The rectal cancer pipeline has grown as pharmaceutical industry players 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 projection period and the approval of new therapies, treatment of this growing industry is set to evolve.Disease overview assessing, etiology, risk factors, screening procedures, and patient key market segments In-depth analysis of most common treatment types according to stage at diagnosis and patient characteristicsAnalysis of physician prescribing trends in the seven major industry s across all stages of diseaseAnalysis of possible future treatment trends with regard to targeted therapies and companion diagnosticsThe standard of care for Stage I–III rectal cancer is based around surgical resection. The use of radiotherapy-based treatment increases with stage, with 66% of Stage IIIc patients treated with surgery and chemoradiation. However, Japanese physicians interviewed indicated that they did not use chemoradiation.First-line treatment of metastatic rectal cancer is based on chemotherapy. Datamonitor’s survey indicated that 85% of Stage IV patients receive treatment containing chemotherapy, and 34% receive chemotherapy without any additional therapy. The use of chemoradiation in the first-line setting can impact treatment choices in the second-line.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 rectal cancer.Gain insight into the treatment strategies and prescribing trends of 127 physicians treating rectal cancer across the seven major industry sExcel deliverable contains extensive treatment trees for each disease stage and country, including percentages and patient numbersAssess rectal cancer sector opportunity by identifying where treatment options are not fulfilling patient needs and how physicians select drugs

Table Of Contents

OVERVIEW•Catalyst
•Summary

EXECUTIVE SUMMARY•Strategic scoping and focus
•Datamonitor key findings
•Related reports

DISEASE DEFINITION AND DIAGNOSIS•Disease definition - Colorectal cancer is the third most common tumor type and cause of cancer-related death in both men and women
- The only differentiator between colon cancer and rectal cancer is primary tumor location

•Etiology - Adenomas are precursors to the majority of colorectal cancer cases
- Inherited and environmental factors are instrumental in the etiology of colorectal cancer

•Symptoms - Change in bowel habits is the principle symptom of colorectal cancer

•Prognosis - Survival rates for colorectal cancer patients still lag behind those in other high-incidence indications

•Presentation and diagnosis - Screening reduces colorectal cancer incidence and mortality

•Influences on diagnosis and treatment rates - Screen for Life: National Colorectal Cancer Action Campaign
- In 2012 the "Be clear on cancer" campaign was launched in the UK

•Referral patterns - Referral is dictated by stage at diagnosis and treatment approach

PATIENT SEGMENTATION•Stage distribution - The American Joint Committee on Cancer TNM classification system has replaced the older Dukes' staging system

CURRENT TREATMENT OPTIONS•Overview of the available drug classes
•Stage I-III - Treatment type
- Chemotherapy prescribing trends
- Chemoradiation prescribing trends

•Stage IV - Treatment type
- Prescribing trends: first line
- Prescribing trends: second line and third line

•Local and distant relapse - Local and distant relapse rates
- Treatment and prescribing trends: local relapse
- Treatment and prescribing trends: distant relapse

•Future changes in therapy - Targeted therapies and companion diagnostics

BIBLIOGRAPHY•Journal papers
•Websites
•Datamonitor reports
•Other

APPENDIX A•Physician data

APPENDIX B•Contributing experts
•Conferences attended
•Report methodology

TABLES•Table: Rectal cancer 5-year survival rates by stage at diagnosis, 2001-07
•Table: Leading treatments for rectal cancer across the seven major industry s
•Table: Percentage of patients receiving surgery, chemoradiation, and chemotherapy combined, in the seven major industries, 2011
•Table: Survey respondents by country and physician type across the seven major industries, 2011

FIGURES•Figure: Relative sensitivity and specificity of different colorectal cancer screening tests
•Figure: Distribution of rectal cancer patients across the seven major industries, by stage, 2011
•Figure: Mean percentage of Stage III rectal cancer patients treated by survey respondents in the seven major industries, 2011
•Figure: Percentage of Stage I-III rectal cancer patients receiving each treatment type in the seven major industries, 2011
•Figure: Percentage of Stage II-IIIc patients treated with surgery and chemotherapy receiving chemotherapy neoadjuvantly, adjuvantly, or both in the seven major industries, 2011
•Figure: Top three chemotherapy regimens used in the adjuvant treatment of Stage IIIb rectal cancer in each of the seven major industries, 2011
•Figure: Percentage of Stage II-IIIc patients treated with surgery and chemoradiation receiving chemoradiation neoadjuvantly, adjuvantly, or both in the seven major industries, 2011
•Figure: Top three chemoradiation regimens used in the neoadjuvant treatment of Stage IIIb rectal cancer in each of the seven major industries, 2011
•Figure: Top three treatment types used in Stage IV rectal cancer across the seven major industries, 2011
•Figure: Top three regimens used in the first-line treatment of Stage IV rectal cancer in each of the seven major industries, 2011
•Figure: Percentage of Stage IV patients treated with surgery and chemotherapy receiving chemotherapy neoadjuvantly, adjuvantly, or both, 2011
•Figure: Top three regimens used adjuvantly with surgery for first-line treatment of Stage IV rectal cancer in each of the seven major industries, 2011
•Figure: Number of Stage IV patients receiving additional chemotherapy after first line across the seven major industries, 2011
•Figure: Top three regimens used for second-line treatment of Stage IV rectal cancer in each of the seven major industries, 2011
•Figure: Top three regimens used for third-line treatment of Stage IV rectal cancer in each of the seven major industries, 2011
•Figure: Percentage of Stage I-III rectal cancer patients experiencing local or distant relapse in the seven major industries, 2011
•Figure: Top three chemotherapy regimens used for treatment of local relapse rectal cancer patients in the seven major industries, 2011
•Figure: Top three chemoradiation regimens used for treatment of local relapse rectal cancer patients in the seven major industries, 2011
•Figure: Top three regimens used for treatment of first-line distant relapse rectal cancer patients in the seven major industries, 2011
•Figure: Top three regimens used for the treatment of second-line distant relapse rectal cancer patients in the seven major industry s in 2011
•Figure: Top three regimens used for the treatment of third-line distant relapse rectal cancer patients in the seven major industry s in 2011
•Figure: Physician opinion regarding the role of companion diagnostics in increasing the uptake of targeted therapies in rectal cancer in the seven major industries, 2011

Companies mentioned

Chattem, Inc., Hutchison 3G UK Limited, Merck KGaA, Schindler Holding Ltd.

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