Non-Small Cell Lung Cancer
Scope
Report Highlights
Reasons to Purchase
Table of Contents
- ABOUT DATAMONITOR HEALTHCARE - page 2
- About the Oncology pharmaceutical analysis team - page 2
- CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Scope of the analysis - page 3
- Datamonitor insight into the NSCLC market - page 4
- CHAPTER 2 INTRODUCTION AND SCOPE - page 19
- Coverage of the Stakeholder Insight Survey - page 19
- Disease definition & epidemiology - page 19
- Diagnosis - page 19
- Resectable disease - page 19
- Non-resectable disease - page 19
- Drug regimens - page 20
- Unmet needs - page 20
- Future focus - page 20
- Coverage of the Stakeholder Insight Survey - page 19
- CHAPTER 3 COUNTRY TREATMENT TREES - page 22
- US - page 23
- Japan - page 25
- France - page 27
- Germany - page 29
- Italy - page 31
- Spain - page 33
- UK - page 35
- CHAPTER 4 DISEASE DEFINITION AND EPIDEMIOLOGY - page 37
- Lung cancer is divided into two major subtypes according to its biology, therapy and prognosis - page 37
- Non-small cell lung cancer accounts for more than 75% of all lung cancers - page 38
- Three major histological subtypes of NSCLC exist - page 38
- Squamous cell carcinoma is associated with relatively better prognosis than other histological subtypes - page 38
- Adenocarcinoma: the most prevalent form of NSCLC today - page 38
- Bronchioalveolar carcinoma is a distinct subclass of adenocarcinoma - page 39
- Large cell carcinoma is often advanced at the time of diagnosis - page 39
- Epidemiology of NSCLC - page 40
- The NSCLC death rate now exceeds that of breast, prostate and colon cancers combined - page 40
- Lung cancer is divided into two major subtypes according to its biology, therapy and prognosis - page 37
- CHAPTER 5 SEGMENTING THE NSCLC POPULATION - page 44
- Segmentation of NSCLC is usually based on the AJCC's TNM staging system - page 44
- Over half of all NSCLC patients across the seven major markets are diagnosed in the advanced stages - page 46
- The majority of NSCLC patients are diagnosed in stage IIIB or above - page 48
- Earlier diagnosis of NSCLC in Japan? - page 48
- Over half of all NSCLC patients across the seven major markets are diagnosed in the advanced stages - page 46
- Extent of resection across the seven major markets - page 48
- Surgical resection offers a cure but the greatest benefit is restricted to early-stage NSCLC - page 49
- Resectable versus non-resectable disease - page 49
- The general trend across the major markets shows that suitability for curative surgery diminshes as disease stage advances - page 49
- Low surgery rate in the UK in early stages - page 51
- Is there overuse of surgery within Japan? - page 53
- The trend of low surgical resection within the UK is repeated at stage IIIA - page 53
- More aggressive surgical rates for advanced stage NSCLC in Germany - page 55
- The general trend across the major markets shows that suitability for curative surgery diminshes as disease stage advances - page 49
- Segmentation of NSCLC is usually based on the AJCC's TNM staging system - page 44
- CHAPTER 6 TREATMENT OF RESECTABLE DISEASE - page 59
- The use of drug therapy in combination with surgery - page 59
- Data from Phase III neo-adjuvant clinical trials is limited - page 59
- The majority of NSCLC neo-adjuvant studies involve stage IIIA patients - page 59
- The largest neo-adjuvant trial in early stage NSCLC to date was halted - page 62
- Increased post-operative complications call into question the use of neo-adjuvant chemotherapy - page 63
- Adjuvant therapy historically showed negative results and was associated with stigma... - page 65
- ...until the International Adjuvant Lung Cancer Trial (IALT) demonstrated improved five-year survival - page 65
- Three key early-stage NSCLC adjuvant chemotherapy studies support the IALT trial - page 66
- Combination of neo-adjuvant and adjuvant chemotherapy show favorable results - page 69
- Data from Phase III neo-adjuvant clinical trials is limited - page 59
- Chemotherapy approaches vary across the four major stages of NSCLC - page 70
- Physicians prefer to use combined neo-adjuvant and adjuvant chemotherapy across the seven major markets for stage I/II resectable patients... - page 71
- Physicians prescribe similar percentages of adjuvant and neo-adjuvant treatments for stage I/II patients - page 73
- Low drug useage for stage I/II resectable patients in Italy... - page 73
- ...while drug use is greater in the UK - page 74
- Minimal differences are found in the prescribing of neo-adjuvant and adjuvant chemotherapy between stages IIIA and IIIB... - page 74
- ...except in France and the UK - page 75
- Both France and the UK shift to more aggressive use of combined neo-adjuvant and adjuvant treatment in stage IIIB NSCLC - page 76
- The combined use of neo-adjuvant and adjuvant therapy is the preferred treatment modality for stage III NSCLC... - page 77
- Combined neo-adjuvant and adjuvant treatment is prescribed most frequently for resectable stage IV NSCLC - page 77
- Combined neo-adjuvant and adjuvant treatment is prescribed for the majority of stage IV resectable NSCLC across the seven major markets... - page 78
- ...except in Japan - page 78
- Physicians prefer to use combined neo-adjuvant and adjuvant chemotherapy across the seven major markets for stage I/II resectable patients... - page 71
- Chemotherapy approaches by disease stage - page 79
- With advancing stage of disease physicians switch from adjuvant chemotherpay alone to combined neo-adjuvant and adjuvant approaches - page 80
- The use of drug therapy is reduced in patients with advanced disease - page 81
- The use of drug therapy in combination with surgery - page 59
- CHAPTER 7 TREATMENT OF NON-RESECTABLE DISEASE - page 82
- Increasing use of chemotherapy with advancing disease in non-resectable NSCLC - page 83
- Early stage non-resectable patients are ideal candidates for radiotherapy - page 83
- Elderly, frail patients of poor performance status comprise a small cohort of early-stage NSCLC patients who do not receive drug treatment - page 84
- Performance status is deemed the key factor to chemotherapy prescribing within advanced non-resectable patients - page 84
- There is high unmet need for drugs that can be administered to poor perfomance NSCLC patients - page 85
- Phase III trials demonstrate greater response to Cell Therapeutics' Xyotax among advanced, pre-menopausal, poor performance status females - page 86
- Quality of life becomes increasingly important within the last few months of a NSCLC patient's life - page 87
- Early stage non-resectable patients are ideal candidates for radiotherapy - page 83
- Use of chemotherapy treatment for non-resectable patients shows little variation at market level - page 88
- US and German physicians take an aggressive approach to chemotherapy treatment of non-resectable stage IV patients - page 89
- Japanese physicians are the lowest prescribers of chemotherapy treatment - page 90
- US and German physicians take an aggressive approach to chemotherapy treatment of non-resectable stage IV patients - page 89
- Increasing use of chemotherapy with advancing disease in non-resectable NSCLC - page 83
- CHAPTER 8 CURRENT DRUG REGIMENS - page 91
- Current first-line NSCLC drug regimens - page 92
- Single, doublet and triplet chemotherapy regimens by disease stage - page 92
- Doublet-regimens dominate the first-line treatment of NSCLC - page 92
- Single, doublet and triplet chemotherapy regimens by market - page 96
- Doublet regimens dominate the first-line treatment of stage IV disease in all seven major markets - page 96
- Platinum-based regimens by disease stage - page 98
- Carboplatin-based regimens lead the first-line treatment of NSCLC - page 98
- Non-platinum-based regimens are suitable for patients who are unable to tolerate the toxicities of platinum regimens - page 102
- The prescribing of oxaliplatin-based therapies is minimal - page 104
- Platinum-based regimens by market - page 104
- Carboplatin-based regimens dominate the treatment of stage IV NSCLC across the seven major markets... - page 105
- ...except in Italy - page 106
- Use of platinum-taxane doublets versus platinum-non-taxane third-generation cytotoxic doublet regimens by disease stage - page 107
- Platinum-taxane versus platinum-non-taxane cytotoxic doublet regimens by market - page 110
- Platinum-non-taxane third-generation cytotoxic regimens dominate the treatment of stage IV disease across all seven major markets - page 110
- The top three first-line NSCLC drug regimens by disease stage - page 111
- Carboplatin-paclitaxel is the leading drug-regimen in first-line NSCLC - page 113
- Single, doublet and triplet chemotherapy regimens by disease stage - page 92
- The top three first-line drug regimens by market - page 113
- Carboplatin-paclitaxel is still at the forefront of first-line stage IV treatment, but only within three markets - page 113
- In France and Italy the first-line stage IV drug regimen of choice is platinum-gemcitabine - page 116
- UK-based physicians reflect new emphasis - page 116
- Japanese physicians pefer carboplatin-etoposide - page 117
- More market variance is seen in the top three first-line drug regimens at stage IV than at stage I/II NSCLC - page 118
- Single-agent regimens by disease stage - page 118
- Molecular targeted therapeutics versus cytotoxics by disease stage - page 121
- Molecular targeted therapeutics versus cytotoxics by market - page 123
- US physicians have the greatest use of targeted therapy-based regimens for first-line advanced NSCLC - page 123
- Iressa-, Tarceva-, Avastin- and Erbitux-based regimens by disease stage - page 124
- First-line use of Iressa-, Tarceva-, Avastin- and Erbitux-based regimens by market - page 128
- Avastin-based regimens are the leading choice for first-line advanced NSCLC, within the US, UK, France and Italy - page 129
- Iressa is the most popular targeted therapeutic in Japan - page 129
- Carboplatin-paclitaxel is still at the forefront of first-line stage IV treatment, but only within three markets - page 113
- Current second-line NSCLC drug regimens - page 130
- The leading second-line NSCLC drug regimens currently used by physicians across the seven major markets - page 130
- Carboplatin-paclitaxel dominates the second-line treatment of NSCLC across the seven major markets - page 132
- Carboplatin-gemcitabine proves a popular choice among Japanese physicians... - page 134
- ...whereas Italian physicians prefer approved single-agent docetaxel - page 134
- The leading second-line NSCLC drug regimens currently used by physicians across the seven major markets - page 130
- Current third-line NSCLC drug regimens - page 134
- The leading third-line NSCLC drug regimens currently used by physicians across the seven major markets - page 134
- Carboplatin-paclitaxel is the leading third-line regimen across the seven major markets... - page 136
- Platinum-triplet regimens are the leading third-line treatment in the US - page 137
- AstraZeneca's Iressa (gefitinib) is reported as the leading third-line regimen among Italian physicians - page 137
- The leading third-line NSCLC drug regimens currently used by physicians across the seven major markets - page 134
- Current NSCLC drug regimens by line setting - page 137
- Platinum-based regimens by line setting - page 137
- Excision repair cross-complementation group 1 (ERCC1) emerges as a marker for cisplatin-resistance - page 140
- Molecular targeted therapeutics versus cytotoxic therapy by line setting - page 141
- As NSCLC patients progress from the first- to the third-line setting, the use of targeted therapeutics doubles - page 142
- Iressa-, Tarceva-, Avastin- and Erbitux-based regimens by line setting - page 143
- Platinum-based regimens by line setting - page 137
- The impact of Alimta and Tarceva on current Taxotere prescribing - page 145
- First-line prescribing of Taxotere-platinum doublet has reached a plateau - page 147
- Taxotere is associated with hematological toxicities - page 147
- Physicians now switching to Alimta due to improvement upon Taxotere's toxicity profile - page 148
- Despite costing twice as much as Taxotere, Alimta is considered cost-effective - page 149
- Alimta may prove a modest challenge to Taxotere in the first-line setting of NSCLC - page 150
- Tarceva's ability to improve progression-free surival renders the agent a significant threat to Alimta and Taxotere in the second-line setting of NSCLC - page 151
- NSCLC physicians may favor Tarceva's favourable toxicity profile to those of Taxotere and Alimta - page 152
- Tarceva's superior toxicity profile is ideal for PS2 patients who cannot tolerate chemotherapy - page 154
- First-line prescribing of Taxotere-platinum doublet has reached a plateau - page 147
- Current first-line NSCLC drug regimens - page 92
- CHAPTER 9 UNMET NEEDS - page 156
- Physician rating of clinical unmet needs within the NSCLC market - page 156
- Unmet needs within today's NSCLC market - page 157
- With just 15% of NSCLC patients surviving beyond five years, effective agents that improve survival are needed - page 157
- Earlier diagnosis of NSCLC could improve patient prognosis - page 158
- Virtually all NSCLC patients relapse following first-line chemotherapy - page 158
- Opportunity for a first-line agent with reduced toxicity - page 159
- Cost-effective molecular targeted therapies are required - page 160
- Despite constituting about 65% of all NSCLC patients, suitable therapeutics for the elderly remain elusive - page 161
- BAC and adenocarcinoma patients are underserved - page 163
- Tarceva and Iressa's secondary resistance is linked with mutations - page 163
- Optimal patient selection is vital for successful development of targeted therapies - page 164
- Analysis of NSCLC unmet needs by country - page 164
- Agents to improve metastatic survival is the greatest unmet need across all seven major markets... - page 166
- ...expect in Japan - page 166
- An improved patient selection process is the least important unmet need across the seven major markets - page 166
- High unmet need for Effective therapeutics for elderly patients in Japan - page 166
- CHAPTER 10 POTENTIAL OF EMERGING THERAPIES - page 168
- Overview of the key NSCLC candidates - page 170
- Genentech/Roche's Avastin (bevacizumab) is the first anti-angiogenic agent to gain approval - page 170
- Avastin's first-line Phase III trial demonstrates 61% improvement of progression-free survival - page 172
- Erbitux (cetuximab), the EGFR monoclonal antibody, is involved in numerous ongoing NSCLC trials - page 173
- Nexavar (sorafenib) is the first oral multi-tyrosine kinase inhibitor to reach the market - page 175
- AstraZeneca's Zactima (vandetanib; ZD6474) targets both VEGF and EGFR - page 176
- Amgen's Vectibix (panitumumab) is a fully humanized monoclonal antibody targeting first- and-second-line NSCLC - page 177
- Phase II Vectibix data show outstanding toxicity profile - page 178
- Genentech/Roche's Avastin (bevacizumab) is the first anti-angiogenic agent to gain approval - page 170
- Physician ratings of key pipeline NSCLC candidates - page 178
- Physician ratings of the five NSCLC candidates are similar suggesting companies need to differentiate their products - page 178
- Physician ratings of key pipeline NSCLC candidates by country analysis - page 180
- Surveyed physicians are more aware of Avastin and Erbitux than Nexavar, Zactima and Vectibix across the seven major markets - page 181
- Avastin is preferred by UK, Spanish and French physicians... - page 181
- Nexavar is preferred to Zactima within the UK and US - page 182
- French physician physicians favor Zactima over Nexavar - page 183
- Vectibix could compete well with Erbitux - page 183
- Overview of the key NSCLC candidates - page 170
- CHAPTER 11 FUTURE FOCUS - page 184
- Perceived future drug regimen prescribing - page 184
- Platinum-doublet regimens will continue to form the backbone of NSCLC treatment - page 186
- Companies involved in the NSCLC arena must differentiate their products - page 187
- Immunotherapies are poorly perceived by physicians - page 188
- Although doublet cytotoxics will remain at the forefront of future treatment of NSCLC, Avastin and Erbitux may reduce the use of platinum-triplet regimens - page 189
- Platinum-doublet regimens will continue to form the backbone of NSCLC treatment - page 186
- Influences on physician prescribing within the future NSCLC market - page 190
- First-line combination chemotherapy is considered the most important scenario within the future NSCLC market - page 192
- Avastin's recent toxicity concerns do not seem to have affected physicians' perceptions of the agent... - page 193
- ...except within Japan - page 195
- First-line combination chemotherapy is considered the most important scenario within the future NSCLC market - page 192
- Perceived future drug regimen prescribing - page 184
- APPENDIX A - page 196
- Supplementary data - page 196
- First-line stage I/II drug regimens - page 196
- First-line stage IIIA drug regimens - page 198
- First-line stage IIIB drug regimens - page 199
- First-line stage IV drug regimens - page 200
- Second-line drug regimens - page 201
- Third-line drug regimens - page 202
- Supplementary data - page 196
- APPENDIX B - page 203
- Bibliography - page 203
- List of tables - page 215
- List of figures - page 220
- Physician research methodology - page 224
- Contributing experts - page 224
- Key opinion leader transcripts - page 224
- APPENDIX C - page 225
- The survey questionnaire - page 225
- 1.0 Segmenting the patient population - page 225
- Segmenting patients by suitability for neo-adjuvant and/or adjuvant therapy - page 225
- Segmenting patients by suitability for drug therapy - page 226
- 2.0 Current drug treatment practice - page 227
- 3.0 Unmet needs - page 233
- 4.0 Future drug useage - page 233
- Disclaimer - page 237
- List of Tables
- Table 1: NSCLC physician breakdown surveyed by Datamonitor, 2006 - page 4
- Table 2: Crude incidence rates of lung cancer by gender (per 100,000) in the seven major markets, 2002 - page 41
- Table 3: Forecast incidence of lung cancer (types C33 and C34) in the seven major markets, 2002-2016 - page 41
- Table 4: Forecast incidence of NSCLC in the seven major markets, 2002-2016 - page 43
- Table 5: American Joint Committee on Cancer TNM staging of NSCLC - page 45
- Table 6: American Joint Committee on Cancer TNM staging of NSCLC - page 46
- Table 7: NSCLC patients diagnosed at each stage (I-IV) (%), 2006 - page 47
- Table 8: Mean NSCLC patients suitable for surgery with curative intent, across the seven major markets, (%) 2006, - page 50
- Table 9: Stage I/II NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 52
- Table 10: Stage IIIA NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 54
- Table 11: Stage IIIB NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 55
- Table 12: Stage IV NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 56
- Table 13: Summary results of Martini et al. (1993) Phase III neo-adjuvant trial in stage IIIA NSCLC patients - page 60
- Table 14: Summary results of Roth et al. (1994) and Rossell et al. (1994) Phase III neo-adjuvant trials in stage IIIA NSCLC patients - page 61
- Table 15: Preliminary results of Pisters et al. (2005) Phase III neo-adjuvant trial in stage I-IIIA NSCLC patients - page 62
- Table 16: Summary of Sorensen et al. (2005) Phase III neo-adjuvant trial in stage I-IIIA NSCLC patients - page 63
- Table 17: Arguments for and against neo-adjuvant NSCLC chemotherapy - page 64
- Table 18: Summary of results of the International Adjuvant Lung Cancer Trial (IALT) - page 66
- Table 19: Summary of key Phase III adjuvant NSCLC trials; CALC GB 9633; NCIC CTG JBR.10 and ANITA - page 67
- Table 20: Arguments for and against adjuvant NSCLC chemotherapy - page 68
- Table 21: Arguments for and against combined neo-adjuvant and adjuvant chemotherapy - page 70
- Table 22: Chemotherapy approaches for resectable stage I/II NSCLC patients in the seven major markets (%), 2006 - page 71
- Table 23: Chemotherapy approaches for resectable stage IIIA NSCLC patients across the seven major markets (%), 2006 - page 75
- Table 24: Chemotherapy approaches for resectable stage IIIB NSCLC patients in the seven major markets (%), 2006 - page 75
- Table 25: Chemotherapy approaches for resectable stage IV NSCLC patients in the seven major markets (%), 2006 - page 77
- Table 26: Mean chemotherapy approaches for resectable NSCLC patients between stages I and IV, across the seven major markets (%), 2006 - page 79
- Table 27: Mean use of chemotherapy treatment within non-surgical NSCLC patients between stage I/II and stage IV, across the seven major markets (%), 2006 - page 82
- Table 28: Use of chemotherapy treatment in non-resectable NSCLC patients by stage across the seven major markets (%), 2006 - page 88
- Table 29: Use of first-line single, doublet and triplet chemotherapy regimens for stage I/II-IV NSCLC across the seven major markets (%), 2006 - page 93
- Table 30: Use of first-line platinum-based regimens for stage I/II and stage IIIA NSCLC in the seven major markets (%), 2006 - page 99
- Table 31: Use of first-line platinum-based regimens for stage IIIB to stage IV across the seven major markets (%), 2005 - page 100
- Table 32: Arguments for platinum-based versus non-platinum-based regimens in NSCLC - page 103
- Table 33: Use of first-line platinum-taxane versus platinum-non-taxane third-generation cytotoxic regimens for the treatment of stage I/II-IV NSCLC in the seven major markets (%), 2006 - page 108
- Table 34: Use of the top-three first-line drug regimens for the treatment of stage I/II-IV NSCLC in the seven major markets (%), 2006 - page 111
- Table 35: Use of first-line single-agent regimens for the treatment of stage I/II-IV NSCLC across the seven major markets (%), 2006 - page 119
- Table 36: Use of first-line MTT-based regimens and cytotoxics for stage I/II-IV NSCLC in the seven major markets (%), 2006 - page 122
- Table 37: Percentage use of first-line Iressa-, Tarceva-, Avastin- and Erbitux-based regimens for the treatment of stage I/II-IV NSCLC in the seven major markets (%), 2006 - page 125
- Table 38: Use of the top three second-line drug regimens for the treatment of all stages of NSCLC in the seven major markets (%), 2006 - page 130
- Table 39: Use of the top three third-line drug regimens for the treatment of all stages of NSCLC in the seven major markets (%), 2006 - page 134
- Table 40: Mean use of platinum-based and non-platinum-based regimens for the treatment of all stages of NSCLC by line setting, across the seven major markets, (%), 2006 - page 138
- Table 41: Mean use of molecular targeted therapeutics versus cytotoxic therapy for the treatment of all stages of NSCLC, within the three line settings, across the seven major markets, (%) 2006 - page 141
- Table 42: Mean use of gefitinib, erlotinib, bevacizumab and cetuximab-based regimens for the treatment of all stages of NSCLC, within the three line settings, across the seven major markets (%), 2006 - page 143
- Table 43: Mean use of Taxotere, Alimta and Tarceva within NSCLC, across the seven major markets (%), 2006 - page 147
- Table 44: TAX-317 and TAX-320 clinical trial results: survival data - page 148
- Table 45: Results of a Phase III randomized trial comparing Alimta to Taxotere in second-line treatment of recurrent NSCLC, 2006 - page 149
- Table 46: Summary of Tarceva's Phase III BR.21 efficacy data - page 152
- Table 47: Comparison of the efficacy results from pivotal trials which gained Tarceva, Taxotere and Alimta FDA and EMEA approval for second-line NSCLC - page 153
- Table 48: Comparison of the key toxicity results from pivotal trials which gained Tarceva, Taxotere and Alimta FDA and EMEA approval for second-line NSCLC - page 153
- Table 49: Physician rating of unmet needs (1-100) in NSCLC across the seven major markets, 2006 - page 156
- Table 50: Summary of Phase III clinical trials involving elderly advanced NSCLC patients - page 162
- Table 51: Preregistration and Phase III NSCLC pipeline, 2006 - page 169
- Table 52: NSCLC clinical trial summary: Avastin - page 171
- Table 53: Avastin E4599 Phase II/III clinical trial results - page 172
- Table 54: NSCLC clinical trial summary: Erbitux, 2006 - page 174
- Table 55: NSCLC clinical trial summary: Nexavar - page 176
- Table 56: NSCLC clinical trial summary: Zactima - page 177
- Table 57: Physician scoring (1-100) of the likelihood of prescribing key NSCLC pipeline drug-based regimens (1-100), in the seven major markets, 2006 - page 179
- Table 58: Physician scoring (1-100) of various drug regimen prescribing for NSCLC patients in 2011, across the seven major markets - page 185
- Table 59: Current use of first-line platinum and non-platinum doublets, triplet regimens, signal transduction and angiogenesis inhibitors for the first-line treatment of all stages of NSCLC, across the seven major markets (%), 2006 - page 189
- Table 60: Physician scoring (1-100) of various prescribing scenarios for NSCLC in 2011 across the seven major markets - page 191
- Table 61: Use of first-line drug regimens for stage I/II NSCLC, regardless of whether received as neo-adjuvant and/or adjuvant treatment, across the seven major markets (%), 2006 - page 197
- Table 62: Use of first-line drug regimens for stage IIIA NSCLC, across the seven major markets (%), 2006 - page 198
- Table 63: Use of first-line drug regimens for stage IIIB NSCLC, across the seven major markets (%), 2006 - page 199
- Table 64: Use of first-line drug regimens for stage IV NSCLC in the seven major markets (%), 2006 - page 200
- Table 65: Use of second-line drug regimens for the treatment of stages I/II to stage IV NSCLC in the seven major markets (%), 2006 - page 201
- Table 66: Use of third-line drug regimens for the treatment of stages I/II to stage IV NSCLC, across the seven major markets (%), 2006 - page 202
- List of Figures
- Figure 1: Diagrammatic overview of the coverage of the Stakeholder Insight: Non-Small Cell Lung Cancer survey, 2006 - page 21
- Figure 2: Population and chemotherapy approach data for NSCLC in the US, 2006 - page 23
- Figure 3: Second- and third-line NSCLC drug regimens in the US, 2006 - page 24
- Figure 4: Population and chemotherapy approach data for NSCLC in Japan, 2006 - page 25
- Figure 5: Second- and third-line NSCLC drug regimens in Japan, 2006 - page 26
- Figure 6: Population and chemotherapy approach data for NSCLC in France, 2006 - page 27
- Figure 7: Second- and third-line NSCLC drug regimens in France, 2006 - page 28
- Figure 8: Population and chemotherapy approach data for NSCLC in Germany, 2006 - page 29
- Figure 9: Second- and third-line NSCLC drug regimens in Germany, 2006 - page 30
- Figure 10: Population and chemotherapy approach data for NSCLC in Italy, 2006 - page 31
- Figure 11: Second- and third-line NSCLC drug regimens in Italy, 2006 - page 32
- Figure 12: Population and chemotherapy approach data for NSCLC in Spain, 2006 - page 33
- Figure 13: Second- and third-line NSCLC drug regimens in Spain, 2006 - page 34
- Figure 14: Population and chemotherapy approach data for NSCLC in the UK, 2006 - page 35
- Figure 15: Second- and third-line NSCLC drug regimens in the UK, 2006 - page 36
- Figure 16: Anatomy of the human lungs - page 37
- Figure 17: Forecast incidence of lung cancer (types C33 and C34) in the seven major markets, 2002-2016 - page 42
- Figure 18: Forecast incidence of NSCLC in the seven major markets, 2002-2016 - page 43
- Figure 19: NSCLC patients diagnosed at each stage (I-IV) (%), 2006 - page 47
- Figure 20: Mean NSCLC patients suitable for surgery with curative intent, across the seven major markets, (%) 2006 - page 50
- Figure 21: Stage I/II NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 52
- Figure 22: Stage IIIA NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 54
- Figure 23: Stage IIIB NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 56
- Figure 24: Stage IV NSCLC patients suitable for surgery with curative intent across the seven major markets (%), 2006 - page 57
- Figure 25: Chemotherapy approaches for resectable stage I/II NSCLC patients in the seven major markets (%), 2006 - page 72
- Figure 26: Change in chemotherapy approaches between stage IIIA and stage IIIB resectable NSCLC in the seven major markets (%), 2006 - page 76
- Figure 27: Chemotherapy approaches for resectable stage IV NSCLC patients in the seven major markets (%), 2006 - page 78
- Figure 28: Mean chemotherapy approaches for resectable NSCLC patients between stage I/II and IV, across the seven major markets, 2006 - page 80
- Figure 29: Mean use of chemotherapy treatment within non-surgical NSCLC patients between stage I/II and stage IV, across the seven major markets (%), 2006 - page 83
- Figure 30: Use of chemotherapy treatment in non-surgical stage IV NSCLC patients in the seven major markets (%), 2006 - page 89
- Figure 31: Mean use of first-line single, doublet and triplet chemotherapy regimens for stage I/II-IV NSCLC across the seven major markets (%), 2006 - page 94
- Figure 32: Use of first-line single, doublet and triplet chemotherapy regimens for stage IV NSCLC in the seven major markets (%), 2006 - page 97
- Figure 33: Mean use of first-line platinum-based regimens from stage I/II-IV, across the seven major markets (%), 2006 - page 101
- Figure 34: Use of key first-line drug regimens for stage IV NSCLC in the seven major markets (%), 2006 - page 105
- Figure 35: Mean use of platinum-taxane doublets versus platinum-non-taxane third-generation cytotoxic doublets for the treatment of stage I/II-IV NSCLC, across the seven major markets (%), 2006 - page 109
- Figure 36: Use of first-line platinum-taxane versus platinum-non-taxane third-generation cytotoxic regimens for the treatment of stage IV NSCLC in the seven major markets (%), 2006 - page 110
- Figure 37: Mean use of the top three first-line drug regimens for the treatment of stage I/II-IV NSCLC, across the seven major markets (%), 2006 - page 112
- Figure 38: Use of the top three first-line drug regimens for the treatment of stage IV NSCLC (%), 2006 - page 114
- Figure 39: Use of the top-three first-line drug regimens for the treatment of stage IV NSCLC (%), 2006 - page 115
- Figure 40: Mean use of first-line single-agent regimens for the treatment of stage I/II-IV NSCLC across the seven major markets (%), 2006 - page 120
- Figure 41: Mean use of first-line MTT-based regimens for stage I/II-IV NSCLC across the seven major markets (%), 2006 - page 123
- Figure 42: Use of first-line MTT-based regimens for stage IV NSCLC in the seven major markets (%), 2006 - page 124
- Figure 43: Mean use of first-line Iressa-, Tarceva-, Avastin- and Erbitux-based regimens for the treatment of stage I/II-IV NSCLC, across the seven major markets (%), 2006 - page 126
- Figure 44: Use of first-line Iressa, Tarceva, Avastin and Erbitux-based regimens for the treatment of stage IV NSCLC in the seven major markets (%), 2006 - page 128
- Figure 45: Use of the top three second-line drug regimens for the treatment of all stages of NSCLC, as a mean of the seven major markets and within the US, Japan and France (%), 2006 - page 131
- Figure 46: Use of the top three second-line drug regimens for the treatment of all stages of NSCLC, within Germany, Italy, Spain and the UK (%), 2006 - page 132
- Figure 47: Use of the top three third-line drug regimens for the treatment of all stages of NSCLC as a mean of the seven major markets and within the US, Japan and France (%), 2006 - page 135
- Figure 48: Use of the top three second-line drug regimens for the treatment of all stages of NSCLC within Germany, Italy, Spain and the UK (%), 2006 - page 136
- Figure 49: Mean use of platinum-based and non-platinum-based regimens for the treatment of all stages of NSCLC within the three line settings, across the seven major markets (%), 2006 - page 139
- Figure 50: Mean use of molecular targeted for the treatment of all stages of NSCLC, within the three line settings, across the seven major markets (%) 2006 - page 141
- Figure 51: Mean use of gefitinib, erlotinib, bevacizumab and cetuximab-based regimens for the treatment of all stages of NSCLC, within the three line settings, across the seven major markets (%), 2006 - page 143
- Figure 52: Timeline of the FDA and EMEA approvals of Taxotere, Alimta and Tarceva within NSCLC, 1999-2006 - page 146
- Figure 53: Mean physician rating of clinical unmet needs (1-100) in NSCLC, across the seven major markets, 2006 - page 157
- Figure 54: Physician rating of clinical unmet needs (1-100) in NSCLC, for the mean, the US, Japan and France, 2006 - page 165
- Figure 55: Physician rating of clinical unmet needs (1-100) in NSCLC for the UK, Spain, Italy and Germany, 2006 - page 165
- Figure 56: Mean physician scoring (1-100) of the likelihood of prescribing key NSCLC pipeline-based regimens (1-100), across the seven major markets, 2006 - page 179
- Figure 57: Physician rating of key NSCLC pipeline-based regimens (1-100) in the seven major markets, 2006 - page 181
- Figure 58: Physician scoring (1-100) of various drug regimen prescribing for NSCLC patients in 2011 in the seven major markets - page 186
- Figure 59: Physician scoring (1-100) of various prescribing scenarios for NSCLC in 2011 - page 192
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