Stakeholder Insight: Acute Leukemias - Reaching the limits of cytotoxic chemotherapy : Market Research Report

Stakeholder Insight: Acute Leukemias - Reaching the limits of cytotoxic chemotherapy

Published by: Datamonitor

Published: Oct. 8, 2009 - 199 Pages

ABOUT DATAMONITOR HEALTHCARE: About the Oncology pharmaceutical analysis team
CHAPTER 1 EXECUTIVE SUMMARY: Scope of the analysis; Datamonitor insight into the acute leukemias market; Datamonitor insight into the AML market; Datamonitor insight into the adult ALL market; Contributing experts; Related reports; Upcoming reports
CHAPTER 2 INTRODUCTION AND SCOPE: Coverage of the Stakeholder Insight Survey; Disease definition and epidemiology; Segmentation of the acute leukemia population; Current drug treatment practice for AML and adult ALL; Key unmet needs within the AML and adult ALL market; Overview of pipeline drugs for AML and adult ALL
CHAPTER 3 AML: COUNTRY TREATMENT TREES: Introduction; Acute myeloid leukemia (AML) country treatment trees; US; Japan; France; Germany; Italy; Spain; UK
CHAPTER 4 AML: PATIENT SEGMENTATION AND EPIDEMIOLOGY: Key findings; Definition of acute myeloid leukemia (AML); AML is a disease of older age; Presentation and diagnosis; Symptoms can vary for AML patients; Segmentation of the acute myeloid leukemia (AML) population; Two classification systems are used in AML; Cytogenetics is the most important prognostic factor; Age is a major determinant of survival; Epidemiology of acute myeloid leukemia (AML); AML accounts for about 30-35% of all leukemias in the seven major markets; Forecast incidence of AML in the seven major markets, 2009-2019
CHAPTER 5 AML: TREATMENT TRENDS: Key findings; Summary of acute myeloid leukemia (AML) treatment strategies; Treatment rates; Induction treatment; Induction treatment overview; Induction treatment trends in patients less than 60 years old; Standard-dose cytarabine with idarubicin is the most popular regimen; There is a low uptake of the hypomethylating agents Vidaza and Dacogen; Induction treatment trends in patients aged 60 or above; The treatment of older AML patients deviates from treatment guidelines; The uptake of Vidaza and Dacogen is significant in the US; Post-induction treatment; Post-induction treatment overview; Post-induction treatment trends in patients less than 60 years old; Post-induction treatment trends in patients aged 60 or above; Consolidation treatment; Consolidation treatment overview; Consolidation treatment trends in patients less than 60 years old; Consolidation treatment trends in patients aged 60 or above; Relapse treatment; Relapse treatment overview; Relapse treatment trends in patients less than 60 years old; Relapse treatment trends in patients aged 60 or above; Mylotarg accounts for about 10% of the market in older, relapsed AML patients; Hematopoietic stem cell transplantation in acute myeloid leukemia (AML)
CHAPTER 6 AML: IMPROVING TREATMENT OUTCOMES: Key findings; Treatment outcomes; Unmet needs; More effective therapies are required for AML; HSCT remains an underutilized procedure; Molecular markers may help improve risk-adapted therapeutic strategies; New product development; A number of new approaches are being investigated in AML; Novel drugs in Phase III development for AML; Onrigin (laromustine; Vion); Zarnestra (tipifarnib; Johnson & Johnson); Amonafide malate (AS1413; Antisoma); Midostaurin (Novartis); PR1 peptide antigen vaccine (The Vaccine Company); Selected marketed drugs investigated in AML; Clolar (clofarabine; Genzyme); Dacogen (decitabine; Eisai/Johnson & Johnson); Vidaza (azacitidine; Celgene); Trisenox (arsenic trioxide; Cephalon)
CHAPTER 7 ALL: COUNTRY TREATMENT TREES: Introduction; Acute lymphoblastic leukemia (ALL) country treatment trees; US; Japan; France; Germany; Italy; Spain; UK
CHAPTER 8 ALL: PATIENT SEGMENTATION AND EPIDEMIOLOGY: Definition of acute lymphoblastic leukemia (ALL); ALL represents less than 1% of all adult cancers; Genetic alterations provide insight into the pathogenesis of ALL; Presentation and diagnosis; Non-specific syndromes are common in ALL; Segmentation of the ALL population; The classification of ALL is still evolving; Patients are usually stratified according to risk; Age: treatment outcomes decline with increasing patient age; Immunophenotype: the outcome of T-lineage ALL is more favorable; Cytogenetics and molecular genetics: the Philadelphia chromosome; Response to therapy: early response to treatment is a critical prognostic factor; Epidemiology of ALL; ALL accounts for about 10-15% of all leukemias in the seven major markets; Forecast incidence of ALL in the seven major markets, 2009-2019
CHAPTER 9 ALL: TREATMENT TRENDS: Summary of acute lymphoblastic leukemia (ALL) treatment strategies; Treatment rates; Induction treatment; Induction treatment overview; The treatment of Philadelphia chromosome-positive ALL; Induction treatment trends; A vincristine-corticosteroid combination is the backbone of induction therapy; The toxicity of asparaginase compromises its use; HyperCVAD is a standard induction therapy in the US; Gleevec is the only molecular targeted therapy used extensively in the induction treatment of adult ALL; Consolidation treatment; Consolidation treatment overview; Consolidation treatment trends; Consolidation therapy of standard-risk ALL patients is largely based on methotrexate; Gleevec is used as a consolidation therapy in Ph+ patients who cannot receive a stem cell transplant; Maintenance treatment; Maintenance treatment overview; Maintenance treatment trends; A very small, off-label use of Tasigna is taking place in the maintenance setting; Clinical trials in ALL; Hematopoietic stem cell transplantation in ALL
CHAPTER 10 ALL: IMPROVING TREATMENT OUTCOMES: Treatment outcomes; Unmet needs; More effective therapies are required for adult ALL; Research efforts should focus on older ALL patients; Prognostic markers are required for risk-adapted therapeutic strategies; New product development; R&D activity in ALL is limited; Novel drugs in late-phase development for adult ALL; Marqibo (liposomal vincristine; Hana BioSciences); Selected marketed drugs investigated in adult ALL; Arranon (nelarabine; GlaxoSmithKline); Clolar (clofarabine; Genzyme); Rituxan (rituximab; Biogen Idec/Genentech/Roche)
BIBLIOGRAPHY: Journals; Websites; Datamonitor reports
APPENDIX A: List of tables; List of figures; Physician research methodology; Physician sample breakdown; US; Japan; France; Germany; Italy; Spain; UK; Contributing experts
APPENDIX B: The survey questionnaire; About Datamonitor; About Datamonitor Healthcare; About the Oncology analysis team; Disclaimer
List of Figures: Figure 1: Acute myeloid leukemia (AML) incidence and patient segmentation data in the US for patients less than 60 years old, 2009; Figure 2: Acute myeloid leukemia (AML) incidence and patient segmentation data in the US for patients aged 60 or older, 2009; Figure 3: Acute myeloid leukemia (AML) treatment data in the US for patients less than 60 years old, 2009; Figure 4: Acute myeloid leukemia (AML) treatment data in the US for patients aged 60 or older, 2009; Figure 5: Acute myeloid leukemia (AML) incidence and patient segmentation data in Japan for patients less than 60 years old, 2009; Figure 6: Acute myeloid leukemia (AML) incidence and patient segmentation data in Japan for patients aged 60 or older, 2009; Figure 7: Acute myeloid leukemia (AML) treatment data in Japan for patients less than 60 years old, 2009; Figure 8: Acute myeloid leukemia (AML) treatment data in Japan for patients aged 60 or older, 2009; Figure 9: Acute myeloid leukemia (AML) incidence and patient segmentation data in France for patients less than 60 years old, 2009; Figure 10: Acute myeloid leukemia (AML) incidence and patient segmentation data in France for patients aged 60 or older, 2009; Figure 11: Acute myeloid leukemia (AML) treatment data in France for patients less than 60 years old, 2009; Figure 12: Acute myeloid leukemia (AML) treatment data in France for patients aged 60 or older, 2009; Figure 13: Acute myeloid leukemia (AML) incidence and patient segmentation data in Germany for patients less than 60 years old, 2009; Figure 14: Acute myeloid leukemia (AML) incidence and patient segmentation data in Germany for patients aged 60 or older, 2009; Figure 15: Acute myeloid leukemia (AML) treatment data in Germany for patients less than 60 years old, 2009; Figure 16: Acute myeloid leukemia (AML) treatment data in Germany for patients aged 60 or older, 2009; Figure 17: Acute myeloid leukemia (AML) incidence and patient segmentation data in Italy for patients less than 60 years old, 2009; Figure 18: Acute myeloid leukemia (AML) incidence and patient segmentation data in Italy for patients aged 60 or older, 2009; Figure 19: Acute myeloid leukemia (AML) treatment data in Italy for patients less than 60 years old, 2009; Figure 20: Acute myeloid leukemia (AML) treatment data in Italy for patients aged 60 or older, 2009; Figure 21: Acute myeloid leukemia (AML) incidence and patient segmentation data in Spain for patients less than 60 years old, 2009; Figure 22: Acute myeloid leukemia (AML) incidence and patient segmentation data in Spain for patients aged 60 or older, 2009; Figure 23: Acute myeloid leukemia (AML) treatment data in Spain for patients less than 60 years old, 2009; Figure 24: Acute myeloid leukemia (AML) treatment data in Spain for patients aged 60 or older, 2009; Figure 25: Acute myeloid leukemia (AML) incidence and patient segmentation data in the UK for patients less than 60 years old, 2009; Figure 26: Acute myeloid leukemia (AML) incidence and patient segmentation data in the UK for patients aged 60 or older, 2009; Figure 27: Acute myeloid leukemia (AML) treatment data in the UK for patients less than 60 years old, 2009; Figure 28: Acute myeloid leukemia (AML) treatment data in the UK for patients aged 60 or older, 2009; Figure 29: Age distribution of acute myeloid leukemia (AML) patients; Figure 30: Percentage distribution of leukemia subtypes in the US, Japan and the five major EU markets, 2009; Figure 31: Average treatment rate for acute myeloid leukemia (AML) patients less than 60 years old in the seven major pharmaceutical markets, 2009; Figure 32: Average treatment rate for acute myeloid leukemia (AML) patients aged 60 or above in the seven major pharmaceutical markets, 2009; Figure 33: Top three chemotherapy regimens used in the induction therapy of acute myeloid leukemia (AML) patients less than 60 years old in the seven major pharmaceutical markets, 2009; Figure 34: Top three chemotherapy regimens used in the induction therapy of acute myeloid leukemia (AML) patients aged 60 or above in the seven major pharmaceutical markets, 2009; Figure 35: Uptake of Dacogen and Vidaza in the treatment of acute myeloid leukemia (AML) in the US, 2009; Figure 36: Top three chemotherapy regimens used in the post-induction therapy of acute myeloid leukemia (AML) patients less than 60 years old in the seven major pharmaceutical markets, 2009; Figure 37: Top three chemotherapy regimens used in the post-induction therapy of acute myeloid leukemia (AML) patients aged 60 or above in the seven major pharmaceutical markets, 2009; Figure 38: Top three chemotherapy regimens used in the consolidation therapy of acute myeloid leukemia (AML) patients less than 60 years old in the seven major pharmaceutical markets, 2009; Figure 39: Top three chemotherapy regimens used in the consolidation therapy of acute myeloid leukemia (AML) patients aged 60 or above in the seven major pharmaceutical markets, 2009; Figure 40: Top three chemotherapy regimens used in the relapse therapy of acute myeloid leukemia (AML) patients less than 60 years old in the seven major pharmaceutical markets, 2009; Figure 41: Top three chemotherapy regimens used in the relapse therapy of acute myeloid leukemia (AML) patients aged 60 or above in the seven major pharmaceutical markets, 2009; Figure 42: Uptake of Mylotarg in the treatment of acute myeloid leukemia (AML) in patients aged under 60 and in patients aged 60 or above, 2009; Figure 43: Average use of hematopoietic stem cell transplantation (HSCT) in the induction, post-induction, consolidation, and relapse treatment of AML in the seven major pharmaceutical markets, 2009; Figure 44: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in the US, 2009; Figure 45: Adult acute lymphoblastic leukemia (ALL) treatment data in the US, 2009; Figure 46: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in Japan, 2009; Figure 47: Adult acute lymphoblastic leukemia (ALL) treatment data in Japan, 2009; Figure 48: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in France, 2009; Figure 49: Adult acute lymphoblastic leukemia (ALL) treatment data in France, 2009; Figure 50: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in Germany, 2009; Figure 51: Adult acute lymphoblastic leukemia (ALL) treatment data in Germany, 2009; Figure 52: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in Italy, 2009; Figure 53: Adult acute lymphoblastic leukemia (ALL) treatment data in Italy, 2009; Figure 54: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in Spain, 2009; Figure 55: Adult acute lymphoblastic leukemia (ALL) treatment data in Spain, 2009; Figure 56: Adult acute lymphoblastic leukemia (ALL) incidence and patient segmentation data in the UK, 2009; Figure 57: Adult acute lymphoblastic leukemia (ALL) treatment data in the UK, 2009; Figure 58: Risk stratification of adult acute lymphoblastic leukemia (ALL) patients in the seven major pharmaceutical markets, 2009; Figure 59: Philadelphia chromosome status in high-risk adult acute lymphoblastic leukemia (ALL) patients in the seven major pharmaceutical markets, 2009; Figure 60: Percentage distribution of leukemia subtypes in the US, Japan and the five major EU markets, 2009; Figure 61: Age distribution of childhood and adult acute lymphoblastic leukemia (ALL) in the seven major markets, 2009; Figure 62: Average treatment rates for adult acute lymphoblastic leukemia (ALL) patients in the seven major pharmaceutical markets, 2009; Figure 63: Top three chemotherapy regimens used in the induction therapy of adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009; Figure 64: Top three chemotherapy regimens used in the consolidation therapy of standard-risk adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009; Figure 65: Top three chemotherapy regimens used in the consolidation therapy of high-risk adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009; Figure 66: Top three chemotherapy regimens used in the maintenance therapy of standard-risk adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009; Figure 67: Top three chemotherapy regimens used in the maintenance therapy of high-risk adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009; Figure 68: Average use of clinical trials in the induction, consolidation, and maintenance therapy of adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009; Figure 69: Average use of hematopoietic stem cell transplantation in the consolidation and maintenance therapy of adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical markets, 2009

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Stakeholder Insight: Acute Leukemias - Reaching the limits of cytotoxic chemotherapy

Table of Contents

Abstract