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.
Key companies: Bristol Myers Squibb, Merck & Co.
Key drugs: Opdivo, Keytruda, and trastuzumab.
Table of contents
- 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
- Areas of opportunity in the metastatic esophageal cancer market and emerging therapy insights
- 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
- Executive summary
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.