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Introduction
In cervical cancer, screening and human papillomavirus (HPV) vaccination have gradually shifted the focus towards preventative, rather than therapeutic strategies. In endometrial cancer, the focus has been on surgery, as it is considered a surgically-managed disease with a limited role for drug therapy. However, despite these therapeutic attitudes, opportunities remain in both markets.
Scope
*Cervical and endometrial cancer overview, including disease definition, epidemiology, discussion of unmet needs, and market potential
*Current treatment of cervical and endometrial cancer and ongoing controversies
*Examination of the late-phase cervical and endometrial cancer pipeline, including drug profiles of late-stage agents
*Stakeholder opinions based on qualitative interviews with key opinion leaders from the US and EU
Highlights
Treatment outcomes are still poor for patients with metastatic or recurrent cervical cancer, creating an opportunity for drug developers. The developing countries also offer a large and growing patient base for companies developing cheaper versions of preventative vaccines, diagnostics and pharmaceuticals.
Endometrial cancer is the most common female genital tract malignancy in the US and Europe. Its incidence is expected to rise in the future, in line with the aging population and the increase in the prevalence of conditions such as obesity and diabetes, which have been implicated in the development of the disease.
In recent years, there has been increased interest in the development of molecular targeted therapies for endometrial cancer. This has been coupled with a changing attitude towards the management of the disease, with a greater interest in the role of drug therapy. As a result, the potential of this market may increase in the future.
Reasons to Purchase
*Estimate the number of treatable patients and understand where unmet needs exist for drug development opportunities
*Understand opportunities and threats in the cervical and endometrial cancer markets
*Analyze the current cervical and endometrial cancer pipeline and the potential of late-stage drugs
Table of Contents :
"Overview 1
Catalyst 1
Summary 1
About healthcare 2
About the Oncology pharmaceutical analysis team 2
Executive Summary 3
Scope of the analysis 3
insight into the cervical and endometrial cancer market 3
Related reports 5
Upcoming reports 5
Table of Contents 6
Patient Potential: cervical cancer 7
Key findings 7
Definition 7
Cervical cancer is the third most common gynecological cancer 7
The majority of cervical cancer patients present with early-stage disease 8
Infection with carcinogenic human papillomavirus (HPV) is a major risk factor for cervical cancer 10
Prevention and screening 11
Secondary prevention: Pap and HPV testing 11
Primary prevention: HPV vaccination 13
Epidemiology 15
Screening has lowered the incidence of cervical cancer 15
Screening has also reduced mortality rates from cervical cancer 17
The burden of cervical cancer is higher in the developing world 19
Current treatment options 21
Early-stage disease is treated with surgery or radiotherapy 21
Chemoradiation is considered the standard of care for locally advanced disease 23
The treatment of recurrent or metastatic disease is based on palliative chemotherapy 24
Unmet need 26
Screening coverage and compliance must be improved 26
Human papillomavirus (HPV) vaccination must be made available worldwide 27
Better systemic therapy is required for metastatic and recurrent disease 27
Increased R&D efforts are required in cervical cancer 28
Market potential: cervical cancer 30
Key findings 30
Current market overview 30
Opportunities and threats 31
Opportunities 31
The treatment of advanced disease remains a significant unmet need 31
The developing world will continue to offer a large patient base 32
Threats 32
HPV vaccination will have an impact on the incidence of the disease in the future 32
The focus in cervical cancer is very much on prevention 32
Patient Potential: endometrial cancer 33
Key findings 33
Definition 33
Adenocarcinoma of the endometrium is the most common female genital tract malignancy in the US and Europe 33
A number of risk factors have been implicated in endometrial cancer 35
About 75% of endometrial cancer patients are diagnosed at an early stage 36
Epidemiology 39
The incidence rate of endometrial cancer has remained constant in the past 20 years 39
Early-stage diagnosis results in a relatively low mortality 41
The US has the highest global incidence of endometrial cancer 42
Current treatment options 43
Surgery is the primary treatment modality for early-stage endometrial cancer 43
The optimal adjuvant therapy is still under investigation 44
Recurrent or metastatic endometrial cancer continues to pose a significant challenge 46
Unmet need 48
Improved therapies are required for the treatment of advanced, metastatic and recurrent disease 49
Less invasive surgical approaches should be explored in endometrial cancer 49
Increased R&D efforts are required in endometrial cancer 50
R&D efforts should be directed towards the identification of molecular targets 51
Market potential: endometrial cancer 52
Key findings 52
Current market overview 52
Opportunities and threats 53
Opportunities 53
The treatment of metastatic and recurrent disease remains an unmet need 53
The incidence of endometrial cancer will increase 53
There is increased interest in the development of molecular targeted therapies 53
Threats 54
Increased awareness will continue to drive early-stage diagnosis, where drug therapy has a limited role 54
Pipeline Analysis: cervical and endometrial cancer 55
Key findings 55
Cervical cancer pipeline overview 55
Cervical cancer late-phase pipeline 58
S-1 (Cefesone; tegafur, gimeracil, oxonic acid; Taiho Pharmaceutical) 58
Drug profile 58
Development overview 59
Product positioning 59
SWOT analysis 60
Gemzar (gemcitabine; Eli Lilly) 61
Drug profile 61
Development overview 62
Product positioning 64
SWOT analysis 66
Tirazone (tirapazamine; SRI International/National Cancer Institute/Stanford University) 66
Drug profile 66
Development overview 68
Product positioning 70
SWOT analysis 71
Z-100 (Ancer 20; Zeria) 72
Drug profile 72
Development overview - 73
Product positioning 74
SWOT analysis 74
Avastin (bevacizumab; Genentech/Roche/Chugai) 75
Drug profile 75
Development overview 76
Product positioning 78
SWOT analysis 80
The future of treatment in cervical cancer 81
Chemotherapy may have a greater role in the treatment of early-stage disease 81
Molecular targeted therapies may be integrated in the treatment of advanced disease 81
Endometrial cancer pipeline overview 82
Endometrial cancer late-phase pipeline 84
Ixempra (ixabepilone; Bristol-Myers Squibb) 84
Drug profile 84
Development overview 85
Product positioning 86
SWOT analysis 88
The future of treatment in endometrial cancer 88
Interest is growing in the potential of molecular targeted therapies 88
Chemotherapy may have an greater role in the management of the disease in the future 89
Bibliography 90
Journals 90
Websites 95
reports 97
Appendix 98
Contributing experts 98
Report methodology 98
About 98
About Healthcare 98
About the Oncology analysis team 99
Disclaimer 101
List of Tables
Table 1: International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer 9
Table 2: Human papillomavirus (HPV) vaccines: Gardasil and Cervarix 13
Table 3: Crude incidence rates of cervical cancer per 100,000 population in the seven major pharmaceutical markets, 2002 15
Table 4: Annual percentage change in the incidence of cervical cancer in the US, 1975-2006 15
Table 5: Forecast incidence of cervical cancer in the seven major pharmaceutical markets, 2002-2019 16
Table 6: Annual percentage change in the mortality of cervical cancer in the US, 1975-2006 17
Table 7: Top five countries with highest and lowest crude incidence rates of cervical cancer, 2002 and 2010 20
Table 8: Single agents used in the treatment of metastatic or recurrent cervical cancer 24
Table 9: Combination chemotherapy used in the treatment of metastatic or recurrent cervical cancer 24
Table 10: Classification of uterine corpus cancer 34
Table 11: Staging of endometrial cancer by the International Federation of Gynecology and Obstetrics (FIGO) 36
Table 12: Grading of endometrial cancer according to the European Society for Medical Oncology (ESMO) guidelines 38
Table 13: Risk stratification for Stage I endometrial cancer according to the European Society for Medical Oncology (ESMO) treatment recommendations 38
Table 14: Crude incidence rates of uterine corpus cancer per 100,000 population in the seven major pharmaceutical markets, 2002 39
Table 15: Forecast incidence of endometrial cancer in the seven major pharmaceutical markets, 2002-2019 40
Table 16: Top five countries with highest and lowest crude incidence rates of endometrial cancer, 2002 and 2010 42
Table 17: Chemotherapy drugs and regimens used in the treatment of recurrent or metastatic endometrial cancer, 2010 47
Table 18: Drugs in development for cervical cancer, 2010 55
Table 19: S-1 - drug profile, 2010 58
Table 20: Ongoing clinical trials for S-1 in cervical cancer, 2010 59
Table 21: Gemzar - drug profile, 2010 62
Table 22: Ongoing clinical trials for Gemzar in cervical cancer, 2010 63
Table 23: Phase III results for Gemzar with cisplatin and radiation in Stage IIB-IVA cervical cancer 64
Table 24: Tirazone - drug profile, 2010 67
Table 25: Ongoing clinical trials for Tirazone in cervical cancer, 2010 68
Table 26: Phase II results for Tirazone with cisplatin in Stage IV or recurrent
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