The development of molecularly targeted cancer drugs is one of the most exciting advancements in oncology. The potential benefits from the identification of drug targets and the associated drugs and tests are illustrated by several novel examples, such as HER2/neu & Herceptin and Gleevec.
The rising incidence of cancer, particularly in the over 50 population, is likely have a significant impact on all areas of cancer treatment; however, for many cancer types, there remains a significant unmet need in effective treatment. Lung cancer is one example, as patient survival is less than five years after diagnosis.
Traditional therapies have failed to provide adequate redress for these patients, signifying a need for an alternative treatment plan. Programs, such as those that grant compassionate use, are becoming more common as provider and patients continue to demand better therapies with the potential for increasing life.
The targeted cancer therapeutics market specifically focuses on five leading segments of targeted therapies: monoclonal antibodies, tyrosine kinase inhibitors, angiogenesis inhibitors, CDK inhibitors, proteasome inhibitors.
Additionally, smaller areas of targeted therapies are covered including mTOR inhibitors, PI3K inhibitors, PARP inhibitors, apoptosis inhibitors, histone deacetylase inhibitors, hedgehog signaling pathway inhibitors and several others.
The use of monoclonal antibodies in cancer therapy is currently the subject of intense investigation. Monoclonal antibodies specifically bind with target antigens and could, therefore, be used in several ways to treat cancer. Antibodies can be used to deliver a cytotoxic drug preferentially to the cancer cell and thus minimize drug interactions with normal cells. Similarly, antibodies can be used to direct other cytotoxic cells, such as macrophages and T cells, to tumor cells lurking in the body. Antibodies can be attached to a radioactive label and injected into a patient to screen for recurrence of tumor growth. Antibodies can also be directed against cells that support tumor growth.
The Advantage of Targeting
Targeted therapy is defined as the use of specific treatments and drugs tailored to each patient and to various types of cancer, in order to stop the spread of cancerous cells in the body with as few side effects or damage to healthy cells as possible. Advances in this field are coming fast and furious, according to specialists, and many new therapies work on a molecular level, using biological agents to stop cancerous and abnormal cells in their tracks.
According to the National Cancer Institute (NIH), targeted cancer therapies are different from standard therapies in the following ways:
• Targeted therapies act on specific molecular targets that are associated with cancer, whereas most standard chemotherapies act on all rapidly dividing normal and cancerous cells.
• Targeted therapies are deliberately chosen or designed to interact with their target, whereas many standard chemotherapies were identified because they kill cells.
• Targeted therapies are often cytostatic (that is, they block tumor cell proliferation), whereas standard chemotherapy agents are cytotoxic (that is, they kill tumor cells).
The problem with many of the “broad” or traditional therapies is that they damage healthy cells while trying to eliminate cancerous cells.
As noted, the incidence of cancer is on the rise. In 2018, the International Agency for Research on Cancer reported that more than 18 million people were diagnosed with cancer. Of these, lung, breast, colorectal, prostate, stomach, liver and esophagus were the most commonly reported. Together, these account for nearly 10 million cases.
Worldwide between 40 and 45 million people are living with cancer and nearly 9.6 million people have died. Cancer deaths occur in about 50% of people who develop cancer in developed countries; this is in contrast to 80% death rate in cancer patients in underdeveloped countries. The risk of developing cancer before the age of 75 years is about 20.2%.
These data highlight the importance of effective cancer therapies in the current market; however, as we move toward 2040, the World Health Organization anticipates an increase to about 28 million new cases annually by 2040, a 62% increase over 2018.
Cancer is a disease characterized by uncontrolled cell proliferation. Despite more than 100 different types of cancer, those of the lung, breast, prostate, and colon-rectum account for nearly half of all new cases per year in the United States. Lung cancer, which is highly correlated with cigarette smoking, is responsible for more deaths than any other form of cancer. Cigarette smoking and other environmental factors are associated with the majority of cancers. Major advances in molecular medicine have shed light on the pathogenesis of cancer at the biochemical level.
The top 15 market participants in targeted therapies, responsible for roughly 97% of targeted cancer therapy revenue, include:
• Johnson & Johnson (J&J)/Janssen
• Takeda Oncology – Millennium Pharms
• Eli Lilly
• Merck EMD Serono
• Bristol-Myers Squibb (BMS)