Market Dynamics
Global Cancer Cachexia Market Drivers
Increasing Prevalence of Cancer Cachexia
According to the International Agency Research on Cancer- Globocan 2020 report, 9,958,133 cancer-related deaths globally in 2020 out of 19,292,789 new cancer cases were identified. Global estimates put the number of cancer cases within five years at 50,550,287. Globally, 28,887,940 new cases of cancer are anticipated by 2040.
Additionally, as per GLOBOCAN 2020, lung cancer cases accounted for 2,206771 new cancer cases diagnosed in 2020 globally, with 495,773 pancreatic, 604,100 esophagus, 1,414,259 prostate, and 1,148,515 colon cancers diagnosed in 2020, globally. As cachexia is highly prevalent in patients with the types mentioned above of cancer, there exists an increasing demand for cancer cachexia therapeutics over the coming years.
Europe accounts for approximately 22.8% of global cancer cases, as per GLOBOCAN 2020. Moreover, cancer incidence is estimated to increase by 21.0% from 2020 to 2040. This rate is relatively high, considering Europe has only 9.0% of the global population. Similarly, a high cancer prevalence rate was observed in Asia, with 9,503,710 new cancer cases in 2020, attributing to 49.3% of global cancer cases. The number of cases is estimated to increase by 59.2% from 2020 to 2040.
Moreover, Cancer Research UK suggests that the population suffering from cancer is expected to increase. As per the report, if recent trends in the incidence of significant cancers and population growth are consistent, it is predicted that there will be 27.5 million new cancer cases worldwide each year by 2040, an increase of 61.7% from 2018. New cancer cases are expected to be higher in males, with an approximate rise of 67.6%, compared to females, with an estimated increase of 55.3%. Thus, the high cancer incidence surges the demand for advanced therapeutics drugs, which drives the growth of the studied market.
Strong R&D and Product Pipeline
Owing to the high incidence of cancer cachexia cases among cancer patients globally, there has been an increasing focus on clinical studies to identify the characteristics of cancer cachexia across several different types of cancers in humans. Understanding the molecular mechanisms involved in muscle loss throughout the progression of cancer cachexia is an urgent issue to improve cancer outcomes. Thus, extensive R&D activities are in progress with a vast product pipeline. For instance, Aavogen Inc. has a pipeline of products, "AVGN7", developed to treat inclusion body myositis, cancer cachexia, and Duchenne muscular dystrophy. The investigational product completed the discovery and proof-of-concept stages, and the preclinical phase is currently ongoing. Additionally, in March 2019, Helsinn Group initiated Phase III Program to evaluate anamorelin for weight loss and anorexia in patients with advanced non-small cell lung cancer (NSCLC) with cachexia. Alumni, a ghrelin receptor agonist, was given manufacturing and marketing authorization by Helsinn Group and Ono Pharmaceutical Co. Ltd in Japan to treat cancer cachexia in malignant tumors of non-small cell lung cancer, gastric cancer, pancreatic cancer, or colorectal cancer.
The University of Copenhagen, in partnership with the New Zealand University Hospital, began clinical research on the impact of medical cannabis on lean body mass (cachexia) in patients receiving chemotherapy that included oxaliplatin or paclitaxel in December 2020. Thus, there has been increasing interest and research activities in evaluating various parameters related to cancer cachexia disease condition and simultaneous product pipeline development by the major players, which is expected to boost the studied market growth over the forecast period significantly.
Global Cancer Cachexia Market Restraint
Stringent Regulatory Requirements
As cancer cachexia occurs more often in terminally-ill cancer patients, the drugs used to treat this disorder usually must adhere strictly to the standards followed by other cancer drugs. Stringent regulatory requirements mean that many countries have long timelines for approving pharmaceutical drugs, especially cancer-related ones. Countries have significant differences in the time required to approve cancer drugs per their prevailing national regulatory standards. For example, in the United States, the FDA must decide within 12 months on regular applications, and within six months, in the case of applications designated for priority review.
In Europe, the CHMP must give its opinion within 210 days. This is followed by a decision-making phase that can take up to three months. Thus, patients generally gain access to promising drugs (like drugs for cancer cachexia) at different times. This severely limits the marketing ability of most large companies. As cancer cachexia drugs are administered to terminally-ill patients, late approvals in countries mean that many patients lose out on potentially necessary medication that can be used to improve their quality of life.
Due to the multifactorial character of cachexia, multimodal interventional trials, like the MENAC study, offer the best chance to connect response with a therapeutic intervention, according to the research article published in Annals of Palliative Medicine in 2019. Hence, meeting the endpoints, as per the requirements of regulatory bodies, has to be worked on for the successful acceptance of the study and subsequent drug approval. Thus, the issues mentioned above act as significant market restraints for the growth of the cancer cachexia market.
Global Cancer Cachexia Market Opportunities
Development of Effective Therapeutics for the Treatment of Target Disease
As cancer cachexia is a multifactorial syndrome characterized by a continuous loss of skeletal muscle mass, various research activities and trials are being designed to evaluate multiple parameters, which aids in the development of effective therapeutics for the treatment of the target disease condition over the coming years. For instance, the role of brown adipose tissue in cachexia attracted significant research interest in recent years. Additionally, as the pathogenesis of the cancer cachexia is multifactorial, treatment options should incorporate multiple-target strategies, which include the use of pharmaconutrients with anti-inflammatory properties, such as omega-3 fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), treatment with peptide hormone "Ghrelin," that is actively involved in anabolic and homeostatic functions, therapeutics developed based on ActRIIB, which is a high-affinity activin type 2 receptor that mediates signaling through a subset of TGF-β family ligands, including activin and myostatin, leading to the regulation of muscle mass and many other combined therapies, which involves an intervention between nutritional and metabolic requirements, to improve the outcomes of cancer patients. Additionally, research activities to develop non-invasive biomarkers to identify tumors likely to induce cachexia and to identify changes in normal tissues that are typical of the induction of cachexia are gaining importance, as this could be expanded to include detecting response to treatment and the development of new therapies.
Regional Analysis
By region, the global cancer cachexia market is bifurcated into North America, Europe, Asia Pacific, Middle East & Africa, and South America.
North America dominated the market and is estimated to register a CAGR of 4% during the forecast period. The dominance of the United States is because of the high prevalence of cancer, the rise in healthcare budgets, and government initiatives to provide treatment options to patients suffering from terminal diseases. According to the Centers for Disease Control and Prevention, between 2010 and 2020, the number of new cancer cases in the United States was expected to increase by about 24% in men to more than 1 million cases/year and by about 21% in women to more than 900,000 cases/year. The increasing incidence of malignant cancers in the country and the increasing cachexia that is well known to be associated with increased mortality and decreased well‐being of patients are gaining more interest, boosting the market growth in the country.
Europe is the second largest region. It is anticipated to reach an expected value of USD 1060 million by 2031, registering a CAGR of 5.1%. According to the Santé Publique France and the French national cancer institute, the number of cancer cases increased significantly from 1990 to 2018. In 1990 there were 215,000 cancer cases recorded, which had increased to 382,000 by 2018. Furthermore, there is an increase in new cancer cases by 65% in men and 93% in women. The increasing prevalence of cancer and cancer cachexia is increasing the demand for research on the diseases in the country. According to clinicaltrials.gov, there are eight studies as of January 2021 in the country on cancer cachexia. In collaboration with the French College of General Hospital Pneumologists, Chugai Pharma France conducted a trial to assess the frequency of cachexia and the management of cachexia and associated symptoms in a patient population with non-small cell lung cancer. Therefore, the increasing burden of cancer and thus the risk of cachexia, and the growing number of research studies in the countries boost the market growth.
Asia Pacific is the third largest region. In China, the primary market growth factors are the increasing cancer burden and the well-established healthcare infrastructure. According to the 2019 analysis by Rui-Mei Feng et al., released in the Cancer Communications Journal, there were 2.9 million additional cancer deaths and an estimated 4.3 million additional cancer cases in China in 2018. Compared to the United States and the United Kingdom, China has lower cancer incidence but 30% and 40% higher cancer mortality than the United Kingdom and the United States. According to Rui-Mei Feng, in an article published in 2019, 40% of the risk factors for chronic diseases can be attributed to environmental and lifestyle factors in China and other developed countries. Tobacco smoking is the most critical carcinogenic risk factor in China, contributing to ~ 24.5% of cancers in males. Hence, considering the abovementioned factors, the market studied is expected to grow in China.
Segmental Analysis
The global cancer cachexia market is segmented by therapeutics, mechanism of action, and region.
By therapeutics, the global cancer cachexia market is segmented into progestogens, corticosteroids, combination therapy, and other therapeutics. The progestogens segment accounted for the largest market share and is estimated to grow at a CAGR of 4.8% during the forecast period. Progestogens, like Medroxyprogesterone Acetate (MPA) and Megestrol Acetate (MA), are currently considered the best treatment option for cancer cachexia. They are available for the treatment of cancer and AIDS-related cachexia. These drugs were fast-acting, and they were also good antiemetics. Although high doses of these agents may produce adrenal suppression, they do not cause side effects, such as myopathy or peptic ulcer disease, usually seen with corticosteroids. Hence, progestogens hold a significant share in the cancer cachexia market, owing to the factors such as the low cost of progestogens and the high efficiency in the treatment of cancer cachexia, which will play a significant role in the progestogens segment to maintain its market position.
By the mechanism of action, the global cancer cachexia market is segmented into appetite stimulators and weight loss stabilizers. The appetite stimulators segment accounted for the largest market share and is estimated to grow at a CAGR of 3.9% during the forecast period. Patients with cancer commonly experience appetite reduction and weight loss. In cancer patients, unintentional weight loss and anorexia (lack of appetite or desire to eat) are linked to worsened performance status, responsiveness, tolerance to treatment, survival, and quality of life. Therefore, for individuals who show decreased appetite, increasing the usage of an appetite stimulant may be an option. One of the key drivers of the overall market's growth is the rising incidence of cancer cachexia instances.
Top Key Players
Pfizer Inc.
Helsinn Group
AAVogenInc.
Artelo Biosciences Inc.
Merck & Co. Inc.
NGM Biopharmaceuticals
Aveo Pharmaceuticals Inc.
Green Cross Wellbeing Corporation
Cannabics Pharmaceuticals Inc.
TCI Peptide Therapeutics
Fresenius Kabi
Aeterna Zentaris Inc.
Aphios Corporation
Bristol-Myers Squibb Company
Tetra Bio-Pharma
Actimed Therapeutics.
Others
