非小細胞肺癌における標的療法

Abstract

Lung cancer is the third most common malignant disease and the first leading cause of cancer death in the western world. Yet platinum agent constitutes the current mainstay of front-line metastatic lung cancer treatment. There are currently two platinum-based compounds that are marketed and clinically used worldwide as treatment for non-small cell lung cancer (NSCLC): cisplatin and carboplatin. These two drugs are combined with paclitaxel, docetaxel, gemcitabine or vinorelbine to build the first-line treatment options. Several different studies have been comparing or are comparing differ combinations of these drugs. Lately gefitinib, pemetrexed and erlotinib have entered the market and are initially used in second or third-line treatments. The third-generation chemotherapeutic agents have expanded the therapeutic options in the treatment of advanced NSCLC. New data on platinum-based chemotherapy has been presented. Both Avastin and Efaproxyn have generated additional data.

In this report we are not only describing the progress of different combinations of approved drugs but as well the progress of 22 late stage drug candidates are described and analysed. Progress profiles and structured information will allow you to pin-point your knowledge-base in a most cost-effective way. New interesting phase III studies have been initiated. By gathering information around most drugs under development for NSCLC and specially the late stage pipeline it is has been clear that four major therapeutic strategies generated most interesting data. With this report you will be able to track down and foresee activities associated with the development of new treatments for lung cancer. According to market analytical studies, the NSCLC drug market is predicted to exceed $4 billion between 2010 and 2015. Chemotherapy drugs will experience generic erosion and three major chemotherapy drugs go off patent before 2012; Aventis' Taxotere (docetaxel), Bristol-Myers Squibb' s Paraplatin (carboplatin) and Eli Lilly' s Gemzar (gemcitabine).

Example of drugs included in this study

Affinitak, Aptosyn, Bevacizumab, Carboxyamidotriazole, Cetuximab, CI-994, Docetaxel, Efaproxyn, Erlotinib, Gefitinib, Gemcitabine, Genasense, Lapatinib IGN-101, Mitumomab, Neovastat, Paclitaxel, Panitumumab, Pemetrexed, Targretin, Telcyta, Tirapazamine, Trastuzumab, Vinflunine, Vinorelbine, Xcytrin, ZD-6474,

Example of companies included in this study

Abgenix, Aphton, AstraZeneca, Bristol-Myers Squibb, Cell Pathways, Eli Lilly, Genentech, Genta, GlaxoSmithKline, ImClone, ISIS Pharmaceuticals, Ligand Pharmaceuticals, OSI Pharmaceuticals, Pfizer, Pharmacyclics, Sanofi-Aventis, Telik

Thorough examination of status and impact of many novel drugs in development Discussion of the challenges in current drug development, including future clinical trials to be made, collaborations and inclusion of novel endpoints. Case studies on major lung cancer drugs on market and in development.

Key reasons to read this report

• Explore the strengths and weaknesses associated with compounds in clinical development.
• Scientific rationale for novel therapeutics in lung cancer, and the results of clinical trials to date.
• Gain insight into the current challenges and commercial opportunities associated with lung cancer

Table of Contents

1. Executive Summary

2. Cancer Highlights

3. Methodology

4. Table of Contents

• 4.1 List of boxes
• 4.2 List of tables
• 4.3 Appendices

5. Introduction

• 5.1 Current Treatment Strategies
• 5.2 Disease Definition
• 5.3 Etiology & Pathophysiology
• 5.4 Prognosis
• 5.5 Epidemiology

6. Progress in current treatment strategies

• 6.1 Docetaxel
• 6.2 Vinorelbine
• 6.3 Gemcitabine
• 6.4 Paclitaxel
• 6.5 Pemetrexed
• 6.6 Gefitinib
• 6.7 Erlotinib
• 6.8 Bevacizumab

7. Key Therapeutic Strategies

• 7.1 Apoptosis
• 7.2 Protein Kinase Inhibition - Antiangiogenesis and Antivascular Agents
  • 7.2.1 EGFR and VEGFR as target
• 7.3 Immunotherapy

8. Competitive Landscape in NSCLC Drug Development: The Late Stage Pipeline

• 8.1 Protein Kinase Inhibitors
• 8.2 Apoptotic Inducers
• 8.3 Immunotherapy
• 8.4 Other Therapeutic Strategies

9. Disclaimer

• 9.1 Liability
• 9.2 Completeness

10. Appendix 1. Treatment Guide Lines*

11. Appendix 2 Progress Profiles on Approved Drugs

• 11.1 Docetaxel
• 11.2 Vinorelbine
• 11.3 Gemcitabine
• 11.4 Paclitaxel
• 11.5 Pemetrexed
• 11.6 Gefitinib
• 11.7 Erlotinib

12. Drug Index

13. Company Index

• Box 1: Quick Facts - Docetaxel
• Box 2: Scientific Data on Docetaxel
• Box 3: Quick Facts - Vinorelbine
• Box 4: Scientific Data on Vinorelbine
• Box 5: Quick Facts - Gemcitabine
• Box 6: Scientific Data on gemcitabine
• Box 7: The PIONEER clinical trial
• Box 8: Quick Facts - Pemetrexed
• Box 9: Scientific Data on Pemetrexed
• Box 10: Quick Facts - Gefitinib
• Box 11: Scientific Data on Gefitinib
• Box 12: Expert comment
• Box 13: Quick Facts - Erlotinib

• Table 1: Chemotherapeutic Drugs for Treatment of NSCLC
• Table 2: Clinical Studies of NSCLC Patients With EGFR Mutations
• Table 3: Progress on Bevacizumab
• Table 4: Near Term Approved Drugs for the Treatment of NSCLC
• Table 5: Chemotherapy Drugs off Patent
• Table 6: Generalized Illustration, Depicting the Key Elements Involved in the Apoptotic Pathways.
• Table 7: VTA Agents Under Development
• Table 8: EGFR or VEGFR Inhibitors
• Table 9: FMS-Like Tyrosine Kinases and Their Synonyms
• Table 10: Fms-related Tyrosine Kinase Targets in Development
• Table 11: Protein Kinase Targets in Clinical Trials for Lung Cancer
• Table 12: Cancer Immunotherapy Strategies
• Table 13: Progress on Lapatinib
• Table 14: Progress on ZD6474
• Table 15: Progress on Trastuzumab
• Table 16: Progress on Panitumumab
• Table 17: Progress on Cetuximab
• Table 18: Progress on Neovastat
• Table 19: Progress on Affinitak
• Table 20: Progress on Sorafenib
• Table 21: Progress on Canfosfamide
• Table 22: Progress on Exisulind
• Table 23: Progress on Genasense
• Table 24: Progress on Bexarotene
• Table 25: Progress on IGN101
• Table 26: Progress on CPG 7909
• Table 27: Progress on Vinflunine
• Table 28: Progress on Talabostat
• Table 29: Ongoing Studies
• Table 30: Progress on Xcytrin
• Table 31: Progress on Tirapazamine
• Table 32: Progress on Efaproxiral

• 10. Appendix 1. Treatment Guide Lines*
• 11. Appendix 2. Progress Profiles on Approved Drugs