Table of Contents
Non-Small Cell Lung Cancer
- Non-small cell lung cancer (NSCLC) described as the most common type of lung cancer that originates in the cells lining the airways or the tissues of the lungs.
- Currently, Lung cancer is the most common cause of death of patients from cancer worldwide. Of the total diagnosed lung cancer incident cases, approximately 85% are constituted for the non-small cell lung cancer (NSCLC) subtype. Lung cancer symptoms usually occur in the later stages of the disease, with poor prognosis.
- The incident cases of NSCLC are further segmented by cancer diagnosis at stage (IA, IB, IIA, IIB, IIIA, IIIB, and IV), sex and age (18–39 years, 40–59 years, 60–79 years, and 80 years and older), cancer histology subtype (adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and others).
- The NSCLC relative survival varies by subtype, where adenocarcinoma has the highest durability, followed by squamous cell carcinoma, and large cell carcinoma.
- Treatments for treating NSCLC may include surgery, radiation therapy, chemotherapy, targeted drug therapy, and immunotherapy.
- Historically, chemotherapy had dominated treatment options for advanced-stage NSCLC patient. However, the introduction of targeted therapies into the market will offset the effect of patent expiries for drugs such as Iressa (gefitinib), Tarceva (erlotinib), and Xalkori (crizotinib) and shifted the treatment landscape for the personalized medicine which will have shown a limited impact on the market.
- As a drug class, immunotherapeutics are projecting to contribute the most to the market expansion. As a result, the drug classes are expected to take patient share away from the branded chemotherapy.
- The use of PD-1 checkpoint inhibitors is expected to take away the significant sales from conventional chemotherapies that are usually used in the first line therapy of NSCLC.
- Coming to the active clinical performances, immune-checkpoint inhibitors are having a higher uptake than second-line market entrants and thus compete among themselves for the market share.
- The phase III trial studies show that nivolumab after surgery and chemotherapy works in treating patients with stage IB-IIIA NSCLC. Monoclonal antibodies, such as nivolumab, works by stimulating the immune system in different ways and thus kill tumor cells found after surgery and is standard of care chemotherapy.
- The phase II trial studies include osimertinib that works with EGFR exon 20 insertion mutation that is stage IIIB-IV in treating patients with NSCLC. Osimertinib works by stopping the growth of tumor cells that includes blocking some of the enzymes needed for cell growth.
- The randomized phase II / III trial studies show that giving maintenance chemotherapy with or without local consolidation therapy is going to work in treating patients with stage IV non-small cell lung cancer.
- Drugs used in the maintenance chemotherapy, include docetaxel, erlotinib hydrochloride, pemetrexed disodium. Local consolidation therapy such as surgery or radiation / stereotactic body radiation may kill cancer cells that are left after initial treatment.
- Using maintenance chemotherapy and local consolidation therapy together are going to work better than maintenance chemotherapy alone in patients treating with stage IV NSCLC. EGFR and ALK inhibitor drug classes are also going to contribute to market growth that follows the first-line label expansions.
- Several new therapies including two IDO-1 inhibitors, from different drug classes, will gain the approvals within the forecast period that will result in increased therapy options and a better competitive market.
- New targeted, and immuno-therapies are going to drive the market growth because of premium pricing and strong clinical developments, but are also going to increase the degree of NSCLC market segments and the complexity of the treatment algorithm, due to their enhanced efficacy in some patient populations. O
- one of the main reasons for the substantial growth in value expected in the forecast period is the limited effect of patent expiry on NSCLC market, as the launch of numerous therapies are not going to be offset by generic erosion and premium therapies are going to occupy a larger market share for most of the forecast period.
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