The preferred initial treatment for metastatic squamous non-small-cell lung cancer (NSCLC), regardless of PD-L1 status, is Keytruda (Merck & Co.), with a platinum doublet (e.g., carboplatin + Abraxane). As a single agent, Keytruda is given to patients whose tumors have PD-L1 expression levels of 50% or more, who have good performance status, and who are negative for EGFR mutations and ALK rearrangements. Although the rate of EGFR mutations is very low in this patient population (less than 4%), anti-EGFR treatments, such as Gilotrif (Boehringer Ingelheim), are used as subsequent therapy. Because pure squamous NSCLC histology is rarely positive for ALK or ROS1 rearrangements and EGFR or BRAF mutations, metastatic squamous NSCLC patients have fewer treatment options compared with their nonsquamous counterparts. Thus, more treatment options are needed for this NSCLC subpopulation, particularly more-effective and more-tolerable immune checkpoint inhibitor combinations.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for metastatic squamous NSCLC?
  • How do current therapies, such as immune checkpoint inhibitors, perform on key treatment drivers and goals for metastatic squamous NSCLC?
  • What are the prevailing areas of unmet need and opportunity in this space?
  • What trade-offs across different clinical attributes and price are acceptable to surveyed oncologists for a hypothetical new first- or later-line treatment for metastatic squamous NSCLC?

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 June 2020.

Key companies: Merck & Co., Bristol Myers Squibb, Roche / Genentech, Celgene, Eli Lilly, Boehringer Ingelheim.

Key drugs: Keytruda, Opdivo, Opdivo + Yervoy, Tecentriq, Abraxane, Cyramza, Gilotrif / Giotrif.

Table of contents

  • Non-Small-Cell Lung Cancer - Unmet Need - Detailed, Expanded Analysis - Metastatic Squamous NSCLC (US/EU)
    • Executive Summary
      • Unmet Need - Metastatic Squamous NSCLC - Executive Summary - August 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products / Regimens for Metastatic Squamous NSCLC and Rationale for Drug Selection
      • 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 Metastatic Squamous NSCLC
        • Importance of Efficacy Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in Metastatic Squamous NSCLC: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in Metastatic Squamous NSCLC: 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 Metastatic Squamous NSCLC: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Metastatic Squamous NSCLC: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Metastatic Squamous NSCLC: United States
        • Overall Performance of Key Therapies for Metastatic Squamous NSCLC: Europe
        • Mean Overall Performance of Key Therapies for Metastatic Squamous NSCLC: United States and Europe
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Nonclinical Attributes: United States
        • Relative Performance of Key Therapies for Metastatic Squamous NSCLC Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Metastatic Squamous NSCLC
        • Surveyed Medical Oncologists' Satisfaction with the Performance of Key Therapies for Metastatic Squamous NSCLC on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Metastatic Squamous NSCLC 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 Metastatic Squamous NSCLC: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Metastatic Squamous NSCLC: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Metastatic Squamous NSCLC: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Metastatic Squamous NSCLC: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Metastatic Squamous NSCLC: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Metastatic Squamous NSCLC: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Metastatic Squamous NSCLC: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Metastatic Squamous NSCLC: Europe
        • Key Findings: Unmet Need in Metastatic Squamous NSCLC and Related Indications
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Metastatic Squamous NSCLC and Related Indications: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Metastatic Squamous NSCLC and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the NSCLC Market and Emerging Therapy Insights
          • Opportunity: A Novel Therapy That Can Extend Overall Survival
          • Opportunity: A Novel Therapy That Can Improve Progression-Free Survival
          • Opportunity: A Novel Biomarker-Driven Therapy That Is Predictive of Response
          • Opportunity: A Novel Agent with Improved Convenience of Administration to Improve Patients' Quality of Life
      • 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
          • First-Line Metastatic Squamous NSCLC Target Product Profile: Attribute Importance
          • Median Overall Survival
          • Median Progression-Free Survival
          • Objective Response Rate
          • Incidence of Grade 3/4 Hematological Toxicities
          • Incidence of Grade 3/4 Immune-Related Adverse Events
          • Incidence of Grade 3/4 Neurotoxicity
          • Price per 28-Day Cycle
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • First-Line Metastatic Squamous NSCLC Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • First-Line Metastatic Squamous NSCLC Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • First-Line Metastatic Squamous NSCLC Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Bibliography

    Author(s): Pragati Tripathi

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