In This Increasingly Crowded Setting, What Key Attributes Will Differentiate Emerging Therapies According to Oncologists and Payers?
Treatment decisions for non-small-cell lung cancer (NSCLC) patients are increasingly based on personalized tumor-specific characteristics. The first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), erlotinib (Genentech/ Roche/ Chugai /Astellas’s Tarceva) and gefitinib (AstraZeneca’s Iressa), have revolutionized the first-line treatment of EGFR-mutation-positive NSCLC, and crizotinib (Pfizer’s Xalkori) has made significant strides in treating anaplastic lymphoma kinase (ALK)-translocation-positive NSCLC. The outcome for previously treated EGFR-mutation-positive NSCLC patients is set to improve further based on the expected entry of third-generation EGFR inhibitors. The recent entry of ceritinib (Novartis’s Zykadia) and alectinib (Genentech/Roche/Chugai’s Alecensa) for previously treated ALK-translocation-positive NSCLC will significantly improve outcomes for these patients. Going forward, the market is expected to become increasingly competitive following the approval of the targeted second-generation and third-generation EGFR and ALK TKIs for previously treated, EGFR-mutation-positive/ALK-translocation-positive NSCLC. Significant clinical and commercial opportunity remains for therapies that can provide greater survival benefits with a better safety profile than current standards of care.