MARKET OUTLOOK

Relapsed/refractory diffuse large B-cell lymphoma (R/RDLBCL) represents an area of high unmet need in non-Hodgkin’s lymphoma (NHL) due to the poor outcomes with current salvage treatment. Rituximab-based chemoimmunotherapy regimens (e.g., R-DHAP, R-ICE, R-ESHAP) are the conventional standard of care for R/RDLBCL followed by conditioning and autologous or allogeneic stem cell transplantation (SCT) in eligible patients. The anti-CD19 CAR T-cell therapies Yescarta (Gilead/Kite) and Kymriah (Novartis) have expanded treatment options for patients with DLBCL, although their current use is restricted to third and subsequent lines of therapy. Despite the evolving market landscape, significant unmet need remains in the treatment of R/RDLBCL due to the limited availability of effective treatment options.

QUESTIONS ANSWERED

  • What are the most important factors that drive hematologist-oncologists’ prescribing decisions for R/R DLBCL?
  • How do current therapies perform on key clinical attributes for R/R DLBCL?
  • What are the major unmet needs and the most lucrative opportunities in R/R DLBCL?
  • When considering new treatment options in this setting, what trade-offs are acceptable to surveyed hematologist-oncologists between key clinical attributes and cost of therapy?

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

Primary research: Survey of 60 U.S. hematologist-oncologists and 30 European hematologist-oncologists.

Key companies: Gilead, Kite Pharma, Novartis, Roche / Genentech.

Key drugs: Rituximab, Yescarta, Kymriah.

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.

Table of contents

  • Non-Hodgkin's Lymphoma And Chronic Lymphocytic Leukemia - Unmet Need - Detailed, Expanded Analysis: Relapsed Or Refractory DLBCL - (US-EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
        • Products / Regimens for Relapsed or Refractory Diffuse Large B-Cell Lymphoma
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Hematologist-Oncologists' Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma
      • Importance of Efficacy Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: 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 Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Overall Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
      • Mean Overall Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States and Europe
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Relapsed or Refractory Diffuse Large B-Cell Lymphoma
      • Surveyed Hematologist-Oncologists’ Satisfaction with the Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Hematologist-Oncologists’ Satisfaction with the Performance of Key Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Europe
      • Key Findings: Unmet Need in Relapsed or Refractory Diffuse Large B-Cell Lymphoma and Related Indications
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need in Relapsed or Refractory Diffuse Large B-Cell Lymphoma and Related Indications: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need in Relapsed or Refractory Diffuse Large B-Cell Lymphoma and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market and Emerging Therapy Insights
        • Opportunity: A Therapy with Improved Survival Outcomes
        • Opportunity: A Therapy That Delays Disease Progression
        • Opportunity: A Therapy That Offers an Improved and Durable Tumor Response
        • Opportunity: A Therapy with an Improved Safety and Tolerability Profile
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
        • Attributes of Key Current and Late-Phase Emerging Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma
        • Assigned Prohibitions for the Conjoint Module
      • Attribute Importance and Part-Worth Utilities
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma 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 Cytokine Release Syndrome
        • Incidence of Grade 3/4 Neurologic Toxicity
        • Price Per Course of Treatment
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Target Product Profiles Included in Scenario 1
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Target Product Profiles Included in Scenario 2
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 3
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 3
        • Relapsed or Refractory Diffuse Large B-Cell Lymphoma Market Simulations: Target Product Profiles Included in Scenario 3
    • Appendix
      • Key Abbreviations
      • Bibliography

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

Sudha Malhotra joined Decision Resource Group in 2018. She is responsible for performing secondary market analysis including patent research, pricing, and clinical trial assessment for major pharmaceutical markets covering a wide range of oncology indications. She obtained her doctorate degree in life sciences from the National Institute of Immunology, New Delhi, India and has authored several original peer-reviewed journal articles. She holds a bachelor’s degree in microbiology and a master’s degree in biomedical sciences both from the University of Delhi, India.

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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