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Markets for Cancer

Cancer is a very fast-growing market owing to the high incidence of the disease - approximately one in three people will develop cancer in their lifetime. Cancer is not one disease, it is many with major differences in prognosis and responsiveness to treatment depending upon which organ, tissue or cell type is involved. The other source of variability is the stage which the tumour has reached before diagnosis with metastatic tumours being the most difficult to treat. Cancer treatment is conventionally based upon three therapeutic modalities:

Surgery
Radiotherapy
Chemotherapy

Drugs used to treat cancer are generally inhibitors of cell growth or division that are inherently cytotoxic, but affect the more rapidly dividing cancer cells more than normal cells. Combination chemotherapy is the norm. The best drug combinations and how these should be used alongside surgery and radiotherapy are determined by clinical research that largely takes place after a new drug is marketed.

The leading product in PDT for cancer is Photofrin (porfirin sodium, QLT), a complex mixture of porphyrins first approved by the FDA in 1998 for the treatment of oesophageal cancer not satisfactorily treated by lasers alone. Its clinical use has been limited by the profound and lasting photosensitivity which patients experience following its use. Porfirin sodium is registered world wide in oesophageal and lung cancer and in certain individual territories for bladder, gastric and cervical cancer. It has also been trialled and may ultimately be registered in a number of other cancers. In 1999 sales of porfirin sodium were just $11million, of which around 80% was in the US.

The most advanced product amongst second generation PDT for cancer is Foscan (temoporfin), developed by Scotia for head and neck cancers. It was recently approved on appeal by the EMEA, but its further development has been hindered by financial difficulties at Scotia. A third product, verteporfin, is under development by QLT for patients with non-melanoma skin cancer.

It seems reasonable to define the market for PDT in cancer in terms of these cancers.

The market estimate of 164,500 suitable patients suggests that if safe and effective PDT treatments were available then annual sales well in excess of $100 million are possible.