Did you know that after small molecules, the second largest drug modality in Prostate Cancer isn’t antibodies, cell therapies, gene therapies, or nucleic acids? It’s radiopharmaceuticals.
Small molecules still dominate in 2024, with Xtandi holding over 40% of the market. And we're about to see significant growth from several others:
➡️ Erleada (J&J), which recently demonstrated a survival edge over Xtandi, is forecasted to reach $5Bn+ in 2028
➡️ Nubeqa (Bayer), with its second win in the metastatic hormone-sensitive prostate cancer (mHSPC) subtype, is projected to reach $2Bn+ in 2028
➡️ With its novel combination of a PARP inhibitor and androgen receptor inhibitor, Akeega (J&J) is also anticipated to grow quickly, becoming a $1Bn+ drug by decade’s end
➡️ Cabozantinib + atezolizumab (Exelixis), a Phase 3 combination therapy, could also potentially gain approval
After small molecules, however, radiopharmaceuticals are expected to make the biggest gains:
➡️ Pluvicto (Novartis), which delivers radiation precisely to PSMA-expressing prostate cancer cells, recently crossed the blockbuster threshold and is on track to exceed $3Bn in sales by 2028.
➡️ With its recent acquisition of Fusion Pharma, AstraZeneca's FPI-2265 is anticipated to reach $1Bn+ in sales next decade if approved, a Phase 2 targeted alpha therapy designed to deliver potent, localized radiation.
➡️ TLX591 (Telix Pharmaceuticals), currently in Phase 3, is a promising PSMA-targeted radiopharmaceutical therapy that aims to deliver precision radiotherapy to prostate cancer cells.
Beyond FPI-2265 and TLX591, the pipeline gets ever more interesting with other modalities emerging:
➡️ Vobra Duo (MacroGenics) is a Phase 2 Antibody–Drug Conjugate (ADC) that could be one of the first ADCs in Prostate Cancer, offering a targeted approach by delivering cytotoxic agents directly to tumor cells. The company announced a pause on the drug today pending more mature progression-free survival (PFS) data but if eventually approved, it has the potential to achieve $1Bn+ in sales.
➡️ Vudalimab (Xencor) is a pioneering Phase 2 Bispecific Antibody which engages both T-cells and cancer cells simultaneously. If successful, it is projected to reach over $500M in sales.
With November's annual Movember fundraiser bringing awareness to Prostate Cancer, it’s an ideal moment to spotlight these advancements. The evolving pipeline shows how targeted innovations are driving forward Prostate Cancer treatment, offering new hope for patients through more precise and powerful options.
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