Ovarian Cancer: Growing importance as secondary indication for targeted therapies
Scope
Report Highlights
Reasons to Purchase
Table of Contents
- ABOUT DATAMONITOR HEALTHCARE - page 2
- About the Oncology pharmaceutical analysis team - page 2
- Richard Faint - Director of Oncology - page 2
- About the Oncology pharmaceutical analysis team - page 2
- CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Scope - page 3
- Datamonitor insight - page 3
- CHAPTER 2 DISEASE OVERVIEW - page 11
- Introduction - page 11
- Types of ovarian cancer - page 12
- Epithelial tumors - page 12
- Stromal tumors - page 13
- Germ cell tumors - page 13
- Subtypes - page 14
- Staging - page 15
- Grading - page 16
- Epidemiology - page 17
- Incidence at diagnosis - page 17
- Stage at diagnosis - page 18
- Incidence by stage - page 20
- Prevalence - page 22
- Key risk factors - page 23
- Prognosis - page 23
- Improving survival for ovarian cancer - page 25
- CHAPTER 3 TREATMENT OPTIONS - page 27
- Surgery - page 27
- Radiotherapy - page 28
- Drug therapy - page 29
- CHAPTER 4 DRUG REGIMENS - page 31
- First-line drug regimens - page 31
- Platinum + taxane - page 31
- Cisplatin versus carboplatin - page 32
- Carboplatin in the US, cisplatin in the EU for NSCLC - page 34
- Is the pattern replicated for ovarian cancer? - page 34
- Dose intensity of platinum drugs - page 36
- Platinum monotherapy? - page 36
- Carboplatin + paclitaxel is the standard of care in most markets - page 38
- Potential for other platinums? - page 39
- Paclitaxel versus docetaxel - page 41
- Similar efficacy, better QOL with docetaxel - page 41
- Paclitaxel dominates in the EU - page 43
- Paclitaxel still expected to dominate in the US - page 44
- Chemotherapy triplet - page 44
- Intraperitoneal chemotherapy - page 45
- Increased survival but also increased toxicity - page 45
- Second-line drug regimens - page 47
- Platinum combination versus platinum monotherapy - page 49
- Carboplatin + paclitaxel - page 49
- Optimal regimen not yet determined - page 50
- Docetaxel - page 50
- Topotecan - page 50
- Tamoxifen - page 51
- More than half of second-line patients are platinum sensitive - page 52
- Fragmented second-line market in the EU - page 52
- Drug regimens in first and second line in the five EU markets - page 56
- Platinum combination versus platinum monotherapy - page 49
- Third-line drug regimens - page 57
- Topotecan - page 57
- Liposomal doxorubicin - page 57
- Gemcitabine - page 58
- Limited use of platinum agents in third line - page 60
- Gemcitabine is the leading third-line regimen in the EU - page 61
- Nevertheless Gemzar's sales are low - page 62
- Topotecan is the second most commonly used agent - page 63
- Platinum still used in a proportion of patients - page 63
- Beyond third-line therapy - page 64
- First-line drug regimens - page 31
- CHAPTER 5 PIPELINE DRUGS - page 65
- Cell Therapeutics - Xyotax (polyglutamate paclitaxel) - page 66
- Impressive results but need to replicate in Phase III trial - page 66
- Effect on QoL - page 67
- Sufficient advantages for reformulated paclitaxel? - page 67
- Novartis - Patupilone (epothilone B) - page 68
- Limited potential for patupilone - page 68
- More epothilone agents on the horizon - page 69
- Unither Therapeutics/ViRexx - OvaRex (oregovomab) - page 69
- Primary endpoint failure will hurt the drug - page 70
- Insufficient marketing capacity and capability - page 71
- Telik - Telcyta (TLK286) - page 71
- Penetrating the second- and third-line market - page 72
- Partner needed - page 72
- Celgene - Thalomid (thalidomide) - page 73
- Lack of Celgene support? - page 73
- Stigma of thalidomide - page 74
- Genentech/Roche - Avastin (bevacizumab) - page 74
- Confidence transferred to ovarian cancer - page 75
- Cost will be a problem for Avastin - page 76
- Genentech/Roche/OSI - Tarceva (erlotinib) - page 76
- Winning streak for Genentech/Roche? - page 77
- Pharmamar - Yondelis (trabectedin) - page 78
- Unlikely to change the treatment paradigm - page 78
- More potential with combination therapy? - page 79
- Marshall Edwards - phenoxodiol - page 79
- Toxicity will be the key factor for phenoxodiol - page 79
- Sanofi-Aventis as a marketing partner? - page 80
- Recently discontinued Phase III pipeline drug - page 80
- InterMune - Actimune (gamma interferon-1b) - page 80
- Phase II drugs in development for ovarian cancer - page 81
- Cell Therapeutics - Xyotax (polyglutamate paclitaxel) - page 66
- CHAPTER 6 APPENDIX A - page 82
- Participating opinion leaders - page 82
- Opinion leader interview transcripts - page 82
- Opinion leader 1 - page 82
- Opinion leader 2 - page 94
- Opinion leader 3 - page 100
- Reference - page 111
- CHAPTER 7 APPENDIX B - page 124
- About Datamonitor - page 124
- About Datamonitor Healthcare - page 124
- About the Oncology analysis team - page 125
- Disclaimer - page 126
- About Datamonitor - page 124
- List of Tables
- Table 1: Subtypes of epithelial, stromal and germ cell tumors - page 14
- Table 2: Ovarian cancer staging - page 15
- Table 3: Grading of ovarian cancer - page 17
- Table 4: Incidence of ovarian cancer between 2002 and 2015 in the seven major markets - page 17
- Table 5: Stage distribution at diagnosis - page 18
- Table 6: Incidence of ovarian cancer by stage in the seven major markets in 2005 - page 20
- Table 7: Prevalence of ovarian cancer in the seven major markets - page 22
- Table 8: Ovarian cancer five-year relative survival rate by stage - page 24
- Table 9: Cisplatin-paclitaxel trial results - page 31
- Table 10: Summary of key clinical trials for carboplatin-based regimens in ovarian cancer - page 33
- Table 11: Top two regimens for first-line therapy of ovarian cancer in the 5 EU markets - page 39
- Table 12: Summary results of Phase III trial of docetaxel versus paclitaxel - page 41
- Table 13: Diagnosis and relapse rate of ovarian cancer by stage - page 47
- Table 14: Top three regimens for second-line therapy of ovarian cancer in the 5 EU markets - page 54
- Table 15: Sales of gemcitabine by indication in the five EU markets in 2005 - page 62
- Table 16: Key Phase III drugs in development for ovarian cancer - page 65
- Table 17: Key Phase III trials of Telcyta for ovarian cancer - page 71
- Table 18: Phase II drugs in development for ovarian cancer - page 81
- List of Figures
- Figure 1: The female reproductive organs - page 12
- Figure 2: Incidence of ovarian cancer between 2002 and 2015 in the seven major markets - page 18
- Figure 3: Stage distribution at diagnosis - page 19
- Figure 4: Incidence of ovarian cancer by stage in the seven major markets in 2005 - page 21
- Figure 5: Prevalence of ovarian cancer in the seven major markets - page 22
- Figure 6: Ovarian cancer five-year relative survival rate by stage - page 24
- Figure 7: Five-year survival rates for ovarian cancer between 1975 and 1997 in the US - page 25
- Figure 8: Percentage of first-line ovarian cancer patients treated with carboplatin- and cisplatin-based regimens in the 5 EU markets - page 35
- Figure 9: Price of Paraplatin in the five EU markets - page 36
- Figure 10: Percentage of first-line ovarian cancer patients treated with taxanes in the 5 EU markets - page 43
- Figure 11: Diagnosis and relapse rate of ovarian cancer by stage - page 48
- Figure 12: Percentage of second-line patients treated with platinum and non-platinum regimens in the five EU markets - page 52
- Figure 13: Percentage of second-line ovarian cancer patients treated with carboplatin-based regimens in the five EU markets - page 53
- Figure 14: Drug regimens in first and second line in the five EU markets - page 56
- Figure 15: Platinum versus non-platinum regimens in third line in the five EU markets - page 60
- Figure 16: Percentage of third-line patients treated with drug regimens in the five EU markets - page 61
- Figure 17: Sales of Gemzar by indication in the five EU markets - page 63
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