Despite the number of therapy options available, advanced or metastatic HR-positive / HER2-negative breast cancer remains incurable and a major cause of mortality and morbidity in women. Later-line therapies that can be used following the development of hormone resistance are greatly needed. Although the recent introduction of targeted therapies such as Piqray (Novartis) have improved patient outcomes, several treatment gaps remain. Emerging therapies such as elacestrant (Radius Health) and sacituzumab govitecan (Immunomedics) are poised to launch in the near term, boosting competition in an already crowded market. As this competition intensifies, novel therapies should address the remaining unmet needs in the treatment of advanced or metastatic HR-positive / HER2-negative breast cancer to differentiate themselves from their rivals.

QUESTIONS ANSWERED

  • What treatment drivers and goals are most likely to influence the choice of therapy for advanced or metastatic HR-positive/HER2-negative breast cancer?
  • How do key current therapies, such as Ibrance (Pfizer) and Piqray (Novartis), perform on key clinical attributes for this patient population?
  • What are the prevailing areas of unmet need and hidden opportunities in this patient population?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European medical oncologists for a hypothetical therapy in advanced or metastatic HR-positive/HER2-negative breast cancer?

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. One market scenario is 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 February 2020.

Key companies: Onyx Pharmaxeauticals / Pfizer, Novartis, Eli Lilly, AstraZeneca, Abbott Laboratories.

Key drugs: Ibrance, Kisqali, Verzenio, Piqray, Faslodex, Afinitor, letrozole, anastrozole, and exemestane.

Table of contents

  • Breast Cancer - Unmet Need - Detailed, Expanded Analysis (US & EU ) Metastatic HR-Positive/ HER2-Negative
    • Executive Summary
      • Unmet Need - Breast Cancer - Executive Summary - June 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products/Regimens for Advanced or Metastatic HR-Positive/HER2-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 HR-Positive/HER2-Negative Breast Cancer
        • Importance of Efficacy Attributes to Prescribing Decisions in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Advanced or Metastatic HR-Positive/HER2-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 HR-Positive/HER2-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 HR-Positive/HER2-Negative Breast Cancer: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States
        • Overall Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: Europe
        • Mean Overall Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States and Europe
        • Relative Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Across Select Convenience of Administration Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer
        • Surveyed Medical Oncologists' Satisfaction with the Performance of Key Therapies for Advanced or Metastatic HR-Positive/HER2-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 HR-Positive/HER2-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 HR-Positive/HER2-Negative Breast Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer: Europe
        • Key Findings: Unmet Need in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer and Related Indications
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer and Related Indications: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Market and Emerging Therapy Insights
          • Opportunity: A Novel Therapy That Can Prolong Overall Survival
          • Opportunity: A Novel Therapy with Delayed Progression-Free Survival
          • Opportunity: A Novel Therapy That Improves Tumor Response
          • Opportunity: A Novel Agent with a Better Safety and Tolerability Profile
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
          • Assigned Prohibitions for the Conjoint Module
        • Attribute Importance and Part-Worth Utilities
          • Second- and Subsequent-Line Advanced or Metastatic HR-Positive/HER2-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 Any Grade Diarrhea
          • Incidence of Any Grade Rash
          • Price per 28-Day Cycle
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • Second- and Subsequent-Line Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • Second- and Subsequent-Line Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • Second- and Subsequent-Line Advanced or Metastatic HR-Positive/HER2-Negative Breast Cancer Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Bibliography

    Author(s): Sorcha Cassidy M.Res., Ph.D

    Sorcha Cassidy M.Res., Ph.D., is an Associate Director in the Oncology team at Decision Resources Group.  Dr. Cassidy manages a team of analysts who conduct extensive primary and secondary market research on several Oncology indications across the major pharmaceutical markets. She also provides sales and client support across all oncology products. She has in-depth expertise in competitive intelligence, secondary and primary market research, and delivering strategic insights that address key client business questions. Dr. Cassidy holds an M.Res and Ph.D in Immunology from Imperial College London where she investigated the role of innate immune modulators (killer immunoglobulin-like receptors [KIR) on natural killer (NK) cells in various diseases and published several peer-reviewed papers. Prior to joining the company, Dr. Cassidy previously worked as a Market Research Manager in Janssen UK and has extensive experience working across multiple Oncology indications at GlobalData and FirstWord Pharma.


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