Breast Cancer Drug Discoveries: What The Future Holds

In 2010, almost 50% of breast cancer sales were due to three branded targeted therapies. With a large unmet clinical need, further agents are required to increase survival and delay disease progression.

Unique breast cancer market share, sales forecasts by launched and Phase III products to 2017
A comprehensive and critical examination and scoring of 72 major breast cancer treatments
Comprehensive market assessment of therapeutic approaches, company share, portfolios and prospects

Breast Cancer Therapy Sales Forecast 2010 - 2017

'What’s the story behind this chart?'

The changing competitive landscape

By 2017, Espicom forecasts a modest increase in the number of players in the market-place compared to 2010, with Roche, and GlaxoSmithKline to a lesser extent, triumphing with targeted therapies directed against the specific subset of BC patients with HER2-positive disease. AstraZeneca, Novartis and Pfizer will face widespread generic competition for their hormonal therapies, leading to a loss of market share. Similarly, Sanofi and Eli Lilly will face declining sales for their chemotherapies.

The market in 2010...

In recent years, more effective treatments have decreased mortality and improved survival rates, resulting in a longer duration of therapy for an increased patient population. In the US, five-year relative survival rates have improved from 63% in the early 1960s to 90% in recent years, while in England, rates for women diagnosed with BC in 2001-2006 reached 82%, compared to 52% 1971-1975. This report estimates that sales of leading brands achieved sales of US$12.7 billion in 2010, with growth due to expanding sales for a number of existing treatments rather than the launch of new products. Sales were split between chemotherapies, hormonal therapies and novel molecular targeted therapies, with the majority of these agents used in combination.

And 2017: how things might change Hormonal therapies

The aromatase inhibitors will suffer from patent expiries in all major markets by 2012, and the report expects significant generic competition and sales for this group to decline by over 92% from US$3.4 billion in 2010, to just US$259 million in 2017. With widespread generic versions of the leading selective oestrogen receptor modulator, tamoxifen, the overall market share of branded hormonal therapies will decline as sales fall from US$4 billion to US$1.4 billion, a drop of 65%. These declines will be tempered by the relative success of AstraZeneca’s Faslodex.

Chemotherapies

By 2017, most chemotherapies will be available as generics. In addition to patent expirations for Sanofi’s Taxotere (docetaxel) and Eli Lilly’s Gemzar (gemcitabine) in 2009/2010, the US patent on Roche’s Xeloda (capecitabine) will expire in 2013. As a direct result, sales will decrease by almost 40% from over US$2.4 billion in 2010 to around US$1.5 billion in 2017, with market share continuing to decline, from 19 to 12%. This general trend is mitigated somewhat by the newer chemotherapies, which are demonstrating sales growth and carving out market share due to their improved safety and efficacy compared to older more established agents.

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Targeted therapies - moving beyond HER2

By 2017, Espicom estimates that a total of ten products will command a 77% market share, with the current therapies, Roche’s Herceptin and Avastin, along with GSK’s Tykerb/Tyverb, accounting for over 80% of these sales. Herceptin will continue as the clear market leader. But what about patients who are HER2 negative? There is an urgent need for more therapies and just a handful are likely to be launched by 2017:

Bayer’s Nexavar is a multi-targeted kinase inhibitor already marketed for the treatment of renal cell carcinoma and hepatocellular carcinoma. Eli Lilly’s anti-VEGFr2 monoclonal antibody, ramucirumab, an angiogenesisinhibitor, may be able to pick up market share from Avastin if the company can demonstrate an improved survival advantage. There has been considerable optimism over a novel class of agents, the PARP inhibitors, including Sanofi’s iniparib, which is under development for triplenegative breast cancer. Nevertheless, doubt has been cast over the effectiveness of this class following the termination of the development of AstraZeneca’s olaparib.

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