Colorectal Cancer – Unmet Need – Detailed, Expanded Analysis (US/EU) Previously Treated RAS And BRAF Mutation-Positive Metastatic Colorectal Cancer

This Unmet Need report focuses on the treatment of previously treated RAS and BRAF  mutation-positive metastatic colorectal cancer. Currently, the NCCN guidelines and treatment practices for metastatic colorectal cancer include the determination of tumor gene status for RAS (KRAS / NRAS) and BRAF  mutation-positive patients. In second- and later-line settings, RAS and BRAF mutation-positive patients are treated with anti-VEGF therapies, such as Avastin (Genentech/Roche), Cyramza (Eli Lilly), Stivarga (Bayer), and Zaltrap (Sanofi / Regeneron), with or without chemotherapy. The novel treatment regimen, consisting of BRAF + MEK inhibitors, Braftovi + Mektovi (Pfizer / Array BioPharma), in combination with the anti-EGFR therapies Erbitux (Eli Lilly / Merck KGaA) or Vectibix (Amgen), is recommended for the subsequent treatment of BRAF  mutation-positive patients. Nevertheless, less-toxic, more-efficacious therapies are needed for the subsequent treatment of these two colorectal cancer subpopulations.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for previously treated RAS / BRAF  mutation-positive metastatic colorectal cancer?
  • What drug attributes are key influences, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for previously treated RASBRAF  mutation-positive metastatic colorectal cancer?
  • What are the prevailing areas of unmet need and opportunity in previously treated RAS / BRAF  mutation-positive metastatic colorectal cancer?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European medical oncologists for a hypothetical new RAS / BRAF  mutation-positive metastatic colorectal cancer drug?

PRODUCT DESCRIPTION

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 60 U.S. and 32 European medical oncologists fielded in April 2020

Key companies: Pfizer / Array BioPharma, Eli Lilly / Merck KGaA, Amgen, Roche / Genentech, Bayer, Taiho  Pharmaceutical

Key drugs: Braftovi, Erbitux, Vectibix, Avastin, Cyramza, Stivarga, Lonsurf

Table of contents

  • Colorectal Cancer - Unmet Need - Detailed, Expanded Analysis (US/EU) Previously Treated RAS And BRAF Mutation-Positive Metastatic Colorectal Cancer
    • Executive Summary: Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer
      • Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer - UN Executive Summary - August 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Regimens for RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer 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 Medical Oncologists' Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer
        • Importance of Efficacy Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: 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 Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Overall Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Mean Overall Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States and Europe
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Nonclinical Attributes: United States
        • Relative Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer
        • Surveyed Medical Oncologists' Satisfaction with the Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Medical Oncologistsu2019 Satisfaction with the Performance of Key Therapies for Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer: Europe
        • Key Findings: Unmet Need in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer and Related Indications
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer and Related Indications: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Market and Emerging Therapy Insights
          • Opportunity: Novel Agents with Significant Efficacy Improvement for RAS Mutation-Positive Patients
          • Opportunity: A New Treatment Option with Longer Survival Rates for BRAF Mutation-Positive Patients
          • Opportunity: A Novel Regimen with an Improved Safety and Tolerability Profile
      • 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
          • Previously Treated RAS and BRAF Mutation-Positive Colorectal Cancer Target Product Profile: Attribute Importance
          • Median Overall Survival
          • Median Progression-Free Survival
          • Objective Response Rate
          • Incidence of Grade 3/4 Hematological Toxicities
          • Incidence of Grade 3/4 Gastrointestinal Toxicities
          • Incidence of Grade 3/4 Dermatological Toxicities
          • Price per 28-day Cycle
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • Previously Treated RAS and BRAF Mutation-Positive Metastatic Colorectal Cancer Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Bibliography

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