Triple-negative breast cancer (TNBC) is a patient population with high unmet need given the poor outcomes associated with current treatment options and the historic lack of targeted therapies available. The treatment landscape has evolved in recent years with the approval of PARP inhibitors Lynparza and Talzenna for patients with germline BRCA mutations and Tecentriq plus Abraxane for PD-L1-positive patients. Despite the availability of new therapies, significant clinical and commercial opportunity remains for the development of targeted and/or immune-based therapies to improve survival outcomes. Our unmet need module analyzes the key drivers of prescribing and assesses how emerging therapies may capitalize on these opportunities.

Questions Answered

  •  What are the key drivers that are most likely to influence treatment uptake for advanced / metastatic TNBC?
  •  How do current therapies perform on key treatment drivers and goals for advanced / metastatic TNBC?
  • What are the prevailing areas of unmet need and opportunities in advanced / metastatic TNBC?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European medical oncologists for a hypothetical therapy in newly diagnosed advanced / metastatic TNBC?

Product Description

Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. Two market scenarios are profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 30 European medical oncologists fielded in May 2019.

Key companies: Roche / Genentech, Celgene, AstraZeneca, Pfizer, Eisai.

Key drugs: Tecentriq, Abraxane, Lynparza, Talzenna, Halaven, Avastin.

Table of contents

  • Breast Cancer - Unmet Need - Detailed, Expanded Analysis: Advanced/Metastatic Triple-Negative Breast Cancer
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
        • Products/Regimens for Advanced or Metastatic Triple-Negative Breast Cancer
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Medical Oncologists' Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer
      • Importance of Efficacy Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Key Findings: Stated vs. Derived Importance
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Overall Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Mean Overall Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer: United States and Europe
      • Relative Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Advanced or Metastatic Triple-Negative Breast Cancer
      • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Advanced or Metastatic Triple-Negative Breast Cancer on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Advanced or Metastatic Triple-Negative Breast Cancer: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Advanced or Metastatic Triple-Negative Breast Cancer: Europe
      • Key Findings: Unmet Need in Advanced or Metastatic Triple-Negative Breast Cancer and Related Indications
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Advanced or Metastatic Triple-Negative Breast Cancer and Related Indications: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Advanced or Metastatic Triple-Negative Breast Cancer and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Advanced or Metastatic Triple-Negative Breast Cancer Market and Emerging Therapy Insights
        • Opportunity: A Novel Agent with Improved Survival Benefit
        • Opportunity: A New Therapy That Improves Progression-Free Survival
        • Opportunity: A Novel Agent with Improved Tumor Response
        • Opportunity: A Novel Therapy with a Better Safety and Tolerability Profile
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Target Product Profile: Attribute Importance
        • Median Overall Survival
        • Median Progression-Free Survival
        • Objective Response Rate
        • Incidence of Grade 3/4 Neutropenia
        • Incidence of Grade 3/4 Gastrointestinal Toxicities
        • Incidence of Grade 3/4 Peripheral Neuropathy
        • Price per 28-Day Cycle
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Market Simulations: Target Product Profiles Included in Scenario 1
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • First-Line Advanced or Metastatic Triple-Negative Breast Cancer Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Priti Girotra, M.Pharm., Ph.D

Priti Girotra, M.Pharm., Ph.D., is an analyst in the oncology team at Decision Resources Group and has authored insightful content on multiple indications including Non-Small-Cell Lung Cancer, Colorectal Cancer, Gastroesophageal Cancer, Malignant Melanoma, and Multiple Myeloma. Prior to joining DRG, Dr. Girotra conducted her Ph.D. research on formulation optimization of nanoparticles containing triptan derivatives for effective brain targeting and therapeutic management of migraine, under a DST-INSPIRE Fellowship at G.J. University of Science & Technology, Hisar, India.


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