...approach avoids large-population dynamics and established protocols, and the market can be entered through side door that has not been locked by the competition.

Novartis' Gleevec for chronic myelogenous leukemia (CML) is one such success story: the CML population is relatively small, but maximizing penetration in a small market proved better than minimal exposure in a large one. Four years after launch Gleevec generates about $1.8 billion in sales, a figure that is expected to rise through 2008. Other niche indications potentially offer the same lucrative launch scenarios and drug developers are beginning to take note.

[ILLUSTRATION OMITTED]

There is currently tremendous growth potential in specialist markets like oncology, where many niche areas with unmet needs remain. One such up-and-coming niche is renal cell carcinoma (RCC) where quantum leaps in therapeutic options are taking place after years of limited alternatives. Accounting for about 3% of all cancers, RCC features 50% cure rates for patients with an early-stage diagnosis but only palliative therapy for the majority of patients who present with advanced stages of the disease.

Encouragingly for drug developers, RCC may have a genetic Achilles' heel. Just as CML patients have mutations in the Philadelphia chromosome targeted by Gleevec, RCC patients show mutations in the VEGFR2 pathway, through which a tumour recruits new blood vessels...

NOTE: All illustrations and photos have been removed from this article.



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