Neuroendocrine tumors (NETs) consists of complex group of tumors that develop predominantly in the digestive or respiratory tracts, but can occur in many areas of the body. These tumors arise from cells called neuroendocrine cells. Like all cancers, NETs develop when the specialized cells undergo changes causing them to divide uncontrollably and grow into an abnormal tissue mass (tumor)”.
This complex group of tumors has total prevalent population of 442,100 in 7 major markets and total incident cases were reported 44,070 in 2016. It is most prevalent in the United States with 193,877 cases in 2016, followed by EU5 and Japan. Among the EU5 countries, Germany has the highest prevalent population of NETs with 48,628 cases, followed by the France and Spain has the lowest prevalent cases. Approximately 70% of NETs patients are functional, and 30% cases non-functional. The highest market share of NETs in 2016 was accounted by United States, followed by EU5 (Germany, France, Italy, Spain & UK) and Japan. In 2016, Among EU5, Germany has the highest market, while Spain had the lowest market.
The treatment for NETs starts with surgery being as the curative option. Medications (including chemotherapy and cytotoxic agents) are often considered after surgery. The somatostatin analogs, Octreotide and Lanreotide remain the keystone of treatment. Cytotoxic therapies such as Streptozocin, 5-FU, or Temozolomide are considered in the palliation of patients with advanced pancreatic NETs and symptoms related to tumor bulk. However for the distant tumors that have grown outside, where regional therapies don’t work, systemic therapies are the only options for treatment. Everliomus is an effective targeted therapy that acts as mTOR inhibitor, Sunitinib is the only orally available tyrosine kinase inhibitor and Radiolabeled Somatostatin Analog therapies are generally considered as targeted therapies.
The current market of NETs is dependent on mTOR inibitors, Tyrosine Kinase Inhibitor, Somatostatin analogs, Chemotherapy and Cytotoxic Agents. However there are several therapies available for the treatment of NETs, associated adverse events; high cost; restricted use of targeted therapy and unsatisfactory efficacy has increased the need of more potential targeted therapy. Although there are numerous drugs in different phases of clinical trials claiming a better future treatment of NETs; only 10 drugs are expected to enter the NETs market by 2027.
The dynamics of Neuroendocrine Tumors (NETs) market is anticipated to change in the coming years owing to the expected launch of potential therapies such as Azedra (Progenics Pharmaceuticals), Sulfatinib (Hutchison MediPharma), Axitinib (Pfizer), RRx-001 (EpicentRx), Entrectinib (Ignyta), AMG-479 (Amgen), Carfilzomib (Amgen), ATG-008 (Antengene), Fosbretabulin (Mateon Therapeutics). Azedra (iobenguane I 131), which is under development by Progenics Pharmaceuticals and is in Pre- registration stage of development for the treatment of malignant, recurrent, and/or unresectable pheochromocytoma and paraganglioma, rare neuroendocrine tumors. The drug is expected to be the most promising emerging therapy after its approval in 2019. The performance, as of now is consistent that raises the hope of patients and investors.