Last Updated 24 October 2014
The prostate cancer market has witnessed considerable changes over the last four years with the launch of five therapies for metastatic castrate-resistant prostate cancer (mCRPC). Abiraterone (Johnson & Johnson/Janssen Biotech/Janssen-Cilag/AstraZeneca’s Zytiga) is established as a key agent to treat mCRPC; enzalutamide follows abiraterone and promises to compete fiercely for a share of this market, including in the commercially lucrative first-line chemotherapy-naive mCRPC setting. A number of emerging therapies are in Phase III development for prostate cancer, including for the untapped nonmetastatic CRPC (nmCRPC) patient population. The expected launch of several emerging therapies for prostate cancer over the next decade will heighten the competition, and it will be imperative for current and emerging therapies to differentiate and position themselves to maximize clinical and commercial success.
Questions Answered in This Report:
- Abiraterone was the 2013 sales leader for prostate cancer across the seven major markets under study in this report. Enzalutamide (Medivation/Astellas Pharma’s Xtandi) gained FDA approval for chemotherapy-naive mCRPC patients in September 2014, emulating the development path of abiraterone. To what extent will the drug compete with abiraterone in mCRPC? Which of abiraterone or enzalutamide is favored by interviewed experts? Which therapies will pose the greatest threat to enzalutamide?
- Several emerging therapies are in late-stage development for prostate cancer, both from existing and novel drug classes. Which emerging therapies will be clinically and commercially successful? How will they differentiate themselves from one another and from current therapies? How will these agents be positioned and fit into the treatment armamentarium for prostate cancer?
- Enzalutamide, ARN-509 (Johnson & Johnson), and ODM-201 (Orion/Bayer HealthCare) are being evaluated in Phase III trials in nonmetastatic CRPC (nmCRPC), an untapped and underserved patient population. What is interviewed experts’ perception of these agents? What efficacy and safety outcomes are experts looking for in this patient segment? What factors will shape the nmCRPC market?
Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.
Primary research: 40 country-specific interviews with prostate cancer experts; physician surveys fielded to approximately 30 physicians (15 medical oncologists and 15 urologists) in the major markets.
Epidemiology: Diagnosed incidence of prostate cancer by risk for biochemical recurrence and TNM status. Clinical- and market-relevant drug-treatable populations.
Population segments in market forecast: Newly diagnosed, low/intermediate risk (hormone-sensitive), newly diagnosed, high/very-high risk (hormone-sensitive), newly diagnosed, metastatic (hormone-sensitive), biochemically recurrent (hormone-sensitive), nonmetastatic castrate-resistant, first-line metastatic castrate-resistant, second-line metastatic castrate-resistant, and third- and fourth-line metastatic castrate-resistant.
Emerging therapies: Phase I/II: 22 drugs; Phase III: 10 drugs.
Market forecast features: Using a proprietary patient-flow model, we forecast population sizes and drug sales for clinically and commercially relevant prostate cancer patient segments through 2023.
Michael Hughes, M.Sc., Ph.D.