Hepatocellular Carcinoma – Unmet Need – Detailed, Expanded Analysis: Advanced Hepatocellular Carcinoma (US/EU5)
Hepatocellular carcinoma, the most common type of liver cancer, occurs as a result of chronic liver cirrhosis. It has a five-year survival rate of only 18%. First-line advanced hepatocellular carcinoma is the largest drug-treatable hepatocellular carcinoma population and thus the most commercially lucrative for drug developers. This therapy market will experience rapid growth, driven by the approval of immune checkpoint inhibitors and combination therapies such as Tecentriq plus bevacizumab and Opdivo plus Yervoy. In this report, we analyze the factors that influence the prescribing decisions of medical oncologists treating advanced hepatocellular carcinoma and review the unmet needs that novel therapies should target.
QUESTIONS ANSWERED
- What are the treatment drivers and goals associated with advanced hepatocellular carcinoma?
- How do immune checkpoint inhibitors in combination with angiogenesis inhibitors (e.g., Roche’s Tecentriq plus bevacizumab) or double-agent immune checkpoint inhibitors (e.g., Bristol Myers Squibb’s Opdivo plus Yervoy) perform on key treatment drivers and goals in advanced hepatocellular carcinoma?
- What are the prevailing areas of unmet need and opportunity in the treatment of advanced hepatocellular carcinoma?
- What trade-offs across different clinical attributes and prices are acceptable to U.S. and European medical oncologists for a hypothetical new drug for advanced hepatocellular carcinoma?
PRODUCT DESCRIPTION
Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease subpopulation. Based on the surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.
Markets covered: United States, France, Germany, United Kingdom
Primary research: Survey of 61 U.S. and 33 European medical oncologists fielded in December 2021
Key companies: Bayer, Eisai, Exelixis / Ipsen, Eli Lilly, Roche / Genentech, Merck & Co., Bristol Myers Squibb
Key drugs: Nexavar, Lenvima, Cabometyx, Cyramza, Opdivo + Yervoy, Keytruda, and Tecentriq + bevacizumab
Table of contents
- Hepatocellular Carcinoma - Unmet Need - Detailed, Expanded Analysis: Advanced Hepatocellular Carcinoma (US/EU5)
- Executive summary
- Unmet Need - Advanced Hepatocellular Carcinoma - Executive Summary - March 2022
- Introduction
- Overview
- Methodology
- Rationale for treatment drivers and goals selection
- Rationale for drug selection
- Products for advanced hepatocellular carcinoma 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 medical oncologists' prescribing decisions in hepatocellular carcinoma
- Importance of efficacy attributes to prescribing decisions in hepatocellular carcinoma: United States
- Importance of efficacy attributes to prescribing decisions in hepatocellular carcinoma: Europe
- Importance of safety and tolerability attributes to prescribing decisions in hepatocellular carcinoma: United States
- Importance of safety and tolerability attributes to prescribing decisions in hepatocellular carcinoma: Europe
- Importance of convenience of administration attributes to prescribing decisions in hepatocellular carcinoma: United States
- Importance of convenience of administration attributes to prescribing decisions in hepatocellular carcinoma: Europe
- Importance of nonclinical factors to prescribing decisions in hepatocellular carcinoma: United States
- Importance of nonclinical factors to prescribing decisions in hepatocellular carcinoma: 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 hepatocellular carcinoma: United States
- Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in hepatocellular carcinoma: Europe
- Product performance against treatment drivers and goals
- Key findings
- Overall performance of key therapies for advanced hepatocellular carcinoma: United States
- Overall performance of key therapies for advanced hepatocellular carcinoma: Europe
- Mean overall performance of key therapies for advanced hepatocellular carcinoma: United States and Europe
- Relative performance of key therapies for advanced hepatocellular carcinoma across select efficacy attributes: United States
- Relative performance of key therapies for advanced hepatocellular carcinoma across select efficacy attributes: Europe
- Relative performance of key therapies for advanced hepatocellular carcinoma across select safety and tolerability attributes: United States
- Relative performance of key therapies for advanced hepatocellular carcinoma across select safety and tolerability attributes: Europe
- Relative performance of key therapies for advanced hepatocellular carcinoma across select convenience of administration attributes: United States
- Relative performance of key therapies for advanced hepatocellular carcinoma across select convenience of administration attributes: Europe
- Relative performance of key therapies for advanced hepatocellular carcinoma across select nonclinical attributes: United States
- Relative performance of key therapies for advanced hepatocellular carcinoma across select nonclinical attributes: Europe
- Assessment of unmet need
- Key findings: unmet need in advanced hepatocellular carcinoma
- Surveyed medical oncologists' satisfaction with the performance of key therapies for advanced hepatocellular carcinoma on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: United States
- Surveyed medical oncologistsu2019 satisfaction with the performance of key therapies for advanced hepatocellular carcinoma 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 advanced hepatocellular carcinoma: United States
- Surveyed medical oncologists' ascribed level of unmet need across key efficacy attributes in advanced hepatocellular carcinoma: Europe
- Surveyed medical oncologists' ascribed level of unmet need across key safety and tolerability attributes in advanced hepatocellular carcinoma: United States
- Surveyed medical oncologists' ascribed level of unmet need across key safety and tolerability attributes in advanced hepatocellular carcinoma: Europe
- Surveyed medical oncologists' ascribed level of unmet need across key convenience of administration attributes in advanced hepatocellular carcinoma: United States
- Surveyed medical oncologists' ascribed level of unmet need across key convenience of administration attributes in advanced hepatocellular carcinoma: Europe
- Surveyed medical oncologists' ascribed level of unmet need across key nonclinical factors in advanced hepatocellular carcinoma: Europe
- Key findings: unmet need in hepatocellular carcinoma and related indications
- Surveyed medical oncologists' ascribed level of unmet need in hepatocellular carcinoma and related indications: United States
- Surveyed medical oncologists' ascribed level of unmet need in hepatocellular carcinoma and related indications: Europe
- Opportunity analysis
- Areas of opportunity in the advanced hepatocellular carcinoma market and emerging therapy Insights
- Opportunity: a novel therapy that can extend overall survival
- Opportunity: a novel therapy with improved tumor response
- Opportunity: a novel therapy with an improved safety and tolerability profile
- Areas of opportunity in the advanced hepatocellular carcinoma market and emerging therapy Insights
- Target product profiles
- Assessing drug development opportunities in first-line advanced hepatocellular carcinoma
- Target product profile methodology
- Attributes and attribute levels
- Assigned prohibitions for the conjoint module
- Attribute importance and part-worth utilities
- First-line advanced hepatocellular carcinoma target product profile: attribute importance
- Median overall survival: first-line advanced hepatocellular carcinoma
- Median progression-free survival: first-line advanced hepatocellular carcinoma
- Objective response rate: first-line advanced hepatocellular carcinoma
- Incidence of any-grade gastrointestinal toxicities: first-line advanced hepatocellular carcinoma
- Incidence of any-grade immune-related adverse events: first-line advanced hepatocellular carcinoma
- Incidence of any-grade hand and foot skin reaction: first-line advanced hepatocellular carcinoma
- Price per 21-day cycle: first-line advanced hepatocellular carcinoma
- Conjoint analysis-based simulation of a market scenario
- First-line advanced hepatocellular carcinoma market simulation: share of preference of target product profiles included in the market scenario
- First-line advanced hepatocellular carcinoma market simulation: likelihood to prescribe target product profiles included in the market scenario
- First-line advanced hepatocellular carcinoma market simulation: target product profiles included in the market scenario
- Appendix
- Bibliography
- Executive summary
Laura Ramos Garcia, M.Sc., Ph.D., is an analyst on the Oncology team at Clarivate. During her training as a Ph.D., she gained in-depth knowledge in the field of cell death and inflammation. As a postdoctoral researcher, she worked on an emerging type of small molecule, PROTAC, that allows targeted protein degradation. She obtained her master of science degree in molecular medicine at Imperial College London and her doctorate in cancer biology at the Institute of Cancer Research (University of London).