Paraganglioma Market

Market Overview

The global Paraganglioma Market size was valued at USD 2.85 billion in 2022. It is estimated to reach USD 3.12 billion by 2031, growing at a CAGR of 1% during the forecast period (2023–2031). The global market is expected to grow rapidly due to the increased prevalence of this disease. Moreover, the key players are introducing novel drugs for the treatment of paraganglioma by receiving approval from the regulatory bodies, which is expected to offer market growth opportunities.

Paraganglioma is a rare type of tumor that arises from specialized cells called paraganglia. These cells are part of the neuroendocrine system, which regulates several bodily functions, like blood pressure and heart rate. Paragangliomas can develop in various locations in the body, but they are most commonly found in the head and neck region along the sympathetic and parasympathetic nervous systems. These tumors are usually noncancerous (benign) but can be locally invasive and cause symptoms based on their size and location.

The symptoms of paragangliomas depend on the specific location of the tumor. They may include high blood pressure, headaches, sweating, palpitations, and other symptoms related to the excessive release of hormones. In some cases, paragangliomas may be discovered incidentally during imaging studies done for unrelated reasons. Treatment of paragangliomas typically involves surgical removal of the tumor. In some cases, additional therapies like radiation therapy or medications may be recommended, particularly if the tumor cannot be completely removed or if it is cancerous.

Market Dynamics

Global Paraganglioma Market Drivers

Rising Prevalence of Paraganglioma 

The flourishing prevalence of paraganglioma globally is expected to expand the market. The precise incidence of paraganglioma remains largely unknown due to the prevalent practice of describing its clinical features alongside those of pheochromocytoma. The collective estimated yearly occurrence of pheochromocytoma/paraganglioma is roughly 0.8 per 100,000 person-years, with an estimated 500 to 1600 cases reported annually in the United States.

Nevertheless, the analysis of the autopsy series demonstrates a prevalence that surpasses initial expectations, indicating that a significant number of these tumors go undetected during an individual's lifetime. Approximately 25% of cases exhibit a genetic association, and the tumors often produce excessive amounts of hormones, which can result in severe hypertension, cardiac dysfunction, and cerebrovascular accidents. This is expected to drive Paraganglioma market growth.

Global Paraganglioma Market Restraint

High Cost of Treatment

Paragangliomas are classified as rare cancers. The limited prevalence of this problem may constrain the overall market scope, as pharmaceutical enterprises and medical device producers may exhibit reduced motivation to allocate resources towards research and development for uncommon ailments compared to more widespread conditions.

The infrequency of paragangliomas may lead to a lack of knowledge among healthcare practitioners and the general populace. The absence of sufficient awareness of a particular issue has the potential to result in delayed or inaccurate diagnoses, hence diminishing the need for targeted diagnostic and therapeutic interventions. These factors are predicted to impede the market growth.

Global Paraganglioma Market Opportunities

Increasing Product Approval

The launch and approval of novel drugs to treat paraganglioma by prominent players in the market are creating opportunities for market growth. For instance, in August 2018, the U.S. FDA granted approval for the initial non-surgical treatment for the uncommon neuroendocrine cancers of pheochromocytoma and paraganglioma. The permission was awarded to Progenics Pharmaceuticals for AZEDRA (iobenguane I131) based on a multi-center investigation conducted by researchers in the Abramson Cancer Center.

AZEDRA is a radiotherapeutic agent with high specificity and activity, designed for the treatment of individuals who are 12 years of age or older and have been diagnosed with pheochromocytoma or paraganglioma. These patients must have a positive iobenguane scan, and their condition must be unresectable, locally progressed, or metastatic, necessitating systemic anticancer therapy. AZEDRA represents the initial and exclusive medication that has received approval for this specific indication.

Regional Analysis

Based on region, the global paraganglioma market is bifurcated into North America, Europe, Asia-Pacific, Latin America, and the Middle East and Africa.

North America Dominates the Global Market

North America is the most significant global paraganglioma market shareholder and is expected to expand substantially during the forecast period. The dominance of the North American region can be ascribed to prominent market participants developing oncology medicines. The presence of a well-established healthcare system, the widespread adoption of innovative radionuclide therapy and radiation therapy techniques by medical professionals, and the comprehensive accessibility of advanced diagnostic equipment in this region boost the paraganglioma market expansion. In addition, paraganglioma is a rare disease, but its incidence has risen in the last several years. For instance, a research study published in the European Journal of Endocrinology in January 2021 estimated that a cohort of 239 individuals diagnosed with either pheochromocytoma or paraganglioma, with a total of 251 tumors, was detected within a population of 5,196,368 individuals during a span of 7 years in Western Canada. The collective prevalence of pheochromocytoma or paraganglioma was 0.66 instances per 100,000 individuals annually.

Additionally, the incidence of pheochromocytoma and paraganglioma showed an age-dependent increase, reaching its peak among those aged 60-79 years, with rates of 8.85 and 14.68 instances per 100,000 individuals per year for males and females, respectively. The algorithm, utilizing laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal), demonstrated a high degree of accuracy in estimating the actual occurrence rate of pheochromocytoma and paraganglioma, with an estimated incidence of 0.54 occurrences per 100,000 individuals per year. Thus, the prevalence of pheochromocytoma and paraganglioma in a non-biased sample of individuals residing in western Canada was unexpectedly elevated compared to reported rates in other global regions. This is expected to drive the market growth in the North American region.

The Asia-Pacific region is expected to grow fastest during the forecast period. The market expansion in this region may be attributed to several factors, including an increasing prevalence of individuals diagnosed with paraganglioma, a corresponding rise in demand for treatment options, and a huge population base. Additionally, government and organizational programs aimed at promoting awareness are anticipated to influence the paraganglioma market's growth favorably. For instance, the First Cancer Care (FCC) project was established by the Centre for Fourth Industrial Revolution of the World Economic Forum India. The primary aim of this project is to enhance the quality of cancer care by utilizing new technologies like artificial intelligence (AI), machine learning, and the Internet of Things (IoT).

Furthermore, there are significant disparities in infrastructure, trained human resources, and financial resources. A committee of experts has identified 18 essential measures to enhance the accessibility of cancer care. Furthermore, the region's surge in clinical trials to develop novel drugs is flourishing. For instance, The Yervoy injectable (Ipilimumab), an Anti-CTLA-4 antibody developed by Ono Pharmaceuticals, is undergoing Phase 3 clinical studies to treat individuals diagnosed with head neck cancers. Such factors are anticipated to boost the regional market growth.

Segmental Analysis

The global paraganglioma market is segmented by type, treatment type, therapeutic drugs, and end-user.

Based on type, the global market is bifurcated into sympathetic paragangliomas, parasympathetic paragangliomas, carotid paragangliomas, cervical paragangliomas, jugular paragangliomas, secretory paragangliomas, and temporal paragangliomas.

Sympathetic paragangliomas are uncommon tumors that originate from chromaffin cells, constituents of the sympathetic nervous system. The sympathetic nervous system is a constituent element of the autonomic nervous system, which induces the "fight or flight" physiological response in the human body. Paragangliomas have the potential to appear in multiple anatomical sites, with sympathetic paragangliomas notably originating from chromaffin cells that are closely linked to the sympathetic ganglia. These tumors often appear within the abdominal region near the adrenal glands, which play a pivotal role in synthesizing adrenaline and other hormones. In certain instances, sympathetic paragangliomas can potentially undergo malignant transformation, resulting in the development of cancerous cells that can metastasize to distant anatomical sites.

Based on treatment type, the global market is bifurcated into peptide receptor radionuclide therapy, surgery, chemotherapy, radiation therapy, and others. 

Peptide Receptor Radionuclide Therapy (PRRT) is a precise molecular therapeutic approach for managing specific cancer types, specifically neuroendocrine tumors (NETs) exhibiting somatostatin receptors. Neuroendocrine tumors encompass a collection of rare tumors that originate from cells within the endocrine and neurological systems responsible for hormone production. Proteins known as somatostatin receptors have been identified as being present on the cellular surface of some neuroendocrine tumor cells.

In addition, peptide receptor radionuclide therapy (PRRT) has demonstrated encouraging outcomes in managing some neuroendocrine tumors, specifically those with high cellular differentiation and expressing somatostatin receptors. Typically, the consideration for its utilization arises in cases where patients exhibit severe or metastatic disease following the exhaustion of alternative therapeutic modalities.

Based on therapeutic drugs, the global market is bifurcated into iobenguane I13, cyclophosphamide, vincristine, and dacarbazine. 

Cyclophosphamide is a type of chemotherapy drug classified within the category of alkylating compounds. This therapeutic intervention is employed for the treatment of many forms of cancer. Cyclophosphamide disrupts the proliferation and dissemination of cancerous cells within the human body. Frequently, it is employed in conjunction with additional chemotherapy agents or therapeutic interventions. Similar to numerous chemotherapy drugs, cyclophosphamide may elicit adverse effects, necessitating careful oversight from healthcare practitioners. Frequently encountered adverse effects encompass symptoms such as nausea, vomiting, hair loss, and an augmented susceptibility to infections due to immunosuppression.

Based on end-users, the global market is bifurcated into hospitals, specialty clinics, cancer research institutes, and others. 

The hospital segment owns the highest market share. Hospitals hold a significant share of the market, as most treatment is done in hospitals. Moreover, the growing number of hospitals across developing countries positively impacts the demand for neurorehabilitation devices. For instance, as per the American Hospital Association Annual Survey 2021, in the United States, there were 1,805 rural community hospitals, 3,336 urban community hospitals, and 3,453 community hospitals in a system in 2019. In addition, total admissions in all United States hospitals were around 36,241,815 in 2019. Also, effective reimbursement policies offered in hospitals in certain countries around the world, which ease the medical cost burden on the patient, contribute to the growth of the hospital segment.

Recent Developments

• October 2023- Perspective Therapeutics, Inc. declared that two forthcoming investigator-initiated trials (IIT) were showcased at the 2023 North American Neuroendocrine Tumor Society (NANETS) Symposium in Montreal, Canada. The first presentation covered the Phase 1 Trial of Pb-212-VMT-alpha-NET for Somatostatin Receptor Positive Tumors in Specific Metastatic or Inoperable Tumors. The second presentation included a Phase 1/2 Trial of Pb-212-VMT-alpha-NET for Pheochromocytoma/Paraganglioma and GI Neuroendocrine Tumors that Had Been Treated with Radioligand Therapy.
• October 2023- Enterome unveiled updated and encouraging results from the Phase 1/2 SPENCER trial of EO2401 in combination with nivolumab for two types of adrenal tumors—adrenocortical carcinoma (ACC) and metastatic pheochromocytoma/paraganglioma (MPP)—today. EO2401 is comprised of three HLA-A2-restricted peptides derived from the microbiome and are non-self. Its purpose is to stimulate memory CD8 T cells that target tumor-associated antigens (TAAs) that are upregulated in adrenal tumors.