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Summary
The prostate cancer market is reaching maturity, and major players' sales have been eroded by the launch of various LHRH agonist depot formulations. Safety concerns with AstraZeneca's Casodex (bicalutamide) have also seen a significant proportion of physicians switching to alternatives. Establishing the optimal timing of antihormonal therapy will provide the key to market growth.
Highlights
The use of bicalutamide has significantly decreased in localized stage between 2003 and 2005 since the EPC trial demonstrated increased mortality with bicalutamide 150mg. This has not only undermined physicians' confidence in the drug in localized stage but it has also affected the uptake of the drug in locally advanced and advanced stage disease.TAB has failed to conclusively establish survival benefit in clinical trials and remains used in a minority of patients in advanced stage. Cost is also a problem for TAB, even in the US. However, oral drugs are expected to be reimbursable under Medicare from 2006 and that should increase the uptake of anti-androgens as well as that of TAB regimens.Although physicians are hopeful of molecular-targeted agents for HRPC, primary research suggests that its use will remain relatively low in 2010 and they are not expected to be used in a level similar to that seen in other tumors. However, opinion leaders have identified angiogenesis inhibitors to be the most promising for prostate cancer.
Scope
- Current treatment practices for hormone-sensitive and hormone-refractory prostate cancer based on 180 physician interviews in the seven major markets
- Changes in prescribing habits for prostate cancer between 2003 and 2005
- Physician awareness and ratings of late-stage pipeline drugs for prostate cancer, including Abbott's Xinlay and Dendreon's Provenge
- Potential drug regimens for prostate cancer in 2010 based on physicians' opinion
Reasons to Purchase
- Quantify the size and scope of the antihormonals market for prostate cancer by examining the uptake of LHRH agonists and anti-androgens
- Examine the potential of late-stage pipeline drugs for prostate cancer through physician awareness and ratings.
- Develop commercial strategies by analyzing physicians' opinion on the potential drug regimens for prostate cancer in 2010
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Content
- Chapter 1 Executive Summary
- Chapter 2 Introduction
- Scope
- The prostate
- Prostate cancer
- Histology
- Etiology
- Age and race
- Family history
- Hormones
- Dietary fat
- Chapter 3 Treatment Trees
- US
- Japan
- France
- Germany
- Italy
- Spain
- UK
- Chapter 4 Antihormonal Therapies
- Stages of diagnosis
- Mis-staging may be common in some markets
- Antihormonal therapy
- Localized stage
- Locally advanced stage
- Advanced stage
- Chapter 5 Antihormonal Drugs
- Localized stage
- LHRH agonist monotherapy is the standard of care in localized stage
- Bicalutamide is the leading anti-androgen
- The lack of clinical evidence for TAB in localized stage
- Locally advanced stage
- More aggressive therapy in locally advanced stage
- Bicalutamide remains dominant
- TAB has yet to gain a wider uptake
- Advanced stage
- LHRH agonist monotherapy remains the standard therapy in advanced stage
- Bicalutamide remains in the driving seat
- The use of TAB is surprisingly low
- Chapter 6 The Use Of Antihormonals Between 2003 And 2005
- Changes in the use of drug classes
- Significant increase in the use of LHRH agonist monotherapy at the expense of TAB
- Decline in the use of anti-androgen in localized stage
- Market differences
- Percentage of patients treated with LHRH agonists between 2003 and 2005
- Market differences
- Percentage of patients receiving anti-androgens between 2003 and 2005
- Market differences
- Percentage of patients treated with TAB between 2003 and 2005
- Market differences
- Chapter 7 Duration Of Treatment
- Treatment duration
- LHRH agonists
- Anti-androgens
- Total androgen blockade
- Overall average treatment duration
- Intermittent hormonal therapy
- IHT is used most commonly in localized stage
- Reduced usage of IHT in more advanced stages
- The use of IHT between 2003 and 2005
- Chapter 8 Recurrent Prostate Cancer
- Remission rate
- The chronic nature of prostate cancer
- Aggressive TAB therapy benefiting localized patients in Japan
- Recurrence rate
- Poor disease control in France?
- Treatment of recurrent prostate cancer
- Leuprolide remains the dominant LHRH agonist
- Increase in the use of bicalutamide
- Leuprolide- and bicalutamide-based regimens are the mainstay of TAB regimens
- Chapter 9 Hormone-Refractory Prostate Cancer
- Progression to HRPC
- High progression rate in localized stage in France, Germany and Spain
- Discrepancy in advanced stages across the markets
- Time to HRPC progression
- Long time to progression in the UK in localized stage
- Asymptomatic versus symptomatic HRPC
- Nearly equal split
- Active treatment of HRPC
- Higher proportion of symptomatic patients are actively treated
- Drug regimens for asymptomatic HRPC
- Top three drug regimens for asymptomatic HRPC
- Drug regimens for symptomatic HRPC
- Top three drug regimens for symptomatic HRPC
- Drug regimens for HRPC in 2003 and 2005
- Estramustine monotherapy increases in use between 2003 and 2005
- Increase in taxane-based regimens
- No increase for vinorelbine
- Decreasing use of 'older' drugs
- Chapter 10 Drugs In Development For Prostate Cancer
- Xinlay (atrasentan) [Abbott]
- Physician awareness of Xinlay
- Physician rating of Xinlay
- Satraplatin [GPC Biotech]
- Physician awareness of satraplatin
- Physician rating of satraplatin
- Provenge [Dendreon]
- Physician awareness of Provenge
- Physician rating of Provenge
- DN-101 (calcitriol) [Novacea]
- Physician awareness of DN-101
- Physician rating of DN-101
- Thalomid (thalidomide) [Celgene]
- Physician awareness of Thalomid
- Physician rating of Thalomid
- GVAX [Cell Genesys]
- Physician awareness of GVAX
- Physician rating of GVAX
- Comparative awareness and physician ratings of pipeline drugs for prostate cancer
- Chapter 11 Future Prescribing
- Drug regimens for hormone-sensitive prostate cancer in 2010
- LHRH agonist monotherapy will still be the standard of care especially in France, Italy and the UK
- Physicians will remain skeptical of TAB
- Chemotherapy plus antihormonals will gain support
- Molecular-targeted agents will be minimally used
- Trends in prescribing for hormone-sensitive prostate cancer
- Drug regimens for HRPC in 2010
- Taxane-based regimens will be the most commonly used drug therapies for HRPC
- Novel agents are not expected to make a significant impact
- Trends in prescribing for HRPC
- Chapter 12 Appendix
- Supplementary data
- Respondent breakdown
- Opinion leader interview transcripts
- Dr Judd W Moul, Professor and Chief, Division of Urologic Surgery, Duke University Medical Center, NC, US
- Dr Daniel Petrylak, Director of Genitourinary Oncology Program, Columbia Presbyterian Medical Center, NY, US
- Dr Alessandro Sciarra, Department of Urology, University La Sapienza, Rome, Italy
- Dr Marcos Lujan, Urology Department, Hospital Universitario de Getafe, Madrid, Spain
- Study questionnaire
- References
- List Of Tables
- List Of Figures
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