The non-small cell lung cancer (NSCLC) market has grown significantly in recent years partly due to the introduction of immune checkpoint inhibitors (ICIs) into the first-line setting and further growth is forecast during the next decade. Specifically, the market is expected to grow from $19.2bn in 2019 to $32.9bn in 2029 across the eight major markets (*8MM) at a moderate compound annual growth rate (CAGR) of 5.5%, according to GlobalData, a leading data and analytics company.
GlobalData's latest report, 'Non-Small Cell Lung Cancer: Global Drug Forecast and Market Analysis to 2029', revealed that the projected increase is primarily derived from numerous product launches (28 agents are forecast to launch during 2019-2029) and increasing international market access to premium priced therapeutics.
Adam Pearson, PhD, Senior Oncology Analyst at GlobalData, comments: "The NSCLC market continues to be one of the largest oncology markets due to high incidence and diverse targeted therapy options for a range of patient populations across multiple lines of therapy. Premium priced immune checkpoint inhibitors, in particular Keytruda, are widely used in the first-line setting across the 8MM, irrespective of histology and PD-L1 status. The non-squamous patient population, constituting the majority of NSCLC, is a highly segmented population defined by a number of actionable mutations, which is set to be further segmented during the forecast period based upon the expected approval of KRASG12C inhibitors and HER2 targeting agents."
Within the established actionable mutation populations, precision medicine is becoming more targeted as concerted research and development (R&D) efforts strive to develop effective treatments for discrete molecular aberrations, which are currently underserved by the market. Such examples include agents targeting EGFR exon 20 insertions.
Establishing novel actionable mutations and expanding the targetable proportion of patients is forecast to contribute significantly to market growth over the forecast period.
Pearson continues "Across multiple oncology indications we are expecting to see the movement of checkpoint inhibitors from the metastatic setting into earlier lines of therapy and NSCLC is no exception. Given the demonstrable efficacy of checkpoint inhibitors in multiple lines of therapy in the metastatic setting, key opinion leaders (KOLs) expect the use of this modality to shift to earlier lines of treatment successfully".
NSCLC is still characterized by a significant level of unmet need despite progress in recent years in the treatment and personalization of therapy options. The most significant environmental unmet need is to improve recommendations around testing, primarily to educate oncologists, and provide access to genomic testing to enable optimal patient care. Increasing utilization of next-generation sequencing (NGS) will significantly improve the ability to develop personalized care for patients.
The greatest clinical unmet needs in NSCLC concern the development of effective therapies to tackle primary and acquired resistance in the targeted and IO therapeutic fields. The use of checkpoint inhibitors as monotherapy, or in combination either with chemotherapy, or most recently with other IO drugs are the most common strategies for treating patients in the first-line setting who do not harbor actionable mutations, representing the majority of patients with NSCLC.
Pearson adds: "GlobalData notes that there is no standard of care for patients in the second line, and the problem persists throughout the 8MM. The unmet need for treating patients with primary and acquired resistance to ICIs is significant and represents a significant commercial opportunity, given the size of this target patient population."
*8MM = US, France, Germany, Italy, Spain, the UK, Japan, and China