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Report: Angiogenesis Inhibitors Will Dominate Kidney Cancer Treatment Through 2021

Immunotherapy agent nivolumab expected to become sales leader (Nov. 26)

Decision Resources, a research and advisory firm based in Burlington, Mass., finds that small-molecule angiogenesis inhibitors will dominate the renal cell carcinoma (RCC) drug market through 2021. In 2011, this drug class held a 68% market share. The company predicts that this share will peak in 2017 at nearly 85% but will decrease to 75% in 2021, owing to the generic erosion of some therapies in this class and to the launch of the novel immunotherapy agent nivolumab (Bristol-Myers Squibb).

Over the next decade, two new small-molecule angiogenesis inhibitors are expected to launch for the treatment of advanced RCC — tivozanib (Aveo Oncology) and dovitinib (Novartis) — in addition to the 2012 launch of Inlyta (axitinib, Pfizer). Together, these agents will capture 18% of RCC therapy sales in 2021. Sutent (sunitinb, Pfizer) is currently the RCC market leader, but Votrient (pazopanib, GlaxoSmithKline) is expected to become the top-selling agent in 2016, owing to its increased use in first-line therapy.

Nivolumab will launch for the treatment of advanced RCC in the second- and third-line settings in 2017 in the U.S.

“Nivolumab will become the sales leader in the third-line setting in 2018 and the patient-share leader in 2020,” said analyst Karen Pomeranz, PhD. “In the second-line setting, it will become the sales leader in 2020. Overall, by 2021, nivolumab will be the second-highest-selling agent for RCC in the markets under study, with sales of nearly $400 million.”

Growth in key RCC patient populations is expected to be relatively flat over the next decade as the disease risk is forecast to remain stable. New therapies launched for stage IV unresectable RCC will partly contribute to a projected 6-month improvement in life expectancy over the next 10 years, with an additional 4 months by 2031 if historic trends continue.

Approximately 30% of patients diagnosed with stages I to III RCC present with an intermittent-to-high risk of relapse, which equates to more than 20,000 cases across all major markets and growing by 1.4% annually through 2031, the company predicts. This presents a treatment opportunity in the adjuvant setting, although there is no current approved therapy in this setting. The risk of disease recurrence is forecast to decrease over the next 20 years, with the largest drop expected to occur in stage III disease at an annual decrease of about 3%.

Source: Decision Resources; November 26, 2012.

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