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市場調査レポート
急性白血病：細胞毒性を有する化学療法の限界
Stakeholder Insight: Acute Leukemias - Reaching the limits of cytotoxic chemotherapy
| 発行 |
Datamonitor |
| 出版日 |
2009年10月 |
商品コード |
102089 |
| ページ情報 |
英文 214 pages |
| 価格 |
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Abstract
Introduction
The drug therapy of acute myeloid leukemia (AML) and adult acute lymphoblastic
leukemia (ALL) is largely based on chemotherapy regimens that have changed
little in the past few decades. Patient outcomes for both diseases remain
poor, particularly for elderly and high-risk patients. As the limits of
cytotoxic chemotherapy are being reached, an unmet need remains for novel,
improved therapies.
Scope of this research
- Analysis of the AML and adult ALL market based on a survey of 180 acute
leukemia specialists, supported by interviews with key opinion leaders.
- Segmentation of the AML and adult ALL populations by age group and risk
group, respectively
- In-depth analysis of treatment patterns, regimens prescribed and treatment
outcomes for AML and adult ALL by age group and risk group, respectively
- Discussion of unmet needs and overview of late-stage pipeline drugs and
marketed drugs investigated for expansion into the AML and adult ALL settings
Research and analysis highlights
The only molecular targeted therapy approved for use in AML is Mylotarg
(gemtuzumab ozogamicin; Wyeth) but it' s use is limited to elderly, relapsed
patients who are not candidates for other chemotherapy. A number of molecular
targeted therapies are currently in development for AML but are expected to
have minimal impact on patient outcomes.
Gleevec (imatinib; Novartis) is the only molecular targeted therapy used
extensively in the treatment of adult ALL. To date, the second generation
tyrosine kinase inhibitors Sprycel (dasatinib; Bristol-Myers Squibb) and
Tasigna (nilotinib; Novartis) have limited use in the treatment of the disease.
Hematopoietic stem cell transplantation (HSCT) has a central role in the
management of both AML and adult ALL. However, it remains an underutilized
procedure and its use is often delayed beyond its optimal timing. Research
efforts are required to optimize the use of this potentially curative approach.
Key reasons to purchase this research
- Understand prescribing trends in the AML and adult ALL markets
- Examine unmet need within the AML and adult ALL markets and identify
opportunities for new product development
- Enhance commercial positioning by increasing understanding of current
dynamics within the AML and adult ALL markets
Table of Contents
EXECUTIVE SUMMARY
- Scope of the analysis
- Datamonitor insight into the acute leukemias market
- Datamonitor insight into the AML market
- Datamonitor insight into the adult ALL market
- Contributing experts
- Related reports
- Upcoming reports
INTRODUCTION AND SCOPE
- Coverage of the Stakeholder Insight Survey
- Disease definition and epidemiology
- Segmentation of the acute leukemia population
- Current drug treatment practice for AML and adult ALL
- Key unmet needs within the AML and adult ALL market
- Overview of pipeline drugs for AML and adult ALL
AML: COUNTRY TREATMENT TREES
- Introduction
- Acute myeloid leukemia (AML) country treatment trees
- US
- Japan
- France
- Germany
- Italy
- Spain
- UK
AML: PATIENT SEGMENTATION AND EPIDEMIOLOGY
- Key findings
- Definition of acute myeloid leukemia (AML)
- AML is a disease of older age
- Presentation and diagnosis
- Symptoms can vary for AML patients
- Segmentation of the acute myeloid leukemia (AML) population
- Two classification systems are used in AML
- Cytogenetics is the most important prognostic factor
- Age is a major determinant of survival
- Epidemiology of acute myeloid leukemia (AML)
- AML accounts for about 30 - 35% of all leukemias in the seven major
markets
- Forecast incidence of AML in the seven major markets, 2009 - 2019
AML: TREATMENT TRENDS
- Key findings
- Summary of acute myeloid leukemia (AML) treatment strategies
- Treatment rates
- Induction treatment
- Induction treatment overview
- Induction treatment trends in patients less than 60 years old
- Induction treatment trends in patients aged 60 or above
- Post-induction treatment
- Post-induction treatment overview
- Post-induction treatment trends in patients less than 60 years old
- Post-induction treatment trends in patients aged 60 or above
- Consolidation treatment
- Consolidation treatment overview
- Consolidation treatment trends in patients less than 60 years old
- Consolidation treatment trends in patients aged 60 or above
- Relapse treatment
- Relapse treatment overview
- Relapse treatment trends in patients less than 60 years old
- Relapse treatment trends in patients aged 60 or above
- Hematopoietic stem cell transplantation in acute myeloid leukemia (AML)
AML: IMPROVING TREATMENT OUTCOMES
- Key findings
- Treatment outcomes
- Unmet needs
- More effective therapies are required for AML
- HSCT remains an underutilized procedure
- Molecular markers may help improve risk-adapted therapeutic strategies
- New product development
- A number of new approaches are being investigated in AML
- Novel drugs in Phase III development for AML
- Selected marketed drugs investigated in AML
ALL: COUNTRY TREATMENT TREES
- Introduction
- Acute lymphoblastic leukemia (ALL) country treatment trees
- US
- Japan
- France
- Germany
- Italy
- Spain
- UK
ALL: PATIENT SEGMENTATION AND EPIDEMIOLOGY
- Definition of acute lymphoblastic leukemia (ALL)
- ALL represents less than 1% of all adult cancers
- Genetic alterations provide insight into the pathogenesis of ALL
- Presentation and diagnosis
- Non-specific syndromes are common in ALL
- Segmentation of the ALL population
- The classification of ALL is still evolving
- Patients are usually stratified according to risk
- Epidemiology of ALL
- ALL accounts for about 10 - 15% of all leukemias in the seven major
markets
- Forecast incidence of ALL in the seven major markets, 2009 - 2019
ALL: TREATMENT TRENDS
- Summary of acute lymphoblastic leukemia (ALL) treatment strategies
- Treatment rates
- Induction treatment
- Induction treatment overview
- Induction treatment trends
- Consolidation treatment
- Consolidation treatment overview
- Consolidation treatment trends
- Maintenance treatment
- Maintenance treatment overview
- Maintenance treatment trends
- Clinical trials in ALL
- Hematopoietic stem cell transplantation in ALL
ALL: IMPROVING TREATMENT OUTCOMES
- Treatment outcomes
- Unmet needs
- More effective therapies are required for adult ALL
- Research efforts should focus on older ALL patients
- Prognostic markers are required for risk-adapted therapeutic strategies
- New product development
- R&D activity in ALL is limited
- Novel drugs in late-phase development for adult ALL
- Selected marketed drugs investigated in adult ALL
BIBLIOGRAPHY
- Journals
- Websites
- Datamonitor reports
APPENDIX A
- Physician research methodology
- Physician sample breakdown
- US
- Japan
- France
- Germany
- Italy
- Spain
- UK
- Contributing experts
APPENDIX B
TABLES
- Table: French-American-British classification of acute myeloid leukemia
(AML)
- Table: Forecast incidence of acute myeloid leukemia (AML) in the seven
major pharmaceutical markets, 2009 - 2019
- Table: Percentage of acute myeloid leukemia (AML) patients less than 60
years old receiving each induction regimen in the seven major pharmaceutical
markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients aged 60 or
above receiving each induction regimen in the seven major pharmaceutical
markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients less than 60
years old receiving each post-induction regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients aged 60 or
above receiving each post-induction regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients less than 60
years old receiving each consolidation regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients aged 60 or
above receiving each consolidation regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients less than 60
years old receiving each relapse regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of acute myeloid leukemia (AML) patients aged 60 or
above receiving each relapse regimen/therapy in the seven major pharmaceutical
markets, 2009
- Table: Examples of therapeutic approaches investigated in the treatment of
acute myeloid leukemia (AML)
- Table: Drugs in Phase III development for acute myeloid leukemia (AML),
2009
- Table: Selected marketed drugs in Phase III development for acute myeloid
leukemia (AML), 2009
- Table: The French-American-British system for the classification of acute
lymphoblastic leukemia (ALL)
- Table: Forecast incidence of acute lymphoblastic leukemia (ALL) in the
seven major pharmaceutical markets, 2009 - 2019
- Table: Results from selected clinical studies evaluating Gleevec in the
treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia
(ALL) patients
- Table: Percentage of treated adult acute lymphoblastic leukemia (ALL)
patients receiving each induction regimen in the seven major pharmaceutical
markets, 2009
- Table: Percentage of standard-risk, adult acute lymphoblastic leukemia
(ALL) patients receiving each consolidation regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of high-risk, adult acute lymphoblastic leukemia (ALL)
patients receiving each consolidation regimen/therapy in the seven major
pharmaceutical markets, 2009
- Table: Percentage of treated adult acute lymphoblastic leukemia (ALL)
standard-risk patients receiving each maintenance regimen/therapy in the seven
major pharmaceutical markets, 2009
- Table: Percentage of treated adult acute lymphoblastic leukemia (ALL)
high-risk patients receiving each maintenance regimen/therapy in the seven
major pharmaceutical markets, 2009
- Table: Group for Research in Adult ALL (GRAAL) trial group
- Table: Programa para el Estudio de la Terapeutica en Hemopatia Maligna
(PETHEMA) trial group
- Table: German Multicenter Study Group on Adult Acute Lymphoblastic
Leukemia (GMALL) trial group
- Table: New therapeutic strategies evaluated in the treatment of acute
lymphoblastic leukemia (ALL), 2009
- Table: Drugs in late-phase development for adult acute lymphoblastic
leukemia (ALL), 2009
- Table: US physician sample breakdown, 2009
- Table: Japan physician sample breakdown, 20 09
- Table: France physician sample breakdown, 20 09
- Table: Germany physician sample breakdown, 20 09
- Table: Italy physician sample breakdown, 20 09
- Table: Spain physician sample breakdown, 20 09
- Table: UK physician sample breakdown, 20 09
FIGURES
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in the US for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in the US for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in the US for patients
less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in the US for patients
aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Japan for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Japan for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Japan for patients
less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Japan for patients
aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in France for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in France for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in France for patients
less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in France for patients
aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Germany for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Germany for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Germany for
patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Germany for
patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Italy for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Italy for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Italy for patients
less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Italy for patients
aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Spain for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in Spain for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Spain for patients
less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in Spain for patients
aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in the UK for patients less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) incidence and patient segmentation
data in the UK for patients aged 60 or older, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in the UK for patients
less than 60 years old, 2009
- Figure: Acute myeloid leukemia (AML) treatment data in the UK for patients
aged 60 or older, 2009
- Figure: Age distribution of acute myeloid leukemia (AML) patients
- Figure: Percentage distribution of leukemia subtypes in the US, Japan and
the five major EU markets, 2009
- Figure: Average treatment rate for acute myeloid leukemia (AML) patients
less than 60 years old in the seven major pharmaceutical markets, 2009
- Figure: Average treatment rate for acute myeloid leukemia (AML) patients
aged 60 or above in the seven major pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the induction therapy of
acute myeloid leukemia (AML) patients less than 60 years old in the seven
major pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the induction therapy of
acute myeloid leukemia (AML) patients aged 60 or above in the seven major
pharmaceutical markets, 2009
- Figure: Uptake of Dacogen and Vidaza in the treatment of acute myeloid
leukemia (AML) in the US, 2009
- Figure: Top three chemotherapy regimens used in the post-induction therapy
of acute myeloid leukemia (AML) patients less than 60 years old in the seven
major pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the post-induction therapy
of acute myeloid leukemia (AML) patients aged 60 or above in the seven major
pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the consolidation therapy
of acute myeloid leukemia (AML) patients less than 60 years old in the seven
major pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the consolidation therapy
of acute myeloid leukemia (AML) patients aged 60 or above in the seven major
pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the relapse therapy of
acute myeloid leukemia (AML) patients less than 60 years old in the seven
major pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the relapse therapy of
acute myeloid leukemia (AML) patients aged 60 or above in the seven major
pharmaceutical markets, 2009
- Figure: Uptake of Mylotarg in the treatment of acute myeloid leukemia
(AML) in patients aged under 60 and in patients aged 60 or above, 2009
- Figure: Average use of hematopoietic stem cell transplantation (HSCT) in
the induction, post-induction, consolidation, and relapse treatment of AML in
the seven major pharmaceutical markets, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in the US, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in the US,
2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in Japan, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in Japan,
2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in France, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in France,
2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in Germany, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in
Germany, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in Italy, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in Italy,
2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in Spain, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in Spain,
2009
- Figure: Adult acute lymphoblastic leukemia (ALL) incidence and patient
segmentation data in the UK, 2009
- Figure: Adult acute lymphoblastic leukemia (ALL) treatment data in the UK,
2009
- Figure: Risk stratification of adult acute lymphoblastic leukemia (ALL)
patients in the seven major pharmaceutical markets, 2009
- Figure: Philadelphia chromosome status in high-risk adult acute
lymphoblastic leukemia (ALL) patients in the seven major pharmaceutical
markets, 2009
- Figure: Percentage distribution of leukemia subtypes in the US, Japan and
the five major EU markets, 2009
- Figure: Age distribution of childhood and adult acute lymphoblastic
leukemia (ALL) in the seven major markets, 2009
- Figure: Average treatment rates for adult acute lymphoblastic leukemia
(ALL) patients in the seven major pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the induction therapy of
adult acute lymphoblastic leukemia (ALL) in the seven major pharmaceutical
markets, 2009
- Figure: Top three chemotherapy regimens used in the consolidation therapy
of standard-risk adult acute lymphoblastic leukemia (ALL) in the seven major
pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the consolidation therapy
of high-risk adult acute lymphoblastic leukemia (ALL) in the seven major
pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the maintenance therapy of
standard-risk adult acute lymphoblastic leukemia (ALL) in the seven major
pharmaceutical markets, 2009
- Figure: Top three chemotherapy regimens used in the maintenance therapy of
high-risk adult acute lymphoblastic leukemia (ALL) in the seven major
pharmaceutical markets, 2009
- Figure: Average use of clinical trials in the induction, consolidation,
and maintenance therapy of adult acute lymphoblastic leukemia (ALL) in the
seven major pharmaceutical markets, 2009
- Figure: Average use of hematopoietic stem cell transplantation in the
consolidation and maintenance therapy of adult acute lymphoblastic leukemia
(ALL) in the seven major pharmaceutical markets, 2009
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