This ‘Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) - Market Insights, Epidemiology, and Market Forecast - 2030' report delivers an in-depth understanding of the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), historical and forecasted epidemiology as well as the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.
The Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market report provides current treatment practices, emerging drugs, Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market share of the individual therapies, current and forecasted Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market size from 2018 to 2030 segmented by seven major markets. The Report also covers current Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) treatment practice/algorithm, market drivers, market barriers, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.
Study Period: 2018-2030
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) is one of the major ionizing radiation toxicities and normal tissue injuries that result from radiotherapy. RIOM is a normal tissue injury lasting between 7 and 98 days, which starts as an acute inflammation of the oral mucosa, tongue, and pharynx after radiotherapy (RT) exposure. Radiation-induced mucositis is initiated by direct injury to basal epithelial cells and cells in the underlying tissue. DNA-strand breaks can result in cell death or injury.
RIOM is a major dose-limiting toxicity in head and neck cancer (HNC) patients. It is a normal tissue injury caused by radiation/RT, which has marked adverse effects on patient quality of life and cancer therapy continuity. It is a challenge for radiation oncologists since it leads to cancer therapy interruption, poor local tumor control, and changes in dose fractionation. RIOM occurs in 100% of altered fractionation radiotherapy HNC patients.
HNCs include cancers in the larynx, throat, lips, mouth, nose, and salivary glands. Tobacco use, heavy alcohol use, and infection with human papillomavirus (HPV) increase the risk of head and neck cancers. Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the mucosal surfaces of the head and neck (for example, those inside the mouth, throat, and voice box). These cancers are referred to as squamous cell carcinomas of the head and neck. HNCs can also begin in the salivary glands, sinuses, or muscles or nerves in the head and neck, but these types of cancer are much less common than squamous cell carcinomas.
Clinical signs of mucosal damage and cell death appear after the first 1-2 weeks of radiation therapy. Initial mucosal damage results in patchy erythema, edema, atrophy, and whitening of the mucosal tissue with increased sensitivity - patients report a burning sensation in the mouth. Further mucosal epithelium loss occurs in the fourth or fifth week of conventionally fractionated radiation, resulting in fibrinous exudation, confluent inflammation, and ulceration. Mouth sores and swelling can cause severe oral pain, swallowing difficulties, weight loss, and dehydration. Mucosal injury makes the patient more susceptible to oral-super infection, which causes more discomfort, changes in taste and appetite, and a lower quality of life.
Diagnosis is based on the symptoms the patient is experiencing and the appearance of the mouth's tissues following bone marrow transplants or radiotherapy. Red burn-like sores or ulcers throughout the mouth are enough to diagnose mucositis. Oral mucositis is typically diagnosed based on the appearance, location, and timing of oral lesions, as well as the medical history, which may show a medication or treatment form that is highly linked with Oral Mucositis. Useful laboratory studies for confirming diagnosis and etiology, especially if the infection is suspected, are as follows. CBC Count, viral culture and fungal testing, etc.
The treatment of RIOM is essentially symptomatic, with the treatment of complicated infections and promotion of wound healing of the oral mucosa. If the patient develops severe RIOM, the suspension of RT may be required. The Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ ISOO) Clinical Practice Guidelines are commonly used to treat RIOM.
When RIOM is accompanied by mild pain, acetaminophen and lidocaine can be applied. Acetaminophen with codeine suspension can be used for moderate pain, and strong opioids such as morphine or fentanyl need to be used when mucositis progresses to cause severe pain. A morphine mouthwash (0.2%) may effectively treat pain due to RIOM to reduce the need for systemic morphine. The destruction of the integrity of oral epithelial cells and the decline in the ability of mucosal repair are major features of RIOM. Many growth factors and cytokines are used clinically to promote mucosal repair and healing in RIOM.
Keratinocyte growth factor (KGF) is a type of human embryonic lung fibroblast growth factor that enhances the regenerative capacity of epithelial tissues and protects them from various toxic agents. Palifermin is an N-terminal, truncated version of KGF. Epidermal growth factor (EGF) enhances mucosal wound healing and tissue generation by regulating epithelial cell proliferation, growth, and migration. And different cytokines or growth factors (KGF, GM-CSF, EGF, and MSCs) affect different cell lines (keratinocytes, macrophages, and fibroblasts), thus promoting the healing of the oral mucosa.
RIOM represents an interaction of oral mucosal cells and tissues, pro-inflammatory cytokines (IL-11, IL-1, and IL-6), and local factors. Benzydamine is a nonsteroidal drug that has shown topical anti-inflammatory, analgesic, anesthetic, and antimicrobial activities and can be used to treat RIOM in patients with HNC. Topically administered corticosteroids have been widely used in treating RIOM, as they can reduce edema, inhibit inflammation, and alleviate symptoms of patients, but the long-term administration of topical steroids may promote candidiasis. Chlorhexidine gluconate is widely recognized as an antimicrobial agent that helps avoid plaque development and control early periodontal infections. Misoprostol is a synthetic analog of prostaglandin E1 with anti-inflammatory and mucosa-protecting properties. Amifostine can enable intensified treatment by ameliorating mucosal destruction, but it does not reduce antitumor efficacy.
LLLT is one of the most recent and promising treatment approaches for RIOM. MASCC/ISOO recommends LLLT for oral mucositis in HNC patients receiving RT. LLLT promotes the proliferation of multiple cells, mainly through activating the mitochondrial respiratory chain and initiating cellular signaling. In addition, it increases the gene expression and protein synthesis of TNF-α, IL-6, and IL-8 to treat RIOM showed good results with reductions in both the incidence and severity of RIOM with no adverse effects and LLLT can reduce the duration of RIOM to relieve pain.
The Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) epidemiology division provides insights about historical and current Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) patient pool and forecasted trends for every seven major countries. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of The report also provides the diagnosed patient pool and their trends along with assumptions undertaken.
In the year 2020, the total incident cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) was 129.7 K cases in the 7MM which are expected to grow during the study period, i.e., 2018-2030.
The disease epidemiology covered in the report provides historical as well as forecasted Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) epidemiology [segmented as Total Incident Cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), Total Grade-specific Cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), and Total Treated Cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC)] in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2018 to 2030.
The drug chapter segment of the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) report encloses the detailed analysis of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) marketed drugs and late stage (Phase-III and Phase-II) pipeline drugs. It also helps to understand the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) 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.
Avasopasem (Galera Therapeutics)
Avasopasem, also known as avasopasem manganese or GC4419 is Galera's lead product candidate. It is an investigational, highly selective small-molecule superoxide dismutase (SOD) mimetic that is being developed for the reduction of radiation-induced severe oral mucositis. Avasopasem manganese is designed to rapidly and selectively convert superoxide to hydrogen peroxide and oxygen, protecting normal tissue from damage associated with radiation therapy. Left untreated, elevated superoxide can damage noncancerous tissues and lead to debilitating side effects, including oral mucositis, which can limit the anti-tumor efficacy of radiation therapy.
SGX942 (dusquetide) (Soligenix)
SGX942 (dusquetide) is an investigational agent being developed by Soligenix. SGX942 is a rapid 4-minute infusion administered twice per week during chemotherapy and/or radiation treatment to reduce the duration and severity of severe oral mucositis. It is an intravenous formulation of the Innate Defense Regulator, dusquetide. Dusquetide is the active ingredient in SGX942, which is unique in its mechanism addressing the underlying innate immune dysfunction that contributes to the severity and duration of mucositis. Dusquetide targets the intracellular control pathways including the protein p62 of the innate immune system - changing the character of the innate immune response.
Validive (Onxeo)
Validive (clonidine Lauriad) is a mucoadhesive tablet based on the Lauriad technology that delivers high concentrations of an anti-inflammatory active principle (clonidine) directly in the oral cavity, the site of irradiation in the treatment of head and neck cancer. The tablet is placed under the patient's upper lip where it adheres to the gums for several hours, releasing the active ingredient into the saliva.
CareMin650 (NeoMedLight)
CareMin650 previously ONCORED from NeoMedLight is a device using the light-emitting fabric Lightex - unique patented technology - emitting light through woven optic fibers. It tackles the huge unmet clinical need of mucositis in cancer patients and reduces its societal, emotional, and economic burden. CareMin650's operating mode is photo-biomodulation, which uses the properties of specific light waves. Photobiomodulation, scientifically and clinically proven by numerous studies, is a complex biological mechanism of cell reparation that stimulates the proliferation and migration of healthy cells. It allows inflammation reduction and so contributes to pain alleviation.
MuReva (MuReva Phototherapy System)
MuReva is developing MuReva Phototherapy System which is an intraoral illuminated mouthpiece that can simultaneously deliver light to all soft tissue susceptible to oral mucositis. The illuminated mouthpiece is made of a soft, flexible silicone material, which is key for the comfort of the patients. It is capable of delivering the correct dosage of light for an efficient treatment.
Cooral (BrainCool)
Cooral is a single-use oral cooling device that links to a portable cooling system and cools the oral mucosa. Cooral is equipped with an ECU200 water cooling unit that circulates 8°C water into an attached mouthpiece which is inserted into the patient's mouth. The Cooral Device is a distinctive product and today has no rival in the market, as was verified by a very rapid patent approval. The product thus presents a 'breakthrough technology,' that is a revolutionary technology with a major clinical advantage over the drugs commercially available.
Note: Detailed emerging therapies assessment will be provided in the final report.
Radiation-induced oral mucositis (RIOM) is one of the most frequent complications in head and neck cancer (HNC) patients undergoing radiotherapy (RT). Head and neck cancer is a common type of neoplasm, including neck tumors, otolaryngology tumors, and oral-maxillofacial tumors, such as nasopharyngeal, oropharyngeal, hypopharyngeal, and laryngeal cancers. In recent years, radiotherapy has become increasingly popular as a treatment for HNC patients. RT techniques include intensity-modulated radiotherapy (IMRT), stereotactic body radiation therapy, particle therapy, and high-dose-rate brachytherapy. The typical radiation regimen for HNC patients comprises a dose of 2 Gy per day for 5-7 continuous weeks, with a total cumulative dose of 60-70 Gy.
RIOM represents a major complication in HNC patients undergoing RT, occurring in almost all patients treated for cancers of the mouth, oropharynx, and nasopharynx. RIOM is an inflammatory or ulcerative lesion caused by radiation-induced damage to basal cells rather than direct damage to superficial cells. RIOM usually appears 2.5 weeks after RT initiation and continues for 2-3 weeks after treatment completion. Clinically, RIOM is characterized by pain in the oropharynx, dysphagia, language disorders, and nutritional deterioration.
Mucositis management mainly relies on symptom management and prevention of complications, which includes pain control, nutritional support, and prophylaxis/treatment of secondary infections. The Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ ISOO) recommends or suggests (depending on the level of supporting evidence) interventions for the prevention or treatment of OM in specific patient populations. Oral care is a key factor in the prevention and mitigation of oral injury; thus, reducing the microbial load and educating the patient regarding oral hygiene is very important. Other preventive measures include cryotherapy, keratinocyte growth factor-1, low-level laser therapy, benzydamine mouthwash, and zinc.
Patients should be educated on the value of good oral health relative to cancer therapy. Oral hygiene instructions should be given, which include tooth brushing, flossing, and rinsing with bland (saline or sodium bicarbonate) solutions. Regular oral assessment during therapy is, therefore, an important component of a program to assure maximum oral health. Diet plays a role in oral health. Therefore, patients should be advised on a food selection that promotes, or which could interfere with, oral health. Since patients may experience modification of taste, changes in appetite, and dysphagia, food recommendations need to balance the need to maintain intake with the increased risk of oral disease. Avoidance of foods containing processed sugar, particularly those of a sticky consistency, should be discussed. Acidic and spicy foods may exacerbate the discomfort of mucositis and should be avoided. Dentists should take initiative to prevent and management of mucositis by reducing and preventing local and systemic infection, patient education, and optimal quality of life.
The Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market size in the 7MM is expected to change during the study period 2018-2030. The therapeutic market of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) in the seven major markets is expected to increase during the study period (2018-2030) with a CAGR of 12.2%. According to the estimates, the highest market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) is found in the United States followed by Japan.
The total market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) therapies in the United States is expected to increase with a CAGR of 13.2% in the study period (2018-2030).
The total market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) therapies in EU-5 countries is expected to increase with a CAGR of 10.9% in the study period (2018-2030).
The total market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) therapies in Japan is expected to increase with a CAGR of 9.5% in the study period (2018-2030).
The drugs which are in pipeline include:
Note: Detailed emerging therapies assessment will be provided in the final report.
Analyst Commentary
Access and Reimbursement Scenario in Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Therapies
Currently, available RIOM treatment in HNC patients focuses on reducing symptoms and complications. The treatment regimens include analgesic and anti-inflammatory drugs, medications, and LLLT. For grade I and II RIOM, the treatments mainly concern oral care, especially postprandial oral cleaning, mouthwash with saline, and nutritional support. Apart from these, patients can also use mucosal protective agents. For grade III-IV RIOM, in addition to the treatment measures of grade I-II, patients can also add anti-inflammatory drugs and hormones.
There is also a need to pay attention to pain management, adding different analgesics according to the level of pain. Low-level laser therapy (LLLT) can also be considered to use for patients. However, at present, for the prevention and treatment of radiation-induced mucosal injury, the medical community has not yet formed any standardized medical nutrition treatment program, and the mechanism of mucosal injury remains to be thoroughly studied.
According to National Institute for Health and Care Excellence (NICE) (2018), low-level laser therapy (LLLT) aims to treat or prevent OM by promoting healing, reducing inflammation, and increasing cell metabolism. A hand-held probe is used to deliver light in the red or near-infrared spectrum to the oral mucosa. It can be delivered intra-orally or extra-orally or as a combination of both approaches. During intra-oral treatment, the probe, which is about the size of the dental curing light, is introduced into the mouth. For extra-oral treatment, the probe is positioned close to the cheek. The procedure typically takes 20-30 min and is delivered two to five times a week for the duration of the oncology treatment. The procedure may be started before treatment with radiotherapy begins, to prevent OM.
NICE also recommends the LLLT for the treatment of RIOM owing to the current evidence on the safety of low-level laser therapy for oral mucositis, which shows no major safety concerns. Evidence on efficacy is adequate in quality and quantity. Therefore, this procedure can be used if standard arrangements are in place for clinical governance, consent, and audit.
As per the European Oral Care in Cancer (EOCC) Group & Oral Care Guidance and Support (2017), patients, particularly those about to commence head and neck radiation treatments, should undergo a comprehensive oral and dental assessment by a specialist. This is to establish general oral health status and identify and manage existing and/or potential sources of infection, trauma, or injury. Depending on patients' oral health, they may need regular oral hygienist visits before, during, and after treatment. Some patients will need regular periodontal follow-up throughout and after treatment.
Benzydamine 0.15% oral solution (Difflam) used 10 mL rinsed around the mouth and spat out four times a day. The United Kingdom Oral Mucositis in Cancer Care Group (UKOMiC) (2015) also recommends that some head and neck patients undergoing radiation may require toothpaste with a higher content of fluoride (over 1,500 ppm) to protect the teeth. These guidelines also state that in the head and neck settings, Difflam is recommended for patients receiving radiation only (up to 50 Gy).
According to the study Elting et al. (2019), the incremental cost of oral mucositis was approximately USD 5,000-30 ,000 among patients receiving radiation therapy. The excess costs associated with mucositis result from managing costly and serious outcomes, most notably, excess days with enteral or parenteral feedings, hospitalization, and episodes of febrile neutropenia. For example, between 15% and 55% of patients undergoing head and neck cancer radiation require enteral feedings.
The study also stated that the mean daily cost of percutaneous endoscopic gastrostomy (PEG) or nasogastric (NG) tube management is approximately USD 30, often required for 4-6 months. The total cost for inserting a PEG tube is almost 10 times that of an NG tube because the PEG tubes are inserted by surgeons (USD 540 and USD 43, respectively). Furthermore, the inpatient cost for patients with PEG tubes is three times that of patients with NG tubes.
Note: Detailed HTA assessment will be provided in the final report.
To keep up with current market trends, we take KOLs and SMEs ' opinions working in the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) domain through primary research to fill the data gaps and validate our secondary research. Their opinion helps to understand and validate current and emerging therapies treatment patterns or Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market trends. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the market and the unmet needs.
The publisher performs Competitively and Market Intelligence analysis of the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) Market by using various Competitive Intelligence tools that includes - SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.
This in-depth analysis of the pipeline assets across different stages of development (Phase III and Phase II), different emerging trends, and comparative analysis of pipeline products with detailed clinical profiles, key cross-competition, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.
The Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market report provides current treatment practices, emerging drugs, Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market share of the individual therapies, current and forecasted Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market size from 2018 to 2030 segmented by seven major markets. The Report also covers current Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) treatment practice/algorithm, market drivers, market barriers, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.
Geography Covered
- The United States
- EU5 (Germany, France, Italy, Spain, and the United Kingdom)
- Japan
Study Period: 2018-2030
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC): Disease Understanding and Treatment Algorithm
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Overview
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) is one of the major ionizing radiation toxicities and normal tissue injuries that result from radiotherapy. RIOM is a normal tissue injury lasting between 7 and 98 days, which starts as an acute inflammation of the oral mucosa, tongue, and pharynx after radiotherapy (RT) exposure. Radiation-induced mucositis is initiated by direct injury to basal epithelial cells and cells in the underlying tissue. DNA-strand breaks can result in cell death or injury.
RIOM is a major dose-limiting toxicity in head and neck cancer (HNC) patients. It is a normal tissue injury caused by radiation/RT, which has marked adverse effects on patient quality of life and cancer therapy continuity. It is a challenge for radiation oncologists since it leads to cancer therapy interruption, poor local tumor control, and changes in dose fractionation. RIOM occurs in 100% of altered fractionation radiotherapy HNC patients.
HNCs include cancers in the larynx, throat, lips, mouth, nose, and salivary glands. Tobacco use, heavy alcohol use, and infection with human papillomavirus (HPV) increase the risk of head and neck cancers. Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the mucosal surfaces of the head and neck (for example, those inside the mouth, throat, and voice box). These cancers are referred to as squamous cell carcinomas of the head and neck. HNCs can also begin in the salivary glands, sinuses, or muscles or nerves in the head and neck, but these types of cancer are much less common than squamous cell carcinomas.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Diagnosis
Clinical signs of mucosal damage and cell death appear after the first 1-2 weeks of radiation therapy. Initial mucosal damage results in patchy erythema, edema, atrophy, and whitening of the mucosal tissue with increased sensitivity - patients report a burning sensation in the mouth. Further mucosal epithelium loss occurs in the fourth or fifth week of conventionally fractionated radiation, resulting in fibrinous exudation, confluent inflammation, and ulceration. Mouth sores and swelling can cause severe oral pain, swallowing difficulties, weight loss, and dehydration. Mucosal injury makes the patient more susceptible to oral-super infection, which causes more discomfort, changes in taste and appetite, and a lower quality of life.
Diagnosis is based on the symptoms the patient is experiencing and the appearance of the mouth's tissues following bone marrow transplants or radiotherapy. Red burn-like sores or ulcers throughout the mouth are enough to diagnose mucositis. Oral mucositis is typically diagnosed based on the appearance, location, and timing of oral lesions, as well as the medical history, which may show a medication or treatment form that is highly linked with Oral Mucositis. Useful laboratory studies for confirming diagnosis and etiology, especially if the infection is suspected, are as follows. CBC Count, viral culture and fungal testing, etc.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Treatment
The treatment of RIOM is essentially symptomatic, with the treatment of complicated infections and promotion of wound healing of the oral mucosa. If the patient develops severe RIOM, the suspension of RT may be required. The Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ ISOO) Clinical Practice Guidelines are commonly used to treat RIOM.
When RIOM is accompanied by mild pain, acetaminophen and lidocaine can be applied. Acetaminophen with codeine suspension can be used for moderate pain, and strong opioids such as morphine or fentanyl need to be used when mucositis progresses to cause severe pain. A morphine mouthwash (0.2%) may effectively treat pain due to RIOM to reduce the need for systemic morphine. The destruction of the integrity of oral epithelial cells and the decline in the ability of mucosal repair are major features of RIOM. Many growth factors and cytokines are used clinically to promote mucosal repair and healing in RIOM.
Keratinocyte growth factor (KGF) is a type of human embryonic lung fibroblast growth factor that enhances the regenerative capacity of epithelial tissues and protects them from various toxic agents. Palifermin is an N-terminal, truncated version of KGF. Epidermal growth factor (EGF) enhances mucosal wound healing and tissue generation by regulating epithelial cell proliferation, growth, and migration. And different cytokines or growth factors (KGF, GM-CSF, EGF, and MSCs) affect different cell lines (keratinocytes, macrophages, and fibroblasts), thus promoting the healing of the oral mucosa.
RIOM represents an interaction of oral mucosal cells and tissues, pro-inflammatory cytokines (IL-11, IL-1, and IL-6), and local factors. Benzydamine is a nonsteroidal drug that has shown topical anti-inflammatory, analgesic, anesthetic, and antimicrobial activities and can be used to treat RIOM in patients with HNC. Topically administered corticosteroids have been widely used in treating RIOM, as they can reduce edema, inhibit inflammation, and alleviate symptoms of patients, but the long-term administration of topical steroids may promote candidiasis. Chlorhexidine gluconate is widely recognized as an antimicrobial agent that helps avoid plaque development and control early periodontal infections. Misoprostol is a synthetic analog of prostaglandin E1 with anti-inflammatory and mucosa-protecting properties. Amifostine can enable intensified treatment by ameliorating mucosal destruction, but it does not reduce antitumor efficacy.
LLLT is one of the most recent and promising treatment approaches for RIOM. MASCC/ISOO recommends LLLT for oral mucositis in HNC patients receiving RT. LLLT promotes the proliferation of multiple cells, mainly through activating the mitochondrial respiratory chain and initiating cellular signaling. In addition, it increases the gene expression and protein synthesis of TNF-α, IL-6, and IL-8 to treat RIOM showed good results with reductions in both the incidence and severity of RIOM with no adverse effects and LLLT can reduce the duration of RIOM to relieve pain.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Epidemiology
The Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) epidemiology division provides insights about historical and current Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) patient pool and forecasted trends for every seven major countries. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of The report also provides the diagnosed patient pool and their trends along with assumptions undertaken.
Key Findings
In the year 2020, the total incident cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) was 129.7 K cases in the 7MM which are expected to grow during the study period, i.e., 2018-2030.
The disease epidemiology covered in the report provides historical as well as forecasted Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) epidemiology [segmented as Total Incident Cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), Total Grade-specific Cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), and Total Treated Cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC)] in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2018 to 2030.
Country Wise- Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Epidemiology
- Estimates show that the highest cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) in the 7MM were in the United States, followed by Japan, France, Germany, the United Kingdom, Italy, and Spain in 2020.
- In the United States, the total number of incident cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) was 50.8 K cases in the year 2020 which is expected to grow during the study period, i.e., 2018-2030.
- In the year 2020, the total incident cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) were 58.91 K cases in EU-5 which are expected to grow during the study period, i.e., 2018-2030.
- In Japan, the total number of prevalent cases of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) was 19.95 K cases in the year 2020 which are expected to grow during the study period, i.e., 2018-2030.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Drug Chapters
The drug chapter segment of the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) report encloses the detailed analysis of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) marketed drugs and late stage (Phase-III and Phase-II) pipeline drugs. It also helps to understand the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) 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.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Emerging Drugs
Avasopasem (Galera Therapeutics)
Avasopasem, also known as avasopasem manganese or GC4419 is Galera's lead product candidate. It is an investigational, highly selective small-molecule superoxide dismutase (SOD) mimetic that is being developed for the reduction of radiation-induced severe oral mucositis. Avasopasem manganese is designed to rapidly and selectively convert superoxide to hydrogen peroxide and oxygen, protecting normal tissue from damage associated with radiation therapy. Left untreated, elevated superoxide can damage noncancerous tissues and lead to debilitating side effects, including oral mucositis, which can limit the anti-tumor efficacy of radiation therapy.
SGX942 (dusquetide) (Soligenix)
SGX942 (dusquetide) is an investigational agent being developed by Soligenix. SGX942 is a rapid 4-minute infusion administered twice per week during chemotherapy and/or radiation treatment to reduce the duration and severity of severe oral mucositis. It is an intravenous formulation of the Innate Defense Regulator, dusquetide. Dusquetide is the active ingredient in SGX942, which is unique in its mechanism addressing the underlying innate immune dysfunction that contributes to the severity and duration of mucositis. Dusquetide targets the intracellular control pathways including the protein p62 of the innate immune system - changing the character of the innate immune response.
Validive (Onxeo)
Validive (clonidine Lauriad) is a mucoadhesive tablet based on the Lauriad technology that delivers high concentrations of an anti-inflammatory active principle (clonidine) directly in the oral cavity, the site of irradiation in the treatment of head and neck cancer. The tablet is placed under the patient's upper lip where it adheres to the gums for several hours, releasing the active ingredient into the saliva.
CareMin650 (NeoMedLight)
CareMin650 previously ONCORED from NeoMedLight is a device using the light-emitting fabric Lightex - unique patented technology - emitting light through woven optic fibers. It tackles the huge unmet clinical need of mucositis in cancer patients and reduces its societal, emotional, and economic burden. CareMin650's operating mode is photo-biomodulation, which uses the properties of specific light waves. Photobiomodulation, scientifically and clinically proven by numerous studies, is a complex biological mechanism of cell reparation that stimulates the proliferation and migration of healthy cells. It allows inflammation reduction and so contributes to pain alleviation.
MuReva (MuReva Phototherapy System)
MuReva is developing MuReva Phototherapy System which is an intraoral illuminated mouthpiece that can simultaneously deliver light to all soft tissue susceptible to oral mucositis. The illuminated mouthpiece is made of a soft, flexible silicone material, which is key for the comfort of the patients. It is capable of delivering the correct dosage of light for an efficient treatment.
Cooral (BrainCool)
Cooral is a single-use oral cooling device that links to a portable cooling system and cools the oral mucosa. Cooral is equipped with an ECU200 water cooling unit that circulates 8°C water into an attached mouthpiece which is inserted into the patient's mouth. The Cooral Device is a distinctive product and today has no rival in the market, as was verified by a very rapid patent approval. The product thus presents a 'breakthrough technology,' that is a revolutionary technology with a major clinical advantage over the drugs commercially available.
Note: Detailed emerging therapies assessment will be provided in the final report.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Market Outlook
Radiation-induced oral mucositis (RIOM) is one of the most frequent complications in head and neck cancer (HNC) patients undergoing radiotherapy (RT). Head and neck cancer is a common type of neoplasm, including neck tumors, otolaryngology tumors, and oral-maxillofacial tumors, such as nasopharyngeal, oropharyngeal, hypopharyngeal, and laryngeal cancers. In recent years, radiotherapy has become increasingly popular as a treatment for HNC patients. RT techniques include intensity-modulated radiotherapy (IMRT), stereotactic body radiation therapy, particle therapy, and high-dose-rate brachytherapy. The typical radiation regimen for HNC patients comprises a dose of 2 Gy per day for 5-7 continuous weeks, with a total cumulative dose of 60-70 Gy.
RIOM represents a major complication in HNC patients undergoing RT, occurring in almost all patients treated for cancers of the mouth, oropharynx, and nasopharynx. RIOM is an inflammatory or ulcerative lesion caused by radiation-induced damage to basal cells rather than direct damage to superficial cells. RIOM usually appears 2.5 weeks after RT initiation and continues for 2-3 weeks after treatment completion. Clinically, RIOM is characterized by pain in the oropharynx, dysphagia, language disorders, and nutritional deterioration.
Mucositis management mainly relies on symptom management and prevention of complications, which includes pain control, nutritional support, and prophylaxis/treatment of secondary infections. The Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ ISOO) recommends or suggests (depending on the level of supporting evidence) interventions for the prevention or treatment of OM in specific patient populations. Oral care is a key factor in the prevention and mitigation of oral injury; thus, reducing the microbial load and educating the patient regarding oral hygiene is very important. Other preventive measures include cryotherapy, keratinocyte growth factor-1, low-level laser therapy, benzydamine mouthwash, and zinc.
Patients should be educated on the value of good oral health relative to cancer therapy. Oral hygiene instructions should be given, which include tooth brushing, flossing, and rinsing with bland (saline or sodium bicarbonate) solutions. Regular oral assessment during therapy is, therefore, an important component of a program to assure maximum oral health. Diet plays a role in oral health. Therefore, patients should be advised on a food selection that promotes, or which could interfere with, oral health. Since patients may experience modification of taste, changes in appetite, and dysphagia, food recommendations need to balance the need to maintain intake with the increased risk of oral disease. Avoidance of foods containing processed sugar, particularly those of a sticky consistency, should be discussed. Acidic and spicy foods may exacerbate the discomfort of mucositis and should be avoided. Dentists should take initiative to prevent and management of mucositis by reducing and preventing local and systemic infection, patient education, and optimal quality of life.
Key Findings
The Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market size in the 7MM is expected to change during the study period 2018-2030. The therapeutic market of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) in the seven major markets is expected to increase during the study period (2018-2030) with a CAGR of 12.2%. According to the estimates, the highest market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) is found in the United States followed by Japan.
The United States Market Outlook
The total market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) therapies in the United States is expected to increase with a CAGR of 13.2% in the study period (2018-2030).
EU-5 Countries: Market Outlook
The total market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) therapies in EU-5 countries is expected to increase with a CAGR of 10.9% in the study period (2018-2030).
Japan Market Outlook
The total market size of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) therapies in Japan is expected to increase with a CAGR of 9.5% in the study period (2018-2030).
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Pipeline Development Activities
The drugs which are in pipeline include:
- Avasopasem (Galera Therapeutics)
- SGX942 (dusquetide) (Soligenix)
- Validive (Onxeo)
- CareMin650 (NeoMedLight)
- MuReva (MuReva Phototherapy System)
- Cooral (BrainCool)
Note: Detailed emerging therapies assessment will be provided in the final report.
Analyst Commentary
- Ongoing development for future therapeutical options plays an important role in the development of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC). Due to the increasing patient pool, the market of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) is expected to increase in the forecast period.
- Lack of public awareness, information about the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), and Lack of Diagnostic Methods of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), and the high economic burden.
Access and Reimbursement Scenario in Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Therapies
Currently, available RIOM treatment in HNC patients focuses on reducing symptoms and complications. The treatment regimens include analgesic and anti-inflammatory drugs, medications, and LLLT. For grade I and II RIOM, the treatments mainly concern oral care, especially postprandial oral cleaning, mouthwash with saline, and nutritional support. Apart from these, patients can also use mucosal protective agents. For grade III-IV RIOM, in addition to the treatment measures of grade I-II, patients can also add anti-inflammatory drugs and hormones.
There is also a need to pay attention to pain management, adding different analgesics according to the level of pain. Low-level laser therapy (LLLT) can also be considered to use for patients. However, at present, for the prevention and treatment of radiation-induced mucosal injury, the medical community has not yet formed any standardized medical nutrition treatment program, and the mechanism of mucosal injury remains to be thoroughly studied.
According to National Institute for Health and Care Excellence (NICE) (2018), low-level laser therapy (LLLT) aims to treat or prevent OM by promoting healing, reducing inflammation, and increasing cell metabolism. A hand-held probe is used to deliver light in the red or near-infrared spectrum to the oral mucosa. It can be delivered intra-orally or extra-orally or as a combination of both approaches. During intra-oral treatment, the probe, which is about the size of the dental curing light, is introduced into the mouth. For extra-oral treatment, the probe is positioned close to the cheek. The procedure typically takes 20-30 min and is delivered two to five times a week for the duration of the oncology treatment. The procedure may be started before treatment with radiotherapy begins, to prevent OM.
NICE also recommends the LLLT for the treatment of RIOM owing to the current evidence on the safety of low-level laser therapy for oral mucositis, which shows no major safety concerns. Evidence on efficacy is adequate in quality and quantity. Therefore, this procedure can be used if standard arrangements are in place for clinical governance, consent, and audit.
As per the European Oral Care in Cancer (EOCC) Group & Oral Care Guidance and Support (2017), patients, particularly those about to commence head and neck radiation treatments, should undergo a comprehensive oral and dental assessment by a specialist. This is to establish general oral health status and identify and manage existing and/or potential sources of infection, trauma, or injury. Depending on patients' oral health, they may need regular oral hygienist visits before, during, and after treatment. Some patients will need regular periodontal follow-up throughout and after treatment.
Benzydamine 0.15% oral solution (Difflam) used 10 mL rinsed around the mouth and spat out four times a day. The United Kingdom Oral Mucositis in Cancer Care Group (UKOMiC) (2015) also recommends that some head and neck patients undergoing radiation may require toothpaste with a higher content of fluoride (over 1,500 ppm) to protect the teeth. These guidelines also state that in the head and neck settings, Difflam is recommended for patients receiving radiation only (up to 50 Gy).
According to the study Elting et al. (2019), the incremental cost of oral mucositis was approximately USD 5,000-30 ,000 among patients receiving radiation therapy. The excess costs associated with mucositis result from managing costly and serious outcomes, most notably, excess days with enteral or parenteral feedings, hospitalization, and episodes of febrile neutropenia. For example, between 15% and 55% of patients undergoing head and neck cancer radiation require enteral feedings.
The study also stated that the mean daily cost of percutaneous endoscopic gastrostomy (PEG) or nasogastric (NG) tube management is approximately USD 30, often required for 4-6 months. The total cost for inserting a PEG tube is almost 10 times that of an NG tube because the PEG tubes are inserted by surgeons (USD 540 and USD 43, respectively). Furthermore, the inpatient cost for patients with PEG tubes is three times that of patients with NG tubes.
Note: Detailed HTA assessment will be provided in the final report.
KOL-Views
To keep up with current market trends, we take KOLs and SMEs ' opinions working in the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) domain through primary research to fill the data gaps and validate our secondary research. Their opinion helps to understand and validate current and emerging therapies treatment patterns or Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market trends. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the market and the unmet needs.
Competitive Intelligence Analysis
The publisher performs Competitively and Market Intelligence analysis of the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) Market by using various Competitive Intelligence tools that includes - SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.
Scope of the Report
- The report covers the descriptive overview of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC), explaining its causes, signs and symptoms, pathophysiology, and currently available therapies.
- Comprehensive insight has been provided into the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) epidemiology and treatment in the 7MM.
- Additionally, an all-inclusive account of both the current and emerging therapies for Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
- A detailed review of the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) market; historical and forecasted is included in the report, covering drug outreach in the 7MM.
- The report provides an edge while developing business strategies, by understanding trends shaping and driving the global Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) market.
Report Highlights
- In the coming years, the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) market is set to change due to the upcoming therapies with a novel route of administrations which are under investigation and ongoing research in the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC); which would expand the size of the market to enable the drug manufacturers to penetrate more into the market.
- The companies and academics are working to assess challenges and seek opportunities that could influence Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
- Major players are involved in developing therapies for Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC). The launch of emerging therapies will significantly impact the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) market.
- A better understanding of disease pathogenesis will also contribute to the development of novel therapeutics for Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC).
This in-depth analysis of the pipeline assets across different stages of development (Phase III and Phase II), different emerging trends, and comparative analysis of pipeline products with detailed clinical profiles, key cross-competition, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Report Insights
- Patient Population
- Therapeutic Approaches
- Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Pipeline Analysis
- Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Market Size and Trends
- Market Opportunities
- Impact of upcoming Therapies
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Report Key Strengths
- 10 Years Forecast
- 7MM Coverage
- Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Epidemiology Segmentation
- Key Cross Competition
- Highly Analyzed Market
- Drugs Uptake
Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Report Assessment
- SWOT Analysis
- Current Treatment Practices
- Unmet Needs
- Pipeline Product Profiles
- Conjoint Analysis
- Market Attractiveness
- Market Drivers and Barriers
Key Questions Answered
Market Insights:
- What was the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Market share (%) distribution in 2018 and how it would look like in 2030?
- What would be the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) total market size as well as market size by therapies across the 7MM during the study period (2018-2030)?
- What are the key findings of the market across the 7MM and which country will have the largest Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market size during the study period (2018-2030)?
- At what CAGR, the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) market is expected to grow in the 7MM during the study period (2018-2030)?
- What would be the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market outlook across the 7MM during the study period (2018-2030)?
- What would be the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) market growth till 2030 and what will be the resultant market size in the year 2030?
- How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?
- Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) patient types/pool where unmet need is more and whether emerging therapies will be able to address the residual unmet need?
- How emerging therapies are performing on the parameters like efficacy, safety, route of administration (RoA), treatment duration, and frequencies based on their clinical trial results?
- Among the emerging therapies, what are the potential therapies which are expected to disrupt the Radiation-induced Oral Mucositis (RIOM) in the Head & Neck Cancer (HNC) market?
Epidemiology Insights:
- What are the disease risks, burdens, and unmet needs of the Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC)?
- What is the historical Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) patient pool in the seven major markets covering the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan?
- What would be the forecasted patient pool of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) in the 7 major markets covering the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan?
- What will be the growth opportunities in the 7MM concerning the patient population about Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC)?
- Out of all the 7MM countries, which country would have the highest prevalent population of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) during the study period (2018-2030)?
- At what CAGR the population is expected to grow in the 7MM during the study period (2018-2030)?
- What are the various recent and upcoming events which are expected to improve the diagnosis of Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC)?
Table of Contents
1. Key Insights2. Report Introduction5. Epidemiology and Market Methodology10. Conclusion12. Patient Journey13. Key Endpoints in Radiation-induced Oral Mucositis in Head & Neck Cancer Clinical Trials18. KOL Views19. Market Drivers20. Market Barriers21. SWOT Analysis22. Unmet Needs24. Publisher Capabilities25. Disclaimer26. About the Publisher
3. Radiation-induced Oral Mucositis (RIOM) in Head & Neck Cancer (HNC) Market Overview at a Glance
4. Executive Summary of Radiation-induced Oral Mucositis (RIOM) in Head and Neck Cancer
6. Disease Background and Overview
7. Diagnosis of Radiation-induced Oral Mucositis in Head and Neck Cancer
8. Treatment of Radiation-induced Oral Mucositis in Head and Neck Cancer
9. Radiation-Induced Oral Mucositis Guidelines
11. Epidemiology and Patient Population
14. Marketed Therapies
15. Emerging Therapies
16. Radiation-induced Oral Mucositis in Head & Neck Cancer: 7 Major Market Analysis
17. Market Access and Reimbursement
23. Appendix
List of Tables
List of Figures
Companies Mentioned (Partial List)
A selection of companies mentioned in this report includes, but is not limited to:
- AMAG Pharmaceuticals/SpePharm
- Camurus
- Innovation Pharmaceuticals
- Enzychem Lifesciences Corporation
- Galera Therapeutics
- EpicentRx/Prothex Pharma
- Soligenix
- Onxeo/Monopar Therapeutics
- Izun Pharmaceuticals
- NeoMedLight
- MuReva Phototherapy (Lumitex)
- BrainCool