Physician Views: Avastin to lose share as front-line therapy for first-line metastatic colorectal cancer?

July 9, 2014
Ref: Physician Views Desk

Two recent developments appear poised to shift the typical US-based treatment regimen for first-line metastatic colorectal cancer in patients with wild-type KRAS gene mutations: approval of Amgen's Vectibix in this setting and study data presented at the ASCO annual meeting from the CALGB80405 study comparing Bristol-Myers Squibb and Eli Lilly's Erbitux with Roche's Avastin in this indication.

Data from CALGB80405 suggest that Erbitux and Avastin – when used in combination with chemotherapy – yield comparable results for the treatment of metastatic colorectal cancer.

These recent developments will arguably have an adverse impact on sales of Avastin, which generates estimated annual global revenue (according to analysts at Credit Suisse) of $3.1 billion in colorectal cancer, of which around a third is thought to be generated in KRAS wild-type patients.

Of the estimated $5 billion global market for metastatic colorectal cancer, the KRAS wild-type population accounts for around 60 percent of all cases. While Avastin – in combination with FOLFOX chemotherapy – dominates the 40 percent share of the market accounted for by patients with KRAS mutations, the wild-type segment is more competitive; Credit Suisse estimates that Avastin and Erbitux each account for around 40 percent of usage, with Vectibix accounting for the remaining 20 percent.

To ascertain how these recent developments will impact the treatment paradigm for metastatic colorectal cancer, FirstWord is polling US-based oncologists. Specifically we are asking them...

What percentage of metastatic colorectal cancer KRAS wild-type patients are currently treated in the first-line setting with an EGFR inhibitor?

What percentage of first-line patients are treated with Erbitux?

To what percentage of first-line patients they expect to prescribe Vectibix to in 12 months time?

To what percentage of first-line patients they expect to prescribe Vectibix or Erbitux to in 12 months time?

Whether they are located in the cetuximab belt – an area of the US where patients treated with Erbitux are known to have a higher chance of suffering from infusion reactions?

You will be able to read the results and analysis on Thursday.

Results and related analysis will be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions.

Note: FirstWord Polls are powered by MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialities and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at