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For a clearer market perspective

The Cancer Market


Outlook to 2014
Competitive landscape, market size,
pipeline analysis and growth
opportunities

Report Price £1995/R2885/$3835


Publication date December 2009
H E A L T H C A R E
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

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Report Overview
In the current decade, oncology has been one of the most important growth
segments among the pharmaceutical markets with a major focus on targeted Pages 194
agents. Most innovation in oncology over the past 10 years has been driven by
scientific advances, particularly in genomics, transcriptomics and proteomics. In Figures 15
the current environment, the successful oncology players of the future will be
those that can anticipate protocol evolution and design the most relevant clinical Tables 76
trials. In recent years, biotech companies have fuelled innovation in oncology
more than ever before. Partnering with biotech companies is a key (but
expensive) source of innovation for many pharma companies as approximately This report provides wide
75% of phase II, III and pre-registration innovative drugs are of biotech origin. coverage across the major
cancer markets, and provides
an analysis of marketed and
At $47.7bn, cancer is one of the largest and fastest growing markets in the pipeline drugs. It also
pharmaceutical industry. However, pricing risk remains the key investment analyzes the growth trends
and future market leaders,
concern in oncology. The key concern, however, is not price erosion driven by forecasting revenues and
competitive forces, but price cuts imposed by payors irrespective of the fact that epidemiology through the
such unilateral price cuts by payors have never occurred in any of the major period 2008-14...
developed markets and would surely jeopardize the premise on which the entire
biopharmaceutical industry has been built.

This report provides coverage of over 95% of the total market for cancer products and enables the reader to
understand the issues behind the market-leading products of today and forecasts the market-leading products of
tomorrow. The report allows the reader to understand which pharmaceutical companies will be the dominant forces in
the cancer arena, and which products will be the strongest performers over the period 2009-14.
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Key Findings
In 2008, antineoplastic mAbs delivered huge sales
of $13.6bn with a market share of 28.6% of total
sales. The key antineoplastic mAbs which contributed to the
higher market share of this class in 2008 were MabThera
(11.0%), Avastin (10.3%), Herceptin (9.7%) and Erbitux (3.4%).
Forecast sales of the total antineoplastics market are
estimated at $65.2bn in 2014.

Roche is the global market leader in cancer,


holding the highest market share of 29.2%
($14.0bn sales) in 2008 based on sales from (MabThera, Figure 4.7: Key drugs in late-stage
Avastin, Herceptin, Tarceva and Xeloda). Roche’s strength development or that have been recently
launched
in the cancer market has been bolstered by its acquisition of
Genentech and purchase of majority stakes in Chugai, which “More than $47.7bn worth of cancer drugs were sold
has provided additional breadth to its portfolio. globally in 2008 with US making up for 39.1% of these
sales. The value of novel targeted therapies, their
combinations with chemotherapy, and the potential of
Eli Lilly’s acquisition of ImClone will increase the adjuvant therapy have demonstrated to improve survival
former’s flow of high-quality, innovative new rates, notably in breast, lung and colon cancers ”
therapies. The transaction will immediately enable Eli Lilly to
offer physicians and their patients a complementary portfolio of
leading oncolytic agents and targeted therapies including Gemzar, Alimta and Erbitux.

Pfizer’s axitinib, Dendreon’s Provenge and GSK/Genmab’s Arzerra are expected to be the top sellers
among late stage pipeline oncolytic agents.

Use this report to...


• Develop insight into patient potential with • Understand which indications have the
the report’s coverage of major indications in the greatest potential to provide franchise
cancer segment, the seven largest geographic growth, and how pharmaceutical companies
pharmaceutical markets and 10 largest are attempting to exploit these opportunities
companies active in the cancer segment today
• Compare the franchises of top
• Quickly understand how recent events are pharmaceutical marketers across major
affecting the performance of major products, indications, and understand how market share
and how their marketers are confronting of leading companies will change over the next
competitive changes in cancer marketplace 6 years

• Gain up-to-date competitive intelligence • Use head-to head comparisons of the leading
across the cancer indications and understand cancer pipeline compounds to understand
the major issues affecting key which companies will have a presence among
pharmaceutical/biotech players key indications over the next 6 years
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Key issues...
FDA approves Cervarix for cervical cancer: In October 2009, FDA approved GSK’s Cervarix for the
prevention of pre-cancerous lesions caused by human papillomavirus (HPV) type 16 & 18 in women aged
10–25 years. Cervarix’s inclusion in children’s vaccine program is a major step towards securing reimbursement.
Cervarix, expected to launch by the end of 2009, faces direct competition from Merck’s Gardasil and will help to
reduce the incidence of cervical cancer in future.

Merck’s Gardasil adds US indication of genital warts for boys and men: On 16th October 2009,
Gardasil’s US label was extended to include its use in both men and boys aged 9–26 years of age. The
pivotal trial results showed an efficacy of 90.4% while preventing external genital lesions of HPV types
6/11/16/18. In addition, Merck also planned to extend its vaccine patient assistance program providing free
Gardasil to 19–26 year old uninsured males meeting eligibility criteria but unable to afford the vaccine.

Roche’s Avastin filed for first-line breast cancer in Japan: In October 2009, Roche’s Japanese
subsidiary, Chugai has filed a Japanese approval for Avastin in the first-line treatment of advanced or
recurrent breast cancer. The filing in first-line breast cancer was supported by an international Phase III trial (first-
line setting), which showed a significant improvement in PFS. This in turn was supported by Japanese Phase II
safety and efficacy data. Approval of the product will expand Avastin’s purview beyond colon cancer in the
country, becoming growth driving event.

Eisai to file first in-house breast cancer drug in major markets: Eisai is planning to file its in-house
developed chemotherapy drug eribulin for pre-treated breast cancer (advanced or metastatic) in all the
major markets (US, 5EU & Japan) by March 2010. Preliminary results from the key Phase III trial demonstrated a
significant improvement in overall survival, the primary endpoint.

Discover...
• What will be the major growth indications in • Which products will be impacted by generic
the cancer segment over the period 2008–14? competitors over the period 2008–14?

• Which companies were the winners and losers • Which pipeline products will be the growth
in the cancer segment in 2008? drivers of the future?

• How have recent major launches from • Which indications are forecast to have the
companies such as Roche, Sanofi-Aventis, highest levels of market potential over the
AstraZeneca, Novartis and Eli Lilly performed? period 2008–14?

• Which companies will become the key players • What will the competitive landscape in lung,
in the cancer segment over the period breast, colorectal, ovarian, prostate, lymphoma
2008–14? and pancreatic cancer in 2014?
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Table of Contents
EXECUTIVE SUMMARY • Uterine and cervical cancer - Herceptin (trastuzumab) –
• Epidemiology of Cancer - Overview Roche/Genentech/Chugai
- Diagnosis, treatment and - Glivec/Gleevec (imatinib) –
• Global Market Analysis
management Novartis
• Pipeline Analysis - Epidemiology - Taxotere (docetaxel) – Sanofi-
• Competitive Landscape - Forecast epidemiology Aventis
• Leukemia • Leading brands by type of cancer
CHAPTER 1 SCOPE AND - Overview • Key recent events in the cancer
METHODOLOGY - Diagnosis, treatment and market
• Scope management - FDA approves Cervarix for
• Methodology - Epidemiology cervical cancer
- Forecast epidemiology - Merck's Gardasil adds US
CHAPTER 2 OVERVIEW AND • Prostate cancer indication of genital warts for
EPIDEMIOLOGY OF CANCER - Overview boys and men
INDICATIONS - Diagnosis, treatment and - Roche's Avastin is filed for first-
• Summary management line breast cancer in Japan
- Epidemiology - Eisai to file first in-house breast
• Introduction
- Forecast epidemiology cancer drug in major markets
• Overview - Novartis's Tasigna bolsters its
• Pancreatic cancer
• Cancer risk factors - Overview CML franchise
• Lung cancer - Diagnosis, treatment and • Antineoplastics
- Overview management - Competitive dynamics of
- Diagnosis, treatment and - Epidemiology antineoplastics
management - Forecast epidemiology - Leading brands of
- Epidemiology • Lymphomas antineoplastics
- NSCLC - Overview - Antineoplastic mAb market
- SCLC analysis
- Diagnosis, treatment and
- Forecast epidemiology - Market dynamics
management
- NSCLC - Key brands analysis
- Epidemiology
- SCLC - Antineoplastic protein kinase
- Forecast epidemiology
• Colorectal cancer inhibitors
- Overview • Head and neck cancer - Market dynamics
- Diagnosis, treatment and - Overview - Key brands analysis
management - Diagnosis, treatment and - Vinca alkaloid market analysis
- Epidemiology management - Market dynamics

- Forecast epidemiology - Epidemiology - Key brands analysis


- Forecast epidemiology - Anti-metabolites
• Breast cancer - Market dynamics
- Overview - Key brands analysis
CHAPTER 3 GLOBAL MARKET
- Diagnosis, treatment and - Platinum compounds
ANALYSIS
management - Market dynamics
- Epidemiology • Summary - Key brands analysis
- Forecast epidemiology • Introduction - Antineoplastic sales forecast
• Ovarian cancer • Market analysis by country • Cytostatic hormonal therapies
- Overview • Market analysis by drug class - Competitive dynamics of
- Diagnosis, treatment and cytostatic hormonal therapies
• Leading brand dynamics
management - Leading brands of cytostatic
- MabThera (rituximab)
- Epidemiology hormonal therapies
–Roche/Genentech
- Forecast epidemiology - Cytostatic gonad hormone
- Avastin (bevacizumab) –
analog market analysis
Roche/Genentech
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Table of Contents
- Market dynamics CHAPTER 5 COMPETITIVE - Regional sales distribution
- Key brands analysis LANDSCAPE - Marketed product portfolio
- Aromatase inhibitors - Pipeline analysis
• Summary
- Market dynamics - Strategic and growth analysis
- Key brands analysis • Introduction
- Drivers of growth
- Anti-androgens - Sales performance of leading - Resistors of growth
- Market dynamics players
• Takeda
- Key brand analysis
• Roche - Sales focus by drug class
- Cytostatic hormonal therapy
- Sales focus by drug class - Regional sales distribution
sales forecast
- Regional sales distribution - Marketed product portfolio
- Global cancer market sales
- Marketed product portfolio - Pipeline analysis
forecast
- Pipeline analysis - Strategic and growth analysis
- Strategic and growth analysis - Drivers of growth
CHAPTER 4 PIPELINE ANALYSIS - Drivers of growth - Resistors of growth
• Summary - Resistors of growth
• Bristol-Myers Squibb
• Introduction • Sanofi–Aventis - Sales focus by drug class
• Key trends in R&D - Sales focus by drug class - Regional sales distribution
- Targeted therapies are changing - Regional sales distribution - Marketed product portfolio
the treatment regimen of cancer - Marketed product portfolio - Pipeline analysis
- Biomarkers are personalizing - Pipeline analysis - Strategic and growth analysis
oncology treatment - Strategic and growth analysis - Drivers of growth
- Drivers of growth - Resistors of growth
- Cancer vaccines enhance the
- Resistors of growth
body's immune response
- Pricing is becoming a major • AstraZeneca CHAPTER 6 APPENDIX
issue for cancer patients - Sales focus by drug class • IMS Data
- Combination treatments are - Regional sales distribution - Antineoplastic and
becoming the treatment of - Marketed product portfolio immunomodulating agents
choice - Pipeline analysis - L1: Antineoplastics
- Strategic and growth analysis - L2: Cytostatic hormone therapy
• Leading drugs in development
- Drivers of growth - Forecast factors
- Phase III and pending approval - Resistors of growth - Glossary
compounds
• Novartis - Abbreviations used in this report
- Enzastaurin – Eli Lilly
- Sales focus by drug class - Index
- BiovaxID – Biovest International
and Accentia Biopharmaceuticals - Regional sales distribution
- Recentin (cediranib) – AstraZeneca - Marketed product portfolio LIST OF FIGURES
- Zactima (vandetanib) – - Pipeline analysis • Types of breast cancers
AstraZeneca - Strategic and growth analysis • Types of leukemia
- Axitinib (AG-13736) – Pfizer - Drivers of growth
- Provenge (sipuleucel-T) – • Chemotherapy options for
- Resistors of growth
Dendreon Hodgkin's disease
• Eli Lilly
- Recently approved/marketed • Head and neck cancers and their
- Sales focus by drug class
drugs risk factors
- Regional sales distribution
- Arzerra (ofatumumab) – • Worldwide cancer market share by
- Marketed product portfolio
GSK/Genmab
- Pipeline analysis region, 2008
- Afinitor (everolimus) – Novartis
- Iressa (gefitinib) – AstraZeneca - Strategic and growth analysis • Current pharmacological treatment
- Tykerb/Tyverb (lapatinib) – GSK - Drivers of growth options for cancer
- Votrient (pazopanib) – GSK - Resistors of growth • Key drugs in late-stage
• Pipeline forecast of key compounds • Pfizer development or that have been
- Factors affecting forecasts - Sales focus by drug class recently launched
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Table of Contents
• Contribution of the top 10 players • Estimated prevalence of uterine and • Breakdown of the global
to growth of the global cancer cervical cancer across seven major antineoplastic market by drug class,
market, 2007–08 markets, 2008 2008
• Roche's cancer sales by drug class, • Forecast epidemiology of uterine • Leading brands in global
2008 and cervical cancer across seven antineoplastics market, 2008
• Sanofi–Aventis's cancer sales by major markets, 2008–14 • Chronology of new indication
drug class, 2008 • Estimated prevalence of leukemia approvals for Eloxatine
• AstraZeneca's cancer sales by drug across seven major markets, 2008 • Antineoplastic sales forecast,
class, 2008 • Forecast epidemiology of leukemia 2008–14
• Novartis's cancer sales by drug across seven major markets, • Breakdown of the global cytostatic
class, 2008 2008–14 hormonal therapies by drug class,
• Pfizer's cancer sales by drug class, • Estimated prevalence of prostate 2008
2008 cancer across seven major markets, • Leading brands in global cytostatic
• Takeda's cancer sales by drug class, 2008 hormonal therapies market, 2008
2008 • Forecast epidemiology of prostate • Cytostatic hormonal therapy sales
• BMS' cancer sales by drug class, cancer across seven major markets, forecast, 2008–14
2008 2008–14 • Global cancer market sales forecast,
• Estimated prevalence of pancreatic 2008–14
LIST OF TABLES cancer across seven major markets, • An overview of enzastaurin
2008 • An overview of BiovaxID
• Estimated prevalence of NSCLC
across seven major markets, 2008 • Forecast epidemiology of • An overview of Recentin
pancreatic cancer across seven
• Estimated prevalence of SCLC • The Horizon Study Program
major markets, 2008–14
across seven major markets, 2008 • An overview of Zactima
• Estimated prevalence of lymphomas
• Forecast epidemiology of NSCLC • Overview of Zactima’s Phase III
across seven major markets, 2008
across seven major markets, development plan
2008–14 • Forecast epidemiology of
• An overview of axitinib
lymphomas across seven major
• Forecast epidemiology of SCLC • An overview of Provenge
markets, 2008–14
across seven major markets,
• An overview of Arzerra
2008–14 • Estimated prevalence of head and
neck cancer across seven major • An overview of Afinitor
• Estimated prevalence of colorectal
markets, 2008 • An overview of Iressa
cancer across seven major markets,
• Forecast epidemiology of head and • An overview of Tykerb/Tyverb
2008
neck cancer across seven major • An overview of Votrient
• Forecast epidemiology of colorectal
markets, 2008–14 • Key pipeline and recently approved
cancer across seven major markets,
2008–14 • Global cancer market by geography, products sales forecast, 2008–14
2008 • Leading players in the global cancer
• Estimated prevalence of breast
cancer across seven major markets, • Breakdown of the global cancer market, 2008–14
2008 market by drug class, 2008 • Regional sales distribution of Roche,
• Forecast epidemiology of breast • Leading brands in the global cancer 2008
cancer across seven major markets, market, 2008 • Roche's cancer product portfolio,
2008–14 • Leading brands in breast cancer, 2008
• Estimated prevalence of ovarian 2008 • Roche's cancer R&D product
cancer across seven major markets, • Leading brands in colon cancer, pipeline, October 2009
2008 2008 • Regional sales distribution of Sanofi-
• Forecast epidemiology of ovarian • Leading brands in prostate cancer, Aventis, 2008
cancer across seven major markets, 2008 • Sanofi–Aventis's cancer product
2008–14 • Leading brands in lung cancer, 2008 portfolio, 2008
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Table of Contents
• Sanofi-Aventis's cancer R&D
product pipeline, October 2009
• Regional sales distribution of
AstraZeneca, 2008
• AstraZeneca's cancer product
portfolio, 2008
• AstraZeneca's cancer R&D product
pipeline, October 2009
• Regional sales distribution of
Novartis, 2008
• Novartis' cancer product portfolio,
2008
• Novartis's cancer R&D product
pipeline, October 2009
• Regional sales distribution of Eli
Lilly, 2008
• Eli Lilly's cancer product portfolio,
2008
• Eli Lilly's cancer R&D product
pipeline, October 2009
• Regional sales distribution of Pfizer,
2008
• Pfizer's cancer product portfolio,
2008
• Pfizer's cancer R&D product
pipeline, October 2009
• Regional sales distribution of
Takeda, 2008
• Takeda's cancer product portfolio,
2008
• Takeda's cancer R&D product
pipeline, October 2009
• Regional sales distribution of BMS,
2008
• BMS' cancer product portfolio, 2008
• BMS' cancer R&D product pipeline,
October 2009
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