What attributes will distinguish emerging therapies in the eyes of oncologists and payers?
Treatment options for triple-negative breast cancer patients are limited, as patients are ineligible for treatment with either hormonal or HER2-targeted agents. Treatment typically involves nontargeted cytotoxic chemotherapies. Therefore, great commercial opportunity exists in developing effective, targeted therapies for this patient population. Interviewed oncologists are hopeful that more-effective targeted therapies are on the horizon for this patient population. However, the most promising emerging agents in development for triple-negative breast cancer target only specific subsets of patients, such as those with BRCA1/2-mutation positive disease. As a result, the majority of the triple-negative breast cancer population is likely to remain underserved for the foreseeable future.
Attributes included in conjoint analysis based assessment of target product profiles for advanced/metastatic triple-negative breast cancer:
- Median overall survival.
- Progression-free survival.
- Overall response rate.
- Lymphopenia (grade 3/4).
- Neuropathy (grade 3/4).
- Thrombocytopenia (grade 3/4).
- Price per 21-day cycle.
Attributes included in assessment of U.S. payers’ receptivity to new therapies for advanced/metastatic triple-negative breast cancer:
- Effect on median overall survival.
- Effect on median progression-free survival.
- Effect on frequency of hematological toxicities.
- Effect on frequency of gastrointestinal toxicities.
Physicians surveyed: 60 U.S. and 30 European oncologists.
Payers surveyed: 20 U.S. MCO PDs.
Comprehensive List of Therapies Included in Our Research and Modeling:
- Nanoparticle paclitaxel (Celgene’s Abraxane)
- Paclitaxel (Bristol-Myers Squibb’s Taxol, generics)
- Paclitaxel + carboplatin (Bristol-Myers Squibb’s Taxol, generics plus Bristol-Myers Squibb’s Paraplatin, generics)
- Bevacizumab + paclitaxel (Roche/Genentech/Chugai’s Avastin plus Bristol-Myers Squibb’s Taxol, generics)
- Capecitabine (Roche/Chugai’s Xeloda, generics)
- Niraparib (Tesaro)
- Buparlisib (Novartis)
- Enzalutamide (Medivation’s Xtandi)
- Sorafenib + capecitabine (Bayer HealthCare/Onyx Pharmaceutical’s Nexavar plus Roche’s Xeloda, generics)
- Glembatumumab vedotin (Celldex Therapeutics)