Angiogenesis inhibitors continue to be the mainstay of first-line and second-line advanced or metastatic renal cell carcinoma. While PD-1 inhibitor, Opdivo entry in the second-line treatment setting captures a significant market share, besides axitinib in this setting. The entry combination regimens composed of immune checkpoint inhibitors and angiogenesis or mTOR inhibitors will have a significant impact on the first- and second-line patient share dynamics. Several areas of high unmet need—notably, treatments for the adjuvant and first-line patient populations—offer significant commercial opportunity for innovative agents. Approval of sunitinib as a first drug treatment option for high-risk early stage (stage I-III), along with estimated entry of multiple immune checkpoint inhibitors is set to rapidly evolve the early stage treatments. This content provides insight on how treatment options for advanced renal cell carcinoma are likely to change over the 2016-2026 forecast period. It also analyzes the current and future sales potential of drugs already in the market and those expected to be approved for the indication.
What will be the impact of immune checkpoint inhibitors in the otherwise dominated angiogenesis inhibitor treatment landscape? What will be the impact of PD-1/PD-L1 inhibitors in the adjuvant treatment setting?
In 2016, two novel small-molecule angiogenesis inhibitors entered the renal cell carcinoma market for use in previously treated patients. How will these agents change the treatment pathways for previously treated advanced or metastatic renal cell carcinoma? How will they compete with current angiogenesis inhibitors and emerging agents from other drug classes?
Immune checkpoint inhibitor combination therapies are a prominent feature of the late-phase development pipeline for renal cell carcinoma and are all positioned in the lucrative first-line setting. What is the commercial potential of combination therapies? How will first-line combination regimens (e.g., Tecentriq + Avastin; Opdivo + Yervoy; Bavencio + Inlyta) be differentiated? Which will be the winners and losers?
Sutent has provided survival benefits in the adjuvant patient population, revitalizing interest in this area of high unmet need. Other angiogenesis inhibitors and immune checkpoint inhibitors are also in late-phase development in the adjuvant patient population. How large is the early-stage (stage I-III) therapy market in renal cell carcinoma? How will it be affected by the potential approvals of angiogenesis and immune checkpoint inhibitors? What will be the uptake of these agents in the adjuvant setting?