Bone Metastasis Market
Key Highlights
- Bone metastasis occurs when cancer cells break free from a malignant tumor, travel through various body parts via the bloodstream or lymph arteries, and develop a new secondary tumor in the bone. Bone metastasis commonly occurs in conjunction with solid tumors and is associated with serious bone complications.
- Bone metastasis is more common than primary bone cancers, especially in adults.
- Bone is the third most common organ affected by metastasis from other types of solid cancers. It is estimated to have an incidence in about 70% of patients with breast and prostate cancer, which are the two most common cancers worldwide. Kidney, lung, thyroid, bladder, and ovary cancers are other commonly spread cancers to the bones.
- The most frequent and important symptom of bone metastasis is pain. In addition, bone metastasis causes bone fractures, hypercalcemia, and spinal cord and nerve compression.
- In metastatic bone disease, the normal bone homeostasis that involves constant remodeling by the coordinated actions of osteoclasts and osteoblasts is disturbed. According to the primary interference mechanism with normal bone remodeling, bone metastasis can be classified as osteolytic, osteoblastic, or mixed.
- Blood tests such as CBC, serum calcium, alkaline phosphate, 25-hydroxyvitamin D, etc., can be performed to identify bone turnover and evaluate hypercalcemia. Biopsy and imaging tests, such as bone and PET scans, CT scans, MRIs, and X-rays, are useful for diagnosing bone metastasis.
- In 2023, the United States accounted for the highest number of total incident cases of Bone metastasis in Solid Tumors in the 7MM.
- In the United States, breast cancer accounted for the maximum number of cases of bone metastasis in solid tumors, constituting approximately ~41% of the total cases in 2023.
- Among EU4 and the UK, males accounted for more bone metastasis cases in solid tumors than females in 2023.
- The drugs used most often for treating bone problems in people with bone metastasis are bisphosphonate, pamidronate, zoledronic acid, and denosumab.
- In the 7MM, the United States accounted for the highest market size, with nearly 70% of the market share of Bone metastasis in the solid tumors market as compared to EU4 and the UK and Japan in 2023.
- In 2023, among EU4 and the UK, Germany accounted for the largest market size, while Spain accounted for the smallest share.
- As per our research, only a few drugs are currently in the clinical development phase for the treatment of solid tumors metastatic to the bone (metastatic prostate, breast, and lung, osteosarcoma, ewing's sarcoma, and other solid tumors.
- Among the emerging therapies, cabozantinib is estimated to have a major influence in the bone metastasis in solid tumors treatment market space.
- Clinical studies of cabozantinib treatment have demonstrated enhanced survival in certain cancers with bone metastasis. Hence, it can end up becoming a viable treatment option in the future, which also provides survival benefit ontop of improvements in QoL of patients.
- Researchers are investigating a few other therapies for the treatment of bone metastasis. Some key players involved in the development are Actuate Therapeutics, QSAM Therapeutics, and others.
- Despite the progress in the past years, there is still a need to better understand the mechanisms for bone metastasis of different malignancies. Clinical challenges also need further attention to improve prediction, early diagnosis, and treatment (via proper biomarkers and therapeutic targets). There is also a need for well-designed studies with large samples and a long follow-up time to verify the effects of current therapeutic methods.
Report Summary
- The report offers extensive knowledge regarding the epidemiology segments (by region, total incident cases of bone metastasis in Solid Tumors, total cases of bone metastasis by solid tumor type and gender-specific cases) and predictions, presenting a deep understanding of the potential future growth in diagnosis rates, disease progression, and treatment guidelines. It provides comprehensive insights into these aspects, enabling a thorough assessment of the subject matter.
- Additionally, an all-inclusive account of the current management techniques and emerging therapies and the elaborative profiles of late stage (Phase III) and prominent therapies that would impact the current treatment landscape and result in an overall market shift has been provided in the report.
- The report also encompasses a comprehensive analysis of bone metastasis in the solid tumor market, providing an in-depth examination of its historical and projected market size (2020–2034). It also includes the market share of therapies, detailed assumptions, and the underlying rationale for our methodology. The report also includes drug outreach coverage in the 7MM region.
- The report includes qualitative insights that provide an edge while developing business strategies by understanding trends through SWOT analysis and expert insights/KOL views, including experts from various hospitals and prominent universities, patient journey, and treatment preferences that help shape and drive the 7MM bone metastasis in the solid tumor market.
The table given below further depicts the key segments provided in the report:
Market
Various key players, such as Exelixis, QSAM Therapeutics, and others, are involved in developing therapies for bone metastasis in solid tumors. The expected launch of emerging therapies and other treatments will lead to a significant increase in the market size during the forecast period [2024–2034].
- In 2023, the total market size of bone metastasis in solid tumors was around USD 1,700 million, which is expected to increase by 2034 during the study period (2020–2034) in the 7MM.
- Among the 7MM, the United States accounted for the highest market size in 2023, followed by Japan for bone metastasis in solid tumors.
- During the forecast period (2024–2034), approval of pipeline candidates such as Cabozantinib is expected to drive the rise in bone metastasis in the solid tumor market size.
Bone Metastasis in Solid Tumors Recent Developments
- In March 2025, the FDA approved Fresenius Kabi Biopharma's denosumab biosimilars, Conexxence and Bomyntra (denosumab-bnht), for all indications of the reference products Prolia and Xgeva, expanding access to more affordable treatments for osteoporosis, bone metastases, and other bone-related conditions.
Bone Metastasis in Solid Tumors Drug Chapters
The section dedicated to drugs in this report provides an in-depth evaluation of pipeline drugs (Phase III and Phase II) related to Bone Metastasis in Solid Tumors.
The drug chapters section provides valuable information on various aspects related to clinical trials of Bone Metastasis in Solid Tumors, such as the pharmacological mechanisms of the drugs involved, designations, approval status, patent information, and a comprehensive analysis of the pros and cons associated with each drug. Furthermore, it presents the most recent news updates and press releases on drugs targeting Bone Metastasis in Solid Tumors.
Marketed Therapies
XOFIGO (Radium-223 dichloride): Bayer HealthCare Pharmaceuticals
XOFIGO, formerly Alpharadin, represents an alpha particle-emitting radioactive therapeutic agent. It is the first FDA-approved α-particle emitter therapeutic agent. XOFIGO has demonstrated significant advantages, including improvements in overall survival and a delay in symptomatic skeletal events for individuals with metastatic castrate-resistant prostate cancer (CRPC).
The active moiety of XOFIGO is the alpha particle-emitting isotope radium-223 (as radium Ra 223 dichloride), which mimics calcium and forms complexes with the bone mineral hydroxyapatite at areas of increased bone turnover, such as bone metastases. The high linear energy transfer of alpha particles (80 keV/micrometer) leads to a high frequency of double-strand DNA breaks in adjacent cells, including tumor cells, osteoblasts, and osteoclasts, resulting in an antitumor effect on bone metastases. The alpha particle range from radium-223 dichloride is less than 100 µm (less than 10 cell diameters), limiting damage to the surrounding normal tissue.
XGEVA/RANMARK (denosumab): Amgen
XGEVA is a RANK ligand (RANKL) inhibitor indicated for the prevention of skeletal-related events (SREs) in patients with bone metastases from solid tumors. It is a fully human monoclonal antibody that binds to RANK Ligand, a protein essential for the formation, function, and survival of osteoclasts (the cells that break down bone). XGEVA prevents RANK Ligand from activating its receptor, RANK, on the surface of osteoclasts, thereby decreasing bone destruction. XGEVA binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption, thereby modulating calcium release from bone.
Note: Detailed assessment will be provided in the final report of Bone metastasis in solid tumors…
Emerging Therapies
Cabozantinib: Exelixis
Cabozantinib inhibits MET, VEGFR2, and RET, proteins that are key drivers of tumor growth, vascularization and/or metastasis. Cabozantinib has shown novel and differentiated activity in multiple cancer indications. The current clinical program for cabozantinib is focused on the treatment of metastatic castration-resistant prostate cancer, or CRPC, and medullary thyroid cancer but also includes the evaluation of other tumor types. Exelixis has implemented a strategy to investigate cabozantinib in a comprehensive development program for CRPC to potentially generate a product that could effectively compete in the CRPC marketplace.
In July 2023, Exelixis announced that it had entered into a Settlement and License Agreement with Teva Pharmaceuticals. This settlement resolved patent litigation brought by Exelixis in response to Teva’s Abbreviated New Drug Application (ANDA) seeking approval to market a generic version of CABOMETYX (cabozantinib) tablets prior to the expiration of the applicable patents. Pursuant to the terms of the Agreement, Exelixis agreed to grant Teva a license to market its generic version of CABOMETYX in the United States beginning on January 1, 2031, if approved by the US FDA and subject to conditions and exceptions common to agreements of this type.
Note: Detailed assessment will be provided in the final report of Bone Metastasis in Solid Tumors…
Bone Metastasis in Solid Tumors Market Outlook
Bone is a recurrent site of metastatic disease in advanced cancer patients. Although bone metastases could occur in conjunction with any solid tumor, they are most commonly observed in breast, prostate, lung cancer, and renal cell carcinoma patients.
Clinical management of patients with bone metastases focuses primarily on palliating pain, preventing bone complications, and maintaining the quality of life. Bone-targeting agents (BTA) are one of the most frequently used forms of treatment for bone metastasis of solid tumors, where they provide prevention of SREs in patients with bone metastasis. BTA’s include XGEVA (denosumab) and bisphosphonates, like zoledronic acid, pamidronate, ibandronate, clodronate, and alendronate
In addition to the above therapies, in May 2013, Bayer received approval for XOFIGO from the US FDA for the treatment of castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastatic disease.
Although XOFIGO has demonstrated prominent efficacy in treating patients with prostate cancer and bone metastases, it is usually introduced into the patient’s treatment plan after symptomatic disease. Therefore, the usage of XOFIGO is severely restricted, not only by its limited indication for use but also by its lower preference in real-world treatment practices.
By referencing various studies and other sources, it was observed that the compliance and persistence of bone-targeted therapy have been historically suboptimal, with significant treatment discontinuation and switching rates. These factors were also considered when calculating the market size of bone metastasis in solid tumors.
Further details are provided in the report…
Bone Metastasis in Solid Tumors Disease Understanding and Treatment
Bone Metastasis in Solid Tumors Overview
The ability of cancer cells to leave a primary tumor, disseminate through the body, and seed new secondary tumors is universally recognized as the basis for metastasis formation. Bone metastasis is a secondary cancer in the bone that commonly occurs in conjunction with solid tumors and is associated with serious bone complications.
Bone metastasis typically occurs in breast, lung, prostate, thyroid, and renal carcinoma, and the bone is the third most prevalent site of metastasis after the liver and lung. Bone metastasis may cause complications such as pain, nerve root or spine cord compression, vertebral or peripheral fractures, hypercalcemia, and bone marrow infiltration that leads to cytopenia.
In metastatic bone disease, the normal bone homeostasis that involves constant remodeling by the coordinated actions of osteoclasts and osteoblasts is disturbed. According to the primary interference mechanism with normal bone remodeling, bone metastasis can be classified as osteolytic, osteoblastic, or mixed. These two major categories of bone metastasis are osteolytic and osteoblastic, based on which type of cells exhibit the predominant activities, and the impaired balance between bone formation and resorption is frequently observed in both types of metastasis. Despite the excess occurrence of bone resorption and formation, growing evidence has suggested the coexistence of osteolytic and osteoblastic metastasis, leading to mixed-type bone metastasis. Based on the distinct cytokine profile detected, lung cancer-derived bone metastasis is preponderantly osteolytic, whereas prostate cancer shows preferential osteoblastic bone metastasis.
Bone metastasis does not occur randomly. This process is a well-organized procedure that involves a vicious cycle between the tumor and bone, where one promotes the other, disrupting the bone matrix and leading to bone metastasis; the general bone metastatic process can be divided into cancer cell escape and dissemination, adhesion and invasion to the bone, and metastasis in bone.
Further details are provided in the report…
Bone Metastasis in Solid Tumors Diagnosis
A basic screening must be performed when one of the signs and symptoms described above are present: a complete blood cell count to evaluate for anemia and myelosuppression; serum calcium, phosphorus, 25-hydroxyvitamin D, alkaline phosphatase, creatinine, thyroid-stimulating hormone, protein electrophoresis, and parathyroid hormone level to identify bone turnover and evaluate hypercalcemia.
Detection of bone metastasis is essential for accurate staging and optimal treatment. There is no standard approach for the detection of bone metastasis in patients with cancer, so the clinical presentation should guide the choice of imaging.
Radiographs are fast, cheap, and widely available and are recommended for the initial evaluation of symptomatic areas, particularly of the extremities.
Positron Emission Tomography (PET) scan is based on the preferential uptake of 18-fluorodeoxyglucose (18FDG) by tumor cells because of their increased glucose metabolism, so it directly detects the presence of tumor by quantifying the metabolic activity. Therefore, it has high sensitivity and specificity for diagnosing distant metastasis, including the bone, and its use in initial staging and further evaluation for metastatic disease is increasing.
Biopsy: To take a sample of the tumor for histopathological examination, the following should be performed: fine-needle aspiration biopsy (FNAB), core-needle biopsy (CNB), or open biopsy (OB), which is a surgical treatment. Each of these three techniques is an established and widely used method of diagnosing neoplastic lesions of human bone. Each of them has its advantages and limitations. The decision about the type of biopsy performed depends on the topographic location of the tumor and the experience of the person performing the test. A biopsy should be planned based on physical examination and diagnostic images (X-ray, Scintigraphy, CT, MRI, and PET) so that the final operative treatment can be carried out from the same operative approach as for biopsy (with the principle of opening one anatomical compartment).
Further details related to country-based variations are provided in the report…
Bone Metastasis in Solid Tumors Treatment
Treatment goals may consist of controlling pain and other symptoms, preserving and restoring function, minimizing the risk of SREs, stabilizing the skeleton, and enhancing local tumor control. Therapeutic options include pain management/analgesia, osteoclast inhibitors, systemic anticancer therapy, radiation therapy, bone-targeting radiopharmaceutical therapy, surgery, and/or image-guided thermal ablation. Treatment choice is influenced by symptoms, impact on quality of life, performance status, estimated life expectancy, treatment goals, and care preferences. Optimal treatment may be complex and may require multimodality treatment strategies.
Patients with bone metastases suffer from significant bone pain at some point in the disease course. Initially, for mild to moderate pain, non-opioid analgesic drugs, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), may be used alone, but for moderate to severe pain, opioids should be the therapy of choice, according to the WHO analgesic ladder approach.
For patients with metastatic bone disease, osteoclast inhibitors, like bisphosphonates and denosumab, may prevent SREs as they slow down or reverse the progression of skeletal metastases and may even improve pain and quality of life.
There are two classes of bisphosphonates: non-nitrogen-containing, such as etidronate, clodronate, and tiludronate, and nitrogen-containing, such as pamidronate, alendronate, ibandronate, risedronate, and zoledronic acid, which are more potent osteoclast inhibitors. When a bisphosphonate is chosen, zoledronic acid is suggested over other bisphosphonates.
Further details related to treatment and management are provided in the report…
Bone Metastasis in Solid Tumors Epidemiology
The Bone Metastasis In Solid Tumors epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by total incident cases, solid tumor type-specific cases, and gender-specific cases in the United States, EU4 countries (Germany, France, Italy, Spain), and the United Kingdom, and Japan from 2020 to 2034.
- In 7MM, the United States accounted for the highest number of total incident cases of Bone metastasis in Solid Tumors in 2023.
- The United States accounted for more cases of bone metastasis in solid tumors in females than in males in 2023.
- Among the EU4 and the UK, Germany accounted for the highest number of cases of bone metastasis in solid tumors, followed by France. In contrast, Spain accounted for the lowest number of cases in 2023.
- In Japan, lung cancer accounted for the highest number of cases of bone metastasis, followed by Breast cancer and Prostate cancer in 2023.
Further details related to epidemiology will be provided in the report…
KOL Views
To stay abreast of the latest trends in the market, we conduct primary research by seeking the opinions of Key Opinion Leaders (KOLs) and Subject Matter Experts (SMEs) who work in the relevant field. This helps us fill any gaps in data and validate our secondary research.
We have reached out to industry experts to gather insights on various aspects of bone metastasis in solid tumors, including the evolving treatment landscape, patients’ reliance on conventional therapies, their acceptance of therapy switching, drug uptake, and challenges related to accessibility. The experts we contacted included medical/scientific writers, professors, and researchers from prestigious universities in the US, Europe, the UK, and Japan.
Our team of analysts at DelveInsight connected with more than 10 KOLs across the 7MM. By obtaining the opinions of these experts, we gained a better understanding of the current and emerging treatment patterns in bone metastasis in the solid tumors market, which will assist our clients in analyzing the overall epidemiology and market scenario.
Some opinions of experts from various regions have been provided below:
Qualitative Analysis
We perform Qualitative and Market Intelligence analysis using various approaches, such as SWOT analysis and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst’s discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.
Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, designation, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy. In efficacy, the trial’s primary and secondary outcome measures are evaluated. Based on these, the overall efficacy is evaluated.
Further, the therapies’ safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the route of administration, order of entry and designation, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.
Market Access and Reimbursement
Because newly authorized drugs are often expensive, some patients escape receiving proper treatment or use off-label, less expensive prescriptions. Reimbursement plays a critical role in how innovative treatments can enter the market. The cost of the medicine, compared to the benefit it provides to patients who are being treated, sometimes determines whether or not it will be reimbursed. Regulatory status, target population size, the setting of treatment, unmet needs, the number of incremental benefit claims, and prices can all affect market access and reimbursement possibilities.
The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.
Bone Metastasis in Solid Tumors Report Insights
- Patient Population
- Therapeutic Approaches
- Bone Metastasis In Solid Tumors Market Size and Trends
- Existing Market Opportunity
Bone Metastasis in Solid Tumors Report Key Strengths
- Eleven-year Forecast
- The 7MM Coverage
- Bone Metastasis in Solid Tumors Epidemiology Segmentation
- Key Cross Competition
Bone Metastasis in Solid Tumors Report Assessment
- Current Treatment Practices
- Reimbursements
- Market Attractiveness
- Qualitative Analysis (SWOT, Conjoint Analysis, Unmet needs)
Key Questions
- Would there be any changes observed in the current treatment approach?
- Will there be any improvements in Bone metastasis in solid tumor management recommendations?
- Would research and development advances pave the way for future tests and therapies for Bone metastasis in solid tumors?
- Would the diagnostic testing space experience a significant impact and lead to a positive shift in the treatment landscape of Bone metastasis in solid tumors?
- What kind of uptake will the new therapies witness in coming years in Bone metastasis in solid tumor patients?






