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Stakeholder Insight: Metastatic And Hormone Refractory Prostate cancerPublished by: Datamonitor Published: Sep. 21, 2004 - 306 Pages Table of ContentsTABLE OF CONTENTS ABOUT DATAMONITOR HEALTHCARE 2 About the oncology pharmaceutical analysis team 2 CHAPTER 1 EXECUTIVE SUMMARY 3 Prostate Cancer Insight: methodology 4 Prostate Cancer Insight: key conclusions 5 Traditionally, total androgen blockade (TAB) has been shunned by urologists. However, new literature reviews are now challenging physicians’ preconceptions and changing prescribing habits in favor of TAB, producing a niche market for low toxicity anti-androgens 6 The average age of Japanese patients is higher than in Western markets. This means that aggressive therapy is often contraindicated. Consequently, more patients receive drug-based therapy, producing a deceptively large drug market that should be targeted by manufacturers 10 Intermittent hormonal therapy (IHT) may provide an improvement in efficacy and side effects over continuous hormonal therapy. Manufacturers of hormonal products must consider how they may capitalize on the uptake of IHT if current trials show an advantage to the new treatment strategy 11 Taxotere is becoming the treatment of choice for hormone refractory prostate cancer (HRPC). Companies with products in development for HRPC should assess their products in combination with the taxane 16 Summary of points: the prostate cancer market to 2015 18 CHAPTER 2 INTRODUCTION 25 The prostate 26 Prostate cancer 27 Histology 27 Etiology 28 Epidemiology 30 Incidence forecasts 32 Point prevelence forecasts 33 CHAPTER 3 SCREENING, DIAGNOSIS AND STAGING 34 Screening 34 Prostate cancer screening 34 Summary and comments 40 Diagnostic methods 41 Staging 42 Clincal staging 42 Gleason grade 45 Physician data 47 Screening 47 The effect of screening on presentation pattern 51 Diagnosis and staging tests 54 CHAPTER 4 TREATMENT OF METASTATIC DISEASE 59 Treatment options for metastatic prostate cancer 59 Surgery 59 Radiotherapy 62 Drug therapy 64 Summary 75 Lymph metastases 75 Distant metastases 76 Physician data 77 Refusing treatment 77 Surgery 79 Radiotherapy 86 Drug therapy 93 CHAPTER 5 TREATMENT OF HRPC 111 Definition of HRPC 111 Development of HRPC 111 Progression to HRPC 112 Prognosis of HRPC 113 Approved agents for HRPC 115 Estramustine 115 Mitoxantrone 119 Key investigational agents for HRPC 121 Taxol (paclitaxel) 121 Taxotere (docetaxel) 122 Taxol versus Taxotere 124 Navelbine (vinorelbine) 125 Ketaconazole 127 Estrogens 128 Physician data 130 Drug therapy for HRPC patients 130 Drug regimens for HRPC 138 The use of cytotoxics in the last five years 150 Key investigational drugs for HRPC 153 Atrasentan (ABT-627) 154 Thalomid (thalidomide) 157 Iressa (gefitinib) 159 YM598 161 Glivec (imatinib) 162 Conclusions 163 CHAPTER 6 SIDE EFFECTS AND SUPPORTIVE CARE 164 Loss of bone integrity and bone pain 164 Sexual function-related side effects including hot flashes 164 Loss of libido 164 Impotence/erectile dysfunction 168 Hot flashes 173 Discontinuation of treatment due to sex-related side effects 179 Incontinence and diarrhea 180 Urinary incontinence 180 Bowel incontinence 184 Diarrhea 186 Discontinuation of treatment due to the side effects 188 Breast-related side effects 189 Gynecomastia 189 Breast pain (and tenderness) 193 Discontinuation of treatment due to gynecomastia and breast pain 196 Psychological side effects 197 CHAPTER 7 SUPPORTING DATA 198 Duration of first-line drug therapy and progression factors 198 Second-line drug therapy 202 Third-line drug therapy 206 CHAPTER 8 APPENDIX A 210 Contributing experts 210 List of tables 211 List of figures 220 Bibliography 226 Physician research methodology 258 Introduction 258 Our research partners 260 Research objectives 260 Questionnaire development 263 Research methodology 264 Data processing 266 Quality control 267 Opinion Leader research 268 Prostate Cancer Insight Questionnaire 270 OncoVision 300 CHAPTER 9 APPENDIX B: ABOUT DATAMONITOR 301 About Datamonitor 301 About Datamonitor Healthcare 301 Datamonitor Healthcare’s research and analysis methodologies 302 Datamonitor Healthcare’s therapy area capabilities 302 About the Oncology analysis team 303 Datamonitor Healthcare’s Consulting expertise 304 Disclaimer 306 AbstractIntroductionProstate cancer is the most common male malignancy in Western countries. Increasing usage of screening and changes in treatment practice means companies will have to adapt to exploit the market. Datamonitor's Metastatic and HRPC Prostate Cancer Insight details physician opinion of currently available products and disease management practice and what they require in the future. Scope Quantitative treatment data from over 440 physicians: 60 from Japan, France, Germany, Italy, Spain and the UK, and 80 from the US Qualitative feedback on key findings and future trends in the treatment of prostate cancer and the management of disease and treatment side effects A strong future focus on key issues, including the increasing use of third generation cytotoxics in HRPC and the implementation of screening in Europe Highlights Clinical trials have shown the lack of activity of estramustine in hormone refractory prostate cancer, but the drug is still commonly used because of the lack of alternatives. Recent trial results of estramustine in combination with Aventis' Taxotere show much greater efficacy and usage of this combination is already significant. In Japan the volume usage of hormonal drug therapy is far more common as the average age of the patient is well over 70 and so curative treatment is often contraindicated. Datamonitor believes the high volume usage of hormonal therapies makes this an important country in which to market effective, low toxicity drugs. Reasons to Purchase Identify hot topics and key issues for practicing prostate cancer specialists the questions they really want answered Identify hot topics and key issues for practicing prostate cancer specialists the questions they really want answered Plan product development to fill prostate cancer market niches as defined by practicing physicians Get Full Details About This Report >> |
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