ABOUT DATAMONITOR HEALTHCARE 2
About the Oncology pharmaceutical analysis team 2

CHAPTER 1 EXECUTIVE SUMMARY 3
Strategic scoping and focus 3
Datamonitor insight into the molecular targeted cancer therapies market 3
Related reports 5
Upcoming related reports 5

CHAPTER 2 MARKET DEFINITION 7
Market definition for this report 7
Molecular targeted cancer therapies by ATC class 7

CHAPTER 3 MARKET OVERVIEW 9
Seven major markets 9
Current and future market overview 9
Molecular targeted cancer therapies represent the top-selling class of anticancer therapy and will continue to achieve high growth to 2018 9
Approvals in new indications will result in significant expansion of the treatable cancer population who receive molecular targeted therapies 11
Higher growth in the five major European markets and Japan will reduce the dominance of the US market over the forecast period 13
Antineoplastic monoclonal antibodies account for the majority of molecular targeted cancer therapy sales 14
Roche's monoclonal antibody franchise dominated the market in 2008 and will continue to do so through to 2018 16
Opportunities and threats 20
Opportunities 20
Threats 25
US 28
Current and future market assessment 28
Growth of the US molecular targeted cancer therapies market will slow in comparison to Japan and the five major European markets 28
Monoclonal antibodies account for 69% of sales in the US market and will remain the leading class in 2018 29
Avastin will remain the leading molecular targeted cancer therapy brand in the US in 2018, with sales of $6.7 billion 30
Opportunities and threats 33
Opportunities 33
Threats 34
Japan 36
Current and future market assessment 36
Molecular targeted cancer therapy sales currently lag behind cytotoxics but will grow at a high rate between 2008 and 2018 36
The pattern of sales by drug class in Japan will resemble the other major markets more closely by 2018 37
Avastin will overtake Gleevec to become the leading molecular targeted cancer therapy brand in Japan by 2018 38
Opportunities and threats 41
Opportunities 41
Threats 42
Five major European markets (5EU) 45
Current and future market assessment 45
Molecular targeted cancer therapy sales will grow at a higher rate than in the US between 2008 and 2018 45
Monoclonal antibodies represent the leading class of molecular targeted cancer therapy in the five major European and markets and will remain so in 2018 46
Avastin will become the leading molecular targeted cancer therapy brand in the five major European markets by 2018 47
Opportunities and threats 50
Opportunities 50
Threats 53
France 56
Current and future market assessment 56
France will remain the second largest market for molecular targeted cancer therapies in the seven major markets in 2018 56
Germany 60
Current and future market assessment 60
Pricing freedom in Germany has driven high sales of molecular targeted cancer therapies, making it Europe's second largest market 60
Italy 64
Current and future market assessment 64
Sales of molecular targeted cancer therapies in Italy will grow at a CAGR of 12.0% from $1.0 billion in 2008 to $3.2 billion in 2018 64
Spain 67
Current and future market assessment 67
Sales of molecular targeted cancer therapies in Spain will grow at a CAGR of 12.1% from $0.9 billion in 2008 to $3.1 billion in 2018 67
UK 70
Current and future market assessment 70
NICE will continue to restrict sales of molecular targeted cancer therapies in the UK through to 2018 70
Rest of the world snapshot 74
Current market assessment 74
Rest of the World sales represent 18% of the global molecular targeted cancer therapies market 74
Sales of molecular targeted cancer therapies in the Rest of the World are highest in Canada, although China could become a key market by 2018 76
Opportunities and threats 77
Opportunities 77
Threats 77

CHAPTER 4 BRAND DYNAMICS 79
Overview of competitive landscape 79
Avastin, Rituxan and Herceptin will maintain their 2008 position as the top 3 molecular targeted cancer therapy brands in 2018 79
Drivers of brand choice 80
Efficacy and toxicity of a drug are the most important drivers of molecular targeted cancer therapy brand choice 80
Trends in marketing strategies 82
Marketing strategy for leading brands 82
Leading molecular targeted cancer therapy brands 84
Avastin (bevacizumab; Roche/Chugai) 84
Drug profile 85
Product positioning 85
SWOT analysis 86
Brand forecast to 2018 87
Rituxan (rituximab; Biogen Idec/Roche/Chugai/Zenyaku Kogyo) 90
Drug profile 91
Product positioning 91
SWOT analysis 92
Brand forecast to 2018 93
Herceptin (trastuzumab; Roche/Chugai) 95
Drug profile 96
Product positioning 96
SWOT analysis 97
Brand forecast to 2018 98
Gleevec (imatinib; Novartis) 100
Drug profile 101
Product positioning 101
SWOT analysis 102
Brand forecast to 2018 103
Erbitux (cetuximab; Eli Lilly/Bristol-Myers Squibb/Merck KGaA) 105
Drug profile 106
Product positioning 106
SWOT analysis 107
Brand forecast to 2018 108

CHAPTER 5 KEY DEVELOPERS 111
Strategic overview 111
Trends in corporate strategy 112
Developers of molecular targeted cancer therapies have turned their attention to indication expansion across multiple tumor types 112
Partnership with a large company has been a successful strategy for several small developers of molecular targeted cancer therapies 113
Roche 114
Corporate strategy 114
Roche's trio of monoclonal antibodies will allow it to maintain its leading position in the molecular targeted therapies market to 2018 114
Molecular targeted cancer therapies portfolio assessment 115
Roche's diverse portfolio of pipeline molecular targeted cancer therapies will further help to consolidate its hold of the market 115
Novartis 117
Corporate strategy 117
Novartis's success in the molecular targeted cancer therapies stems from the pursuit of a niche indication 117
Molecular targeted cancer therapies portfolio assessment 118
Novartis's portfolio shows both a continuing commitment to niche indications as well as an increasing focus on higher incidence tumor types 118
Portfolio assessment of other leading companies 120
Strategy overview 120
Big Pharma companies are turning to biologics in order to maintain their presence in the oncology market 120

CHAPTER 6 CASE STUDIES 124
Embracing companion diagnostics will enhance the commercial potential of molecular targeted cancer therapies 124
Herceptin: companion diagnostics can help a company to establish and dominate a market segment 127
Erbitux/Vectibix: companion diagnostics will offset negative impact of label restriction and facilitate indication expansion 128
Erbitux: companion diagnostics are useful in demonstrating cost-effectiveness 129
Iressa: companion diagnostics set to play an important role in the turnaround of a troubled drug's fortunes 129

BIBLIOGRAPHY 131
Journal papers 131
Websites 134
Datamonitor reports 138
Other 140

APPENDIX A - MARKET ASSUMPTIONS 142
New product launches 142
Patent expiries 142
Data definitions, limitations and assumptions 144
Standard units 144
Japanese market data 144
Rest of the World 144
Derivation of sales forecasts and pricing trends 144
Forecast methodology 145
Report methodology 145

APPENDIX B 146
About Datamonitor 146
About Datamonitor Healthcare 146
About the Oncology analysis team 147
Disclaimer 148

List of Tables
Table 1: Definition of the molecular targeted therapies market, 2009 7
Table 2: Sales and growth of molecular targeted cancer therapy drug classes in the seven major markets, 2008-2018 10
Table 3: Key events impacting the molecular targeted cancer therapies market, 2008-2018 11
Table 4: Top 5 branded molecular targeted cancer therapies in the seven major markets in 2008 and 2018 17
Table 5: Molecular targeted cancer therapy sales forecasts in the seven major markets ($m), 2008-2018 18
Table 6: Summary of opportunities and threats impacting the molecular targeted cancer therapies market across the seven major markets, 2009-2018 20
Table 7: Sales and growth of molecular targeted cancer therapy drug classes in the US, 2008-2018 28
Table 8: Top 5 branded molecular targeted cancer therapies in the US in 2008 and 2018 30
Table 9: Molecular targeted cancer therapy sales forecasts in the US ($m), 2008-2018 31
Table 10: Summary of opportunities and threats impacting the molecular targeted cancer therapies market in the US, 2009-2018 33
Table 11: Sales and growth of molecular targeted cancer therapy drug classes in Japan, 2008-2018 36
Table 12: Top 5 branded molecular targeted cancer therapies in Japan in 2008 and 2018 38
Table 13: Molecular targeted cancer therapy sales forecasts in Japan major markets ($m), 2008-2018 39
Table 14: Summary of opportunities and threats impacting the molecular targeted cancer therapies market in Japan, 2009-2018 41
Table 15: Sales and growth of molecular targeted cancer therapy drug classes in the five major European markets, 2008-2018 45
Table 16: Top 5 branded molecular targeted cancer therapies in the five major European markets in 2008 and 2018 47
Table 17: Molecular targeted cancer therapy sales forecasts in the five major European markets ($m), 2008-2018 48
Table 18: Summary of opportunities and threats impacting the molecular targeted cancer therapies market in the five major European markets, 2009-2018 50
Table 19: Top 5 branded molecular targeted cancer therapies in France in 2008 and 2018 57
Table 20: Molecular targeted cancer therapy sales forecasts in France ($m), 2008-2018 58
Table 21: Top 5 branded molecular targeted cancer therapies in Germany in 2008 and 2018 61
Table 22: Molecular targeted cancer therapy sales forecasts in Germany ($m), 2008-2018 62
Table 23: Top 5 branded molecular targeted cancer therapies in Italy in 2008 and 2018 65
Table 24: Molecular targeted cancer therapy sales forecasts in Italy ($m), 2008-2018 65
Table 25: Top 5 branded molecular targeted cancer therapies in Spain in 2008 and 2018 68
Table 26: Molecular targeted cancer therapy sales forecasts in Spain ($m), 2008-2018 68
Table 27: Top 5 branded molecular targeted cancer therapies in the UK in 2008 and 2018 71
Table 28: Molecular targeted cancer therapy sales forecasts in the UK ($m), 2008-2018 72
Table 29: Comparison of molecular targeted cancer therapy drug class sales ($m) in the seven major markets and Rest of the World, 2008 75
Table 30: Comparison of molecular targeted cancer therapy sales ($m) in the BRIC countries, Australia and Canada, 2008 76
Table 31: Branded molecular targeted cancer therapy drug sales in the seven major markets ($m), 2008-2018 79
Table 32: Marketing strategies employed by the companies behind the top four molecular targeted cancer therapy brands, 2009 83
Table 33: Avastin - drug profile, 2009 85
Table 34: Impacting factors on the revenues of Avastin, 2009-2018 88
Table 35: Rituxan - drug profile, 2009 91
Table 36: Impacting factors on the revenues of Rituxan, 2009-2018 94
Table 37: Herceptin - drug profile, 2009 96
Table 38: Impacting factors on the revenues of Herceptin, 2009-2018 99
Table 39: Gleevec - drug profile, 2009 101
Table 40: Impacting factors on the revenues of Gleevec, 2009-2018 104
Table 41: Erbitux - drug profile, 2009 106
Table 42: Impacting factors on the revenues of Erbitux, 2009-2018 109
Table 43: Leading companies in the molecular targeted cancer therapies market by sales in the seven major markets, 2008-2018 111
Table 44: Assessment of Roche's molecular targeted cancer therapies portfolio, 2009 115
Table 45: Assessment of Novartis's molecular targeted cancer therapies portfolio, 2009 118
Table 46: Assessment of Bristol-Myers Squibb's molecular targeted cancer therapies portfolio, 2009 121
Table 47: Assessment of Celgene's molecular targeted cancer therapies portfolio, 2009 122
Table 48: Assessment of Pfizer's molecular targeted cancer therapies portfolio, 2009 123
Table 49: Commercially available companion diagnostics for molecular targeted cancer therapies, 2009 126
Table 50: Regional launch dates for new molecular targeted therapies in the seven major markets, 2008-2018 142
Table 51: Patent expiry dates for the approved molecular targeted cancer therapies in the seven major pharmaceutical markets, 2008-2018 143