Non-Hodgkin's Lymphoma - Is There Room to Emulate Rituxan's Success?

Business Wire, Feb 20, 2008

NEW YORK -- Reportlinker.com announces that a new market research report related to the Pharmaceutical industry is available in its catalogue.

Stakeholder Opinions: Non-Hodgkin's Lymphoma - Is there room to emulate Rituxan's success?

To order this report:

www.reportlinker.com/p074966/2008/02/Stakeholder-Opinions- Non-Hodgkins-Lymphoma---Is-there-room-to-emulate-Rituxans-success.html

Non-Hodgkin's lymphoma (NHL) is the most common hematological malignancy and is comprised of around 30 different disease subtypes. Each of these present with a distinct set histological, genetic and clinical characteristics. Treatment options in NHL include chemotherapy, targeted therapies, stem cell transplantation and radiotherapy.

NHL background and epidemiology, including forecast incidence of the major subtypes in the seven major marketsTreatment of NHL by subtype and line of therapy, including major treatment controversies and areas of unmet needExamination of pipeline activity including profiles of late-phase pipeline drugsStakeholder opinions based on qualitative interviews with opinion leaders from the US and Europe

Rituxan-based regimens constitute the mainstay of first-line treatment options in several NHL subtypes. Uptake of Rituxan in the maintenance setting for follicular lymphoma (FL) has allowed the drug to achieve further market penetration.

There is a lack of consensus over the treatment of relapsed and refractory disease in most NHL subtypes. Refractory patients are poorly served by currently available treatment options. Other unmet needs include detection of patients with aggressive lymphoma at high risk of relapse and an efficacious maintenance therapy for these patients.

The NHL late-phase pipeline is relatively active, with 10 Phase IIII drugs and 46 Phase II drugs. Monoclonal antibodies are among those agents that continue to demonstrate promising signs of clinical and commercial potential. However, Rituxan's status as market leader is unlikely to be challenged within the next 510 years.

Understand current epidemiological trends in non-Hodgkin's lymphoma and ongoing treatment optionsIdentify limitations of therapy currently available to non-Hodgkin's lymphoma patients and the potential of future therapyIdentify the key products in late-phase development for NHL. Consider, assess and react to opportunities and risks influencing their future potential

Table of Contents

ABOUT DATAMONITOR HEALTHCARE 2

About the Oncology pharmaceutical analysis team 2

Andrew Paramore - Oncology Lead Analyst & Head of Product Development 2

CHAPTER 1 EXECUTIVE SUMMARY 3

Scope of analysis 3

Datamonitor insight into the non-Hodgkin's lymphoma market 3

Related reports 5

Upcoming reports 5

CHAPTER 2 NON-HODGKIN'S LYMPHOMA: DISEASE BACKGROUND 7

Chapter summary 7

Disease overview and classification 7

Disease overview 7

Disease classification 8

NHL is classified under the WHO classification system 8

Immunophenotype differs between NHL subtypes 9

Several genetic abnormalities linked to NHL 10

NHL can follow an aggressive or indolent disease course 11

Diagnosis, staging and prognosis in NHL 13

Diagnosis of NHL 13

Ann Arbor staging system 14

Ann Arbor classification used for staging NHL but of limited prognostic use 14

Determining prognosis for NHL 15

International Prognostic Factor Index for aggressive NHL 15

International Prognostic Factor Index for FL 16

Molecular profiling in NHL 17

Epidemiology 19

Incidence of NHL in the seven major markets 19

NHL is the most commonly occurring hematological malignancy in the seven major markets 19

NHL incidence will total 122,000 in the seven major markets in 2007 20

Incidence of NHL by subtype in the seven major markets 22

Distribution of NHL subtypes varies considerably across the seven major markets 22

DLBCL and FL account for over 50% of new NHL diagnoses 23

Age distribution of NHL incidence rate 26

Mortality 27

NHL mortality will reach 47,000 in the seven major markets in 2007 27

Etiology 29

Immunodeficiency and immunosuppression as risk factors for NHL 30

Acquired immunodeficiency syndrome (AIDS) 30

Congenital immunodeficiency 30

Immunosuppressive drugs 30

Autoimmune disorders 30

Infections as risk factors for NHL 31

Human T-cell lymphotrophic virus (HTLV-1) 31

Epstein-Barr virus (EBV) 31

Helicobacter pylori 31

Hepatitis C 31

Occupational, environmental and lifestyle risk factors 31

Pesticides 31

Hair dyes 32

Lifestyle factors 32

CHAPTER 3 CURRENT TREATMENT OPTIONS FOR NON-HODGKIN'S LYMPHOMA 33

Chapter summary 33

Overview of NHL treatment options 33

Chemotherapy 34

Targeted therapies 35

Rituxan has made a large impact on NHL treatment outcomes 36

Radioimmunotherapies combine a monoclonal antibody and radioactive component 36

Drug developers aiming for widened indications for approved targeted therapies 36

Other drug classes 38

Combination regimens 38

Radiotherapy 39

Myeloablative therapy and stem cell transplantation 40

Treatment outcome measurements for NHL 40

Treatment of DLBCL 42

DLBCL overview 42

Induction therapy in DLBCL 42

R-CHOP established as standard of care for induction therapy in DLBCL 42