Emerging Oncology Trends 2020 Aptitude Health Blog Post

Emerging Oncology Trends
Dramatic advances within the last decade have reshaped the global oncology market. A record number of new cancer drugs have received regulatory approval. Some of these treatments, such as immunotherapies, have permanently altered the way we approach cancer treatment.

Yet while the global oncology market has enjoyed many triumphs, the industry continues to struggle against lengthy R&D timelines. Regulatory approval and patent filing can be a minefield, and competition within the market is keen. A costly misstep can threaten a company’s chances of success.

To thrive in the modern oncology market, companies must stay abreast of industry trends. As the industry looks to the decade ahead, companies must consider recent changes within the marketplace and anticipate future trends.

New treatment strategies have revolutionized the oncology market. Increased pharmaceutical spending, particularly in the Asian market, is also changing the oncology landscape. Analyzing these trends allows companies to position themselves for success in 2020.

Therapeutic Trends
The popularity of immunotherapies continued to grow throughout 2019. Immunotherapies have rapidly become the first-line treatment in the US for metastatic non-small cell lung cancer, metastatic melanoma, and metastatic renal cell carcinoma.

In the US, over 200,000 patients received immunotherapies during 2018. This number represents a 100% increase from 2017. Experts anticipate that the use of immunotherapies will only rise during the years ahead.

A growing number of cancer patients also underwent biomarker testing within the last 2 years. Thirty-nine percent of oncology trials in 2018 used biomarkers to classify patients into various treatment groups. Immunotherapy with biomarkers offers more-robust survival rates, and oncologists have taken note. Today, most cancer patients who test positive for biomarkers receive targeted therapies. However, the use of biomarkers remains lower in the US than in Europe.

A record number of new oncology drugs were launched in 2018. As of 2019, several existing drugs were also approved for additional indications. Meanwhile, the use of oral therapies for cancer treatment has increased.

Researchers have observed that these drugs can decrease patient and healthcare burdens. Oral drugs can reduce or eliminate the need for treatment at an infusion center or hospital. Pharma companies continue to explore improved methods of administering cancer drugs.

Industry Spending and Financial Outlook
In 2018 and 2019, the largest pharma companies continued to dominate the oncology market. Twenty-eight companies brought in over $5 billion in global sales in 2018. Spending on oncology medications reached almost $150 billion in 2018 and the global oncology drug market is expected to reach $176 billion by 2025.

As innovative therapies emerge, the use of supportive care drugs has dropped. However, the average cost of new medications continues to rise, and spending is heavily concentrated. Recent cancer drug spending focused primarily on the top 38 drugs, which account for 80% of total expenditures.

While oncology drug sales are on the rise, financial risks remain. Clinical trial success rates fell between 2017 and 2018. The duration of oncology trials has decreased slightly, but still exceeds that of other disease areas. Launching new clinical trials still represents a significant financial investment for most pharma companies.

Companies and Competitors
The US remains the largest pharma market worldwide. But within the last few years, China’s share of the market has grown. Today, China is the second-largest pharma market and continues to drive spending and growth within the industry. Researchers estimate that oncology spending in China has more than doubled within the past 5 years. The development of novel therapeutic drugs continues to generate competition in the US, Japan, and the 5 biggest countries of the European Union. However, Japan plans to actively slow oncology spending in the coming years as the country reforms its pricing rules. The effect this will have on the global oncology market remains to be seen.

As of late 2018, 711 pharma companies were active in late-stage oncology R&D. However, 10 oncology companies continue to dominate the industry, producing 2 to 3 times as many products and indications as their competitors. By investing in extensive R&D, these companies have retained their position in the global oncology market.

Recent R&D Activities
While the duration of clinical oncology trials is lengthy, success rates in clinical trials are largely unchanged over the last decade. Yet clinical trial complexity has sharply increased. Greater complexity in phase I trials, in particular, has contributed to this rise.

In spite of these changes, productivity is on the rise. Clinical trial productivity, measured by success rates relative to trial effort, has improved more than 20% since 2010.

Today, more than 700 companies are undertaking clinical development activities for oncology drugs. Treatments combining immunotherapies and next-generation biotherapeutics are an area of particular interest.

Treatment Costs
Oncology spending continues to grow, with certain treatments driving up global costs. In the US, spending on cancer drugs doubled between 2013 and 2018, and oncology costs exceeded $66 billion last year. This trend is reflected in Europe and Asia.

Outside the US, older branded drugs are driving growth. Oncology spending in China doubled in the past 5 years, largely due to the increased use of existing branded medications. Recent reforms, including updates to China’s National Reimbursement Drug List, are expected to create new opportunities for innovating treatments and driving market growth. Elsewhere in the Asia market, Japan has sought to control treatment costs through the use of generic medications.

Innovative and Emerging Treatments
The number of patients treated with programmed cell death protein 1 (PD-1) and PD-1 ligand 1 (PD-L1) inhibitors continues to grow. Since their introduction in 2014, these drugs have become the first-line treatment for many forms of cancer. As researchers recognize that PD-1 and PD-L1 inhibitors offer significantly better outcomes, oncologists have begun to use these treatments earlier and more often.

Cyclin-dependent kinase (CDK)4/6-targeted breast cancer therapies are also on the rise in both Europe and the US. CDK4/6 inhibitors are primarily used in combination with hormone therapy to treat cancers that test as hormone receptor positive, but negative for the human epidermal growth factor receptor 2 biomarker. CDK4/6 represents a remarkable advance for aggressive metastatic diseases.

As of 2019, almost 100 next-generation biotherapeutics are under clinical investigation for oncology. A wide range of mechanisms are being explored and research in this area is progressing rapidly; 2020 will undoubtedly bring new tools to aid in the fight against cancer.