An estimated number of 18.1 million new cancer cases were registered last year, according to A Cancer Journal for Clinicians 2018;0:1‐31. Moreover, it is a leading cause of global deaths. The deaths due to cancer remain recognized as the only barrier in the increasing life expectancy in the world.
The incidence, as well as the diagnosis of cancer, is increasing rapidly. It can be attributed to a downward shift in the demographic dividend of the population and increasing industrial pollution.
How common is Lung cancer?
According to Cancer.org, Lung cancer (both small cell and non-small cell) is the most commonly diagnosed and second most common cancer in both men and women. About 13% of all new cancers are lung cancers.
Around 80-85% of all the cancers are Non-small cell lung cancer (NSCLC). The main subtypes of the NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
The age-adjusted Non-small cell lung cancer incidence is 47.2 per 100,000 individuals and is most frequently diagnosed among people between 65 and 74 years old (SEER), in the US.
As per the American Cancer Society estimates, NSCLC incidence in the United States for 2018 are about 234,030 new cases in which 121,680 are men and 112,350 are women.
According to the WHO, if we talk about the incidence of the subtypes of NSCLC, squamous cell carcinoma accounts for 25–30% cases of lung cancers, adenocarcinoma accounts for 40% cases whereas large cell carcinoma accounts for 10–15%.
How many people die of Lung cancer?
Every sixth death in the world is due to cancer, making it the second leading cause of death (second only to cardiovascular diseases.
Non-Small Cell Lung Cancer Therapeutics landscape
The Non-Small Cell Lung Cancer Treatment trends have shifted from molecular histologic subtype-based towards targeted therapies. The current treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, immune checkpoint inhibitors, or some combination of these, depending on the type of cancer, stage of the disease, and overall health as well as the age of the patient.
Early diagnosis of the cancer is necessary as most stage I/II NSCLC can be surgically removed. Earlier, the NSCLC therapy market revolved around chemotherapy regimens.
The Non-small cell lung cancer therapeutic efficacy has significantly improved with the introduction of targeted therapies. In case of any mutations, targeted therapies are the best NSCLC therapy option.
The targeted therapies include anti-angiogenesis therapy, epidermal growth factor receptor (EGFR) inhibitors, ALK inhibitors, an immune checkpoint inhibitor, drugs that target other genetic changes, etc.
Moreover, the cancerous cells are tested for epidermal growth factor receptor (EGFR), which, in excess, facilitates the faster growth of the cells. Drugs like Afatinib (Gilotrif), Gefitinib (Iressa), Erlotinib (Tarceva), Osimertinib (Tagrisso), Dacomitinib (Vizimpro), etc. block the EGFR signalling pathway helping in treating cancer.
Another cause of Non-small cell lung cancer can be a rearrangement in a gene called (ALK Anaplastic lymphoma kinase). Drugs such as Crizotinib (Xalkori), Ceritinib (Zykadia), Alectinib (Alecensa), Brigatinib (Alunbrig), Lorlatinib (Lorbrena), and others target the mutated ALK protein hampering the cell division in excess.
If the mutation in BRAF gene is the cause of NSCLC, drugs such as Dabrafenib (Tafinlar), Trametinib (Mekinist) are used to treat metastatic NSCLC.
Programmed cell death to beat cancer has brought a revolutionary transformation in the cancer treatment landscape. Immune checkpoint inhibitors, fundamentally those that act by blocking the programmed cell death receptor-1 (PD-1) and its ligand the programmed cell death ligand-1 (PD-L1) have emerged as novel NSCLC treatment option, demonstrating undoubted superiority over chemotherapy in terms of efficacy. Several regulatory organizations globally have recognized immunotherapy as one of the viable options for Non-small cell lung cancer treatment. The available approved immune checkpoint modulators such as Pembrolizumab (Keytruda), Nivolumab (Opdivo), and Atezolizumab (Tecentriq) are recommended in first-line and second-line metastatic NSCLC.
Imfinzi (durvalumab) is approved for unresectable Stage III NSCLC and as maintenance after chemoradiotherapy in locally advanced disease.
Companies investing to advance Non-small cell lung cancer Market
Key pharma companies involved in propelling the Non-small cell lung cancer therapy market and trying to dominate the significant major NSCLC market share are Novartis, BeiGene, Transgene, Heat Biologics, Bristol-Myers Squibb, Achilles Therapeutics, Mersana, BeyondSpring Pharmaceuticals, and others.
Non-small cell lung cancer Pipeline
The current research is looking toward the employment of effective therapies, such as targeted therapies, personalized therapies, and Immunotherapy. Targets currently being used or investigated in the treatment of NSCLC include the human epidermal growth factor (HER) family of receptors, EGFR, KRAS, ALK, PI3K/AKT/mTOR, IGF-1R, MET, ROS, Monoclonal antibodies, T-cell therapies, immune checkpoint inhibitors, etc.
Drugs, such as Tislelizumab (BeiGene), Capmatinib (Novartis), TG4010 (Transgene), HS-110 (Heat Biologics), XMT-1536 (Mersana), Plinabulin (BeyondSpring Pharma) and others are being developed as the highly effective Non-small cell lung cancer therapies.
The launch of these emerging NSCLC therapies is expected to significantly impact Non-small Cell Lung Cancer treatment scenario in the coming years, 2019–2028.
Non-small cell lung cancer Market forecast
With the identification and increased understanding of gene rearrangement in NSCLC, research efforts have focused on identifying molecular targets and use this knowledge in developing molecularly targeted therapies and for guiding NSCLC treatment decisions.
The Non-small cell lung cancer market size is expected to grow remarkably during the period of forecast due to the enormous growth drivers, such as increasing prevalence, higher awareness, increase in diagnosis and mutation analysis rate, rising healthcare expenditure, and others. Additionally, launches of upcoming therapies will also contribute to the overall growth of the market during the forecast period of 2019–2028.