The National Cancer Moonshot Initiative, announced by President Obama in January, is gaining momentum. “We are at an inflection point, and the science is ready for the concerted new effort this initiative will deliver. Cancer is now known to be hundreds of diseases, each with unique features, driving forces, and vulnerabilities to treatments — and scientific understanding of how cancer develops and spreads has improved our ability to intervene and attack it”, President Obama stated in his 2016 State of the Union Address. You can access more information about the initiative and the initial announcement here.
At the upcoming ASCO meeting, on June 6 in Chicago, Vice-President Joe Biden will provide the professional cancer community an update to this Moonshot Initiative.
MDOutlook proudly exhibits at ASCO and will present its efforts and accomplishments in bringing deeper insights to the management of cancer. Please visit us at ASCO (booth 4043), or contact us by phone (+1.404.496.4136) / email to learn more.
MDOutlook® introduces excerpts from an MDOutlook’s OncoScape™: Patient Segmentation and Referral Patterns for Advanced Lung Cancer in the US.
This research is based on an on-line survey across multiple specialties, including oncologists, surgeons, primary care and emergency room physicians, that suspect and diagnose advanced lung cancer.
OncoScape Methodology
Primary research phase involved multiple surveys in the US to verified and validated medical oncologists, radiation oncologists, surgeons, pulmonologists, primary care physicians and emergency room physicians with an identified involvement in or suspicion of lung cancer utilizing targeting parameters
Fielded: 2014
Research via 45-minute interactive web-based survey instruments, utilizing proven MDOutlook methodology and proprietary technology
Response: 447 physicians across medical specialties from MDOutlook’s proprietary cancer panels
Patients were separated by prior treatment experience
Analysis and reporting by physician segmentation, treatment setting and patient segmentation
Commercialization Considerations: Importance of Patient Segmentation When Defining the Market Size
When developing complex forecasting models, patient demographics are often considered and epidemiological information collected in each market. The limitation to this approach is that epidemiological information does not equal market size. Not all patients will be considered as candidates for a particular therapy. Therefore, patient segmentation upfront is needed to adequately and informatively define the market size.
MDOutlook analysts performed a segmentation study to quantify the volume of the US market for patients in advanced (inoperable or metastatic) lung cancer who had not (yet) undergone any systemic therapy for the advanced disease. Patients with suspected or confirmed lung cancer were split into 3 staging groups key to our clients’ commercialization strategy:
“Treatment Naïve”– patients who initially present with advanced (inoperable or metastatic) disease and have never been diagnosed with or treated for any type of lung cancer
“Recurrent – No Prior Chemotherapy” – those who have been treated previously because of early (operable) lung cancer and whose disease has now recurred to an advanced (inoperable or metastatic) state. They did NOT receive any adjuvant chemotherapy as part of their treatment for early lung cancer
“Recurrent – Chemotherapy Experienced” – patients who have been treated previously because of early (operable) lung cancer and whose disease has now recurred to an advanced (inoperable or metastatic) state. As part of their treatment for early lung cancer, they received adjuvant chemotherapy. For this staging group, we asked respondents to consider patients who received their adjuvant chemotherapy from them or from another physician as being “NEW to you for advanced disease”
Conclusions
Over 60% of all patients diagnosed with advanced lung cancer present for the first time as inoperable or metastatic
A higher percentage of patients recur that did not have initial chemotherapy (21.8%) vs those that had prior chemotherapy (15.8%)
Small Cell Lung Cancer accounts for less than 15% of advanced lung cancer patients
The data was compared and mapped against data from other primary and secondary sources epidemiology to quantify the full U.S. market (data not shown)
Commercialization Considerations: Importance of Patient Referral Patterns when Developing Forecasts and Launch Strategies
Once the patient population is clearly defined and segmented, it’s equally important for forecasting and launch strategies to understand the costs that will be needed to reach the treating physicians of these patients. To accomplish this, an understanding of who is treating the patients when needs to be established. With referral patterns mapped out, a picture begins to develop of what it takes to reach and unlock the targeted patient population. This allows the dedication of defined commercialization resources in the most focused way.
MDOutlook analysts used the segmented patient populations to map the referral patterns from the time the patients were suspected of advanced lung cancer, through diagnosis and onto the treating physicians. There emerged important, major and sometimes subtler differences between patient segments, the diagnosis and subsequent management of patients. A rather striking example is shared below.
Conclusions
Patients suspected of, but not previously diagnosed with, advanced lung cancer are referred to community pulmonologists from multiple specialties
Once newly diagnosed with advanced lung cancer, the vast majority of patients, regardless of histology, are referred to medical oncologists for treatment
Conclusions
Suspected recurrent advanced lung cancer patients are predominantly referred to community pulmonologists from primary care physicians
In stark contrast to treatment naïve patients, community pulmonologists refer the majority of their diagnosed advanced lung cancer patients, who are recurrent without chemotherapy experience, to radiation oncologists for treatment
Impact on Your Commercialization Strategy
Building the commercialization strategy for new medicines or new indications is a daunting challenge, ever more so in oncology. Many factors, considerations and assumptions must be weighed and decided. Critical to any planning (and subsequent measurement of success) is reality-based market sizing and correctly quantified segmentation, including patients, physicians and treatment settings.
MDOutlook has supported many clients in doing exactly this using multi-channel intelligence assets and our proprietary panel of more than 95,000 cancer treaters. MDOutlook strengthens your commercialization efforts with primary research and actionable insights.
On Friday, NPR had a very interesting and inspiring interview with Dr. Siddhartha Mukherjee, oncologist at Columbia University in New York. He has written a new article called The Improvisational Oncologist in this week’s Sunday Magazine of the New York Times. In this article, he focuses on the emergence of immuno-oncology in daily practice, and how to use it optimally within the complexity of managing cancer.
Dr. Mukherjee describes – what I have called it many times – the ‘modern day alchemist’, often changing the treatment approach, trying something radically new in the quest for the ‘holy grail’: curing a patient’s cancer. With modern day scientific advances, the management of cancer has become infinitely more complex than when I was in med school. It has also become much more interesting and challenging at the same time, offering vastly improved outcomes and thereby hope to patients.
It is stories like these, and the inspiring work of 95,000+ cancer treaters we collaborate with at MDOutlook that keeps our team motivated on our quest to advance cancer management by providing oncology intelligence.
Thank you to all, and not in the least our team, to move this forward!
Jan Heybroek
President, MDOutlook
MDOutlook® are pleased to share excerpts from a recent MDOutlook’s OncoPulse™: Understanding Patient Pathways for mCRC in Europe. This analysis is based on an on-line survey of European oncologists managing (metastatic) Colorectal Cancer.
OncoPulse Methodology
Primary research phase involved European surveys to verified and validated medical oncologists with an identified involvement in mCRC utilizing targeting parameters within the proprietary MDOutlook® global cancer treater panel of 96,000+ oncologists
Fielded: late 2015 in 5 major European markets, translated into local languages
Research via 25-minute interactive web-based survey instruments, utilizing proven MDOutlook methodology and proprietary technology
Response: 125 oncologists with a minimum of 5 mCRC treated within the previous 3 months
Commercialization Considerations: Relevance of Physician Segmentation by Clinical Practice
Reporting and analyzing physicians’ prescribing habits and preferences by line of therapy provides insight into preferred therapies and relevant adoption trends. Yet, taking the analysis to the next level can yield a deeper understanding of the market: segmenting the respondents by clinical practice characteristics in addition to certain demographics offers previously unseen insights.
MDOutlook analysts performed a segmentation study of the treatment of mCRC cancer in the EU5. As one expects, there are differences by country in total use of doublets* in 1st line (*Doublet = FOLFOX or FOLFIRI). Diving a layer deeper, for instance, yields insight that patient volume (high vs. low volume) materially impacts prescribing of different doublets and combinations. Finally, adding practice setting (academic vs. community) as a third criteria yields targeting insights around the specific combination physicians prefer by setting (e.g. academic high volume mCRC treaters).
The key takeaway is that a deeper dive analysis across multiple regions and different identifiable characteristics of prescribers and their practices will lead to more targeted insights around behavior. Thus ultimately leading to more relevant commercialization and communication strategies and tactics.
Conclusions
Following on from Head to Head data comparing bevacizumab with EGFR therapy, despite only being eligible for use in around 50% of first line patients, EGFR use is close to or exceeding bevacizumab in the treatment of first line patients in the majority of European countries
Large majority of the mCRC patients (~65-90%) in EU5 countries receive doublet in 1st line therapy in combination with a targeted antibody, but understanding how physicians use it differently is critical
German physicians use the most doublet overall (87%), but the least doublet alone (5%)
Over 20% of 1st line mCRC patients in UK received no targeted antibody – more than twice the rate seen in other countries
Conclusions
In Spain, the distribution of doublet usage (alone or with a biologic agent) in patients between the high and low volume treaters do not show a clinically meaningful difference
In the UK, however, the high volume treaters strongly prefer doublet + bevacizumab for their patients while the low volume treaters soundly favor doublet alone for their mCRC patients in 1st line therapy
The UK situation appears to reflect the relative complexity of gaining reimbursement for bevacizumab compared to the limited indication that is approved by NICE
Conclusions
In Germany, a meaningfully higher proportion of mCRC patients in 1st line receive doublet with a biologic in academic high vs academic low treaters
However, with the community physicians, the proportion of patients receiving doublet with a biologic agent is not significantly different between the high and low treaters
