Multiple myeloma remains an incurable hematological malignancy despite the availability of several treatments. Resistance to therapy is the primary challenge associated with the disease’s relapse and recurrence, especially in elderly patients. The foremost goal in the third-line treatment of multiple myeloma is extending the patient’s survival. The mainstays of treatment have been agents that affect the immune system, such as Bristol Myers Squibb’s Revlimid and Pomalyst / Imnovid used with the generic corticosteroid dexamethasone. The prescribing of proteasome inhibitors such as Amgen / Ono Pharmaceutical’s Kyprolis and Takeda’s Ninlaro, along with the emergence of novel drugs such as Janssen’s Darzalex, Sanofi’s Sarclisa, and Karyopharm’s Xpovio, is having an impact on treatment choices in the third-line setting. However, in the absence of a uniform treatment regimen, the choice of third-line therapy for multiple myeloma remains fragmented.
QUESTIONS ANSWERED
- What treatment drivers and goals are most likely to influence the choice of third-line therapy or regimen in multiple myeloma?
- What drug attributes are key influences, which have limited impact, and which are hidden opportunities?
- How do current therapies perform on key clinical drug attributes for this patient population?
- What are the prevailing areas of unmet need and hidden opportunities in this patient population?
- What trade-offs across clinical attributes and price are acceptable to surveyed hematologist-oncologists for a new therapy or regimen for third-line multiple myeloma?
PRODUCT DESCRIPTION
Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.
Markets covered: United States, United Kingdom, France, Germany
Primary research: Survey of 61 U.S. and 30 European hematologist-oncologists fielded in May 2021
Key companies: Janssen, Bristol Myers Squibb, Takeda, Amgen / Ono Pharmaceutical, Sanofi, Karyopharm Therapeutics.
Key drugs: Darzalex, Revlimid, Ninlaro, Kyprolis, Pomalyst / Imnovid, Sarclisa, Xpovio
- Multiple Myeloma - Unmet Need - Detailed, Expanded Analysis (US/EU) Relapsed Or Refractory Third-Line Multiple Myeloma
- Executive Summary
- Unmet Need - Relapsed or Refractory Third-Line Multiple Myeloma - Executive Summary - August 2021
- Introduction
- Overview
- Methodology
- Rationale for Treatment Drivers and Goals Selection
- Rationale for Drug Selection
- Regimens for Relapsed or Refractory Third-Line Multiple Myeloma and Rationale for Drug Selection
- Treatment Drivers and Goals
- Key Findings: Attribute Importance
- Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Hematologist-Oncologists' Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma
- Importance of Efficacy Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Importance of Efficacy Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Importance of Safety and Tolerability Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Importance of Safety and Tolerability Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Importance of Convenience of Administration Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Importance of Convenience of Administration Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Key Findings: Stated vs. Derived Importance
- Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Product Performance Against Treatment Drivers and Goals
- Key Findings
- Overall Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Overall Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Mean Overall Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma: United States and Europe
- Relative Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma Across Select Efficacy Attributes: United States
- Relative Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma Across Select Efficacy Attributes: Europe
- Relative Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma Across Select Safety and Tolerability Attributes: United States
- Relative Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma Across Select Safety and Tolerability Attributes: Europe
- Relative Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma Across Select Convenience of Administration Attributes: United States
- Relative Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma Across Select Convenience of Administration Attributes: Europe
- Assessment of Unmet Need
- Key Findings: Unmet Need in Relapsed or Refractory Third-Line Multiple Myeloma
- Surveyed Hematologist-Oncologists' Satisfaction with the Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
- Surveyed Hematologist-Oncologists' Satisfaction with the Performance of Key Therapies for Relapsed or Refractory Third-Line Multiple Myeloma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Relapsed or Refractory Third-Line Multiple Myeloma: United States
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Relapsed or Refractory Third-Line Multiple Myeloma: Europe
- Key Findings: Unmet Need in Relapsed and Refractory Third-Line Multiple Myeloma or Related Indications
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need in Relapsed or Refractory Third-Line Multiple Myeloma and Related Indications: United States
- Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need in Relapsed or Refractory Third-Line Multiple Myeloma and Related Indications: Europe
- Opportunity Analysis
- Areas of Opportunity in the Relapsed or Refractory Third-Line Multiple Myeloma Market and Emerging Therapy Insights
- Opportunity: A Novel Therapy or Regimen That Extends Overall Survival
- Opportunity: A Novel Therapy or Regimen That Improves Progression-Free Survival
- Opportunity: A Novel Therapy or Regimen with Improved Safety and Tolerability
- Target Product Profiles
- Assessing Drug Development Opportunities
- Target Product Profile Methodology
- Attributes and Attribute Levels
- Assigned Prohibitions for the Conjoint Module
- Attribute Importance and Part-Worth Utilities
- Relapsed or Refractory Third-Line Multiple Myeloma Target Product Profile: Attribute Importance
- Median Overall Survival
- Median Progression-Free Survival
- Overall Response Rate
- Incidence of Grade 3/4 Hematological Toxicity
- Incidence of Grade 3/4 Cardiac Toxicity
- Incidence of Any-Grade Gastrointestinal Toxicity
- Price per 28-Day Cycle
- Conjoint Analysis-Based Simulation of a Market Scenario
- Relapsed or Refractory Third-Line Multiple Myeloma Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
- Relapsed or Refractory Third-Line Multiple Myeloma Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
- Relapsed or Refractory Third-Line Multiple Myeloma Market Simulation: Target Product Profiles Included in the Market Scenario
- Appendix
Ananya Sadhu, Ph.D.
Ananya Sadhu, Ph.D., is an analyst on the Oncology team at Clarivate. She is primarily responsible for pancreatic cancer and hepatocellular carcinoma content and client support. She has authored several syndicated reports and forecasts for the pancreatic cancer and hepatocellular carcinoma therapy market. Previously, she was a postdoctoral fellow at the National Centre of Biological Sciences in Bangalore, where she studied the role of chromatin architecture in regulating gene expression in breast cancer. She also worked as a scientific officer at Arvind Remedies, where she coordinated various stages of nonclinical / clinical research activities for drug development of a patented polyherbal formulation. She holds a Ph.D. in molecular biology from the National Institute of Immunology in New Delhi.