The oncology landscape has traditionally been dominated by small molecule chemotherapies that act on non-specific targets, and therefore affect both malignant and healthy cells. Immune checkpoint inhibitors, however, are targeted drugs that prevent cancer cells from turning off T cells by blocking ligand-receptor interactions that initiate immune checkpoints.
Associate Analyst Adam Bradbury explains: "Over the past five years, immune checkpoint inhibitor trials have reported strong clinical data in many tumor types across oncology, including melanoma, kidney cancer, colorectal cancer, and non-small cell lung cancer. Tecentriq (atezolizumab) and Opdivo (nivolumab) are the two currently approved immune checkpoint inhibitors within uro-oncology, and are marketed for bladder and kidney cancer, respectively.
"Other immune checkpoint inhibitors, such as durvalumab and avelumab, are expected to gain approval for bladder cancer in the next five years. This treatment group's uptake is predicted to be considerable due to the relatively high toxicity associated with chemotherapy agents and the typically poor performance status of many elderly patients, which necessitates the use of less-toxic targeted therapies."
GBI Research finds that, by contrast, the treatment landscape for kidney cancer already contains many targeted therapies, including angiogenesis inhibitors such as Sutent (sunitinib malate) and Votrient (pazopanib hydrochloride), and cancer immunotherapies such as the immune checkpoint inhibitor Opdivo, which gained FDA approval in November 2015 for metastatic kidney cancer patients who have received a prior angiogenesis inhibitor therapy.
Bradbury continues: "The list of cancers that may be susceptible to the checkpoint inhibitor class of immunotherapy drugs is rapidly expanding. In recent years, Opdivo has been approved for melanoma, Hodgkin's lymphoma and squamous non-small cell lung cancer, and it is likely to be approved for further oncology indications during the forecast period of 2015-2022. Increasing clinician familiarity will see Opdivo's uptake and usage expand, translating into strong revenues.
"Despite immune checkpoint inhibitors clearly holding much promise within the urological cancers market, with several in the late-stage pipeline, no substantial checkpoint inhibitor approvals are expected for prostate cancer - the most prevalent urological cancer - by 2022."
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SOURCE GBI Research