The colon cancer pipeline has grown as pharmaceutical companies are attracted by the high incidence and success of other developers. Cytotoxics will remain an integral part of treatment, but with key brands expected to come off patent over the forecast period and the approval of new therapies, treatment of this growing market is set to evolve.
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The standard of care for Stage I–III colon cancer is based around surgical resection. Advanced Stage II and Stage III tumors often require additional therapy in combination with surgery. FOLFOX accounts for 50% of the Stage IIIb market and is the preferred adjuvant chemotherapy regimen in all major pharmaceutical markets, except the UK.
First-line treatment of metastatic colon cancer is based on chemotherapy. Bevacizumab plus FOLFOX remains the most prescribed first-line regimen in less cost-conservative markets. However, in almost all pharmaceutical markets FOLFOX remains the chemotherapy of choice over FOLFIRI despite similar clinical efficacy in the metastatic setting.
Datamonitor’s survey indicated that the use of targeted therapies in the first- and second-line settings will increase. Increasing pressure to demonstrate cost-effectiveness of drugs and anticipated approval of new targeted therapies means the use of companion diagnostics will play an increasingly important role in the treatment of colon cancer.
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