Stakeholder Insight: Breast Cancer (Hormone Receptor-Negative) - Triple-negative breast cancer offers a significant opportunity to new market entrants while Herceptin dominates the HER-2-positive market

  • OVERVIEW
    • Catalyst
    • Summary
  • EXECUTIVE SUMMARY
    • Scope of the analysis
    • Datamonitor insight into the hormone receptor-negative breast cancer market
    • Contributing experts
    • Related reports
    • Upcoming related reports
  • 1. INTRODUCTION AND SCOPE
    • Coverage of the Stakeholder Insight Survey
      • Epidemiology
      • Treatment options
      • Treatment trends
      • Future treatment
  • 2. EPIDEMIOLOGY
    • Introduction and background
    • Key points
    • Disease definition and diagnosis criteria
    • Global variation and historical trends
      • Incidence rates
      • Prevalence
    • Risk factors
      • Reproductive factors
      • Exogenous hormones
      • Lifestyle factors
      • Socioeconomic factors
      • Genetic predisposition
    • Epidemiologic forecasting of breast cancer
      • Sources of epidemiologic data
      • Categorization and stratification
    • Description of methods
      • Statistical analysis
    • Epidemiologic forecast results
      • Estimated incident cases and future trends of breast cancer
      • Segmentation of incident cases: 2010
      • Estimated prevalent cases
    • Discussion
      • US
      • Japan
      • Europe
      • Strengths of our epidemiologic projections
    • Conclusions
  • 3. DISEASE OVERVIEW
    • Introduction
      • Breast cancer is the most common tumor type in females
      • Anatomy of the breast
      • Histology of breast cancer
    • Patient segmentation
      • Staging of breast cancer
      • Molecular markers for breast cancer
  • 4. TREATMENT OPTIONS
    • Introduction
      • Overview of breast cancer treatment options
      • Overview of drug therapies approved for hormone receptor-negative breast cancer
      • Treatment options and treatment outcomes in early-stage (Stage I–III) breast cancer
      • Treatment options and treatment outcomes in metastatic (Stage IV) breast cancer
  • 5. TREATMENT TRENDS: STAGE I–III
    • Triple-negative breast cancer
      • Treatment rates
      • Neoadjuvant therapy
      • Adjuvant therapy
    • HER-2-positive breast cancer
      • Treatment rates
      • Neoadjuvant therapy
      • Adjuvant therapy
  • 6. TREATMENT TRENDS: STAGE IV AND RELAPSE
    • Triple-negative breast cancer
      • Stage IV at initial diagnosis
      • Local relapse
      • Distant relapse
    • HER-2-positive breast cancer
      • Stage IV at initial diagnosis
      • Local relapse
      • Distant relapse
  • 7. FUTURE TREATMENT
    • Late-phase pipeline products overview
    • Afatinib (BIBW-2992; Boehringer Ingelheim)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Afinitor (everolimus; Novartis)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Iniparib (BSI-201; BiPar Sciences/Sanofi-Aventis)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Eribulin (E7389; Eisai)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Neratinib (HKI-272; Pfizer)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Pertuzumab (Genentech/Roche/Chugai)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Ramucirumab (IMC-1121B; Eli Lilly)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Trastuzumab-DM1 (ImmunoGen/Genentech/Roche/Chugai)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Votrient (pazopanib; GlaxoSmithKline)
      • Drug overview
      • Drug profile
      • Key historical events
      • Clinical trial data
      • Clinical and commercial attractiveness
    • Future treatment scenarios
      • Triple-negative breast cancer future treatment scenarios
      • HER-2-positive breast cancer future treatment scenarios
  • BIBLIOGRAPHY
    • Chapter 2. Epidemiology
      • Journal papers
    • Chapter 3. Disease Overview
      • Journal papers
      • Websites
    • Chapter 4. Treatment Options
      • Journal papers
      • Websites
    • Chapter 5. Treatment Trends: Stage I–III Breast Cancer
      • Journal papers
      • Websites
      • Datamonitor reports
      • Other
    • Chapter 6. Treatment Trends: Stage IV and Relapsed Breast Cancer
      • Journal papers
      • Websites
      • Other
    • Chapter 7. Future Treatment
      • Journal papers
      • Websites
      • Other
  • APPENDIX A
    • Abbreviations
    • Physician research methodology
    • Physician sample breakdown
    • Contributing experts
  • APPENDIX B
    • The survey questionnaire
      • Screener
      • Introduction
      • Section 2 – Neoadjuvant and adjuvant chemotherapy for Hormone receptor negative/ HER-2-positive patients
      • Section 3 – Neoadjuvant and adjuvant chemotherapy for Triple-negative (ER-negative, PR-negative and HER-2-negative) patients
      • Section 4 – Stage IV disease
      • Section 5 – Local relapse
      • Section 6 – Distant relapse
      • Section 7 – Future scenarios
    • Datamonitor consulting
    • Disclaimer
  • TABLES
    • Table: Cancer registry data sources from the seven major markets
    • Table: Prevalence of breast cancer subtypes in newly diagnosed patients (%)
    • Table: Incident breast cancer cases in the seven major markets, 2010–19
    • Table: Age-specific incident cases of breast cancer in the seven major markets, 2010
    • Table: Incident breast cancer cases by menopausal status in the seven major markets, 2010
    • Table: Stage-specific breast cancer incident cases in the seven major markets, 2010
    • Table: Distribution of incident breast cancer cases by cancer subtypes in the seven major markets, 2010
    • Table: Estimated 5-year prevalent cases of breast cancer in the seven major markets, 2010–19
    • Table: Total 5-year prevalent cases by stage at diagnosis in the seven major markets, 2010
    • Table: Approved cytotoxic therapies for breast cancer in the seven major markets, November 2010
    • Table: Approved molecular targeted therapies for breast cancer in the seven major markets, November 2010
    • Table: Summary of treatment outcomes for selected adjuvant drug regimens in Stage I–III breast cancer
    • Table: Summary of treatment outcomes for selected neoadjuvant drug regimens in Stage I–III breast cancer
    • Table: Summary of treatment outcomes for selected drug regimens in Stage IV breast cancer
    • Table: Products in late-phase development (Phase III clinical trials or pre-registration) for breast cancer, November 2010
    • Table: Afatinib – drug profile, 2010
    • Table: Afatinib: key historical events, 2007–10
    • Table: Clinical development of afatinib in breast cancer, 2010
    • Table: Afinitor – drug profile, 2010
    • Table: Afinitor: key historical events, 2003–10
    • Table: Clinical development of Afinitor in breast cancer, 2010
    • Table: Iniparib – drug profile, 2010
    • Table: Iniparib: key historical events, 2006–10
    • Table: Clinical development of iniparib in breast cancer, 2010
    • Table: Eribulin – drug profile, 2010
    • Table: Eribulin: key historical events, 2006–10
    • Table: Clinical development of eribulin in breast cancer, 2010
    • Table: Neratinib – drug profile, 2010
    • Table: Neratinib: key historical events, 2008–10
    • Table: Clinical development of neratinib in breast cancer, 2010
    • Table: Pertuzumab – drug profile, 2009
    • Table: Pertuzumab: key historical events, 2003–10
    • Table: Clinical development of pertuzumab in breast cancer, 2010
    • Table: Ramucirumab – drug profile, 2010
    • Table: Ramucirumab: key historical events, 2005–10
    • Table: Clinical development of Ramucirumab, 2010
    • Table: Trastuzumab-DM1 – drug profile, 2010
    • Table: Trastuzumab-DM1: key historical events, 2000–10
    • Table: Clinical development of trastuzumab-DM1 in breast cancer, 2010
    • Table: Votrient – drug profile, 2010
    • Table: Votrient: key historical events, 2005–10
    • Table: Clinical development of Votrient in breast cancer, 2010
    • Table: Breast cancer chemotherapy regimen abbreviations
    • Table: Medical specialty of respondents to the Stakeholder Insight: Breast Cancer (Hormone Receptor-Negative) questionnaire
    • Table: Number of years spent in specialty for respondents to the Stakeholder Insight: Breast Cancer (Hormone Receptor-Negative) questionnaire
    • Table: Type of hospital worked in by respondents to the Stakeholder Insight: Breast Cancer (Hormone Receptor-Negative) questionnaire
  • FIGURES
    • Figure: Age-adjusted incidence rates of breast cancer in the seven major markets, 2008
    • Figure: Age-adjusted female breast cancer incidence rates in the seven major markets, 1983–2002
    • Figure: The human female breast
    • Figure: Histological classification of breast cancer
    • Figure: Molecular biomarkers used in breast cancer
    • Figure: Percentage of Stage I triple-negative breast cancer patients receiving each treatment modality across the seven major markets, 2010
    • Figure: Percentage of Stage II triple-negative breast cancer patients receiving each treatment modality across the seven major markets, 2010
    • Figure: Percentage of Stage III triple-negative breast cancer patients receiving each treatment modality across the seven major markets, 2010
    • Figure: Percentage of Stage I triple-negative breast cancer patients receiving each neoadjuvant regimen across the seven major markets, 2010
    • Figure: Percentage of Stage II triple-negative breast cancer patients receiving each neoadjuvant regimen across the seven major markets, 2010
    • Figure: Percentage of Stage III triple-negative breast cancer patients receiving each neoadjuvant regimen across the seven major markets, 2010
    • Figure: Percentage of Stage I triple-negative breast cancer patients receiving each adjuvant regimen across the seven major markets, 2010
    • Figure: Percentage of Stage II triple-negative breast cancer patients receiving each adjuvant regimen across the seven major markets, 2010
    • Figure: Percentage of Stage III triple-negative breast cancer patients receiving each adjuvant regimen across the seven major markets, 2010
    • Figure: Percentage of Stage I HER-2-positive, hormone receptor-negative breast cancer patients receiving each treatment modality across the seven major markets, 2010
    • Figure: Percentage of Stage II HER-2-positive, hormone receptor-negative breast cancer patients receiving each treatment modality across the seven major markets, 2010
    • Figure: Percentage of Stage III HER-2-positive, hormone receptor-negative breast cancer patients receiving each treatment modality across the seven major markets, 2010
    • Figure: Percentage of Stage I HER-2-positive, hormone receptor-negative breast cancer patients receiving each neoadjuvant regimen across the seven major markets, 2010
    • Figure: Uptake of key agents in the neoadjuvant setting in Stage I HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage II HER-2-positive, hormone receptor-negative breast cancer patients receiving each neoadjuvant regimen across the seven major markets, 2010
    • Figure: Uptake of key agents in the neoadjuvant setting in Stage II HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage III HER-2-positive, hormone receptor-negative breast cancer patients receiving each neoadjuvant regimen across the seven major markets, 2010
    • Figure: Uptake of key agents in the neoadjuvant setting in Stage III HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage I HER-2-positive, hormone receptor-negative breast cancer patients receiving each adjuvant regimen across the seven major markets, 2010
    • Figure: Uptake of key agents in the adjuvant setting in Stage I HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage II HER-2-positive, hormone receptor-negative breast cancer patients receiving each adjuvant regimen across the seven major markets, 2010
    • Figure: Uptake of key agents in the adjuvant setting in Stage II HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage III HER-2-positive, hormone receptor-negative breast cancer patients receiving each adjuvant regimen across the seven major markets, 2010
    • Figure: Uptake of key agents in the adjuvant setting in Stage III HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Correlation between percentage of Stage II HER-2-positive, hormone receptor-negative adjuvant patients receiving anthracycline versus Herceptin, 2010
    • Figure: Percentage of triple-negative breast cancer patients with Stage IV disease at diagnosis receiving each first-line treatment modality across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients with Stage IV disease at diagnosis receiving each first-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for first-line treatment of triple-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of first-line triple-negative breast cancer patients with Stage IV disease at diagnosis progressing to second-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients with Stage IV disease at diagnosis receiving each second-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for second-line treatment of triple-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of second-line triple-negative breast cancer patients with Stage IV disease at diagnosis progressing to third-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients with Stage IV disease at diagnosis receiving each third-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for third-line treatment of triple-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of third-line triple-negative breast cancer patients with Stage IV disease at diagnosis progressing to fourth-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients with Stage IV disease at diagnosis receiving each fourth-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for fourth-line treatment of triple-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of fourth-line triple-negative breast cancer patients with Stage IV disease at diagnosis progressing to further lines of chemotherapy across the seven major markets, 2010
    • Figure: Percentage of Stage I–III triple-negative breast cancer patients who experience local relapse across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving each treatment modality for local relapse across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving each regimen for local relapse across the seven major markets, 2010
    • Figure: Uptake of key agents for local relapse in triple-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage I–III triple-negative breast cancer patients who experience distant relapse across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving each first-line treatment modality for distant relapse across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving each first-line regimen for distant relapse across the seven major markets, 2010
    • Figure: Uptake of key agents in the first-line for distant relapse in triple-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving first-line chemotherapy for distant relapse who progress to second-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving each second-line regimen for distant relapse across the seven major markets, 2010
    • Figure: Uptake of key agents in the second-line for distant relapse in triple-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving second-line chemotherapy for distant relapse who progress to third-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving each third-line regimen for distant relapse across the seven major markets, 2010
    • Figure: Uptake of key agents in the third-line for distant relapse in triple-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of triple-negative breast cancer patients receiving third-line chemotherapy for distant relapse who progress to further lines of chemotherapy across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis receiving each first-line treatment modality across the seven major markets, 2010
    • Figure: Percentage HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis receiving each first-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for first-line treatment of HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of first-line HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis progressing to second-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis receiving each second-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for second-line treatment of HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of second-line HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis progressing to third-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis receiving each third-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for third-line treatment of HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of third-line HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis progressing to fourth-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis receiving each fourth-line regimen across the seven major markets, 2010
    • Figure: Uptake of key agents for fourth-line treatment of HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis across the seven major markets, 2010
    • Figure: Percentage of fourth-line HER-2-positive, hormone receptor-negative breast cancer patients with Stage IV disease at diagnosis progressing to further lines of chemotherapy across the seven major markets, 2010
    • Figure: Percentage of Stage I–III HER-2-positive, hormone receptor-negative breast cancer patients who experience local relapse across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving each treatment modality for local relapse across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving each regimen for local relapse across the seven major markets, 2010
    • Figure: Uptake of key agents for local relapse in HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of Stage I–III HER-2-positive, hormone receptor-negative breast cancer patients who experience distant relapse across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving each first-line treatment modality for distant relapse across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving each first-line regimen for distant relapse across the seven major markets, 2010
    • Figure: Uptake of key agents in the first-line for distant relapse in HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving first-line chemotherapy for distant relapse who progress to second-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving each second-line regimen for distant relapse across the seven major markets, 2010
    • Figure: Uptake of key agents in the second-line for distant relapse in HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving second-line chemotherapy for distant relapse who progress to third-line chemotherapy across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving each third-line regimen for distant relapse across the seven major markets, 2010
    • Figure: Uptake of key agents in the third-line for distant relapse in HER-2-positive, hormone receptor-negative breast cancer patients across the seven major markets, 2010
    • Figure: Percentage of HER-2-positive, hormone receptor-negative breast cancer patients receiving fourth-line chemotherapy for distant relapse who progress to further lines of chemotherapy across the seven major markets, 2010
    • Figure: Phase II trial results investigating neoadjuvant Afinitor plus Femara in hormone receptor-positive breast cancer
    • Figure: Phase II results investigating first/second-line Afinitor monotherapy in metastatic breast cancer
    • Figure: Phase II results investigating second-line Afinitor in combination with Herceptin and paclitaxel in HER-2-overexpressing metastatic breast cancer
    • Figure: Phase II randomized study evaluating iniparib in combination with Gemzar and carboplatin in first-line or higher triple-negative breast cancer
    • Figure: Phase II study investigating second-line or higher eribulin in chemotherapy-refractory advanced breast cancer patients
    • Figure: Phase II study investigating third-line or higher eribulin in chemotherapy-refractory advanced breast cancer patients
    • Figure: Phase III study investigating third-line or higher eribulin in chemotherapy-refractory advanced breast cancer patients
    • Figure: Phase I/II safety and efficacy trial of neratinib in combination with weekly paclitaxel in patients with solid tumors and HER-2-positive metastatic breast cancer
    • Figure: Phase II study results for pertuzumab in HER-2-positive metastatic breast cancer following failure of prior Herceptin
    • Figure: Phase II study results of pertuzumab in metastatic breast cancer
    • Figure: Phase II study of trastuzumab-DM1 in metastatic HER-2-positive breast cancer patients previously treated with at least one line of therapy (including anti-HER-2 therapy)
    • Figure: Phase II study of trastuzumab-DM1 in metastatic HER-2-positive breast cancer patients previously treated with at least two lines of therapy (including Herceptin and Tykerb)
    • Figure: Phase II results investigating first-line Tykerb with or without Votrient in HER-2-positive advanced or metastatic breast cancer
    • Figure: Likelihood of future scenarios in Stage I–III triple-negative breast cancer (mean scores), 2010
    • Figure: Likelihood of future scenarios in metastatic triple-negative breast cancer (mean scores), 2010
    • Figure: Likelihood of future scenarios in Stage I–III HER-2-positive, hormone receptor-negative breast cancer (mean scores), 2010
    • Figure: Likelihood of future scenarios in metastatic HER-2-positive, hormone receptor-negative breast cancer (mean scores), 2010

Report

Published by
Datamonitor
Published on
03 Nov 2010
Product code
HC00031-001
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