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Summary in Thirty Seconds
We analyzed trending and awareness patterns of NTRK (Neurotrophic Tyrosine Receptor Kinase) and NTRK-targeting compounds in academic and community oncologists.
Awareness of NTRK outpaced awareness of the compounds being developed to address the biomarker.
Trending and awareness of the biomarker developed significant momentum only after NTRK-targeting compounds showed successful clinical trial results.
The trending of the compounds peaked among community oncologists about one year after they received FDA approval, and the trending was much stronger for the generic name compared to the brand name.
An important implication of these findings for pharmaceutical developers is that the name chosen for the generic drug name is critical.
NTRK trending begins to rise in community oncologists approximately one year after that of academic oncologists, quite likely because academic oncologists are far more frequently involved in clinical trials targeting the specific biomarker.
Community Oncologists
Previously, it was emphasized that if you don’t measure it, you can’t impact it. As an example of this adage, we explored trending and awareness patterns in community oncologists. These oncologists provide the majority of all cancer care,[1] particularly in terms of first-line care. (For context, a 2018 ASCO survey[2] of almost 400 practices found that 21% were academic and another study found that well over half of cancer care is provided by community oncologists.[3]) Therefore, what happens in community oncology practices matters, including how soon and comparatively how much awareness community oncologists have of emerging biomarkers.
Trending and Awareness of NTRK and NTRK-targeting Compounds
We analyzed trending and awareness patterns of NTRK (Neurotrophic Tyrosine Receptor Kinase) and NTRK-targeting compounds in community oncologists and generated the following results:
Numerous findings are evident in these results. Awareness of the biomarker (NTRK) outpaced awareness of the compounds being developed to address the biomarker. Second, trending and awareness of the biomarker developed significant momentum only after NTRK-targeting compounds showed successful clinical trial results (positive results were reported in the last years of the 2010 decade). Additionally, community oncologist NTRK trending had a small peak around the time clinical trials began (and a year after interim Phase I results were announced) for the targeting compounds. Third, the trending of these compounds (using either the generic or brand name) peaked among community oncologists about one year after they received FDA approval (larotrectinib in 2018; entrectinib in 2019). However, while trending peaked for both generic and brand names, it was much stronger (more than two times greater) for the generic name compared to the brand name in both drugs. This suggests that community oncologists are more aware of and use generic names far more than brand names in their practices, notably in this case, and possibly for other rare-instance oncology drugs. Finally, as repotrectinib has not yet gained FDA approval, its trending and awareness lag notably behind the two now FDA-approved drugs, particularly when using the generic names of these two approved drugs.
Generic versus Brand Name Implications
An important implication of these findings for pharmaceutical developers is that the name chosen for the generic drug name is critical. Finding ways to identify the biomarker within both the generic and brand name is important—the three NTRK compounds evaluated in this analysis incorporate “TRK” (or that sound) into the generic name, and the two FDA-approved drugs do so as well. A great deal of time and money is spent on developing a strong brand name; however, well-thought-out efforts are vital with generic names as well, given that the community oncologists, who provide the majority of care for people with cancer, appear to be at least twice as likely to use the generic name over the brand name.
Trending and Awareness in Community vs. Academic Oncologists
An interesting question arising from these results was how community oncologists compare to academic oncologists in NTRK trending and awareness. The following graphs summarize the results of this question:
These results indicate that NTRK trending begins to rise in community oncologists approximately one year after that of academic oncologists, quite likely because academic oncologists are far more frequently involved in clinical trials targeting the specific biomarker. The trending rise is also more consistent for academic vs. community oncologists, who show a more inconsistent trending pattern. For similar reasons, the level of awareness in academic oncologists builds sooner and generally at a greater rate than that of community oncologists. This may also be due to academic oncologists serving more frequently in tertiary roles (with not only more frequent clinical trials but for care focused on higher-stage cancer, where targeted therapy is more often used in current practice) compared to community oncologists.[4]
Conclusions
The preceding example provides ways in which trending and awareness metrics can be used to guide decision-making in many arenas—compound and drug naming choices, whom to target and when to do so in building biomarker awareness, emphasizing the importance of being out front in introducing new compounds and drugs, what to expect when introducing new targeted treatments, and providing baseline levels of trending and awareness by which one can evaluate the effectiveness of compliant awareness campaigns for clinical trials as well as other outreach. Importantly, none of these issues could be addressed without access to a means of measurement. And if you don’t measure it, you can’t impact it.