Non-Small-Cell Lung Cancer – Unmet Need – Detailed, Expanded Analysis – Metastatic Nonsquamous Non-Small-Cell Lung Cancer Without Driver Mutations (US/EU)

Metastatic non-small-cell lung cancer (NSCLC) is a highly segmented indication defined by tumor histology and mutational status. Metastatic nonsquamous NSCLC patients are routinely tested for the presence of molecular aberrations. While the minority of patients found positive for EGFR, ALK, BRAF, ROS1, c-MET, or RET aberrations are eligible to receive approved targeted agents, patients without driver mutations have limited treatment options. In the last decade, approval of multiple immune checkpoint inhibitors in the first-line setting has revolutionized the treatment of metastatic nonsquamous NSCLC without driver mutations. Immunotherapies such as Keytruda (Merck & Co.), Tecentriq (Roche / Genentech), Opdivo plus Yervoy (Bristol Myers Squibb), and Libtayo (Sanofi / Regeneron Pharmaceuticals) dominate the market as monotherapy and in combination with cytotoxic agents. However, a large population of patients with metastatic disease is unresponsive to immunotherapies; hence, there is a strong need for efficacious therapies in this patient setting.

QUESTIONS ANSWERED

  • What are the drivers and constraints in the treatment of metastatic nonsquamous NSCLC without driver mutations?
  • How do current therapies, such as immune checkpoint inhibitors, perform on key treatment drivers and goals for this patient population?
  • What are the prevailing areas of unmet need and hidden opportunities in the treatment of this patient population?
  • What trade-offs across different clinical attributes and price are acceptable to surveyed medical oncologists for a hypothetical new first-line treatment for metastatic nonsquamous NSCLC without driver mutations?

PRODUCT DESCRIPTION

Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on 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 in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 62 U.S. medical oncologists and 30 European medical oncologists fielded in February 2022

Key companies: Merck & Co., Bristol Myers Squibb, Roche / Genentech, Sanofi / Regeneron

Key drugs: Keytruda, Tecentriq, Opdivo, Yervoy, Libtayo

Table of contents

  • Non-Small-Cell Lung Cancer - Unmet Need - Detailed, Expanded Analysis - Metastatic Nonsquamous Non-Small-Cell Lung Cancer Without Driver Mutations (US/EU)
    • Executive summary
      • Unmet Need - Metastatic nonsquamous NSCLC without driver mutations - Executive Summary - May 2022
    • Introduction
      • Overview
      • Methodology
      • Rationale for treatment drivers and goals selection
        • Rationale for drug selection
          • Products / regimens for metastatic NSCLC without driver mutations 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 metastatic nonsquamous NSCLC without driver mutations
        • Importance of efficacy attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: United States
        • Importance of efficacy attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Importance of safety and tolerability attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: United States
        • Importance of safety and tolerability attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Importance of convenience of administration attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: United States
        • Importance of convenience of administration attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Importance of nonclinical factors to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: United States
        • Importance of nonclinical factors to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: 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 metastatic nonsquamous NSCLC without driver mutations: United States
        • Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in metastatic nonsquamous NSCLC without driver mutations: Europe
      • Product performance against treatment drivers and goals
        • Key findings
        • Overall performance of key therapies for metastatic nonsquamous NSCLC without driver mutations: United States
        • Overall performance of key therapies for metastatic nonsquamous NSCLC without driver mutations: Europe
        • Mean overall performance of key therapies for metastatic nonsquamous NSCLC without driver mutations: United States and Europe
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select efficacy attributes: United States
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select efficacy attributes: Europe
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select safety and tolerability attributes: United States
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select safety and tolerability attributes: Europe
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select convenience of administration attributes: United States
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select convenience of administration attributes: Europe
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select nonclinical attributes: United States
        • Relative performance of key therapies for metastatic nonsquamous NSCLC without driver mutations across select nonclinical attributes: Europe
      • Assessment of unmet need
        • Key findings: unmet need in metastatic nonsquamous NSCLC without driver mutations
        • Surveyed medical oncologistsu2019 satisfaction with the performance of key therapies for metastatic nonsquamous NSCLC without driver mutations on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: United States
        • Surveyed medical oncologistsu2019 satisfaction with the performance of key therapies for metastatic nonsquamous NSCLC without driver mutations on efficacy, safety and tolerability, convenience of administration, and nonclinical factors: Europe
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key efficacy attributes in metastatic nonsquamous NSCLC without driver mutations: United States
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key efficacy attributes in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key safety and tolerability attributes in metastatic nonsquamous NSCLC without driver mutations: United States
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key safety and tolerability attributes in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key convenience of administration attributes in metastatic nonsquamous NSCLC without driver mutations: United States
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key convenience of administration attributes in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key nonclinical factors in metastatic nonsquamous NSCLC without driver mutations: United States
        • Surveyed medical oncologistsu2019 ascribed level of unmet need across key nonclinical factors in metastatic nonsquamous NSCLC without driver mutations: Europe
        • Key findings: unmet need in metastatic nonsquamous NSCLC without driver mutations and related indications
        • Surveyed medical oncologists' ascribed level of unmet need in metastatic nonsquamous NSCLC without driver mutations and related indications: United States
        • Surveyed medical oncologists' ascribed level of unmet need in metastatic nonsquamous NSCLC without driver mutations and related indications: Europe
      • Opportunity analysis
        • Areas of opportunity in the metastatic nonsquamous NSCLC without driver mutations market and emerging therapy insights
          • Opportunity: a novel therapy that can extend patient survival
          • Opportunity: a novel therapy that improves progression-free survival
          • Opportunity: a novel therapy with improved safety and tolerability profile
          • Opportunity: a novel biomarker-driven therapy that is predictive of response to therapy
      • 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
          • First-line metastatic nonsquamous NSCLC without driver mutations target product profile: attribute importance
          • Median overall survival (months)
          • Median progression-free survival (months)
          • Objective response rate (% of patients)
          • Incidence of grade 3/4 hematological toxicities (% of patients)
          • Incidence of grade 3/4 immune-related adverse events (% of patients)
          • Incidence of grade 3/4 gastrointestinal toxicities (% of patients)
          • Price per 21-day cycle
        • Conjoint analysis-based simulation of a market scenario
          • First-line metastatic nonsquamous NSCLC without driver mutations market simulation: share of preference of target product profiles Included in the market scenario
          • First-line metastatic nonsquamous NSCLC without driver mutations market simulation: likelihood to prescribe target product profiles included in the market scenario
          • First-line metastatic nonsquamous NSCLC without driver mutations market simulation: target product profiles included in the market scenario
      • Appendix
        • Key abbreviations
        • Bibliography

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