Table of Contents

Pipeline/Commercial Insight: Supportive Care in Oncology - Significant growth opportunities exist in new supportive care indications - Analysis of the current and future potential of the oncology supportive care market. Includes in-depth profiles of the late-phase pipeline, strategic recommendations and forecasts to 2016 for key marketed products across the seven major markets.

Product Code: dmhc2297

Publication Date: 15-Jun-2007

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Overview

Introduction

Supportive care can be defined as those products used to prevent and/or treat the adverse side effects that arise as a result of the tumor itself or administration of anticancer therapies, in particular cytotoxic chemotherapy. While the antihormonal therapies and novel molecular targeted therapies do not exist without some toxicity, these are not as severe as those associated with chemotherapy.

Scope

· Overview of the current oncology supportive care market, including profiles of key marketed products and events impacting each during 200616

· Examination of the oncology supportive care pipeline with in-depth clinical and commercial profiles of Phase III and some key Phase II candidates

· Seven-market sales forecasts from 2006 to 2016 for branded oncology supportive care products and key pipeline candidates

· Detailed discussion of key strategic issues in the oncology supportive care market, including one commercial impact case study

Highlights

The oncology supportive care market is forecast to undergo slightly positive growth at a CAGR of 0.6%, from a seven-market sales total of $13,763m in 2006 to $14,679m in 2016. This low level of growth is largely due to an increasing level of patent expiry and generic competition, including the impending launch of biosimilars in the EU.

The erythropoietins class has come under increasing levels of scrutiny of late due to emerging doubts over safety of these products. As a result the FDA and EMEA are recommending more restrictive conditions for use and increased monitoring of patients. It is expected that sales of these products will suffer as a result of these restrictions.

Any significant future growth in the oncology supportive care market will likely come from product development in new indications, such as EGFR-inhibitor associated skin rash. However, given the early-phase of clinical development for such products, it will be some time before any impact is made and true future potential can be determined.

Reasons to Purchase

· Understand market specific drivers and predict the future potential of key marketed and pipeline oncology supportive care products

· Assess the impact of product launches and identify the opportunities and risks for key products within the oncology supportive care market

· Adopt knowledge to drive strategic planning for marketed products and optimize the market penetration of new entrants

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ABOUT DATAMONITOR HEALTHCARE	2
About the Oncology pharmaceutical analysis team	2
Andrew Paramore - Oncology Lead Analyst & Head of Product Development	2
CHAPTER 1 EXECUTIVE SUMMARY	3
Objective of the analysis	3
Datamonitor insight into the oncology supportive care market	3
Related reports	5
Upcoming reports	5
CHAPTER 2 PIPELINE OVERVIEW	7
Pipeline overview	7
Pipeline by developmental phase and indication	9
The oncology supportive care pipeline in its entirety is relatively sparse	9
Pipeline split by phase	11
The late-phase pipeline will flourish in the future, as early-stage agents move forward in development	12
Pipeline split by indication	12
Chemotherapy-induced nausea and vomiting is the most popular indication in terms of pipeline activity	13
Significant unmet needs in the cancer-related mucositis market means the early-phase pipeline has increased in activity	13
A greater level of activity would have been expected in the cancer-related thrombocytopenia pipeline	13
Pipeline by company	14
At least 67 companies are involved in the oncology supportive care pipeline	14
The high involvement of smaller companies in the oncology supportive care pipeline is not surprising, given that 82% of compounds are in early-phase development	14
The top three companies in terms of marketed and pipeline oncology supportive care products are Amgen, GlaxoSmithKline and Roche	15
Amgen	15
GlaxoSmithKline	16
Roche	18
Key metrics	20
Datamonitor pipeline assessment summary	23
CHAPTER 3 MARKET DEFINITION AND PIPELINE DYNAMICS	29
Supportive care overview	29
Market definition and classification of products	30
A4A - Anti-emetics and anti-nauseants	30
Playing a key role in the prophylaxis and/or treatment of acute and delayed chemotherapy-induced nausea and vomiting	30
Defining the emetic risk of various cytotoxics used to treat cancer	31
Anti-emetic mode of action is conferred by blocking the action of various neuroreceptors	31
Classes of anti-emetic/anti-nauseant	32
B3C - Erythropoiesis-stimulating products	35
Anemia may severely affect patient quality of life	35
Products capable of stimulating the production of red blood cells can be used to treat cancer-related anemia	35
Key erythropoiesis-stimulating products	35
L3A1 - Colony-stimulating factors	36
Neutropenia was potentially fatal before the introduction of current supportive care measures	36
Colony-stimulating factors promote the production of white blood cells to prevent neutropenia	36
Key colony-stimulatings factors	37
L3A9 - All other immunostimulating agents excluding interferons	37
Thrombocytopenia increases the risk of severe bleeding in cancer patients	37
Only one formally approved agent exists for the prevention of thrombocytopenia to date	38
M5B1/M5B2 - Bisphosphonate bone calcium regulators	38
Bone metastases and tumor-induced hypercalcemia can cause significant morbidity in cancer patients	38
Bisphosphonates are used in the prevention and/or treatment of cancer-related skeletal events due to their ability to restore normal balance to bone activity	39
Key bisphosphonates approved for oncology indications	39
V3D0 - Detoxifying agents for antineoplastic treatment	40
Mucositis can result in significant complications, exacerbated by further cancer treatment and any therapy-related nausea and vomiting	40
Use of the only growth factor approved for mucositis to date is restricted by its cost, particularly in more conservative markets	41
Current market dynamics	41
A top-line view of the oncology supportive care market	41
The large majority of drug classes underwent significant sales growth between 2005 and 2006	41
The oncology supportive care market by drug class	42
Epidemiology	45
Epidemiology of cancer	45
A continuously expanding patient base	45
Increased incidence a consequence of aging populations and lifestyle modifications	45
Epidemiology of supportive care indications	47
CHAPTER 4 MARKETED PRODUCTS FORECAST ANALYSIS	49
Country-specific assumptions and effects	49
Generic pricing and erosion assumptions	49
Product assumptions and effects	49
A4A1 - 5-HT3 serotonin receptor antagonists	49
Drug class asumptions	49
Helsinn Pharma/MGI Pharma's Aloxi (palonosetron)	50
Sanofi-Aventis's Anzemet (dolasetron)	53
Roche/Chugai's Kytril (granisetron)	54
Astellas' Nasea (ramosetron)	55
Novartis's Navoban (tropisetron)	56
Welfide/Japan Tobacco's Serotone (azasetron)	56
Nisshin Kyorin Pharmaceuticals' Sinseron (indisetron)	57
GlaxoSmithKline's Zofran (ondansetron)	57
A4A9 - Other anti-emetics/anti-nauseants	58
Merck & Co's Emend (aprepitant)	58
B3C0 - Erythropoiesis-stimulating products	64
Drug class assumptions	64
Controversy affecting the drug class as a whole	64
Amgen's Aranesp (darbepoetin alfa)	71
Amgen Epogen/Johnson & Johnson's Procrit/Kirin's Eprex (epoetin alfa)	74
Roche's NeoRecormon (epoetin beta)	76
L3A1 - Colony-stimulating factors	78
Chugai's Granocyte (lenograstim)	78
Bayer Schering/Berlex's Leukine (sargramostim)	80
Amgen's Neulasta (pegfilgrastim)	81
Amgen's Neupogen (filgrastim)	83
Kyowa Hakko Kogyo's Neu-Up (nartograstim)	85
L3A9 - Other immunostimulating agents	85
Wyeth's Neumega (oprelvekin)	85
M5B1/M5B2 - Oral and injectable bisphosphonates	88
Drug class assumptions	88
Proctor & Gamble/Sanofi-Aventis's Actonel (risedronic acid)	88
Novartis's Aredia (pamidronic acid)	90
Astellas' Bisphonal (incadronic acid)	91
Roche/GlaxoSmithKline's Bondronat/Boniva/Bonviva (ibandronic acid)	92
Bayer Schering's Bonefos (clodronic acid)	96
Novartis's Zometa (zoledronic acid)	97
V3D0 - Other detoxifying agents for cancer	100
Amgen's Kepivance (palifermin)	100
Forecasts	102
Forecast methodology	102
CHAPTER 5 PIPELINE ANTI-EMETIC PRODUCTS ANALYSIS AND FORECASTS	103
Pipeline overview	103
Definition of current comparator	104
GlaxoSmithKline's Zofran (ondansetron)	104
The preferred 5-HT3 receptor antagonist in the seven major markets	104
Reckitt Benckiser Healthcare/BioDelivery Sciences' Emezine (reformulated prochlorperazine maleate)	105
Drug profile	105
Issue of a non-approvable letter by the FDA for Emezine may not bode well for the drug's future	105
Clinical trial data	106
Pharmacokinetic studies indicate that Emezine's route of administration may result in a higher plasma concentration than traditional formulations	106
Datamonitor comments	106
BioDelivery Sciences believes Emezine to confer advantages by virtue of its formulation	106
The widespread availability of generic prochlorperazine and more efficacious newer anti-emetics means that uptake of Emezine may be limited	107
Hana Biosciences/NovaDel Pharma's Zensana (reformulated ondansetron)	108
Drug profile	108
Long-term stability issues means reformulation of Zensana was necessary, however, this has delayed commercialization	108
Clinical trial data	108
Zensana has been proven bioequivalent to Zofran	108
Surveyed members of the oncology community ranked Zensana highly in terms of potential ease of use	109
Datamonitor comments	110
Zensana confers administration advantages over traditionally formulated ondansetron, however, the drug's price point should be set with caution	110
ProStrakan's Sancuso (reformulated granisetron)	111
Drug profile	111
Sancuso allows for an alternative route of administration to Kytril	111
Clinical trial data	111
Phase III data show Sancuso to confer comparable efficacy and safety to oral Kytril	111
Datamonitor comments	112
Sancuso must be priced competitively in order to avoid being driven out of the market by generic versions of 5-HT3 anatagonists	112
AP Pharma's APF-530 (reformulated slow-release granisetron)	113
Drug profile	113
Slow-release formulation of granisetron should provide consisent protection against chemotherapy-induced nausea and vomiting	113
Clinical trial data	114
Clinical data support the use of a single injection of APF-530 adminstered 30 minutes before chemotherapy to provide continuous protection	114
Datamonitor comments	115
While generic versions of granisetron will see uptake, APF-530 may lose out somewhat to Sancuso due to its formulation	115
GlaxoSmithKline's casopitant (GW-679769)	115
Drug profile	115
Casopitant could become the second NK-1 antagonist to reach the market	115
Clinical trial data	116
Casopitant in combination with Zofran is effective in patients receiving moderately-emetogenic chemotherapy	116
Varying doses of capositant are effective in preventing nausea and vomiting associated with highly-emetogenic chemotherapy	118
Datamonitor comments	120
Given the youth of the NK-1 antagonist drug class, casopitant could represent a valuable addition to treatment options	120
Forecasts	122
Datamonitor drug assessment summary	124
Future potential of pipeline anti-emetic products	125
The pipeline anti-emetics will enjoy reasonable uptake and sales, however, no major breakthroughs in the prevention and/or treatment of chemotherapy-induced nausea and vomiting will be provided	125
CHAPTER 6 PIPELINE ERYTHROPOIESIS-STIMULATING PRODUCTS ANALYSIS AND FORECASTS	126
Pipeline overview	126
Definition of current comparator	127
Amgen's Aranesp (darbepoetin alfa)	127
Available across most of the seven major markets and a more convenient dosing schedule for patients	127
Shire's Dynepo (epoetin delta)	127
Drug profile	127
The first recombinant erythropoietin to be produced in human cells	127
Clinical trial data	128
A complete dearth of information relating to Dynepo's development in cancer-related anemia...	128
...however, equal efficacy to Epogen/Procrit has been demonstrated in treatment of anemia related to chronic kidney disease	128
Datamonitor comments	129
Ongoing patent litigation with Amgen resulted in delayed European launch of Dynepo, plus a ban on US launch until relevant patents have expired	129
Dynepo's pricing at a 30% discount to its competitors in Germany means that some off-label use in oncology indications is likely	129
Roche's Mircera (continuous erythropoietin receptor activator)	130
Drug profile	130
A novel erythropoiesis-stimulating agent with several theoretical advantages over competitors	130
Suspension of recruitment into an oncology Phase II due to an imbalance in fatalities across treatment arms	131
Clinical trial data	132
Mircera appears to have dose-dependent clinical activity in anemic NHL patients receiving chemotherapy	132
Phase II results in NSCLC patients support the feasibility of extended administration of Mircera	133
Mircera produces a rapid and sustained hemoglobin response in multiple myeloma patients	134
Datamonitor comments	134
Despite potentially negative publicity surrounding suspension of enrollment into the NH19960 study, Mircera's reputation should remain relatively intact	134
Hurdles put in place by Amgen need to be overcome	135
Entering the EU market is likely to be slightly easier for Roche	135
The entire erythropoietin drug class has come under fire	136
Forecasts	137
Datamonitor drug assessment summary	138
Future potential of pipeline erythropoeisis-stimulating products	139
Both pipeline erythropoietins are expected to see some off-label use prior to formal approval in oncology indications	139
CHAPTER 7 PIPELINE ANTI-NEUTROPENIA PRODUCTS ANALYSIS AND FORECASTS	141
Pipeline overview	141
The current cancer-related neutropenia pipeline	141
An exceedingly sparse pipeline means any threat to currently marketed products is minimal	141
CHAPTER 8 PIPELINE ANTI-THROMBOCYTOPENIA PRODUCTS ANALYSIS AND FORECASTS	142
Pipeline overview	142
Definition of current comparator	143
Wyeth's Neumega (oprelvekin)	143
Chosen only due to the complete lack of other commercially approved products in this indication	143
GlaxoSmithKline/Ligand Pharmaceuticals' Promacta (eltrombopag)	143
Drug profile	143
Promacta's oral availability may represent a significant advantage	143
Clinical trial data	144
Early trial data demonstrates Promacta's ability to boost platelet levels in cancer patients undergoing chemotherapy, but fails to meet primary endpoint	144
Positive Phase III data in other indications mean that theoretically, Promacta should confer efficacy in cancer-related thrombocytopenia	144
Datamonitor comments	145
A severe lack of approved agents for the prevention and/or treatment of cancer-related thrombocytopenia provides opportunity	145
A gap in the market exists for a product such as Promacta, which GlaxoSmithKline should take full advantage of	146
Amgen's AMG-531	146
Drug profile	146
A novel drug designed to specifically target the thrombopoietin receptor	146
Clinical trial data	147
No cancer-specific study data exist, making it difficult to judge AMG-531's potential in this patient population	147
Datamonitor comments	148
Amgen's leading status in the oncology supportive care market will prove invaluable for AMG-531	148
Forecasts	149
Datamonitor drug assessment summary	150
Future potential of pipeline anti-thrombocytopenia products	151
Following initial off-label use in oncology indications, the anti-thrombocytopenia pipeline products are forecast to enjoy significant sales	151
CHAPTER 9 PIPELINE ANTI-MUCOSITIS PRODUCTS ANALYSIS AND FORECASTS	153
Pipeline overview	153
Definition of current comparator	154
Amgen's Kepivance (palifermin)	154
Chosen only due to the complete lack of other commercially approved products in this indication	154
MGI Pharma's Saforis (L-glutamine)	154
Drug profile	154
Increasing availability of L-glutamine in the oral mucosa may prevent the onset of mucositis	154
Clinical trial data	155
Phase III trial results showing Saforis is capable of significantly reducing the incidence of oral mucositis forms the basis for NDA submission	155
Earlier Phase III results show Saforis appears to reduce the incidence of oral mucositis	156
Datamonitor comments	156
Cost and route of administration of Amgen's Kepivance places Saforis at a significant advantage	156
Forecasts	157
Datamonitor drug assessment summary	158
Future potential of pipeline anti-mucositis products	159
A relatively low level of peak sales are deceptive in the face of reasonable uptake of Saforis in cancer-releated mucositis	159
CHAPTER 10 PIPELINE CANCER-RELATED SKELETAL EVENTS PRODUCTS ANALYSIS AND FORECASTS	161
Pipeline overview	161
Definition of current comparator	162
Novartis's Zometa (zoledronate)	162
The leading bisphosphonate for the prevention and/or treatment of cancer-related skeletal events	162
Amgen's denosumab (AMG-162)	162
Drug profile	162
The first targeted therapy for cancer-related skeletal events	162
Clinical trial data	164
Interim results show denosumab to be at least as effective as intravenous bisphosphonates in reducing the risk of cancer-related skeletal events	164
Interim results show denosumab normalizes bone turnover more frequently than intravenous bisphosphonates	165
Datamonitor comments	166
By virtue of its monoclonal antibody formulation, denosumab is likely to be more expensive than currently marketed bisphosphonates...	166
...however, its lack of association with osteonecrosis of the jaw may work in its favor	166
Amgen's experience represents a major advantage for denosumab	167
Forecasts	167
Datamonitor drug assessment summary	168
Future potential of pipeline cancer-related skeletal events products	169
Denosumab theoretically confers several advantages over currently available bisphosphonates, therefore uptake and accompanying sales are forecast to be encouraging	169
CHAPTER 11 COMMERCIAL IMPACT AND LIFECYCLE MANAGEMENT: CASE STUDY	171
The changing oncology supportive care market	171
Current areas of commercial opportunity	171
Several areas of supportive care are drastically underserved at present	171
Potentially increasing range of use for current products	172
Increasing use of targeted therapies	173
A shift towards increased use of molecular targeted therapies will introduce new supportive care challenges	173
New supportive care measures need to be developed, thereby providing significant commercial opportunity...	174
...yet, it could be that the high cost of the targeted therapies will result in hampered uptake of supportive care products	175
The threat of biosimilars	176
The biologic supportive care products will no longer be protected from generic competition	176
Some biosimilar products can be launched in the EU immediately...	176
...however, the US is lagging behind	176
The high cost of some supportive care products inhibits their use, indicating a great desire for cheaper biosimilar versions...	177
...although biosimilar drugs bring with them a new set of issues	177
Increased safety concerns in future	177
As seen with the erythropoeitins class, increased vigilance with respect to safety may be enforced in the future	177
How the oncology supportive care market will change	178
On the whole, the oncology supportive care market will undergo positive growth...	178
...albeit at a minimal growth rate, due to a lack of major innovation	179
Future growth is likely to come from those early-phase products targeting new supportive care indications	180
APPENDIX A - MARKET DATA AND MAJOR BRAND KEY FACTS	181
A4A (anti-emetics and anti-nauseants) class market data	181
B3C (erythropoiesis-stimulating products) class market data	184
L3A1 (colony-stimulating factors) class market data	186
L3A9 (other immunostimulating agents) class market data	188
M5B1/M5B2 (oral and injectable bisphosphonates) class market data	189
V3D0 (other detoxifying agents for cancer) class market data	191
Sales data and forecasts	191
PowerPoint Executive Presentation	192
APPENDIX B - SALES FORECASTS	193
US forecasts	193
Japan forecasts	196
France forecasts	199
Germany forecasts	202
Italy forecasts	205
Spain forecasts	208
UK forecasts	211
Five major European markets (EU5) forecasts	214
Seven major market forecasts	217
APPENDIX C	221
Bibliography	221
List of tables	233
List of figures	234
Methodology	235
Datamonitor forecast methodology	235
Forecasts for marketed drugs	235
Forecasts for pipeline drugs	236
Datamonitor drug assessment methodology	237
About Datamonitor	239
About Datamonitor Healthcare	239
About the Oncology analysis team	240
Disclaimer	241
List of Tables
Table 1: Late-phase oncology supportive care pipeline, 2007	7
Table 2: Phase II oncology supportive care pipeline, 2007	8
Table 3: Phase I oncology supportive care pipeline, 2007	9
Table 4: Supportive care pipeline split by phase and indication, 2007	10
Table 5: Amgen's marketed oncology supportive care portfolio, 2007	15
Table 6: Amgen's pipeline oncology supportive care portfolio, 2007	16
Table 7: GlaxoSmithKline's marketed oncology supportive care portfolio, 2007	17
Table 8: GlaxoSmithKline's pipeline oncology supportive care portfolio, 2007	18
Table 9: Roche's marketed oncology supportive care portfolio, 2007	19
Table 10: Roche's pipeline oncology supportive care portfolio, 2007	19
Table 11: Late-phase pipeline oncology supportive care products sales forecasts ($m), 2007-16	20
Table 12: Marketed 5-HT3 receptor antagonists, 2007	33
Table 13: Marketed erythropoiesis-stimulating products, 2007	35
Table 14: Marketed colony-stimulating factors, 2007	37
Table 15: Marketed bisphosphonates approved for oncology indications, 2007	40
Table 16: Seven major market sales of marketed supportive care products by drug class, 2006	42
Table 17: Key anti-emetics in the oncology supportive care market across the seven major markets, 2007	43
Table 18: Key erythropoiesis-stimulating products in the oncology supportive care market across the seven major markets, 2007	43
Table 19: Key colony-stimulating factors in the oncology supportive care market across the seven major markets, 2007	44
Table 20: Key bisphosphonates in the oncology supportive care market across the seven major markets, 2007	44
Table 21: Other key products in the oncology supportive care market across the seven major markets, 2007	45
Table 22: Crude incidence rates of cancer by gender per 100,000 in the seven major pharmaceutical markets, 2002	46
Table 23: Forecast incidence of cancer across the seven major markets, 2001-15	46
Table 24: Proportion of patients receiving anti-emetics for chemotherapy-induced nausea and vomiting, 2006	47
Table 25: Proportion of patients receiving bisphosphonates for cancer-related skeletal events, 2006	48
Table 26: Generic pricing and erosion assumptions, 2007	49
Table 27: Aloxi versus Zofran: response rates from a Phase III trial to prevent CINV from moderately-emetogenic chemotherapy	51
Table 28: Aloxi versus Zofran: response rates from a Phase III trial to prevent CINV from highly-emetogenic chemotherapy	51
Table 29: Emend in a Phase III trial to prevent CINV from moderately-emetogenic chemotherapy	60
Table 30: Emend in a Phase III trial to prevent CINV from highly-emetogenic chemotherapy	60
Table 31: Fosaprepitant and Emend in a Phase III trial to prevent chemotherapy-induced nausea and vomiting from highly-emetogenic chemotherapy	62
Table 32: Relative potencies of the commercially available bisphosphonates	88
Table 33: Ongoing development for Actonel in oncology indications, 2007	89
Table 34: Approval information for Bondronat/Bonviva/Boniva	93
Table 35: Ongoing clinical development for Bondronat, 2007	93
Table 36: Average physician preference for use of Bondronat in oncology indications across the seven major markets, 2006	94
Table 37: Ongoing Phase III clinical development for Zometa, 2007	99
Table 38: Ongoing clinical development for Kepivance, 2007	101
Table 39: Late-phase anti-emetics for chemotherapy-induced nausea and vomiting pipeline, 2007	103
Table 40: Phase I/II anti-emetics for chemotherapy-induced nausea and vomiting pipeline, 2007	104
Table 41: Results from the Phase II study investigating three different doses of APF-530	114
Table 42: Clinical trials investigating casopitant in chemotherapy-induced nausea and vomiting, 2007	116
Table 43: Treatment arms in a Phase II study investigating casopitant in the prevention of nausea and vomiting from moderately-emetogenic chemotherapy	117
Table 44: Results from a Phase II study investigating casopitant in the prevention of nausea and vomiting from moderately-emetogenic chemotherapy	118
Table 45: Treatment arms in a Phase II study investigating casopitant in the prevention of nausea and vomiting from highly-emetogenic chemotherapy	119
Table 46: Results from a Phase II study investigating casopitant in the prevention of nausea and vomiting from highly-emetogenic chemotherapy	120
Table 47: Pipeline anti-emetic products forecasting assumptions (1 of 2)	122
Table 48: Pipeline anti-emetic products forecasting assumptions (2 of 2)	122
Table 49: Pipeline anti-emetic products sales forecasts ($m), 2007-16	123
Table 50: Erythropoiesis-stimulating products pipeline, 2007	126
Table 51: Results from the BA16728 Phase II study investigating varying doses of Mircera in NHL patients	132
Table 52: Results from the NA17101 Phase II study investigating varying doses of Mircera in NSCLC patients	133
Table 53: Pipeline erythropoiesis-stimulating agents forecasting assumptions	137
Table 54: Pipeline erythropoiesis-stimulating agents sales forecasts ($m), 2007-16	137
Table 55: Anti-neutropenia products pipeline, 2007	141
Table 56: Anti-thrombocytopenia products pipeline, 2007	142
Table 57: Clinical trials investigating AMG-531 in cancer-related thrombocytopenia, 2007	147
Table 58: Pipeline anti-thrombocytopenia products forecasting assumptions	149
Table 59: Pipeline anti-thrombocytopenia products sales forecasts ($m), 2007-16	149
Table 60: Anti-mucositis products pipeline, 2007	153
Table 61: Results from a Phase III study investigating Saforis in breast cancer patients	155
Table 62: Results from a Phase III study investigating Saforis in cancer patients	156
Table 63: Pipeline anti-mucositis products forecasting assumptions	157
Table 64: Pipeline anti-mucositis products sales forecasts ($m), 2007-16	158
Table 65: Cancer-related skeletal events products pipeline, 2007	161
Table 66: Phase III clinical trials investigating denosumab in oncology, 2007	163
Table 67: Phase II clinical trials investigating denosumab in oncology, 2007	163
Table 68: Interim results from study investigating denosumab in bisphosphonate-naïve metastatic breast cancer patients	164
Table 69: Interim results from study investigating denosumab in advanced cancer patients who had received prior bisphosphonate therapy, 2006	165
Table 70: Pipeline cancer-related skeletal events products forecasting assumptions	167
Table 71: Pipeline cancer-related skeletal events products sales forecasts ($m), 2007-16	168
Table 72: Products in development for currently unmet supportive care challenges, 2007	172
Table 73: Common side effects associated with the molecular targeted therapies	174
Table 74: Products in development for new supportive care challenges, 2007	175
Table 75: Oncology supportive care market forecast sales, 2006-16	178
Table 76: Aloxi: key facts	181
Table 77: Anzemet: key facts	181
Table 78: Emend: key facts	182
Table 79: Kytril: key facts	182
Table 80: Nasea: key facts	182
Table 81: Navoban: key facts	183
Table 82: Serotone: key facts	183
Table 83: Sinseron: key facts	183
Table 84: Zofran: key facts	184
Table 85: Aranesp: key facts	184
Table 86: Epogen/Procrit: key facts	185
Table 87: NeoRecormon: key facts	185
Table 88: Granocyte: key facts	186
Table 89: Leukine: key facts	186
Table 90: Neulasta: key facts	187
Table 91: Neupogen: key facts	187
Table 92: Neu-Up: key facts	188
Table 93: Neumega: key facts	188
Table 94: Actonel: key facts	189
Table 95: Aredia: key facts	189
Table 96: Bisphonal: key facts	190
Table 97: Bondronat: key facts	190
Table 98: Bonefos: key facts	190
Table 99: Zometa: key facts	191
Table 100: Kepivance: key facts	191
Table 101: Marketed supportive care product forecasts in the US, 2006-16 (1 of 3)	193
Table 102: Marketed supportive care product forecasts in the US, 2006-16 (2 of 3)	194
Table 103: Marketed supportive care product forecasts in the US, 2006-16 (3 of 3)	195
Table 104: Marketed supportive care product forecasts in Japan, 2006-16 (1 of 3)	196
Table 105: Marketed supportive care product forecasts in Japan, 2006-16 (2 of 3)	197
Table 106: Marketed supportive care product forecasts in Japan, 2006-16 (3 of 3)	198
Table 107: Marketed supportive care product forecasts in France, 2006-16 (1 of 3)	199
Table 108: Marketed supportive care product forecasts in France, 2006-16 (2 of 3)	200
Table 109: Marketed supportive care product forecasts in France, 2006-16 (3 of 3)	201
Table 110: Marketed supportive care product forecasts in Germany, 2006-16 (1 of 3)	202
Table 111: Marketed supportive care product forecasts in Germany, 2006-16 (2 of 3)	203
Table 112: Marketed supportive care product forecasts in Germany, 2006-16 (3 of 3)	204
Table 113: Marketed supportive care product forecasts in Italy, 2006-16 (1 of 3)	205
Table 114: Marketed supportive care product forecasts in Italy, 2006-16 (2 of 3)	206
Table 115: Marketed supportive care product forecasts in Italy, 2006-16 (3 of 3)	207
Table 116: Marketed supportive care product forecasts in Spain, 2006-16 (1 of 3)	208
Table 117: Marketed supportive care product forecasts in Spain, 2006-16 (2 of 3)	209
Table 118: Marketed supportive care product forecasts in Spain, 2006-16 (3 of 3)	210
Table 119: Marketed supportive care product forecasts in the UK, 2006-16 (1 of 3)	211
Table 120: Marketed supportive care product forecasts in the UK, 2006-16 (2 of 3)	212
Table 121: Marketed supportive care product forecasts in the UK, 2006-16 (3 of 3)	213
Table 122: Marketed supportive care product forecasts in the EU5, 2006-16 (1 of 3)	214
Table 123: Marketed supportive care product forecasts in the EU5, 2006-16 (2 of 3)	215
Table 124: Marketed supportive care product forecasts in the EU5, 2006-16 (3 of 3)	216
Table 125: Marketed supportive care product forecasts across the seven major markets, 2006-16 (1 of 4)	217
Table 126: Marketed supportive care product forecasts across the seven major markets, 2006-16 (2 of 4)	218
Table 127: Marketed supportive care product forecasts across the seven major markets, 2006-16 (3 of 4)	219
Table 128: Marketed supportive care product forecasts across the seven major markets, 2006-16 (4 of 4)	220
Table 129: Datamonitor drug assessment parameters	237
List of Figures
Figure 1: Supportive care pipeline split by phase and indication, 2007	10
Figure 2: Supportive care pipeline split by phase, 2007	11
Figure 3: Supportive care pipeline split by indication, 2007	12
Figure 4: Supportive care pipeline split by company, 2007	14
Figure 5: Pipeline anti-emetic products sales forecasts in the oncology supportive care market ($m), 2007-16	21
Figure 6: Pipeline erythropoiesis-stimulating agents sales forecasts in the oncology supportive care market ($m), 2007-16	21
Figure 7: Pipeline anti-thrombocytopenia products sales forecasts in the oncology supportive care market ($m), 2007-16	22
Figure 8: Pipeline anti-mucositis products sales forecasts in the oncology supportive care market ($m), 2007-16	22
Figure 9: Pipeline cancer-related skeletal events products sales forecasts in the oncology supportive care market ($m), 2007-16	23
Figure 10: Datamonitor drug assessment summary for the pipeline anti-emetics in the oncology supportive care market, 2007	24
Figure 11: Datamonitor drug assessment summary for the pipeline erythropoiesis-stimulating products in the oncology supportive care market, 2007	25
Figure 12: Datamonitor drug assessment summary for the pipeline anti-thrombocytopenia products in the oncology supportive care market, 2007	26
Figure 13: Datamonitor drug assessment summary for the pipeline anti-mucositis products in the oncology supportive care market, 2007	27
Figure 14: Datamonitor drug assessment summary for the pipeline cancer-related skeletal events products in the oncology supportive care market, 2007	28
Figure 15: Forecast incidence of cancer across the seven major markets, 2001-15	47
Figure 16: Pipeline anti-emetic products sales forecasts ($m), 2007-16	123
Figure 17: Datamonitor drug assessment summary for the pipeline anti-emetics, 2007	124
Figure 18: Pipeline erythropoiesis-stimulating agents sales forecasts ($m), 2007-16	138
Figure 19: Datamonitor drug assessment summary for the pipeline erythropoiesis-stimulating products, 2007	139
Figure 20: Pipeline anti-thrombocytopenia products sales forecasts ($m), 2007-16	150
Figure 21: Datamonitor drug assessment summary for the pipeline anti-thrombocytopenia products, 2007	151
Figure 22: Pipeline anti-mucositis products sales forecasts ($m), 2007-16	158
Figure 23: Datamonitor drug assessment summary for the pipeline anti-mucositis products, 2007	159
Figure 24: Pipeline cancer-related skeletal events products sales forecasts ($m), 2007-16	168
Figure 25: Datamonitor drug assessment summary for the pipeline cancer-related skeletal events products, 2007	169
Figure 26: Oncology supportive care market forecast sales, 2006-16	179
Figure 27: Datamonitor drug assessment summary for the pipeline cancer-related skeletal events products, 2007	238

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