Cancer is second only to cardiovascular disease as a leading cause of death in most western countries and statistics predict that more than one in four persons will suffer from it in one form or other at some stage during their life. In 1997, there were 6 million cancer deaths and 10 million cases of cancer worldwide, making it a major focus for the pharmaceutical market.
The World Health Organization (WHO) believes that cancer will continue to be one of the leading causes of death worldwide. In 1997, 2.5 million people died of it in the developed world (21% of all deaths) and this was more than matched by 3.6 million deaths in the developing world. At the present time, cancer is responsible for only 9% of all deaths in the developing regions but this is set to change. By 2020 the WHO predicts that there will be an annual incidence of 15 million cases worldwide and a doubling of new cancer cases in developing countries (due to dietary and environmental changes and increased longevity) compared with a 40% rise in industrialised countries.
Cancer is a general term used to describe a group of over 100 related diseases that are characterised by loss of control of cell growth. This abnormal growth causes the development of a cellular mass or tumour which frequently invades the surrounding tissue and spreads (metastases) to other parts of the body. Metastases are commonly the cause of morbidity and mortality and once present a cure is difficult to achieve.
Cells become cancerous as a result of genetic abnormality which may be inherited but is more often the result of damage by cancer-causing agents (carcinogens), tobacco and dietary factors being the most significant. More than one damaging incident is necessary to change a cell into a cancer cell but these events tend to accumulate with time. Consequently, the incidence of nearly all cancers increases markedly with age.
Cancers are classified as haematological (blood) malignancies or solid tumours, depending on the site of development. They can arise almost anywhere but are more frequent in certain organs and tissues. The eight most common cancers in terms of incidence and mortality (in total about 60% of all cancers) occur in the lung, stomach, breast, colon/rectum, mouth, liver, cervix and oesophagus. Early detection offers the best chance of a cure and with some cancers (breast and cervix), screening asymptomatic individuals has proved advantageous.
The three conventional methods used to treat cancer are surgery, radiotherapy and chemotherapy. Each has a place either singly or in combination with one or both of the others. For many early stage cancers, surgery offers a good chance of a cure but if the tumour is inaccessible, too advanced locally or if metastases are present, then surgery alone is inadequate and a combination of treatments is likely to achieve the best results.
Radiotherapy is the option for 50�60% of cancer patients. It is useful for treating tumours in sites where surgery is inappropriate and for treating tumours naturally sensitive to radiation. It can also be combined with chemotherapy or surgery pre- or postoperatively. It has undesirable side effects, both acute (which resolve a few weeks after treatment) and more serious, long-term effects which may appear at a later date.
Photodynamic therapy is a new approach to the treatment of cancer which involves treating the patient with a photosensitive drug, eg Photofrin. The drug is absorbed by all cells but leaves healthy cells more rapidly than cancer cells. When the patient is exposed to laser light, the drug is activated and kills the cancer cells with minimal damage to normal cells. The technique can only be used to treat surface tumours or those in the lining of internal organs because laser light can only pass through 3cm of tissue. Second generation drugs in development absorb more penetrating light.
Chemotherapy is the use of cytotoxic drugs administered either orally or by injection to kill or disable cancer cells so that they lose their ability to replicate. These drugs disrupt replication by targeting nucleic acids and enzymes involved in cell division. The advantage of chemotherapy over radiation and surgery is that it can reach most parts of the body. This means that it can be used to treat widespread metastases and although it cannot generally cure metastatic disease, it can offer palliation and an improved quality of life.
The problem with cytotoxic drugs is that they affect both cancer cells and healthy cells giving rise to unwanted side effects. Proliferating cells, eg bone marrow cells, hair follicles and gastrointestinal epithelial cells are the most vulnerable to cytotoxic drugs putting the patient at risk of infection and spontaneous bleeding and causing nausea and vomiting and hair loss. The severity of the side effects depends on the drug, its dose and the status of the patient.
Despite their limitations chemotherapeutic drugs remain the standard therapy for metastatic cancer treatment. They include alkylating agents, anti-metabolites, antibiotics and plant alkaloids, each having different mechanism of action.
Alkylating agents (eg cyclophosphamide, ifosfamide, chlorambucil, carmustine, doxorubicin and 5-FU) cause cross-linking and abnormal base-pairing in DNA molecules thus disrupting DNA synthesis. Other drugs with a DNA-damaging action are the platinum containing compounds (eg cisplatin) and topoisomerase inhibitors. Inhibitors of topoisomerases I and II cause DNA strand breakages by interfering with DNA uncoiling during replication. A number of these drugs have been launched or are in development eg topotecan, irinotecan (topoisomerase I inhibitors) and etoposide, teniposide and crisnatol (toposiomerase II inhibitors).
Anti-metabolites (eg methotrexate and 5-FU) inhibit the synthesis of DNA while anti-cancer antibiotics either bind directly to DNA, thereby deforming its structure, or inhibit enzymes involved in its synthesis. They include actinomycins, anthracyclines, bleomycins and mitomycin-C.
The vinca alkaloids, vincristine, vinblastine and vindesine (used mainly in the treatment of lymphatic malignancies and leukaemias) are derived from the periwinkle plant. They are mitotic poisons in that they inhibit the assembly of the spindle apparatus during mitosis and consequently prevent cell proliferation.
The taxoids are also mitotic poisons. They promote the assembly of the microtubules of the spindle apparatus but prevent them from being broken down once the cell has divided, thus preventing further cell division and eventually causing cancer cell death. Taxol (paclitaxel), which is marketed by Bristol-Myers Squibb as a first line treatment for ovarian cancer and metastatic breast cancer, is one of the best selling anti-cancer drugs. Its competitor, Taxotere (docetaxol), is marketed by Rhône-Poulenc Rorer and is effective against breast and non-small-cell lung cancer (NSCLC).
A major problem with chemotherapy is the development of drug resistance. It is the main cause of treatment failure following an initial good response. Multidrug resistance is a particular challenge for drug development. When tumour cells are exposed to a single drug such as vincristine they develop resistance not only to that drug but to other drugs that are of dissimilar structure and function. This is due to an increase in the expression of a drug efflux pump protein, Pgp, which bales out the drug from the cell, thereby reducing the drug to an ineffective level.
Systemic or oral administration of anti-cancer drugs causes side effects due to the toxic effects of the drug on normal tissue. Injecting drugs directly into the tumour, provided that the tumour is accessible, is not the answer because the drug is rapidly removed from the site of injection. New drug delivery systems reaching the market are designed for slow release of the drug at the tumour site. Products include liposome-encapsulated drugs, lipid-based and polymer-based drug delivery. The development of biodegradable controlled-release polymer implants is particularly valuable for the treatment of brain cancers.
Hormonal therapies are frequently used for the palliative treatment of hormone dependent cancers ie breast, prostate and endometrial cancer. They are usually preferred over the more toxic chemo- and radiotherapies. The basis of the treatment is the withdrawal of hormone support from the tumour with the aim of causing it to regress. The main categories of drugs used are steroid receptor antagonists (anti-oestrogens and anti-androgens), luteinising-hormone releasing hormone (LHRH) agonists, steroid hormone agonists (progestins) and steroid synthesis inhibitors (eg aromatase inhibitors such as Arimidex and Femara). The anti-oestrogen tamoxifen is a long established drug used for treating all stages of breast cancer. More recently developed drugs are the pure anti-oestrogens and the selective oestrogen receptor modulators (SERMs) of which raloxifene is the most recent one to reach the market.
An important aspect of cancer treatment is supportive care in the control of pain and emesis (nausea and vomiting). A wide selection of analgesics of different strengths is available to control or prevent pain. Emesis is one of the commonest side effects of chemotherapy and this is treated with anti-emetic drugs of which there is a wide selection available.
By the end of the decade, the biotechnology companies expect to deliver a wide range of new cancer drugs. These new drugs are biological, based on naturally occurring proteins or genetic material. They include immunotherapy treatments to boost the immune system to respond to the cancer (therapeutic vaccines, monoclonal antibodies and cytokines), gene therapy and antisense therapy and inhibitors of metastasis (angiogenesis and metalloproteinase inhibitors). These agents are targeted to the tumour directly and more specifically, to individual molecules or genes. Consequently they promise to have few side effects which means that larger and more effective doses of drug can be given.
Tumours are not readily recognised by the immune system. Consequently, current cancer vaccine research is aimed at stimulating an immune response from the subject. More than 30 cancer vaccines are in Phase I and Phase II trials and six are currently in Phase III trials. Ribi Immunochem has filed an approval application for its melanoma vaccine, Melacine, which if approved will be the first tumour-specific therapeutic vaccine to be marketed worldwide.
Cytokines are secreted proteins that regulate, among other systems, the activities and interactions of cells of the immune system. They include interferons (IFNs), interleukins (ILs), colony-stimulating factors (CSFs) and tumour necrosis factor (TNF). IL-2 is marketed by Chiron as a recombinant form under the name of Proleukin for the treatment of advanced renal cell carcinoma. CSFs do not act directly on tumour cells but promote the production of blood cells from the bone marrow. They are used to restore bone marrow function following radio- or chemotherapy. Granulocyte colony-stimulating factor (G-CSF) is marketed as a recombinant form by Amgen under the name of Neupogen.
Early attempts to develop monoclonal antibodies (MAbs) for cancer therapy were unsuccessful but several products are now approaching the market. Once an antigen expressed by a cancer cell has been identified, a MAb specific to that antigen can be produced. It can then be injected into the bloodstream to target the tumour directly, either alone or linked to a radioactive isotope or chemotherapy drug. Rituximab was launched in the US in November 1997 for the treatment of non-Hodgkin's lymphoma and Bexxar is currently in Phase II/III trials for the same indication.
Hopes of improvement in survival times lie in improved methods of treating metastases. Angiogenesis inhibitors are drugs with the potential to inhibit the development of new tumour blood vessels thus preventing tumour growth. Matrix metalloproteinase inhibitors prevent the degradation of the extracellular matrix, an event which is necessary for the tumour to invade the surrounding tissue and metastasise. Two orally available inhibitors (AG-3340 and BAY-12-9566) are at a late stage of development.
Other approaches to cancer therapy and areas of drug development under investigation include gene therapy, antisense therapy, apoptosis stimulators, fusion toxins, signal transduction inhibitors and telomerase inhibitors. Drugs in these categories are in clinical trials but none as yet is ready for the market.
The worldwide market for anti-cancer drugs amounted to $11.7 billion in 1997 and is projected to reach $14.7 billion by 2000. North America, particularly the US, is the biggest market, accounting for $5.5 billion in 1997. Sales in the five major markets of Europe, Japan and North America are presented in Chapter 4, along with market projections to 2002.
The report contains 19 company profiles representing a cross section of the many companies marketing and developing cancer therapeutics. It includes market leaders and established companies with a significant interest in marketing and developing cancer therapeutics. The current market leader is Bristol-Myers Squibb with worldwide sales of $2,420 million, followed by Zeneca with sales of $1,400 million. There is also a selection drawn from new biotechnology companies developing novel approaches to the treatment and prevention of cancer.
CONTENTS
LIST OF TABLES
LIST OF FIGURES
EXECUTIVE SUMMARY
ABBREVIATIONS AND GLOSSARY
CHAPTER 1 INTRODUCTION
1.1 What is cancer?
1.2 The biology of cancer
1.2.1 Metastasis
1.2.2 Genes involved in human cancer
1.2.2.1 The p53 gene
1.3 What causes cancer?
1.3.1 Environmental causes
1.3.1.1 Tobacco
1.3.1.2 Diet
1.3.1.3 Physicochemical causes
1.3.1.4 Cancer and viruses
1.3.2 Familial cancers
1.4 Can cancer be prevented?
1.5 Cancer treatment
1.6 Types of cancer
1.6.1 Lung cancer
1.6.2 Stomach cancer
1.6.3 Colorectal cancer
1.6.4 Primary liver cancer
1.6.5 Breast cancer
1.6.6 Ovarian cancer
1.6.7 Cervical cancer
1.6.8 Endometrial cancer
1.6.9 Prostate cancer
1.6.10 Oesophageal cancer
1.6.11 Mouth cancer
1.6.12 Skin cancer
1.6.13 Bladder cancer
1.6.14 Lymphoma
1.6.15 Kidney cancer
1.6.16 Pancreatic cancer
1.6.17 Leukaemia
1.7 Chemoprevention
1.7.1 Breast cancer chemoprevention trials
1.7.2 The Prostate Cancer Prevention Trial
1.8 Cancer screening
1.9 The new WHO cancer programme
�
CHAPTER 2 CANCER THERAPY
2.1 Surgery
2.1.1 Laser surgery
2.2 Radiotherapy
2.2.1 Mechanism of action of radiotherapy
2.2.2 Radiotherapy in cancer treatment
2.2.3 Objectives of radiotherapy in the treatment of cancer
2.2.4 Integration of radiotherapy with surgery and chemotherapy
2.2.5 Adverse effects of radiotherapy
2.2.6 New approaches to radiotherapy
2.3 Photodynamic therapy
2.4 Chemotherapy
2.4.1 Treatment schedules
2.4.1.1 Combination therapy
2.4.2 Side effects
2.4.3 The cell cycle and chemotherapy
2.4.3.1 The cell cycle
2.4.4 Chemotherapeutic agents
2.4.4.1 Alkylating agents
2.4.4.2 Anti-metabolites
2.4.4.3 Anti-cancer antibiotics
2.4.4.4 Plant alkaloids
2.4.4.5 Taxoids
2.4.5 Drug resistance
2.4.5.1 Mechanisms of drug resistance
2.5 Novel drug delivery systems
2.5.1 Liposome-based drug delivery
2.5.2 Lipid-based drug delivery
2.5.3 Polymeric based drug delivery
2.5.3.1 Polymer-based drug delivery to the brain
2.6 Hormonal therapy
2.6.1 What are hormones?
2.6.2 Hormones and cancer
2.6.3 Endocrine cancer therapies
2.6.3.1 Steroid receptor antagonists
2.6.3.2 LHRH superagonists
2.6.3.3 Steroid agonists
2.6.3.4 Steroid synthesis inhibitors
2.7 Supportive care
2.7.1 The control of pain
2.7.2 Emesis
CHAPTER 3 CANCER BIOTHERAPY
3.1 Immunotherapy
3.1.1 The immune system
3.1.2 Cancer vaccines
3.1.2.1 Approach to vaccine development
3.1.2.2 Vaccines in development
3.1.2.3 Progress in melanoma vaccine development
3.1.3 Cytokines
3.1.3.1 Interferons
3.1.3.2 Interleukins
3.1.3.3 Tumour necrosis factor
3.1.3.4 Colony-stimulating factors
3.1.3.5 Immune system enhancers
3.1.4 Monoclonal antibodies
3.1.4.1 MAb directed tumour-activated prodrugs
3.2 Angiogenesis and angiogenesis inhibitors
3.3 Matrix metalloproteinases
3.4 Gene therapy
3.4.1 Tumour suppressor gene therapy
3.4.2 Suicide gene therapy
3.4.3 Immunomodulatory gene therapy
3.4.4 Gene therapy products in development
3.4.5 Some pre-clinical developments
3.5 Antisense technology
3.6 Apoptosis
3.7 Collateral targeting
3.8 Fusion toxins
3.9 Signal transduction inhibitors
3.10 Telomerase and telomerase inhibitors
3.10.1 Telomerase inhibitor development
3.11 Future prospects
CHAPTER 4 THE CANCER MARKET
4.1 World cancer statistics
4.1.1 The situation worldwide
4.1.2 Cancer in the US
4.1.3 Cancer in the European Union
4.1.4 Cancer in the UK
4.1.5 Cancer in Japan
4.1.6 Cancers of the brain and nervous system
4.1.7 Prostate cancer
4.2 Market shares and values
4.2.1 Companies and products
4.2.2 New market entrants
4.2.1.1 Chemotherapeutics and hormonal therapies
4.2.1.2 Biotherapies
CHAPTER 5 COMPANY PROFILES
5.1 Asta Medica AG
5.1.1 Agreements re cancer therapy
5.1.2 Financial highlights
5.1.3 Cancer products marketed and in development
5.2 Avax Technologies Inc
5.2.1 Financial highlights
5.2.2 Cancer products in development
5.3 Biomira Inc
5.3.1 Agreements re cancer therapy
5.3.2 Financial highlights
5.3.3 Cancer products in development
5.4 Bristol-Myers Squibb
5.4.1 Agreements re cancer therapy
5.4.2 Financial highlights
5.4.3 Cancer drugs marketed and in development
5.5 Cell Genesys
5.5.1 Agreements re cancer therapy
5.5.2 Financial highlights
5.5.3 Cancer drugs in development
5.6 Corixa Corporation
5.6.1 Agreements re cancer vaccine development
5.6.2 Financial highlights
5.7 Ligand Pharmaceuticals
5.7.1 Agreements re cancer therapy
5.7.2 Financial highlights
5.7.3 Cancer products in development
5.8 Eli Lilly and Company
5.8.1 Agreements re cancer therapy
5.8.2 Financial highlights
5.8.3 Cancer products marketed and in development
5.9 Matrix Pharmaceutical Inc
5.9.1 Financial highlights
5.9.2 Cancer drugs in development
5.10 Novartis Pharma AG
5.10.1 Agreements re cancer therapy
5.10.2 Financial highlights
5.10.3 Cancer drugs marketed and in development
5.11 Pharmacia & Upjohn
5.11.1 Agreements re cancer therapy
5.11.2 Financial highlights
5.11.3 Cancer products marketed and in development
5.12 Rhône-Poulenc Rorer Inc
5.12.1 Agreements re cancer therapy
5.12.2 Financial highlights
5.12.3 Cancer drugs marketed and in development
5.13 Ribi ImmunoChem Research Inc
5.13.1 Agreements re cancer therapy
5.13.2 Financial highlights
5.13.3 Cancer products in development
5.14 Schering-Plough Corp
5.14.1 Agreements re cancer therapy
5.14.2 Financial highlights
5.14.3 Cancer products marketed
5.14.4 Cancer products in development
5.15 Sequus Pharmaceuticals Inc
5.15.1 Agreements re cancer therapy
5.15.2 Financial highlights
5.15.3 Cancer products marketed and in development
5.16 Sugen Inc
5.16.1 Agreements re cancer therapy
5.16.2 Financial highlights
5.16.3 Cancer therapies in development
5.17 Takeda Chemical Industries Ltd
5.17.1 Financial highlights
5.17.2 Cancer drugs marketed and in development
5.18 Vion Pharmaceuticals Inc
5.18.1 Agreements re cancer therapy
5.18.2 Financial highlights
5.18.3 Products in development
5.19 Zeneca Group plc
5.19.1 Agreements re cancer therapy
5.19.2 Financial highlights
5.19.3 Anti-cancer drugs marketed and in development
DIRECTORY
REFERENCES �
LIST OF TABLES
Table 1.1 The number of cases and deaths worldwide for the eight most common cancers in 1996
Table 1.2 Screening techniques for common cancers
Table 2.1 Launched alkylating agents and other DNA targeting agents
Table 2.2 Alkylating agents and other DNA targeting agents in clinical development
Table 2.3 Topoisomerase inhibitors launched and in development
Table 2.4 Launched anti-metabolites
Table 2.5 Anti-metabolites in development
Table 2.6 Antibiotic chemotherapeutic agents marketed
Table 2.7 Anti-cancer antibiotics in clinical development
Table 2.8 Hormonal agents in clinical development and currently used for the treatment of hormonal-dependent cancers
Table 2.9 Analgesics for pain relief in cancer
Table 2.10 Emetogenic potential of chemotherapeutic agents
Table 2.11 Anti-emetic drugs used in conjunction with cancer chemotherapy
Table 3.1 Cells of the immune system
Table 3.2 Cancer vaccines in clinical development
Table 3.3 Launched cytokines marketed or in development for a cancer indication
Table 3.4 Cytokines in development for cancer therapy
Table 3.5 MAb cancer therapies in clinical development
Table 3.6 Angiogenesis inhibitors in clinical trials
Table 3.7 Matrix metalloproteinase inhibitors in development for the treatment of cancer
Table 3.8 Gene therapy products in clinical development
Table 3.9 Antisense compounds in clinical development
Table 3.10 Inhibitors and activators of apoptosis
Table 3.11 Regulators of apoptosis under investigation
Table 3.12 Drugs in development primarily as apoptosis stimulants
Table 3.13 Tyrosine kinase inhibitors in development
Table 4.1 The number of cases and deaths worldwide for the eight most common cancers in 1996
Table 4.2 1997 incidence estimates by cancer type for the major geographical regions
Table 4.3 Estimated incidence and death figures for the major types of cancer in the US in 1998
Table 4.4 US five-year relative survival rates from diagnosis for common cancers (%)
Table 4.5 Main sites of incident cases of the five major cancers in men and women in the European Union
Table 4.6 Incidence of common cancers in the European Union and selected countries
Table 4.7 Cancer mortality, major sites and selected European markets, 1993-1995
Table 4.8 Incidence and mortality data for the major cancers in Japan
Table 4.9 Primary cancers of the brain and nervous system, 1997
Table 4.10 Incidence of metastatic brain tumours in 1997
Table 4.11 The estimated worldwide incidence and mortality of prostate cancer in 1998
Table 4.12 Age-specific incidence of prostate cancer in selected world regions in 1998
Table 4.13 Age-specific prevalence of prostate cancer in selected world regions in 1998
Table 4.14 Worldwide sales of anti-cancer drugs in 1997 ($ million)
Table 4.15 Projected worldwide anti-cancer therapy market 1997�2002 ($ million)
Table 4.16 Projected anti-cancer therapy market for North America 1997�2002 ($ million)
Table 4.17 Projected anti-cancer therapy market for Europe 1997�2002 ($ million)
Table 4.18 Projected anti-cancer therapy market for Japan 1997�2002 ($ million)
Table 4.19 World sales of oncology products by major company in 1997
Table 4.20 Doxil sales and estimated sales 1996-2002
Table 4.21 Chemotherapeutic agents approaching the market
Table 4.22 Anti-cancer hormone therapies approaching the market
Table 5.1 Asta Medica's financial data, 1994-1997 ($ million)
Table 5.2 Sales by geographical region 1995-1997 ($ million)
Table 5.3 Cancer products marketed by Asta Medica
Table 5.4 Biomira's financial highlights 1995-1997 ($ million)
Table 5.5 Bristol-Myers Squibb's financial highlights 1995�1997 ($ million)
Table 5.6 Bristol-Myers Squibb's sales by region, 1995-1997 ($ million)
Table 5.7 Bristol-Myers Squibb's sales by therapeutic category, 1996�1997 ($ million)
Table 5.8 Sales of anti-cancer drugs 1996-1997 ($ million)
Table 5.9 Bristol-Myers Squibb's cancer drugs
Table 5.10 Bristol-Myers Squibb's cancer drugs in development.
Table 5.11 Cell Genesys' financial data for 1995�1997 ($ thousands)
Table 5.12 Corixa's financial data for 1996-1997 ($ thousands)
Table 5.13 Ligand's financial data 1995-1997 ($ thousands)
Table 5.14 Eli Lilly's financial highlights 1995-1997 ($ million)
Table 5.15 Sales by area ($ million) 1995-1997
Table 5.16 Sales by industry category ($ million) 1995-1997
Table 5.17 Matrix Pharmaceutical's financial highlights 1995-1997 ($ thousands)
Table 5.18 Matrix's products in development
Table 5.19 Novartis' financial highlights, 1996-1997 ($ million)
Table 5.20 Cancer drugs currently marketed
Table 5.21 Novartis' oncology development portfolio
Table 5.22 Pharmacia & Upjohn's financial highlights 1995-1997 ($ million)
Table 5.23 Sales of top selling oncology products 1996-1997 ($ million)
Table 5.24 Sales by geographical area 1996-1997 ($ million)
Table 5.25 Sales by business segment 1996-1997 ($ million)
Table 5.26 Pharma sales by indication, 1996-1997 ($ million)
Table 5.27 New products and new indications in the US and Europe
Table 5.28 Rhône-Poulenc Rorer's financial highlights, 1995�1997 ($ billion)
Table 5.29 Rhône-Poulenc Rorer's 1997 sales by geographic area
Table 5.30 Ribi Immunochem's financial data 1996�1997 ($ million)
Table 5.31 Schering-Plough's financial highlights in 1996 and 1997 ($ million)
Table 5.32 Sales by geographical area in 1996 and 1997 ($ million)
Table 5.33 Sales by business segment in 1996 and 1997 ($ million)
Table 5.34 Pharmaceutical sales by category in 1996 and 1997 ($ million)
Table 5.35 Sales of leading products in 1996 and 1997 ($ million)
Table 5.36 Sequus' financial highlights 1995�1997 ($ thousands)
Table 5.37 Sugen's financial highlights 1995�1997 ($ million)
Table 5.38 Tyrosine kinase inhibitors in development for the treatment of cancer
Table 5.39 Takeda's financial highlights for 1995�1997 ($ million)
Table 5.40 Takeda's leading products for 1997 ($ million)
Table 5.41 Vion's financial data, 1997 ($ million)
Table 5.42 Zeneca's financial figures 1995�1997 ($ million)
Table 5.43 Zeneca's geographic markets in 1996�1997 ($ million)
Table 5.44 Zeneca's sales by division in 1996�1997 ($ million)
Table 5.45 Zeneca's sales by therapeutic category in 1996�1997 ($ million)
Table 5.46 Zeneca's leading products in 1997 ($ million)
Table 5.47 Zeneca's key oncology products in 1997 ($ million)
Table 5.48 Zeneca's anti-cancer drugs
Table 5.49 Zeneca's anti-cancer drugs: development portfolio
�
LIST OF FIGURES
Figure 1.1 Distribution of deaths by main causes in developed countries in 1997
Figure 1.2 Distribution of deaths by main causes in developing countries in 1997
Figure 1.3 The mechanisms of tumour metastasis
Figure 2.1 The cell cycle
Figure 2.2 How resistance develops during cancer therapy
Figure 4.1 The number of cases and deaths worldwide for the eight most common cancers in 1996
Figure 4.2 1997 incidence estimates by cancer type for the major geographical regions
Figure 4.3 Global distribution of the anti-cancer drug market in 1997
Figure 4.4 Global distribution of the cytotoxic drug market in 1997
Figure 4.5 Global distribution of the cytostatic hormone therapy market in 1997
Figure 4.6 Global distribution of the market for immunostimulating agents in 1997
Figure 4.7 Global distribution of the market for immunosuppressive agents in 1997
Published: November 1998
Ref: BS977E
Pages: 150+
Price: £520/$1,095/¥125,000
© PJB Publications Ltd. 2001 All rights reserved. |