For a clearer market perspective

The Cancer Market

Outlook to 2014
Competitive landscape, market size,
pipeline analysis and growth
opportunities

Report Price £1995/R2885/$3835

Publication date December 2009
H E A L T H C A R E
 The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

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Report Overview
In the current decade, oncology has been one of the most important growth
segments among the pharmaceutical markets with a major focus on targeted Pages 194
agents. Most innovation in oncology over the past 10 years has been driven by
scientific advances, particularly in genomics, transcriptomics and proteomics. In Figures 15
the current environment, the successful oncology players of the future will be
those that can anticipate protocol evolution and design the most relevant clinical Tables 76
trials. In recent years, biotech companies have fuelled innovation in oncology
more than ever before. Partnering with biotech companies is a key (but
expensive) source of innovation for many pharma companies as approximately This report provides wide
75% of phase II, III and pre-registration innovative drugs are of biotech origin. coverage across the major
cancer markets, and provides
an analysis of marketed and
At $47.7bn, cancer is one of the largest and fastest growing markets in the pipeline drugs. It also
pharmaceutical industry. However, pricing risk remains the key investment analyzes the growth trends
and future market leaders,
concern in oncology. The key concern, however, is not price erosion driven by forecasting revenues and
competitive forces, but price cuts imposed by payors irrespective of the fact that epidemiology through the
such unilateral price cuts by payors have never occurred in any of the major period 2008-14...
developed markets and would surely jeopardize the premise on which the entire
biopharmaceutical industry has been built.

This report provides coverage of over 95% of the total market for cancer products and enables the reader to
understand the issues behind the market-leading products of today and forecasts the market-leading products of
tomorrow. The report allows the reader to understand which pharmaceutical companies will be the dominant forces in
the cancer arena, and which products will be the strongest performers over the period 2009-14.
 The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Key Findings
In 2008, antineoplastic mAbs delivered huge sales
of $13.6bn with a market share of 28.6% of total
sales. The key antineoplastic mAbs which contributed to the
higher market share of this class in 2008 were MabThera
(11.0%), Avastin (10.3%), Herceptin (9.7%) and Erbitux (3.4%).
Forecast sales of the total antineoplastics market are
estimated at $65.2bn in 2014.

Roche is the global market leader in cancer,

holding the highest market share of 29.2%
($14.0bn sales) in 2008 based on sales from (MabThera,
Avastin, Herceptin, Tarceva and Xeloda). Roche’s strength
in the cancer market has been bolstered by its acquisition of
Genentech and purchase of majority stakes in Chugai, which
has provided additional breadth to its portfolio.
Eli Lilly’s acquisition of ImClone will increase the
former’s flow of high-quality, innovative new
therapies. The transaction will immediately enable Eli Lilly to
offer physicians and their patients a complementary portfolio of
leading oncolytic agents and targeted therapies including Gemzar, Alimta and Erbitux.
Figure 4.7: Key drugs in late-stage
development or that have been recently
launched
“More than $47.7bn worth of cancer drugs were sold
globally in 2008 with US making up for 39.1% of these
sales. The value of novel targeted therapies, their
combinations with chemotherapy, and the potential of
adjuvant therapy have demonstrated to improve survival
rates, notably in breast, lung and colon cancers ”

Pfizer’s axitinib, Dendreon’s Provenge and GSK/Genmab’s Arzerra are expected to be the top sellers
among late stage pipeline oncolytic agents.

Use this report to...

• Develop insight into patient potential with
the report’s coverage of major indications in the
cancer segment, the seven largest geographic
pharmaceutical markets and 10 largest
companies active in the cancer segment today
• Quickly understand how recent events are
affecting the performance of major products,
and how their marketers are confronting
competitive changes in cancer marketplace
• Understand which indications have the
greatest potential to provide franchise
growth, and how pharmaceutical companies
are attempting to exploit these opportunities
• Compare the franchises of top
pharmaceutical marketers across major
indications, and understand how market share
of leading companies will change over the next
6 years

• Gain up-to-date competitive intelligence • Use head-to head comparisons of the leading
across the cancer indications and understand cancer pipeline compounds to understand
the major issues affecting key which companies will have a presence among
pharmaceutical/biotech players key indications over the next 6 years
 The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Key issues...
FDA approves Cervarix for cervical cancer: In October 2009, FDA approved GSK’s Cervarix for the
prevention of pre-cancerous lesions caused by human papillomavirus (HPV) type 16 & 18 in women aged
10–25 years. Cervarix’s inclusion in children’s vaccine program is a major step towards securing reimbursement.
Cervarix, expected to launch by the end of 2009, faces direct competition from Merck’s Gardasil and will help to
reduce the incidence of cervical cancer in future.

Merck’s Gardasil adds US indication of genital warts for boys and men: On 16th October 2009,
Gardasil’s US label was extended to include its use in both men and boys aged 9–26 years of age. The
pivotal trial results showed an efficacy of 90.4% while preventing external genital lesions of HPV types
6/11/16/18. In addition, Merck also planned to extend its vaccine patient assistance program providing free
Gardasil to 19–26 year old uninsured males meeting eligibility criteria but unable to afford the vaccine.

Roche’s Avastin filed for first-line breast cancer in Japan: In October 2009, Roche’s Japanese
subsidiary, Chugai has filed a Japanese approval for Avastin in the first-line treatment of advanced or
recurrent breast cancer. The filing in first-line breast cancer was supported by an international Phase III trial (first-
line setting), which showed a significant improvement in PFS. This in turn was supported by Japanese Phase II
safety and efficacy data. Approval of the product will expand Avastin’s purview beyond colon cancer in the
country, becoming growth driving event.

Eisai to file first in-house breast cancer drug in major markets: Eisai is planning to file its in-house
developed chemotherapy drug eribulin for pre-treated breast cancer (advanced or metastatic) in all the
major markets (US, 5EU & Japan) by March 2010. Preliminary results from the key Phase III trial demonstrated a
significant improvement in overall survival, the primary endpoint.

Discover...
• What will be the major growth indications in • Which products will be impacted by generic
the cancer segment over the period 2008–14? competitors over the period 2008–14?

• Which companies were the winners and losers • Which pipeline products will be the growth
in the cancer segment in 2008? drivers of the future?

• How have recent major launches from • Which indications are forecast to have the
companies such as Roche, Sanofi-Aventis, highest levels of market potential over the
AstraZeneca, Novartis and Eli Lilly performed? period 2008–14?

• Which companies will become the key players • What will the competitive landscape in lung,
in the cancer segment over the period breast, colorectal, ovarian, prostate, lymphoma
2008–14? and pancreatic cancer in 2014?
 The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Table of Contents
EXECUTIVE SUMMARY • Uterine and cervical cancer - Herceptin (trastuzumab) –
• Epidemiology of Cancer - Overview Roche/Genentech/Chugai
- Diagnosis, treatment and - Glivec/Gleevec (imatinib) –
• Global Market Analysis
management Novartis
• Pipeline Analysis - Epidemiology - Taxotere (docetaxel) – Sanofi-
• Competitive Landscape - Forecast epidemiology Aventis
• Leukemia • Leading brands by type of cancer
CHAPTER 1 SCOPE AND - Overview • Key recent events in the cancer
METHODOLOGY - Diagnosis, treatment and market
• Scope management - FDA approves Cervarix for
• Methodology - Epidemiology cervical cancer
- Forecast epidemiology - Merck's Gardasil adds US
CHAPTER 2 OVERVIEW AND • Prostate cancer indication of genital warts for
EPIDEMIOLOGY OF CANCER - Overview boys and men
INDICATIONS - Diagnosis, treatment and - Roche's Avastin is filed for first-
• Summary management line breast cancer in Japan
- Epidemiology - Eisai to file first in-house breast
• Introduction
- Forecast epidemiology cancer drug in major markets
• Overview - Novartis's Tasigna bolsters its
• Pancreatic cancer
• Cancer risk factors - Overview CML franchise
• Lung cancer - Diagnosis, treatment and • Antineoplastics
- Overview management - Competitive dynamics of
- Diagnosis, treatment and - Epidemiology antineoplastics
management - Forecast epidemiology - Leading brands of
- Epidemiology • Lymphomas antineoplastics
- NSCLC - Overview - Antineoplastic mAb market
- SCLC analysis
- Diagnosis, treatment and
- Forecast epidemiology - Market dynamics
management
- NSCLC - Key brands analysis
- Epidemiology
- SCLC - Antineoplastic protein kinase
- Forecast epidemiology
• Colorectal cancer inhibitors
- Overview • Head and neck cancer - Market dynamics
- Diagnosis, treatment and - Overview - Key brands analysis
management - Diagnosis, treatment and - Vinca alkaloid market analysis
- Epidemiology management - Market dynamics

- Forecast epidemiology - Epidemiology - Key brands analysis

- Forecast epidemiology - Anti-metabolites
• Breast cancer - Market dynamics
- Overview - Key brands analysis
CHAPTER 3 GLOBAL MARKET
- Diagnosis, treatment and - Platinum compounds
ANALYSIS
management - Market dynamics
- Epidemiology • Summary - Key brands analysis
- Forecast epidemiology • Introduction - Antineoplastic sales forecast
• Ovarian cancer • Market analysis by country • Cytostatic hormonal therapies
- Overview • Market analysis by drug class - Competitive dynamics of
- Diagnosis, treatment and cytostatic hormonal therapies
• Leading brand dynamics
management - Leading brands of cytostatic
- MabThera (rituximab)
- Epidemiology hormonal therapies
–Roche/Genentech
- Forecast epidemiology - Cytostatic gonad hormone
- Avastin (bevacizumab) –
analog market analysis
Roche/Genentech

Table of Contents
- Market dynamics
- Key brands analysis
- Aromatase inhibitors
- Market dynamics
- Key brands analysis
- Anti-androgens
- Market dynamics
- Key brand analysis
- Cytostatic hormonal therapy
sales forecast
- Global cancer market sales
forecast
CHAPTER 4 PIPELINE ANALYSIS
• Summary
• Introduction
• Key trends in R&D
- Targeted therapies are changing
the treatment regimen of cancer
- Biomarkers are personalizing
oncology treatment
- Cancer vaccines enhance the
body's immune response
- Pricing is becoming a major
issue for cancer patients
- Combination treatments are
becoming the treatment of
choice
• Leading drugs in development
- Phase III and pending approval
compounds
- Enzastaurin – Eli Lilly
- BiovaxID – Biovest International
and Accentia Biopharmaceuticals
- Recentin (cediranib) – AstraZeneca
- Zactima (vandetanib) –
AstraZeneca
- Axitinib (AG-13736) – Pfizer
- Provenge (sipuleucel-T) –
Dendreon
- Recently approved/marketed
drugs
- Arzerra (ofatumumab) –
GSK/Genmab
- Afinitor (everolimus) – Novartis
- Iressa (gefitinib) – AstraZeneca
- Tykerb/Tyverb (lapatinib) – GSK
- Votrient (pazopanib) – GSK
• Pipeline forecast of key compounds
- Factors affecting forecasts
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities
CHAPTER 5 COMPETITIVE
LANDSCAPE
• Summary
• Introduction
- Sales performance of leading
players
• Roche
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• Sanofi–Aventis
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• AstraZeneca
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• Novartis
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• Eli Lilly
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• Pfizer
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• Takeda
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
• Bristol-Myers Squibb
- Sales focus by drug class
- Regional sales distribution
- Marketed product portfolio
- Pipeline analysis
- Strategic and growth analysis
- Drivers of growth
- Resistors of growth
CHAPTER 6 APPENDIX
• IMS Data
- Antineoplastic and
immunomodulating agents
- L1: Antineoplastics
- L2: Cytostatic hormone therapy
- Forecast factors
- Glossary
- Abbreviations used in this report
- Index
LIST OF FIGURES
• Types of breast cancers
• Types of leukemia
• Chemotherapy options for
Hodgkin's disease
• Head and neck cancers and their
risk factors
• Worldwide cancer market share by
region, 2008
• Current pharmacological treatment
options for cancer
• Key drugs in late-stage
development or that have been
recently launched

Table of Contents
• Contribution of the top 10 players
to growth of the global cancer
market, 2007–08
• Roche's cancer sales by drug class,
2008
• Sanofi–Aventis's cancer sales by
drug class, 2008
• AstraZeneca's cancer sales by drug
class, 2008
• Novartis's cancer sales by drug
class, 2008
• Pfizer's cancer sales by drug class,
2008
• Takeda's cancer sales by drug class,
2008
• BMS' cancer sales by drug class,
2008
LIST OF TABLES
• Estimated prevalence of NSCLC
across seven major markets, 2008
• Estimated prevalence of SCLC
across seven major markets, 2008
• Forecast epidemiology of NSCLC
across seven major markets,
2008–14
• Forecast epidemiology of SCLC
across seven major markets,
2008–14
• Estimated prevalence of colorectal
cancer across seven major markets,
2008
• Forecast epidemiology of colorectal
cancer across seven major markets,
2008–14
• Estimated prevalence of breast
cancer across seven major markets,
2008
• Forecast epidemiology of breast
cancer across seven major markets,
2008–14
• Estimated prevalence of ovarian
cancer across seven major markets,
2008
• Forecast epidemiology of ovarian
cancer across seven major markets,
2008–14
The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities
• Estimated prevalence of uterine and
cervical cancer across seven major
markets, 2008
• Forecast epidemiology of uterine
and cervical cancer across seven
major markets, 2008–14
• Estimated prevalence of leukemia
across seven major markets, 2008
• Forecast epidemiology of leukemia
across seven major markets,
2008–14
• Estimated prevalence of prostate
cancer across seven major markets,
2008
• Forecast epidemiology of prostate
cancer across seven major markets,
2008–14
• Estimated prevalence of pancreatic
cancer across seven major markets,
2008
• Forecast epidemiology of
pancreatic cancer across seven
major markets, 2008–14
• Estimated prevalence of lymphomas
across seven major markets, 2008
• Forecast epidemiology of
lymphomas across seven major
markets, 2008–14
• Estimated prevalence of head and
neck cancer across seven major
markets, 2008
• Forecast epidemiology of head and
neck cancer across seven major
markets, 2008–14
• Global cancer market by geography,
2008
• Breakdown of the global cancer
market by drug class, 2008
• Leading brands in the global cancer
market, 2008
• Leading brands in breast cancer,
2008
• Leading brands in colon cancer,
2008
• Leading brands in prostate cancer,
2008
• Leading brands in lung cancer, 2008
• Breakdown of the global
antineoplastic market by drug class,
2008
• Leading brands in global
antineoplastics market, 2008
• Chronology of new indication
approvals for Eloxatine
• Antineoplastic sales forecast,
2008–14
• Breakdown of the global cytostatic
hormonal therapies by drug class,
2008
• Leading brands in global cytostatic
hormonal therapies market, 2008
• Cytostatic hormonal therapy sales
forecast, 2008–14
• Global cancer market sales forecast,
2008–14
• An overview of enzastaurin
• An overview of BiovaxID
• An overview of Recentin
• The Horizon Study Program
• An overview of Zactima
• Overview of Zactima’s Phase III
development plan
• An overview of axitinib
• An overview of Provenge
• An overview of Arzerra
• An overview of Afinitor
• An overview of Iressa
• An overview of Tykerb/Tyverb
• An overview of Votrient
• Key pipeline and recently approved
products sales forecast, 2008–14
• Leading players in the global cancer
market, 2008–14
• Regional sales distribution of Roche,
2008
• Roche's cancer product portfolio,
2008
• Roche's cancer R&D product
pipeline, October 2009
• Regional sales distribution of Sanofi-
Aventis, 2008
• Sanofi–Aventis's cancer product
portfolio, 2008
 The Cancer Market Outlook to 2014
Competitive landscape, market size, pipeline analysis and growth opportunities

Table of Contents
• Sanofi-Aventis's cancer R&D
product pipeline, October 2009
• Regional sales distribution of
AstraZeneca, 2008
• AstraZeneca's cancer product
portfolio, 2008
• AstraZeneca's cancer R&D product
pipeline, October 2009
• Regional sales distribution of
Novartis, 2008
• Novartis' cancer product portfolio,
2008
• Novartis's cancer R&D product
pipeline, October 2009
• Regional sales distribution of Eli
Lilly, 2008
• Eli Lilly's cancer product portfolio,
2008
• Eli Lilly's cancer R&D product
pipeline, October 2009
• Regional sales distribution of Pfizer,
2008
• Pfizer's cancer product portfolio,
2008
• Pfizer's cancer R&D product
pipeline, October 2009
• Regional sales distribution of
Takeda, 2008
• Takeda's cancer product portfolio,
2008
• Takeda's cancer R&D product
pipeline, October 2009
• Regional sales distribution of BMS,
2008
• BMS' cancer product portfolio, 2008
• BMS' cancer R&D product pipeline,
October 2009
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