Melanoma Treatment is Undergoing Dramatic Changes as Yervoy and Zelboraf Rapidly Penetrate the Metastatic Patient Population in the U.S. and Europe; However, Drug Usage and BRAF Screening in Europe is Lower Compared to the U.S. Market
BioTrends Research Group, one of the world’s leading research and advisory firms for specialized biopharmaceutical issues, finds that in the United States and Europe there is strong physician desire for new therapies for the treatment of early stage melanoma. The and reports confirm there is higher use of adjuvant therapy which is often used to treat early stage melanoma in the U.S. market compared to the major European markets (France, Germany, Italy, Spain and the United Kingdom).
Adjuvant therapies consist mainly of interferon therapies and, notably, the U.K. market has not fully adopted this therapeutic option, resulting in the U.K. having the lowest treatment rates in this setting. In the U.S. adjuvant setting, interferon therapy is more commonly utilized with medical oncologists reporting a significant decrease in the use of high dose Intron A in the next six months, offset by an increase in the use of Sylatron, a pegylated form of interferon-alpha-2b marketed by Merck and Co., Inc., and other therapies (such as Genentech/Roche’s Zelboraf, Bristol-Myers Squibb’s Yervoy and clinical trials).
In the advanced melanoma setting, medical oncologists in both studies reported that the major changes they are making in the treatment of melanoma consists mainly of prescribing Yervoy, a monoclonal antibody and Zelboraf, a first-in-class personalized treatment that works on patients with a mutation. These respondents also noted they are now conducting the mutation testing which has a higher rate of screening uptake in the U.S., compared to the major European markets.
In the major European markets, usage of Yervoy and Zelboraf is highly correlated to access with Spain and Italy having the lowest access and usage rates, while Germany and the U.K. have the highest access and usage rates. Medical oncologists in all countries included in our surveys report that usage of these new agents for advanced melanoma is expected to grow in the next six months, suggesting that these agents have not yet fully penetrated the eligible population.
Medical oncologists in the U.S. reported that Zelboraf and Yervoy have replaced older agents in the first-line advanced melanoma setting compared to major European markets where respondents are still more likely to utilize Merck’s Temodar/Temodal and generic dacarbazine in this patient population. There is a notable difference in the label for Yervoy that enables first-line use in the U.S. but restricts prescribing to the second-line in Europe. As Zelboraf has only recently launched in Europe, uptake has likely been constrained as regulatory evaluations of the drug are still ongoing in some countries.
In terms of level of interest with late stage products in development for advanced melanoma, medical oncologists in both the U.S. and major European markets were most interested in Yervoy in combination with existing therapies: Zelboraf or Temodar or generic dacarbazine.
“Medical oncologists are very interested in combining Yervoy, an immunotherapy that stimulates the body’s own immune system to fight the cancer, with other commonly used therapies in melanoma, with the goal of increasing the response rate over Yervoy monotherapy and extending the length of survival,” said BioTrends Oncology Therapeutic Director Dan Winkelman.
is an annual syndicated report designed to provide a view of the current and future management of melanoma based on primary research fielded with 100 medical oncologists in the United States. is also an annual syndicated report which is fielded in Europe, to gauge 258 medical oncologists’ and 77 dermatologists’ perspectives in the largest European markets (France, Germany, Italy, Spain and United Kingdom). Both reports provide insight into practice patterns, attitudes and perceptions, and current and projected use of various products. TreatmentTrends also evaluate perceived product advantages and disadvantages, as well as sales and messaging efforts of key market players.
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