Gastroesophageal Cancer – Unmet Need – Detailed, Expanded Analysis – Metastatic Esophageal Cancer (US/EU)
Metastatic esophageal cancer remains a subpopulation for which few treatment options exist. For decades, treatment was limited to chemotherapy-based regimens such as FOLFOX and DCF, but the recent approvals of the immune checkpoint inhibitors Keytruda (Merck & Co.) and Opdivo (Bristol Myers Squibb) as single agents and in combination with chemotherapy are beginning to change the treatment landscape. Nevertheless, substantial need remains for more-efficacious treatments for metastatic esophageal cancer, particularly for tumors with low PD-L1 expression.
QUESTIONS ANSWERED
How satisfied are U.S. and European medical oncologists with current treatment options for metastatic esophageal cancer?
What are the treatment drivers and goals most likely to influence the choice of therapy for metastatic esophageal cancer?
How do current therapies, such as Keytruda and Opdivo, perform on key clinical attributes, and what are the hidden opportunities for drug developers in this patient population?
What trade-offs are U.S. and European medical oncologists willing to make across key clinical attributes and pricing when considering hypothetical target product profiles for metastatic esophageal cancer?
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 62 U.S. and 30 European medical oncologists fielded in April 2022.
Gastroesophageal Cancer - Unmet Need - Detailed, Expanded Analysis - Metastatic Esophageal Cancer (US/EU)
Executive summary
Unmet need - esophageal cancer - executive summary - August 2022
Introduction
Overview
Methodology
Rationale for treatment drivers and goals selection
Rationale for drug selection
Regimens for metastatic esophageal cancer 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 esophageal cancer
Importance of efficacy attributes to prescribing decisions in metastatic esophageal cancer: United States
Importance of efficacy attributes to prescribing decisions in metastatic esophageal cancer: Europe
Importance of safety and tolerability attributes to prescribing decisions in metastatic esophageal cancer: United States
Importance of safety and tolerability attributes to prescribing decisions in metastatic esophageal cancer: Europe
Importance of convenience of administration attributes to prescribing decisions in metastatic esophageal cancer: United States
Importance of convenience of administration attributes to prescribing decisions in metastatic esophageal 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 metastatic esophageal cancer: United States
Stated vs. derived importance of key efficacy, safety and tolerability, convenience of administration, and nonclinical attributes to prescribing decisions in metastatic esophageal cancer: Europe
Product performance against treatment drivers and goals
Key findings
Overall performance of key therapies for metastatic esophageal cancer: United States
Overall performance of key therapies for metastatic esophageal cancer: Europe
Mean overall performance of key therapies for metastatic esophageal cancer: United States and Europe
Relative performance of key therapies for metastatic esophageal cancer across select efficacy attributes: United States
Relative performance of key therapies for metastatic esophageal cancer across select efficacy attributes: Europe
Relative performance of key therapies for metastatic esophageal cancer across select safety and tolerability attributes: United States
Relative performance of key therapies for metastatic esophageal cancer across select safety and tolerability attributes: Europe
Relative performance of key therapies for metastatic esophageal cancer across select convenience of administration attributes: United States
Relative performance of key therapies for metastatic esophageal cancer across select convenience of administration attributes: Europe
Assessment of unmet need
Key findings: unmet need in metastatic esophageal cancer
Surveyed medical oncologistsu2019 satisfaction with the performance of key therapies for metastatic esophageal 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 metastatic esophageal 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 metastatic esophageal cancer: United States
Surveyed medical oncologists' ascribed level of unmet need across key efficacy attributes in metastatic esophageal cancer: Europe
Surveyed medical oncologists' ascribed level of unmet need across key safety and tolerability attributes in metastatic esophageal cancer: United States
Surveyed medical oncologists' ascribed level of unmet need across key safety and tolerability attributes in metastatic esophageal cancer: Europe
Surveyed medical oncologists' ascribed level of unmet need across key convenience of administration attributes in metastatic esophageal cancer: United States
Surveyed medical oncologists' ascribed level of unmet need across key convenience of administration attributes in metastatic esophageal cancer: Europe
Key findings: unmet need in metastatic esophageal cancer and related indications
Surveyed medical oncologists' ascribed level of unmet need in metastatic esophageal cancer and related indications: United States
Surveyed medical oncologists' ascribed level of unmet need in metastatic esophageal cancer and related indications: Europe
Opportunity analysis
Areas of opportunity in the metastatic esophageal cancer market and emerging therapy insights
Opportunity: a novel therapy that can prolong survival, particularly for patients with low PD-L1 expression
Opportunity: a novel therapy with less burden on quality of life
Opportunity: a novel therapy that is more convenient to administer
Target product profiles
Assessing drug development opportunities
Target Product Profile methodology
Attributes and attribute levels
Attributes of key current and late-phase emerging therapies for metastatic esophageal cancer
Assigned prohibitions for the conjoint module
Attribute importance and part-worth utilities
Metastatic esophageal cancer Target Product Profile: attribute importance
Median overall survival
Median progression-free survival
Objective response rate
Incidence of hematological toxicities of any grade
Incidence of gastrointestinal toxicities of any grade
Treatment discontinuation due to adverse effects
Price per 28-day cycle
Conjoint analysis-based simulation of a market scenario
Metastatic esophageal cancer market simulation: share of preference of Target Product Profiles included in the market scenario
Metastatic esophageal cancer market simulation: likelihood to prescribe Target Product Profiles included in the market scenario
Metastatic esophageal cancer market simulation: Target Product Profiles included in the market scenario
Appendix
Key abbreviations
Bibliography
Tiffany Chan
Tiffany Chan, Ph.D., is an analyst on the Oncology team at Clarivate. Prior to joining Clarivate, she worked as a postdoctoral researcher at the University of Oxford, where her research focused on the high-throughput screening of 177Lu-PSMA combination therapies for the treatment of prostate cancer. She obtained her Ph.D. in chemistry from Imperial College London, which is affiliated with the Imperial Centre of Excellence in Neurotechnology and the Department of Biomedical Engineering.