Surveyed U.S. Oncologists Indicate That if Iressa and Tomtovok Were Approved for Treating NSCLC Patients With EGFR Mutations, Both Agents Would Threaten Tarceva's Market Position in This Niche Population

BURLINGTON, Mass., Dec. 2, 2010 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the testing rate for epidermal growth factor receptor (EGFR) mutation—a predictor of response to Genentech/Roche/OSI/Chugai's EGFR inhibitor Tarceva—in non-small-cell lung cancer (NSCLC) patients will increase by approximately 50 percent over the next 12 months, according to surveyed U.S. oncologists. In line with increased EGFR mutation testing, approximately 40 percent more patients who harbor mutant EGFR will receive Tarceva despite the fact that more than half of Tarceva prescribers indicate that obtaining reimbursement for first-line use is burdensome. However, if the emerging EGFR inhibitors Iressa (AstraZeneca) and/or Tomtovok (Boehringer-Ingelheim) were to be approved for advanced NSCLC patients with mutant EGFR, surveyed oncologists indicate that both would threaten Tarceva's market position in the treatment of this niche population.  

The new U.S. Physician & Payer Forum report entitled How Will Clinician and Payer Attitudes to Mutation-Specific Prescribing Shape the NSCLC and CRC Markets? finds that, first-line prescribing of Tarceva in NSCLC patients with mutant EGFR would increase further were Tarceva to be approved by the U.S. Food and Drug Administration for this indication. Furthermore, despite significant proportions of surveyed physicians identifying advantages of Iressa and Tomtovok over Tarceva, if the drugs were to become available, only a minority of surveyed oncologists indicate that approval for use of these drugs in NSCLC patients with mutant EGFR would justify a price premium over Tarceva.

"Forty percent of surveyed managed care organizations indicate that if Iressa and Tomtovok were priced at a 20 percent premium to Tarceva they would be excluded from the formulary," said Decision Resources Analyst Janie Cox, Ph.D. "Even at a comparable price to Tarceva, up to 25 percent of managed care organizations would exclude these drugs—and if they were covered, insufficient efficacy data is cited as the main hurdle to preferred brand status for both Iressa and Tomtovok."    

The report also finds that surveyed oncologists are increasingly likely to test for Kirsten rat sarcoma viral oncogene homolog (KRAS) and, to a lesser extent, B-type Raf Kinase (BRAF) mutation in colorectal cancer (CRC) patients. KRAS mutation predicts a lack of response to Imclone/Bristol-Myers Squibb/Merck Serono's Erbitux and Amgen/Takeda's Vectibix, which are consequently labeled for treatment of KRAS wild-type patients only, while BRAF mutation—which is mutually exclusive of KRAS mutation in CRC patients—may also predict a lack of response to these agents, and therefore offers potential for further targeting treatment of KRAS wild-type patients.

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