Of the Several Exciting Agents in Late-Stage Development, Do Any Have the Potential to Dramatically Improve Survival?
Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers; of these lung cancers, approximately 90% are EGFR wild-type/untested. Despite significant advances in the treatment of advanced/metastatic NSCLC in the first-line setting, treatment options for later-line settings have not changed over the past decade. Chemotherapies such as docetaxel (Sanofi’s Taxotere, generics) and pemetrexed (Eli Lilly’s Alimta) and the EGFR inhibitor erlotinib (Genentech/Roche/Chugai/Astellas’s Tarceva) remain the standards of care for EGFR wild-type/untested patients. No targeted agents are available in the second- and later-line settings; therefore, these patients remain difficult to treat. Thus, significant clinical and commercial opportunity remains for novel, highly efficacious, and tolerable therapies.
Attributes included in conjoint analysis based assessment of target product profiles for previously treated EGFR wild-type/untested NSCLC:
- Median overall survival (months).
- Median progression-free survival (months).
- Objective response rate (% of patients).
- Availability of predictive biomarker.
- Incidence of grade 3/4 neutropenia (% of patients).
- Incidence of all grades diarrhea (% of patients).
Attributes included in assessment of U.S. payers’ receptivity to new therapies for previously treated EGFR wild-type/untested NSCLC:
- Effect on MOS.
- Effect on PFS.
- Incidence of grade 3/4 neutropenia.
- Incidence of all grades rash.
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:
- Erlotinib (Genentech/Roche/Chugai/Astellas’s Tarceva)
- Docetaxel (Sanofi’s Taxotere, generics)
- Pemetrexed (Eli Lilly’s Alimta)
- Nivolumab (Bristol-Myers Squibb/Ono Pharmaceutical)
- Pembrolizumab (Merck & Co.)
- Dacomitinib (Pfizer)
- Onartuzumab (Genentech/Roche/Chugai’s MetMAb) + erlotinib
- Selumetinib (AstraZeneca) + docetaxel