Table of Contents

Glioblastoma Review - Temodar partnering pipeline drugs - Overview of current treatment modalities and analysis of drugs in development for glioblastoma

Product Code: BFHC0611

Publication Date: 10-Sep-2003

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Overview

Introduction

According to Datamonitor’s estimate, nearly 30,000 new cases of glioblastoma are expected to be diagnosed in the 7 major pharmaceutical markets in 2003. This Brief examines the currently available treatment for glioblastoma, comprising surgery, radiotherapy and chemotherapy, and key drugs currently in development for glioblastoma, supported by an opinion leader’s views on the pipeline drugs.

Scope

· Overview of current treatment modalities of glioblastoma, including surgery and radiotherapy

· Detailed analysis of commonly used drug regimens for glioblastoma

· Analysis of drugs in development for glioblastoma, including those in phase II and above

· Opinions on current and pipeline drugs from a leading physician in the field of brain tumor

Report Highlights

Incidence of glioblastoma is set to increase significantly as the proportion of elderly population increases

Temodar may creep into first-line usage in combination with surgery and radiotherapy

Opinion leader remains pessimistic about the potential of pipeline drugs for glioblastoma

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Table of Contents

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EXECUTIVE SUMMARY	4
Scope	4
Key findings for the glioblastoma market	4
Datamonitor estimates that there are approximately 30,000 new cases of glioblastoma in the seven major markets annually. Because glioblastoma predominantly affects the elderly patients, incidence is likely to increase significantly in the long term due to the ageing population. This represents a significant opportunity for pharmaceutical and biotechnology companies to target	5
Schering-Plough’s Temodar (temozolomide) is the gold standard for the treatment of recurrent glioblastoma after surgery and/or radiotherapy. However, Datamonitor believes that Temodar will creep into first-line treatment of glioblastoma in combination with surgery and radiotherapy	6
There are a number of agents in clinical trials that may have potential for glioblastoma such as AstraZeneca’s Iressa, Novartis’s Glivec and Celgene’s Thalomid. However, benefits have been modest in clinical trials so far and these agents are unlikely to gain any significant uptake. Datamonitor believes that these agents need to be investigated in combination with Temodar to maximize efficacy and thus, commercial potential	7
INTRODUCTION	10
Overview	10
The brain	10
Subtypes of brain cancer	12
Astrocytoma	13
Incidence	14
Prognosis	17
TREATMENT	19
Treatment modalities	19
Supportive care	19
Surgery	19
Radiotherapy	20
Chemotherapy	23
Carmustine	23
Procarbazine-CCNU-vincristine (PCV)	24
Temodar (temozolomide)	26
High-grade astrocytomas	26
In combination with radiotherapy	27
Synergy with chemotherapy	27
Other clinical trial results	28
Off-label usage	29
Opinion leader view	29
Gliadel wafer	30
PIPELINE ANALYSIS	31
Cotara (TNT-1)	31
Edotecarin (J-107088)	33
NBI-3001 (IL-4)	33
Celebrex (celecoxib)	34
Tarceva (erlotinib)	35
Iressa (gefitinib)	36
Glivec (imatinib)	37
RSR13 (efaproxiral)	38
Sarasar (SCH66336; lonafarnib)	39
Talampanel (AMPA agonist)	39
Thalomid (thalidomide)	40
Xcytrin (motexafin gadolinium)	42
Zarnestra (R115777/tipifarnib)	43
SU5416 (semaxanib)	44
AP12009	44
Summary and conclusions	46
APPENDIX	51
R&D research methodology	51
Introduction	51
Hypothesis formulation	51
Hypothesis testing	52
Ongoing information update	52
Product specific primary research	52
Data verification and quality control	53
Opinion leader	53
References	53
How to contact experts in your industry	58
Disclaimer	59
List of Tables
Table 1: Types of brain cancer	12
Table 2: Classifications of gliomas	14
Table 3: Incidence rates of glioblastoma by age in 1999 in the US	15
Table 4: Estimated incidence of glioblastoma by age in 2003 in the seven major markets	16
Table 5: Relative survival rates of glioblastoma versus other cancers	17
Table 6: Common treatment modalities for glioblastoma except chemotherapy	22
Table 7: Other clinical trial results involving Temodar	28
Table 8: Key pipeline drugs in development for glioblastoma	31
Table 9: Summary of clinical trial results for current and pipeline drugs for glioblastoma	46
List of Figures
Figure 1: The brain	11
Figure 2: Types of brain cancer	13
Figure 3: Incidence rates of glioblastoma by age in 1999 in the US	15
Figure 4: Estimated incidence of glioblastoma by age in 2003 in the seven major markets	16
Figure 5: Relative survival rates of glioblastoma versus other cancers	17
Figure 6: Competitive positioning of current and pipeline glioblastoma drugs	48

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