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Cancer testing is one of the most important growth opportunities for the next three to five years in the diagnostics segment. The National Cancer Institute estimates that about ten million Americans have or have had some form of cancer. Overall costs of the disease are $126 billion annually. Pharmaceutical companies are developing more than 300 new medicines for cancer, some of which are in development for more than one type of the disease, for a total of more than 500 ongoing R&D projects. The goal of this TriMark Publications report is to review the market for tumor marker testing equipment and supplies using screening reagents and instruments for analysis of individual components in blood, serum or plasma. It defines the dollar volume of sales, both worldwide and in the U.S., and analyzes the factors that influence the size and the growth of the market segments. Also examined are the subsections of each market segment, including: the physician office labs, hospital labs and commercial laboratories. Additionally, the numbers of institutions using this type of testing and the factors that influence purchases are discussed. The report surveys almost all of the companies known to be marketing, manufacturing or developing instruments and reagents for the clinical point-of-care market in the U.S. Each company is discussed in depth with a section on its history, product line, business and marketing analysis, and a subjective commentary of the company's market position.
By Purchasing This Report You Will Have: · An improved understanding of the current state and future of the cancer diagnostic testing market. · The latest information on the leading companies engaged in research and development and products in the pipeline. · The leading perspective of recent cancer diagnostic developments and revelations. · Knowledge of the cancer diagnostics market as an area of growth, research and investment. Analysis includes the use of charts and graphs measuring product growth and trends within the marketplace. In addition, a discussion of research into the cancer diagnostics arena provides the reader with a deeper understanding of the possibilities for future treatment and avenues for possible research and development budgets. Company-specific information, including sales figures, product pipeline status and research and development trends is provided throughout the report. The report will: · Identify viable technology drivers through a comprehensive look at platform technologies for cancer diagnostics, including, probe-based nucleic acid assays, microarrays and sequencing. · Obtain a complete understanding of the chief cancer diagnostics tests-i.e., predictive, screening, prognostic, monitoring, pharmacogenomic and theranostic-from their basic principles to their applications. · Discover feasible market opportunities by identifying high-growth applications in different clinical diagnostic areas, focusing on the biggest and expanding markets in oncology. · Focus on global industry development through an in-depth analysis of the major world markets for cancer diagnostics, including growth forecasts. This report answers the following questions in this report: · What are the near-term business opportunities in the cancer diagnostics market? · What are the current and forecasted sizes of the cancer diagnostics market? · What are the business models currently used by companies in cancer diagnostics? · How will manufacturers, researchers, physicians, patients and payers influence the cancer diagnostics market? · What are the drivers and bottlenecks influencing the cancer diagnostics market? · What are the technologies used in the cancer diagnostics sector? · Who holds the proprietary rights to cancer diagnostics market technology? · What are current applications of this technology? · What regulatory processes must cancer diagnostics undergo in the United States, Japan and Europe? · How will new cancer diagnostics change treatment and payment paradigms? · How will cancer diagnostic testing reduce healthcare expenditures?
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Table of Contents:
- 1. Overview 8
- 1.1 Statement of Report 8
- 1.2 About This Report 8
- 1.3 Scope of the Report 9
- 1.4 Objectives 10
- 1.5 Methodology 10
- 1.6 Executive Summary 11
- 2. Introduction to Cancer Biology and the Diagnostic Industry 14
- 2.1 Cancer 14
- 2.1.1 The Disease 14
- 2.1.2 Metastasis 14
- 2.1.3 Demographics and Statistics of Cancer 14
- 2.2 The Drivers of the Biotech and Diagnostics Industry 19
- 2.2.1 Technological Innovation 20
- 2.2.2 Government Funding 21
- 2.3 Outlook for Tumor Markers 21
- 3. Tumor Markers Market Segment Analysis: Size, Growth and Share 23
- 3.1 Market Description 24
- 3.2 Clinical Diagnostic Serum Based Cancer Markers 31
- 3.3 PSA Testing Market Size 32
- 3.4 DNA Markers 33
- 3.5 Serum Proteins 33
- 3.6 Enzymes 34
- 3.7 Occult Blood 34
- 3.8 Histology and In Situ Hybridization (ISH) 35
- 3.9 Cervical Cytology 36
- 3.10 Immunohistochemistry 38
- 3.11 In Vivo Detection Cancer Products 39
- 3.12 Radionuclides and X-Ray Detection Products 39
- 3.13 Human Papillomavirus (HPV) Testing 39
- 3.14 Bladder Cancer Testing 43
- 3.15 Tumor Assays for Adjuvant Chemotherapy 46
- 4. Diagnostic Methods for Cancer Detection 59
- 4.1 Organ Specific Tumor Markers 59
- 4.1.1 Colon Cancer 59
- 4.1.2 Prostate Cancer 66
- 4.1.3 Pancreatic Cancer 83
- 4.1.4 Breast Cancer 85
- 4.1.5 Ovarian Cancer 94
- 4.1.6 Cervical Cancer 99
- 4.1.7 Lung Cancer 101
- 4.1.8 Testicular Cancer 106
- 4.1.9 Bladder Cancer 106
- 4.1.10 Hepatic Cancer 112
- 4.1.11 Stomach Cancer 114
- 4.1.12 Malignant Melanoma 115
- 4.1.13 Acute Myeloid Leukemia (AML) and Acute Lymphoblastoid Leukemia (ALL) 115
- 4.1.14 Lymphoma 116
- 4.2 Clinical Laboratory Methods for Measuring Tumor Markers 117
- 4.2.1 Abbott Diagnostics AxSYM 117
- 4.2.2 Roche Diagnostics Elecsys 117
- 4.2.3 Beckman Coulter Diagnostics Access 117
- 4.2.4 Bayer Diagnostics ADVIA Centaur 118
- 4.2.5 Dade Diagnostics Stratus 118
- 4.2.6 Diagnostic Products Corporation Immulite 118
- 4.2.7 Tosoh Medics A1A 119
- 4.2.8 CIS bio International Kryptor 120
- 4.2.9 Ortho-Clinical Diagnostics Vitros ECiQ 120
- 4.2.10 Fujirebio Diagnostics, Inc. 120
- 4.2.11 bioMérieux Vidas 121
- 4.2.12 Eisai Picolumi 121
- 4.2.13 Tosoh Medics, Inc. 121
- 4.3 New Technologies for Cancer Diagnostics 122
- 4.3.1 New and Improved Immunoassays 122
- 4.3.2 Immunohistochemical Tests 123
- 4.3.3 Molecular (DNA and Genomic) Diagnostic Assays 124
- 4.3.4 Genomics and Genetic Markers 125
- 4.3.5 Proteomics and New Protein Markers 126
- 4.3.5.1 Inside the ProteinChip System 126
- 4.3.5.2 Rapid Biological Assays on a Chip 126
- 4.3.5.3 Proteome Pattern Recognition 127
- 4.3.6 New Platform Technologies Including Flow Cytometry 127
- 4.3.7 Stem Cell Markers 130
- 4.3.8 Monoclonal Antibodies 130
- 4.3.9 Proteomics and Cancer Antibodies 134
- 4.3.10 Pharmacogenomics and Oncology Diagnostics 134
- 4.3.11 DNA Microarrays 137
- 4.3.12 In Vitro Diagnostic Multivariate Index Assays (IVDMIA) 139
- 4.3.13 Prostate PX Score 139
- 4.3.14 Prostate-63 139
- 4.3.15 Future Directions 139
- 4.4 Clinical Methods for Diagnosis of Cancer 140
- 4.4.1 Screening 140
- 4.4.2 Sigmoidoscopy 142
- 4.4.3 Imaging 142
- 4.4.4 Theranostics 144
- 5. Implications of Molecular Biology for New Diagnostic Cancer Tests 145
- 6. Companies Entering the Cancer Diagnostics Market with Novel Technology Platforms 146
- 6.1 Abbott Diagnostics 146
- 6.2 Affymetrix, Inc. 147
- 6.3 Agendia BV 148
- 6.4 Agensys, Inc. 148
- 6.5 Ambrilla Biopharma, Inc. 149
- 6.6 AMDL, Inc. 149
- 6.7 Asuragen, Inc. 151
- 6.8 Aureon Biosciences Corporation 151
- 6.9 Bard Diagnostics, Inc. 151
- 6.10 Bayer Diagnostics 152
- 6.11 Beckman Coulter, Inc. 152
- 6.12 Biocode S.A. 154
- 6.13 BioCurex 154
- 6.14 Biomedical Diagnostics 154
- 6.15 Biomerica 155
- 6.16 bioMérieux 155
- 6.17 Biomira 155
- 6.18 BioModa, Inc. 156
- 6.19 Bruker Daltonics 156
- 6.20 Byk Gulden 156
- 6.21 Cepheid 156
- 6.22 Clarient, Inc. 157
- 6.23 CytoCore (Formerly known as Molecular Diagnostics, Inc.) 159
- 6.24 Correlogic Systems, Inc. 159
- 6.25 Cytogen Corporation 159
- 6.26 diaDexus, LLC 162
- 6.27 DiagnoCure, Inc. 163
- 6.28 Diagnostic Products Corporation 164
- 6.29 Diagnostic Systems Laboratories, Inc. 164
- 6.30 DRG International, Inc. 164
- 6.31 Eisai Co., Ltd. 165
- 6.32 Enigma Diagnostics Ltd. 166
- 6.33 Epigenomics 166
- 6.34 Exact Sciences Corporation 166
- 6.35 Exagen Diagnostics, Inc. 167
- 6.37 Gene Logic, Inc. 167
- 6.38 Gen-Probe, Inc. 168
- 6.39 Genomic Health 168
- 6.40 Geron Corporation 169
- 6.42 Immunicon Corporation 170
- 6.43 Immunomedics, Inc. 174
- 6.44 Incyte Pharmaceuticals, Inc. 175
- 6.45 Ipsogen 175
- 6.46 LabCorp 175
- 6.47 Matritech 176
- 6.48 Mitsubishi Kagaku Medical 180
- 6.49 Molecular Devices (Formerly known as Arcturus Bioscience, Inc.) 180
- 6.50 Myriad Genetics, Inc. 180
- 6.51 Poniard Corporation 185
- 6.52 Nexell Therapeutics, Inc. 186
- 6.53 Northwest Biotherapeutics, Inc. 186
- 6.54 Nuvelo, Inc. 187
- 6.55 Panacea Pharmaceuticals, Inc. 187
- 6.56 Oncotech, Inc. 188
- 6.57 Polymedco, Inc. 189
- 6.58 Princeton BioMeditech Corporation 189
- 6.59 Qiagen 191
- 6.60 Sanko Junyaku Co., Ltd. 192
- 6.61 Tosoh Medics, Inc. 192
- 6.62 TriPath Imaging, Inc. 192
- 6.63 UroCor, Inc. 194
- 6.64 Ventana Medical Systems, Inc. 198
- 6.65 Veridex 199
- 6.66 Vermillion, Inc. (Formerly known as Ciphergen) 199
- 6.67 Worldwide Medical Corporation 200
- 6.68 Xenomics, Inc. 200
- 7. Business Trends in the Industry 201
- 7.1 Industry Consolidation 201
- 7.2 Breadth of Product Offering and Pricing 201
- 7.3 Government Regulation of Medical Devices 202
- 7.4 Strategic Business and Marketing Considerations 203
- 7.5 Commercial Opportunities in Cancer Markers 204
- 7.6 Moderators of Growth 205
- 7.7 Biotechnology Industry Trends 205
- 7.8 Pharmaceutical Industry Trends 206
- 7.9 Acquisition, License Agreement, Partnerships 208
- 7.10 Legal Developments 210
- 7.11 Sales and Marketing Strategies for Tumor Marker Tests 211
- 7.11.1 North American Market 212
- 7.11.2 International Markets 213
- 7.11.2.1 Europe 213
- 7.11.2.2 Central and South America 214
- 7.11.2.3 Asia/Pacific 214
- 8. Tumor Marker Testing: Important Issues 215
- 8.1 Trends in Patient Care and Reimbursement 215
- 8.2 Trends in Reimbursement Practice 216
- 8.3 Clinical Laboratory Improvement Act (CLIA) 218
- 8.4 Unmet Needs in Tumor Markers 219
- 9. Important New Technology Areas 220
- 9.1 Proteins 220
- 9.2 DNA Sequencing 221
- 9.3 The Human Genome Project (HGP) 222
- 9.4 Liquid Phase Chromatography 223
- 9.5 Polymerase Chain Reaction (PCR) 223
- 9.6 Capillary Electrophoresis 224
- 9.7 Proteomics 225
- 9.8 Use of Mass Spectroscopy in Sequencing 226
- 9.9 High-Throughput Organic Synthesis 230
- 10. New Cancer Markers in Basic Research 232
- 10.1 Genetics of Cancer 232
- 10.2 Telomerase 235
- 10.3 Stomach Cancer 237
- 10.4 Head and Neck Cancer 238
- 10.5 Breast Cancer 239
- 10.6 Prostate Cancer: p27 (Kip1) A New Molecular Marker for Prostate Cancer 240
- 10.7 PSMA 241
- 10.8 Cervical Cancer: NMPI79 242
- 10.9 Pancreatic Cancer: Peritoneal Cytology 242
- 10.10 Colorectal Cancer: CEA Doubling Time 242
- 10.11 Uterine and Kidney Cancer: MN/CA9 242
- 10.12 MMSC1 Scaffold Gene 242
- 10.13 p16 Tumor Suppressor Gene 243
- 10.14 MTS2 and p19 Cell Cycle Genes 243
- 10.15 Complement Factor H Related Proteins 243
- 10.16 MUC 2, 3, 4 243
- 10.17 Cytokeratins 244
- 10.18 Colon Cancer: Serum VEGF 244
- 10.19 Ras Oncogenes 244
- 10.20 Lung Cancer: Ribonucleoprotein A2/B1 245
- 10.21 BCLA-4 Matrix Protein 245
- 10.22 RAK Antigens 245
- 10.23 Serum Urokinase Receptors 245
- 10.24 Chips 246
- 10.25 Survivin 246
- 10.26 Human Endometrial Specific Steroid Binding Factor (hESF1) 246
- 10.27 Reg-4 Protein 247
- 10.28 Nox-1 247
- 10.29 PSP94 Binding Protein 247
- 10.30 Ettan DIGE Technology 247
- 10.31 YKL-40 248
- 10.32 AFP-L3 248
- 10.33 DNA Methylation Technology 248
- 10.34 Transthyretin and Apolipoprotein A1 248
- 10.35 ADAM 12 249
- 10.36 Ovarian Cancer: Vermillion's SELDI-based ProteinChip 249
- 10.37 Lung Cancer: Labeled Porphyrin Binding 249
- 10.38 C-MAP, A Cervical Cancer Screening System 249
- 10.39 Lung Cancer: Pro-Gastrin-Releasing Peptide (ProGRP) 249
- 10.40 Prostate Cancer: PCA3 249
- 10.41 Bladder Cancer: ImmunoCyt/uCyt+ 252
- 10.42 Shc Proteins 252
- 10.43 Oncology Biomarker Qualification Initiative 252
- 10.44 Anti-Glycan Antibodies 253
- 11. Market Trends and Forecasts 254
- 11.1 Ultrasensitive Cancer Tests 254
- 11.2 Mergers and Acquisitions of Diagnostic Companies 255
- 11.3 RT-PCR 255
- 11.4 Genetic Tests of Hereditary Cancer Risk 256
- 11.5 DNA Measurements 256
- 11.6 Technical and Practical Issues for Potential New Markers 256
- 11.7 Genetic Profiling 257
- 11.8 Ploidy 258
- 11.9 Advances in Sputum Analysis for Screening and Early Detection of Lung Cancer 258
- 11.10 Pharmacogenetic Tests for Cancer 259
- 11.11 Worldwide Healthcare Spending 260
- 11.12 R&D Expenditures 260
- Appendix 1: Web Links 261
- Appendix 2: Cancer Information Resources 263
- Appendix 3: Colon Cancer Staging 264
- Appendix 4: Reimbursement for Tumor Marker Testing 265
- Appendix 5: The Pathology of Prostate Cancer 267
- Appendix 6: Government Regulation of Tumor Marker Tests 269
- Appendix 7: The Clinical Laboratory Improvement Act (CLIA) 271
- Appendix 8: Marketers of Occult Blood Diagnostic Test Kits 273
- INDEX OF FIGURES
- Figure 4.1: Model of Colorectal Cancer Development 61
- Figure 4.2: ASCO-CAP Guidelines for HER2 Testing in Breast Cancer: Equivocal Results with IHC 90
- Figure 4.3: ASCO-CAP Guidelines for HER2 Testing in Breast Cancer: Results by FISH 91
- Figure 4.4: The BTA stat Test vs. Cytology 111
- Figure 6.1: Qiagen Global Sales 192
- Figure 10.1: Estimates for PCA3 Test Volume in U.S., 2005-2008 251
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- INDEX OF TABLES
- Table 2.1: Organ-Specific Medicines in Development for Cancer, 2007 15
- Table 2.2: Estimates for the Leading Sites of New Cancer Cases and Deaths in the U.S. by Sex 16
- Table 2.3: Estimated Worldwide Number of New Cancer Cases and Deaths by Type of Cancer 16
- Table 2.4: Estimated Number of New Cancer Cases and Deaths by Region 17
- Table 2.5: Cancer Death Rates per 100,000 Population (and Rank) for all Cancer Sites by Country 18
- Table 2.6: Cancer Associated Genes 18
- Table 2.7: Carcinogens in the Workplace 19
- Table 2.8: Private Funding Levels for the Biotechnology Segment, 1995-2006 20
- Table 2.9: Herceptin Worldwide Sales, 2000-2007 21
- Table 2.10: Classes of Drugs Used to Treat Breast Cancer 22
- Table 3.1: In Vitro Cancer Marker Market Segments Worldwide, 2001 and 2007 24
- Table 3.2: Tumor Markers Currently in Common Use 26
- Table 3.3: Global IVD Cancer Tumor Marker Testing Market Segments Projected Growth Rates, 2005-2010 28
- Table 3.4: Worldwide Market Size in Dollar Volume for Tumor Marker Assays Product Market, 2001-2010 28
- Table 3.5: U.S. Market Size in Dollar Volume for Tumor Marker Assays Product Market, 2001-2010 28
- Table 3.6: Worldwide In Vitro Cancer Tumor Marker Diagnostics Market Size, 2001-2010 29
- Table 3.7: U.S. In Vitro Cancer Tumor Marker Diagnostics Market Size, 2001-2010 29
- Table 3.8: Japanese In Vitro Cancer Tumor Marker Diagnostics Market Size, 2001-2010 30
- Table 3.9: European In Vitro Cancer Tumor Marker Diagnostics Market Size, 2001-2010 30
- Table 3.10: Global Distribution of IVD Cancer Tumor Marker Diagnostic Testing, 2005 30
- Table 3.11: Estimated Market Share of Major Competitors in U.S. Cancer Tumor Marker Diagnostics Market 31
- Table 3.12: Major Presence in Cancer Tumor Marker Diagnostics Markets 31
- Table 3.13: Worldwide PSA Sales, 2000-2010 32
- Table 3.14: U.S. PSA Sales, 2000-2010 33
- Table 3.15: Serum Markers Used Clinically 33
- Table 3.16: ASCO-CAP Guidelines for HER-2 Testing in Breast Cancer 38
- Table 3.17: Drivers of IHC Growth 39
- Table 3.18: Bladder Cancer Testing Efforts in the U.S. and Germany 43
- Table 3.19: Worldwide Bladder Cancer Marker Sales, 2001-2010 45
- Table 3.20: U.S. Bladder Cancer Marker Sales, 2001-2010 45
- Table 3.21: Worldwide NMP22 Sales, 2001-2010 46
- Table 3.22: Current Breast Cancer Product and Product Opportunities 54
- Table 3.23: Products in Various Stages of Development for Cancers Other than Breast Cancer 55
- Table 4.1: Colorectal Cancer Stages 60
- Table 4.2: Worldwide CEA Sales, 2001-2010 62
- Table 4.3: U.S. CEA Sales, 2001-2010 62
- Table 4.4: Population Statistics of Serum Levels of PSA in Men Over 50 Years of Age 71
- Table 4.5: PSA Doubling Time and Time to Reach PSA of 1,000 72
- Table 4.6: PSA Doubling Times 72
- Table 4.7: Worldwide CA-19-9 Sales, 2001-2010 84
- Table 4.8: U.S. CA-19-9 Sales, 2001-2010 84
- Table 4.9: CA-19-9 Levels in Management of Pancreatic Cancer 85
- Table 4.10: Worldwide CA-15-3 Sales, 2001-2010 86
- Table 4.11: U.S. CA-15-3 Sales, 2001-2010 86
- Table 4.12: TPA Marker Sensitivity 88
- Table 4.13: ASCO-CAP Guidelines for HER2 Testing in Breast Cancer: How to Interpret Test Results 89
- Table 4.14: Siemens Oncogene Science Biomarker Group Reagents 92
- Table 4.15: Worldwide CA-125 Sales, 2001-2010 95
- Table 4.16: U.S. CA-125 Sales, 2001-2010 96
- Table 4.17: Number of Pap Smears Performed by Country 101
- Table 4.18: Lung Cancer Survival Rates 102
- Table 4.19: Lung Cancer Facts 103
- Table 4.20: Patient Category Applications 108
- Table 4.21: Worldwide AFP Marker Sales, 2001-2010 113
- Table 4.22: U.S. AFP Cancer Marker Sales, 2001-2010 114
- Table 4.23: Potential Uses of Molecular Diagnostics in Cancer Management 124
- Table 4.24: Colorectal Cancer Monoclonal Antibody Imaging Kits 132
- Table 6.1: Product Sales as a Percent of Total Product Sales, 2004-2006 153
- Table 6.2: Tumor Diagnosis Immunoassay 165
- Table 6.3: Tumor Diagnosis Radioimmunoassay 165
- Table 6.4: Summary of Matritech's Product Development Programs 178
- Table 6.5: Statements of Operations Data for Matritech, 2002-2006 178
- Table 6.6: Results of Operations of Matritech, 2005 and 2006 179
- Table 6.7: PBM Product List 190
- Table 7.1: List and Discounted Prices for Abbott Tumor Marker Tests 202
- Table 8.1: CPT Codes for Tumor Markers 217
- Table 10.1: Familial Cancer Syndromes and Tumor Suppressor Genes 233
- Table 10.2: Oncogenes and Anti-oncogenes 233
- Table A3: TNM Classification 264
- Table A7: Financial Comparison for Moderate and Waived CLIA Labs 271
- Table A8: List of Marketers of Occult Blood Diagnostic Test Kits 273
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