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In Terms of Effect on Overall Survival, Current and Emerging Therapies Have No Advantage Over Avastin/FOLFIRI in the Treatment of Second-Line Metastatic Colorectal Cancer, According to Clinical Data and Thought Leader Opinion

BURLINGTON, Mass., July 15, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the effect of a therapy on overall survival and progression-free survival are attributes that most influence surveyed U.S. and European oncologists' prescribing decisions for second-line metastatic colorectal cancer. Clinical data and the opinions of interviewed thought leaders, however, indicate that current and emerging therapies have no advantage over the sales-leader bevacizumab (Genentech/Roche/Chugai's Avastin)/FOLFIRI (5-fluorouracil, leucovorin and irinotecan) on overall survival, one of the greatest unmet needs in second-line metastatic colorectal cancer. However, opinion leaders express optimism that clinical trial data could show that the mechanism of action of Eli Lilly/ImClone's ramucirumab could confer a benefit on progression-free survival.

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The Decision Base 2013 report entitled As the Second-Line Treatment Setting for Colorectal Cancer Becomes More Crowded, How Will Oncologists and Payers Differentiate Among New Therapies?  finds that surveyed U.S. oncologists would prescribe ramucirumab, in combination with FOLFIRI, to a median of 20 percent of their second-line drug-treated, metastatic colorectal cancer patients. This modest patient share demonstrates the struggle that a new agent will face penetrating the familiarity of Avastin, as well as strong competition from aflibercept (Sanofi/Regeneron's Zaltrap) and regorafenib (Bayer Healthcare's Stivarga), the latter of which is currently used primarily in later lines of treatment.

The findings also reveal that the safety and tolerability of second-line therapies for metastatic colorectal cancer are another important consideration in oncologists' prescribing decisions, as the incidence of colorectal cancer increases with age and, as a result, therapies in this setting have a great impact on the quality of life in an elderly population.  

The report also finds that surveyed managed care organization (MCO) pharmacy directors are receptive to novel therapies that offer an improvement in median overall survival over currently available therapies, but while some emerging therapies hold promise, they are unlikely to match payers' requirements for widespread inclusion on their formularies.

"Avastin in combination with FOLFIRI is currently the most widely used regimen for the second-line treatment of metastatic colorectal cancer," said Decision Resources Business Insights Analyst Dana Gheorghe, Ph.D. "An emerging therapy like ramucirumab will find it difficult to penetrate the already crowded second-line market, given physicians' familiarity with Avastin. However, if ramucirumab can show competitive advantages in efficacy, and safety in Phase III trials, we believe it has the potential to compete strongly following its anticipated launch in 2015."

About Decision Resources
Decision Resources ( is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources Group company.

About Decision Resources Group
Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources Group at

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SOURCE Decision Resources
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