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Research & Reports

Searching in Biopharma (1902)

Colorectal Cancer | Landscape & Forecast | Disease Landscape & Forecast

Colorectal Cancer | Landscape & Forecast | Disease Landscape & Forecast

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Colorectal cancer is the third-most-common cancer globally and is associated with a five-year overall survival of 65.1%. Current treatment for metastatic colorectal cancer is dominated by chemotherapy regimens in combination with angiogenesis inhibitors and EGFR inhibitors. Several areas of high unmet need—notably, RAS-mutant patient populations—offer significant commercial opportunity for innovative agents. Although sales of immune checkpoint inhibitors and emerging BRAF/MEK inhibitor combinations will increase over the 2017-2027 forecast period, generic and biosimilar competition will also have a major impact on therapy sales. This report provides insight on how treatment options for colorectal cancer are likely to change over the 2017-2027 forecast period. It also analyzes the current and future earnings potential of drugs already in the market and those expected to be approved for colorectal cancer.

Questions answered:

We forecast that sales of colorectal cancer therapies will decline over the 2017-2027 study period. What will be the major constraints on therapy sales? What are the key drivers of growth over this period? What are the drug development activities of note? What challenges and opportunities remain?

Two BRAF/MEK inhibitors combinations—Mektovi/Braftovi/Erbitux and Zelboraf/Erbitux/irinotecan—have shown promising efficacy in BRAF-mutant colorectal cancer patients. What is thought-leader opinion of these agents and of this drug class? For which patient populations will these agents be positioned? Will these agents receive approval in the markets under study? How will use of these agents affect prescribing of other agents for colorectal cancer?

In 2017, the FDA approved Keytruda (Merck) and Opdivo (Bristol-Myers Squibb) for second- and later-line treatment of MSI-H/dMMR colorectal cancer that is refractory to a fluoropyrimidine, irinotecan, and oxaliplatin. In 2018, Opdivo plus low-dose Yervoy received FDA approval in the same setting. How do key opinion leaders perceive these therapies? Will these therapies receive label expansions across the G7? Which other immune checkpoint inhibitors are being developed and in which patient populations?

Retrospective analyses of clinical trials with Avastin and EGFR inhibitors have shown that the side on which the tumor is located could be a prognostic factor for response to these agents. How do key opinion leaders view these data? Will “sidedness” have an impact on the treatment of metastatic colorectal cancer over the forecast period?


Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.

Primary research: 20 country-specific interviews with thought leaders.

Epidemiology: Diagnosed incident cases of stage I, II, III , and IV colorectal cancer.

Population segments in market forecast:Stage II colon cancer;stage II rectal cancer;stage III colon cancer;stage III rectal cancer;stage IV colorectal cancer wild-type BRAF and RAS, first-line (left-sided);stage IV colorectal cancer wild-type BRAF and RAS, first-line (right-sided);stage IV colorectal cancer mutant RAS, first-line;stage IV colorectal cancer mutant BRAF, first-line;stage IV colorectal cancer wild-type BRAF and RAS,second-line (left-sided); stage IV colorectal cancer wild-type BRAF and RAS,second-line (right-sided); stage IV colorectal cancer mutant RAS, second-line; stage IV colorectal cancer mutant BRAF, second-line; stage IV colorectal cancer wild-type BRAF and RAS, third-line (left-sided); stage IV colorectal cancer wild-type BRAF and RAS, third-line (right-sided); stage IV colorectal cancer mutant RAS, third-line; stage IV colorectal cancer mutant BRAF.

Emerging therapies: Phase III: 12 drugs; Phase II: 26 drugs; Phase I: 14 drugs.

Table of contents

  • Disease Landscape & Forecast
    • Key Updates
      • February 2019
      • October 2018
    • Market Outlook
      • Key Findings
        • Market Overview
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Colorectal Cancer?
        • What Factors Are Constraining the Market for Colorectal Cancer?
      • Segment-Specific Trends
        • Stage II/III Colorectal Cancer
        • First-Line Metastatic Colorectal Cancer
        • Second-Line Metastatic Colorectal Cancer
        • Third-Line Metastatic Colorectal Cancer
    • Forecast
      • Market Forecast Assumptions
      • Market Forecast Dashboard
    • Etiology & Pathophysiology
      • Disease Overview
      • Disease Pathophysiology
        • Etiology
        • Pathophysiology
      • Staging and Classification
        • Staging of Colorectal Cancer
        • Screening of Colorectal Cancer
      • Key Pathways and Drug Targets
    • Epidemiology
      • Key Findings
      • Epidemiology Populations
        • Diagnosed Incident Cases
        • Stage Distribution of Colorectal Cancer
        • Recurrent Incident Cases of Colorectal Cancer
        • Drug-Treatable Populations
        • Drug-Treated Populations
    • Current Treatment
      • Key Findings
      • Treatment Goals
      • Key Current Therapies
        • Overview
        • Immune Checkpoint Inhibitors
        • Angiogenesis Inhibitors
        • EGFR Inhibitors
        • Chemotherapy
      • Medical Practice
        • Stage II/III Colon Cancer
        • Stage II/III Rectal Cancer
        • Treatment of Colorectal Cancer with Resectable Liver Metastases
        • First-Line Treatment of Metastatic Colorectal Cancer
        • Second-Line Treatment of Metastatic Colorectal Cancer
        • Third- and Later-Line Treatment of Metastatic Colorectal Cancer
        • Treatment Guidelines
        • Region-Specific Treatment Practices
    • Unmet Need Overview
      • Current and Future Attainment of Unmet Needs in Colorectal Cancer
    • Emerging Therapies
      • Introduction
      • Key Emerging Therapies
        • Notable Developments Among Key Emerging Therapies for Colorectal Cancer
        • BRAF/MEK Inhibitors
        • Tyrosine Kinase Inhibitors
        • Immune Checkpoint Inhibitors
        • Therapeutic Vaccines
        • Immunomodulators
        • Cancer Stem-Cell Pathway Inhibitors
        • Chemotherapy
      • Early-Phase Pipeline Analysis
        • Notable Developments in the Early-Phase Pipeline for Colorectal Cancer
    • Access & Reimbursement Overview
      • Region-Specific Reimbursement Practices
        • United States
        • EU5
        • Japan
      • Looking for More?
    • Methodology
      • Bottom-Up Forecasting Overview
        • Patient Populations
        • Drug- and Regimen-Specific Assumptions
      • Bottom-Up Forecast Assumptions
        • General Sources of Data
        • General Statements About Pricing
        • Dosing, Cycles of Therapy, and Compliance
        • Generic Erosion
        • Biosimilar Erosion
        • Out-Year Forecasting
        • Emerging Therapy Prices
      • Primary Market Research
        • Experts Interviewed
    • Appendix
      • Colorectal Cancer Bibliography

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  • Pub Date: February 2019
  • Author(s): Jorrit Schafer, M.Sc.,Ph.D; Alison Isherwood, MSc, MRes, PhD
  • Jorrit Schäfer, , is a business insights analyst at Decision Resources Group. Prior to joining DRG, Dr. Schäfer worked as a postdoctoral research associate at Imperial College London, where he studied the impact of antibiotic stress on RNA repair in bacteria. Dr. Schäfer holds a in molecular medicine and a in molecular cell biology from Imperial College London.

  • Alison Isherwood, , joined Decision Resources Group in 2008, as an Epidemiologist. Alison holds a in Medical Microbiology, Masters by Research in the Life Sciences and a in Epidemiology all from the University of Edinburgh. Prior to joining Decision Resources Inc., she was working on her in Molecular Virology, specializing on the severe acute respiratory syndrome (SARS) coronavirus, at the University of Reading. In her role at Decision Resources Group, Alison is currently an Epidemiology team lead as well as project managing custom epidemiology work in multiple therapy areas. Alison’s area of specialization at DRG is cancer, particularly breast cancer.

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