Chondrosarcoma Market Insight, Epidemiology And Market Forecast - 2032

Key Highlights

• As per the NCCN Guidelines, nearly 65% of chondrosarcoma cases are related to isocitrate dehydrogenase (IDH1 or IDH2) mutations.
• In 2022, the market size of chondrosarcoma was highest in the US among the 7MM, accounting for approximately USD 8 million, which is further expected to increase by 2032.
• Conventional chondrosarcomas, which is the major subtype, are considered chemotherapy- and radiation-resistant, resulting in limited treatment options. Most advanced conventional chondrosarcomas are treated with chemotherapy without any survival benefit.
• For widespread disease, NCCN recommends considering RT, surgery, and/or ablative therapies for symptomatic sites, systemic therapy, or clinical trial. NCCN recommends that comprehensive genomic profiling (CGP) with a validated and/or FDA-approved assay should be considered for patients with metastatic chondrosarcoma to identify potential targeted therapy opportunities.
• Current chemotherapy recommendations include cisplatin and doxorubicin. Other combinations of Gemcitabine, Ifosfamide, Dasatinib, and Pazopanib have also been used but with limited success, especially in dedifferentiated and metastatic cases.
• Ivosidenib has been added as a treatment option for patients with IDH1-mutant conventional or dedifferentiated chondrosarcoma in the NCCN guidelines.
• Since chondrosarcomas are rare, it is usually very difficult to get any commercial pharma interest to pursue them. Currently, there is only one potential emerging drug in the pipeline. For the Phase I trials, it is difficult to draw conclusions because of the low numbers of chondrosarcoma enrolled and at different dose levels.
• INBX-109 is expected to witness the first mover advantage while creating its niche in a subset of patients which are unresectable or metastatic conventional chondrosarcoma. The company anticipates topline data readout from this pivotal trial by the second half of 2024, which will pave the path to approval in chondrosarcoma by 2025.

This “Chondrosarcoma - Market Insights, Epidemiology and Market Forecast - 2032 report delivers an in-depth understanding of the Chondrosarcoma, historical and forecasted epidemiology as well as the Chondrosarcoma market trends in the United States, EU4 (Germany, Spain, Italy, and France) and the United Kingdom, and Japan.

The Chondrosarcoma market report provides current treatment practices, emerging drugs, market share of individual therapies, and current and forecasted 7MM Chondrosarcoma market size from 2019 to 2032. The report also covers current Chondrosarcoma treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market's underlying potential.

Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2019-2032

Chondrosarcoma Disease Understanding and Treatment Algorithm

Chondrosarcoma Overview

Chondrosarcoma is a group of bone tumors made up of cells that make too much cartilage. The most common type of chondrosarcoma, called conventional chondrosarcoma, usually grows very slowly. Rare subtypes of chondrosarcoma, called dedifferentiated chondrosarcoma, myxoid chondrosarcoma, clear cell chondrosarcoma, and mesenchymal chondrosarcoma, may grow more quickly and may spread to other parts of the body.

They may occur at any age but are more common in older adults. Symptoms of chondrosarcoma are usually mild and depend on tumor size and location.

Chondrosarcoma Diagnosis

The patient's journey begins with symptoms such as persistent bone pain even at rest, swelling, and a large palpable mass on the affected bone. Followed by a visit to the orthopedist, where the patient is suggested diagnostic tests such as MRI, CT scan, and plain radiography. After the diagnosis patient is referred to an oncologist for further treatment. A tissue biopsy is performed of the mass removed from the most aggressive portion of the cancer as determined by imaging for confirmatory diagnosis. Once chondrosarcoma is confirmed, relevant treatment is given to the patient.

Further details related to diagnosis are provided in the report.

Chondrosarcoma Treatment

The current management of chondrosarcoma depends on the type, the grade, and the location of the tumor, while the best predictor of clinical behavior is the grading system. It is well-established that surgical treatment is the best and the only treatment for chondrosarcoma, as other treatments, such as radiotherapy and chemotherapy, are rendered unresponsive and refractory. Curettage, radical resection, and amputation are the primary surgical treatment options, while these procedures often require considerable judgment and are based on factors such as the size and site of the lesion and its degree of malignancy.

Radiation therapy and chemotherapy have limited to arguably no effect on conventional chondrosarcoma. Rarer chondrosarcoma subtypes are more responsive to chemotherapy and/or radiation therapy. Chemotherapy might have a role in dedifferentiated chondrosarcoma, although the positive effect is not consistently reported in the literature. Except for mesenchymal chondrosarcoma, most chondrosarcomas do not respond to chemotherapy or radiation therapy. Current chemotherapy recommendations include cisplatin and doxorubicin, extrapolated from recommended osteosarcoma treatment regimens.

Further aggressive surgery appears to constitute a good chance of cure in patients with local recurrence but without metastatic disease.

Chondrosarcoma Epidemiology

As the market is derived using a patient-based model, the Chondrosarcoma epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by total incident cases of chondrosarcoma, primary chondrosarcoma cases, grade-specific cases of chondrosarcoma, mutation-specific cases of chondrosarcoma, stage-specific cases of conventional chondrosarcoma in the 7MM covering the United States, EU4 countries (Germany, France, Italy, and Spain), United Kingdom, and Japan from 2019 to 2032. The total incident cases of chondrosarcoma in the 7MM comprised approximately 2,331 cases in 2022 and are projected to increase during the forecasted period.

• The total number of incident cases of chondrosarcoma in the United States was around 1,371 cases in 2022.
• The United States contributed to the largest incident population of chondrosarcoma, acquiring ~59% of the 7MM in 2022. Whereas EU4 and the UK, and Japan accounted for around 37% and 4% of the total population share, respectively, in 2022.
• Among the EU4 countries, France accounted for the largest number of Chondrosarcoma cases, followed by Germany, whereas Spain accounted for the lowest number of cases in 2022.
• According to the publisher's estimates, in the United States, there were around 485, 584, 177, and 125 cases of Grade I, II, III, and IV, respectively, in 2022.
• Among the stage-specific rates of conventional chondrosarcoma, localized conventional chondrosarcoma accounted for approximately 75% of the patient share, while rest of them were metastatic in nature
• When it comes to disease progression, the rate is quite high in patients with high grade conventional chondrosarcoma as compared to the one's with low grade conventional chondrosarcoma

Chondrosarcoma Drug Chapters

The drug chapter segment of the Chondrosarcoma report encloses a detailed analysis of the Chondrosarcoma late-stage (Phase II) pipeline drug. There are currently no approved therapies for chondrosarcoma. It also helps understand the Chondrosarcoma clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug, and the latest news and press releases.

Emerging Drug

INBRX-109: Inhibrx

INBRX-109 is the most advanced therapeutic candidate of Inhibrx and is designed to target tumor-biased direct cell death induction by DR5 activation in numerous cancer types. Efficacy and safety data from the ongoing Phase I INBRX-109 expansion cohorts for the treatment of chondrosarcoma demonstrated very promising results. The median progression-free survival (PFS) is 7.6 months, and five patients remain in the study. Currently, the drug is being evaluated in a potentially registration-enabling Phase II trial, and the company anticipates topline data readout from this pivotal trial by the second half of 2024, which will pave the path to approval in chondrosarcoma by 2025. The drug is expected to create its position in both first and second-line metastatic patients with fast uptake. Considering there is no other competition in the same patients, it is not expected to achieve its peak in revenue until it gets challenged with patents. The drug has been granted ODD and FTD.

Note: Detailed emerging therapies assessment will be provided in the final report.

Drug Class Insights

The existing treatment guidelines recommend using classes such as IDH1 inhibitors and tyrosine kinase inhibitors (TKIs).

Mutations in the isocitrate dehydrogenase 1/2 (IDH1/2) enzymes occur in up to 65% of chondrosarcomas and accumulate the oncometabolite D-2-hydroxyglutarate (2-HG). IDH1 inhibitors have resulted in durable disease control in a cohort of patients with advanced chondrosarcoma. Furthermore, mutant IDH1 inhibition in chondrosarcoma cell lines decreased 2-HG production dose-dependent and inhibited tumor cell growth. These data provide a biological rationale for mutant IDH1 inhibition as a clinical strategy in mutant IDH1 chondrosarcoma. Hence IDH1 inhibitor such as Ivosidenib has been added as a treatment option for patients with IDH1-mutant conventional or dedifferentiated chondrosarcoma in the NCCN guidelines. The observation that IDH mutations are commonly detected in chondrosarcomas offers hope that targeted mutant IDH inhibitors may provide a treatment strategy and improve outcomes for these patients.

Another class recommended by the treatment guidelines includes TKIs. Tyrosine kinase receptors are key for activating cellular downstream pathways that contribute to the pathogenesis of bone sarcomas. TKIs are progressively emerging as a therapeutic alternative for patients with recurrent unresectable or metastatic diseases that can no longer benefit from surgery or conventional chemotherapy. Dasatinib and Pazopanib have shown modest efficacy in chondrosarcoma metastatic and widespread chondrosarcoma and are recommended by the NCCN guidelines.

Moreover, the upcoming treatment landscape is poised to expand further after new classes, such as tetravalent death receptor 5 (DR5) agonist antibodies, emerge. Designed to overcome the limitations of earlier-generation agonists and exploit the tumor-specific cell death induced by DR5 activation. DR5 is one of two pro-apoptotic receptors for the trimeric tumor necrosis factor-related apoptosis-inducing ligand (TRAIL).

Chondrosarcoma Market Outlook

For both appendicular and axial chondrosarcomas, surgical treatment remains the mainstay of treatment due to its continued superiority for the long-term survival of patients, although advancements in survival over the last decade have been insignificant. Rarer chondrosarcoma subtypes are more responsive to chemotherapy and/or radiation therapy. Chemotherapy is generally ineffective in conventional chondrosarcoma, and there is no standard systemic therapy for advanced conventional chondrosarcoma. Moreover, the current chemotherapy recommendations include cisplatin and doxorubicin, which are extrapolated from recommended osteosarcoma treatment regimens.

The current market has been based on the prevailing treatment pattern across the 7MM, which presents minor variations in the overall prescription pattern. Chemotherapy, radiation + chemotherapy, and others such as pazopanib, regorafenib, and dasatinib are the current treatment options in the forecast model.

The expected launch of upcoming therapy and greater integration of early patient screening, medication in secondary care and other clinical settings, research on best methods for implementation, and an upsurge in awareness will eventually facilitate the development of effective treatment options. However, since Chondrosarcoma is an orphan disease, it is difficult to conduct clinical trials. The meager outcome data for locally advanced or metastatic patients indicate that new treatment options are needed. For the Phase I trials, it is difficult to draw conclusions because of the low numbers of chondrosarcoma enrolled and at different dose levels. Some Phase II trials show promising results, which support further research. Retrospective studies are encouraged as they could add to the limited data available. Efforts to increase the number of studies on this orphan disease are urgently needed.

• The total market size of Chondrosarcoma in the 7MM is approximately USD 9 million in 2022 and is projected to increase during the forecast period (2023-2032).
• The market size in the 7MM expected to increase at a CAGR of 24.8% due to increasing awareness of the disease and the launch of the emerging therapy.
• Among EU4 countries, France accounts for the maximum market size in 2022, while Spain occupies the bottom of the ladder.
• In Japan, the highest revenue among current therapies includes pazopanib, regorafenib, and dasatinib, followed by chemotherapy.
• The majority of therapies that are being evaluated for chondrosarcoma are in the early phase of development. Hence, the pipeline's only potential Phase II drug includes INBRX-109 by Inhibrx.

Chondrosarcoma Drugs Uptake

This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2019-2032. In Chondrosarcoma, Inhibrx is the only emerging player developing INBRX-109, with a fast uptake, with a probability-adjusted peak share of 50% in the first line setting and we expect the peak share to be higher in case of second line setting as there remains a huge unmet need in patients who have relapsed after undergoing Surgery alone or along with radiotherapy and chemotherapy.

Further detailed analysis of emerging therapies drug uptake in the report.

Chondrosarcoma Pipeline Development Activities

The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I stage. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities

The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for Chondrosarcoma emerging therapy.

KOL Views

To keep up with current market trends, we take KOLs and SMEs' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts contacted for insights on Chondrosarcoma evolving treatment landscape, patient reliance on conventional therapies, patient's therapy switching acceptability, and drug uptake, along with challenges related to accessibility, include Medical/scientific writers; Medical Oncologists; Orthopedists and Professors; MD, FACS, Chair of the Department of Orthopedic Surgery, and professor at UC Davis Comprehensive Cancer Center in Sacramento, California; MD, Director, Sarcoma Oncology Center, California; and others.

This analysts connected with 30+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as MD Anderson Cancer Center, Sarcoma Oncology Center, Cancer Research UK Barts Centre in London, MD Anderson Cancer Center, etc., were contacted. Their opinion helps understand and validate current and emerging therapy treatment patterns or Chondrosarcoma market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.

Qualitative Analysis

The publisher performs Qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and Analyst views. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.

The analyst views analyze multiple emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry.

In efficacy, the trial's primary and secondary outcome measures are evaluated; for instance, in Chondrosarcoma trials, progression-free survival is one of the most important primary outcome measures.

Further, the therapies' safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials.

Market Access and Reimbursement

Reimbursement of rare disease therapies can be limited due to lack of supporting policies and funding, challenges of high prices, lack of specific approaches to evaluating rare disease drugs given limited evidence, and payers' concerns about budget impact. The high cost of rare disease drugs usually has a limited effect on the budget due to the small number of eligible patients being prescribed the drug. The US FDA has approved several rare disease therapies in recent years. From a patient perspective, health insurance and payer coverage guidelines surrounding rare disease treatments restrict broad access to these treatments, leaving only a small number of patients who can bypass insurance and pay for products independently. Overall, treatment for bone and joint cancers can easily exceed USD 100,000 for a single patient. This is particularly true if a patient receives surgery, chemotherapy, and radiation therapy. The cost will be much higher if one includes bone-replacing endoprostheses or artificial limbs used in cases requiring amputation.

The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.

Scope of the Report

• The report covers a segment of key events, an executive summary, descriptive overview of Chondrosarcoma, explaining its causes, signs and symptoms, pathogenesis, and currently available therapies.
• Comprehensive insight into the epidemiology segments and forecasts, disease progression, and treatment guidelines has been provided.
• Additionally, an all-inclusive account of the current and emerging therapies, along with the elaborative profiles of late-stage and prominent therapies, will impact the current treatment landscape.
• A detailed review of the Chondrosarcoma market, historical and forecasted market size, market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach.
• The report provides an edge while developing business strategies, by understanding trends, through SWOT analysis and expert insights/KOL views, patient journey, and treatment preferences that help shape and drive the 7MM Chondrosarcoma market.

Chondrosarcoma Report Insights

• Patient Population
• Therapeutic Approaches
• Chondrosarcoma Pipeline Analysis
• Chondrosarcoma Market Size and Trends
• Existing and future Market Opportunity

Chondrosarcoma Report Key Strengths

• Ten Years Forecast
• 7MM Coverage
• Chondrosarcoma Epidemiology Segmentation
• Key Cross Competition
• Drugs Uptake and Key Market Forecast Assumptions

Chondrosarcoma Report Assessment

• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Market Attractiveness
• Qualitative Analysis (SWOT and Analyst Views)

Key Questions Answered

Market insights

• What was the Chondrosarcoma total market size, the market size by therapies, market share (%) distribution in 2019, and what would it look like in 2032? What are the contributing factors for this growth?
• How will IDH1 inhibitors as a class affect the treatment paradigm in the first line and second line of Chondrosarcoma in the US?
• What will be the impact of INBRX-109's expected approval in 2025?
• How would DR5 agonists perform as a class in the first- and second-line?
• What are the pricing variations among different geographies for approved and off-label therapies?
• How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?

Epidemiology insights

• What are the disease risk, burdens, and unmet needs of Chondrosarcoma? What will be the growth opportunities across the 7MM with respect to the patient population pertaining to Chondrosarcoma?
• What is the historical and forecasted Chondrosarcoma patient pool in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• Why do only limited patients appear with symptoms? Why is the current year diagnosis rate not high?
• Which type of primary Chondrosarcoma is the largest contributor in patients affected with Chondrosarcoma?
• Which grade of Chondrosarcoma have high metastatic potential?
• How many Chondrosarcoma patients are associated with IDH mutations?

Current treatment scenario, marketed drugs, and emerging therapies

• What are the current options for the treatment of Chondrosarcoma? What are the current guidelines for treating Chondrosarcoma in the US and Europe?
• How many companies are developing therapies for the treatment of Chondrosarcoma?
• How many emerging therapies are in the mid-stage and late stage of development for the treatment of Chondrosarcoma?
• What are the recent novel therapies, targets, mechanisms of action, and technologies being developed to overcome the limitation of existing therapies?
• What key designations have been granted for the emerging therapies for Chondrosarcoma?
• What will be the impact of INBX-109's expected entry for the unresectable or metastatic conventional chondrosarcoma patient pool?
• What is the cost burden of current therapies on the patient?
• Patient acceptability in terms of preferred treatment options as per real-world scenarios?
• What are the country-specific accessibility issues of expensive, current therapies? Focusing on the reimbursement policies.
• What is the 7MM historical and forecasted market of Chondrosarcoma?

Reasons to Buy

• The report will help develop business strategies by understanding the latest trends and changing treatment dynamics driving the chondrosarcoma market.
• Insights on patient burden/disease incidence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• Understand the existing market opportunity in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of approved products in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.
• Detailed analysis and ranking of class-wise potential current and emerging therapies under the Analyst view section to provide visibility around leading classes.
• Highlights of Access and Reimbursement policies of current therapies, barriers to accessibility of expensive off-label therapies, and patient assistance programs.
• To understand Key Opinion Leaders' perspectives around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet need of the existing market so that the upcoming players can strengthen their development and launch strategy.