Esophageal Cancer - Market Insight, Epidemiology and Market Forecast - 2032

Key Highlights:

• Esophageal cancer (EC) occurs in the esophagus - a long hollow muscular tube that transports food from the neck to the stomach. Esophageal cancer, also known as esophagus cancer, develops in the cells that line the esophagus and occurs when a malignant tumor arises in the esophagus lining.
• In 2022, the market size of Esophageal Cancer (EC) was highest in the US, accounting for approximately USD 400 million, which is further expected to increase by 2032.
• Esophageal malignancies are often discovered as a result of a person's indications or symptoms. Examinations, testing, and a biopsy (a sample of esophageal cells) will be required to confirm the diagnosis if esophageal cancer is suspected. If cancer is discovered, more tests will be performed to establish the stage of the malignancy. The gold standard for identifying esophageal cancer is Gastroscopy.
• Histologically, there are two forms of primary Esophageal Cancer: squamous cell carcinoma and adenocarcinoma; small cell carcinoma is an uncommon type of Esophageal Cancer. These several types of cancer arise in various types of cells in the esophagus. They evolve in distinct ways, necessitating therapeutic techniques tailored to each individual.
• The staging system most often used for Esophageal Cancer is the American Joint Committee on Cancer (AJCC) TNM system, which is based on three key pieces of information, that is the extent of the tumor (T), spread to nearby lymph nodes (N) and spread (metastasis) to distant sites (M).
• The exact cause of Esophageal Cancer is unknown; however, it is thought to be related to abnormalities (mutations) in the DNA of esophageal cells. The DNA of Esophageal Cancer cells frequently shows changes in many different genes; however, it is unclear if specific gene changes can be found in all Esophageal Cancers.
• In March 2021, the FDA approved KEYTRUDA (pembrolizumab) for use in combination with platinum and fluoropyrimidine-based chemotherapy for patients with metastatic or locally advanced esophageal or gastroesophageal carcinoma who are ineligible for surgical resection or definitive chemoradiation.
• Esophageal Cancer, a relatively uncommon cancer, has very limited information and guidance available, with few opportunities for people to share experiences. This ends up leading to a lack of awareness about the disease. Its symptoms are also often mild until the cancer advances, and symptoms can be easily confused with other illnesses and digestive problems.
• The emerging pipeline for Esophageal Cancer patients consists of drugs in different lines of therapies, adjuvant, and neoadjuvant settings. It is estimated that potential drugs that can significantly change the market during the forecast period include zanidatamab, sintilimab, tislelizumab, and sotigalimab. These drugs are in the late stages of clinical development, and other players are evaluating their potential candidates in different stages of clinical development.

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

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

Geography Covered

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

Study Period: 2019-2032

Esophageal Cancer (EC) Disease Understanding and Treatment

Esophageal Cancer (EC) Overview

Esophageal cancer develops when cancer cells form in the esophagus, a tube-like tissue that connects the throat and stomach. The esophagus transports food from the mouth to the stomach. The cancer begins in the esophagus's inner layer and can spread to other layers of the esophagus and other organs of the body (metastasis).

Typically, symptoms of Esophageal Cancer do not appear until the tumor has grown large enough to impede eating, swallowing, or digesting food. The most common symptom of Esophageal Cancer is difficulty swallowing, particularly a sensation that food is lodged in the throat; in some individuals, choking on food occurs. These symptoms develop with time, with greater discomfort while swallowing as the esophagus narrows due to cancer growth.

Esophageal Cancer (EC) diagnosis

Esophageal malignancies are often discovered by indications or symptoms. Exams, testing, and a biopsy (a sample of esophageal cells) will be required to confirm the diagnosis; if cancer is identified, more tests will help establish the extent (stage). When diagnosed late, Esophageal Cancer has a terrible prognosis; however, if diagnosed early, curative therapy is feasible. Before symptoms cause individuals to seek medical assistance, the condition slowly advances. Effective presymptomatic screening procedures may enhance disease outcomes. Recent research has shed light on the early detection of Esophageal Cancer using blood testing, sophisticated endoscopic imaging, and artificial intelligence.

Further details related to country-based variations are provided in the report…

Esophageal Cancer (EC) treatment

Everyone who has esophageal cancer receives some form of therapy. Several factors, including personal preferences, cancer stage, and overall health, determine the appropriate course of therapy for each patient. Many medical professionals regularly collaborate in cancer care to construct a patient's comprehensive treatment plan, including various treatments.

Esophagectomy is the principal treatment for early-stage esophageal cancer, albeit its precise significance in superficial (T1A) cancers is still unclear, given the introduction of endoscopic mucosal therapy. A multimodal strategy for treating locally advanced cancers, comprising neoadjuvant chemotherapy or combination chemoradiotherapy (CRT) followed by surgery, is strongly recommended.

The cornerstone of contemporary esophageal cancer management is preoperative assessment. Preoperative staging accuracy is critical since the tumor board's decisions on the use of multimodal therapy will be dependent on the precision and specifics of the clinical staging evaluation. Upper endoscopy, high-resolution contrast CT scan, FDG-PET scan, and EUS are all part of the standardized evaluation of a patient undergoing curative treatment for early-stage or advanced esophageal cancer.

Doctors typically recommend combining radiation treatment, chemotherapy, and surgery for a tumor that has not spread beyond the esophagus and lymph nodes. Locally advanced esophageal cancer is usually treated with radiation treatment, chemotherapy, and surgery. Radiation treatment and chemotherapy are often combined in “chemoradiotherapy.” Radiation treatment, chemotherapy, and other drug-based therapies are commonly used to treat metastatic esophageal cancer.

Esophageal Cancer (EC) Epidemiology

As the market is derived using a patient-based model, the Esophageal Cancer (EC) epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by Total Diagnosed Incident Cases of Esophageal Cancer (EC), Age-specific Cases of Esophageal Cancer (EC), Histology-specific Cases of Esophageal Cancer (EC), Gender-specific Cases of Esophageal Cancer (EC), Mutation-specific Cases of Esophageal Cancer (EC), Stage-specific Cases of Esophageal Cancer (EC) and Line wise treated Cases of Esophageal Cancer (EC) in the 7MM covering the United States, EU4 countries (Germany, France, Italy, Spain) and the United Kingdom, and Japan from 2019 to 2032.

• The total diagnosed incident cases of Esophageal Cancer (EC) in the US comprised ~20,000 cases in 2022 and are projected to reach ~24,000 cases by 2032 at a CAGR of 1.9%, accounting for the second-highest diagnosed incident cases in the 7MM.
• In 2022, as per the age-specific cases, the 65 and above segment accounted for the highest number of cases of Esophageal Cancer. In contrast, the < 45 age group accounted for the least number of cases in the United States.
• In the United States, ~16,000 cases of Esophageal Cancer were found in case of males, whereas females accounted for ~4,200 cases of Esophageal Cancer in 2022.
• As per the Histology-specific incident cases of Esophageal Cancer, non-squamous Esophageal Cancer cases accounted for ~7,400 cases of Esophageal Cancer, whereas ~3,100 cases of squamous Esophageal Cancer were found in 2022 in the United Kingdom.

Esophageal Cancer (EC) Drug Chapters

The drug chapter segment of the Esophageal Cancer (EC) report encloses a detailed analysis of Esophageal Cancer (EC) marketed drugs and late-stage (Phase III and Phase II) pipeline drugs. It also helps understand the Esophageal Cancer (EC) 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.

Marketed Drugs

CYRAMZA (ramucirumab): Eli Lilly and Company

CYRAMZA, as a single agent or in combination with paclitaxel, is indicated for the treatment of patients with advanced or metastatic, gastric or gastroesophageal junction (GEJ) adenocarcinoma with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy. The recommended dosage of CYRAMZA as a single agent or combined with weekly paclitaxel is 8 mg/kg every 2 weeks, administered by IV infusion over 60 min. Ramucirumab is a VEGFR2 antagonist that binds VEGFR2 explicitly and blocks the binding of VEGFR ligands, VEGF-A, VEGF-C, and VEGF-D. As a result, ramucirumab inhibits ligand-stimulated activation of VEGFR2, thereby inhibiting ligand-induced proliferation and migration of human endothelial cells.

VITRAKVI (larotrectinib): Bayer

VITRAKVI (larotrectinib) is an oral TRK inhibitor for the treatment of adult and pediatric patients with solid tumors with an NTRK gene fusion without a known acquired resistance mutation that is either metastatic or where surgical resection will likely result in severe morbidity and have no satisfactory alternative treatments or have progressed following treatment. It is indicated for the treatment of adult and pediatric patients with solid tumors that have a neurotrophic receptor tyrosine kinase (NTRK) gene fusion without a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity, and have no satisfactory alternative treatments or that have progressed following treatment.

Note: Detailed current therapies assessment will be provided in the full report of Esophageal Cancer (EC)…

Emerging Drugs

Zanidatamab: Zymeworks

Zanidatamab is given with chemotherapy plus or minus Tislelizumab as a combination therapy in HER2-Expressing Gastrointestinal (GI) Cancers, including Gastroesophageal Adenocarcinoma (GEA). Zanidatamab is given along with oxaliplatin (CAPOX) or 5-fluorouracil (5-FU) and cisplatin (FP) with or without tislelizumab. This emerging asset has a novel mechanism of action. It uses biparatropic binding as it targets two HER2 epitopes. The drug has also received fast-track designation in combination with SoC chemotherapy for first-line Gastroesophageal Adenocarcinoma. As far as safety is concerned, no severe treatment-related adverse events (TRAE) were observed. The most common Grade =3 TRAE was diarrhea which was manageable in the outpatient setting.

Sintilimab: Innovent Biologics

Sintilimab is an investigational PD-1 inhibitor developed by Innovent and Eli Lilly. The drug is currently in the Phase III stage of clinical development in combination with chemotherapy as first-line treatment in subjects with unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma. It is a first-line treatment option with cisplatin + paclitaxel or cisplatin + fluorouracil regimen for patients with unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma, as per the clinical assessment of sintilimab, a 12-month overall survival of 64% was found as compared to the 88% overall survival rate of zanidatamab. The Objective Response Rate (ORR) was also slightly lesser than zanidatamab. The safety profile of Sinitilimab was not as good as zanidatamab. A decrease in neutrophil count, WBCs, and hypokalemia was observed.

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

Drug Class Insights

The therapies used for esophageal cancer include chemotherapy, targeted therapy, and immunotherapy. Chemotherapy uses medications to eradicate cancer cells, often by preventing cancer cells from growing, dividing, and proliferating. Targeted therapy for esophageal cancer includes HER2-targeted therapy and anti-angiogenesis therapy.

A chemotherapy regimen, or schedule, typically consists of a predetermined number of cycles administered over a predetermined period. A patient may be administered one medicine at a time or a mixture of drugs simultaneously. As previously stated, chemotherapy and radiation therapy are frequently used concurrently to treat esophageal cancer, a procedure known as chemoradiotherapy. Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system's ability to attack cancer cells.

Two types of immunotherapy drugs are approved to treat adenocarcinoma and squamous cell carcinoma of the esophagus and the gastroesophageal junction. This cancer grows where the stomach and esophagus meet. Pembrolizumab (KEYTRUDA) and nivolumab (OPDIVO) are both checkpoint inhibitors that target the PD-1/PD-L1 pathway.

As few potential therapies are being investigated to manage Esophageal Cancer (EC), predicting that the treatment space will experience significant reconstitution during 2023-2032 is safe.

The key players that can significantly change the market during the forecast period include zanidatamab, sintilimab, tislelizumab, and sotigalimab. All the aforementioned drugs are given in combination with chemotherapies. These drugs are in the late stages of clinical development, and other players are evaluating their potential candidates in different stages of clinical development.

• Among the 7MM countries, the United States comprised the largest market size, accounting for ~40% of the total market size.
• Among the EU4 and the UK, Italy captured the smallest market size, accounting for ~8% of the total market size of EU4 and the UK.
• Regarding neoadjuvant therapies, platinum + taxane is expected to garner market revenue of USD 0.8 million by 2022.
• The Esophageal Cancer (EC) market size in Japan is expected to increase at a CAGR of 0.6% during the forecast period (2023-2032).

Esophageal Cancer (EC) Drugs Uptake

This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2019-2032. For example, for Zanidatamab + CAPOX + Fluoropyrimidine ± Tislelizumab, which is expected to be launched in the US by 2025, the drug uptake is expected to be medium, with a probability-adjusted peak patient share of ~5% in the US, expected to peak at 6 years from the year of launch.

Esophageal Cancer (EC) 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 Esophageal Cancer (EC) emerging therapies.

KOL Views

To keep up with current market trends, we take KOLs and SME's opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry experts contacted for insights on Esophageal Cancer (EC) evolving treatment landscape, patient reliance on conventional therapies, patient's therapy switching acceptability, and drug uptake, along with challenges related to accessibility, including Medical/scientific writers and Professors from renowned universities in the US, Europe, the UK, and Japan.

This analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. National Cancer Center Hospital, University of Kentucky, etc., were contacted. Their opinion helped understand and validate current and emerging therapy treatment patterns of Esophageal Cancer (EC) 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 SWOT analysis. 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.

Market Access and Reimbursement

The cost of newly approved medications is usually high, so patients escape from proper treatment or opt for off-label and cheap medications. It affects market access to newly launched medications, and reimbursement is crucial. The decision to reimburse often comes down to the 'drug's price relative to the benefit it produces in treated patients. Market access and reimbursement options can differ depending on regulatory status, target population size, the setting of care, unmet needs, the magnitude of incremental benefit claims, and costs.

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, and a descriptive overview of Esophageal Cancer (EC), explaining the definition of Esophageal Cancer (EC), types and risk factors involved in Esophageal Cancer (EC), pathophysiology, and the treatment of Esophageal Cancer (EC).
• Comprehensive insights into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression, and treatment guidelines have been provided.
• Additionally, an all-inclusive account of the current and emerging therapies and the elaborative profiles of late-stage and prominent therapies will impact the current treatment landscape.
• A detailed review of the Esophageal Cancer (EC) 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 Esophageal Cancer (EC) market.

Esophageal Cancer (EC) Report Insights

• Patient Population
• Therapeutic Approaches
• Esophageal Cancer (EC) Pipeline Analysis
• Esophageal Cancer (EC) Market Size and Trends
• Existing and future Market Opportunity

Esophageal Cancer (EC) Report Key Strengths

• Ten years Forecast
• The 7MM Coverage
• Esophageal Cancer (EC) Epidemiology Segmentation
• Key Cross Competition
• Attribute analysis
• Drugs Uptake and Key Market Forecast Assumptions

Esophageal Cancer (EC) Report Assessment

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

Key Questions Answered

Market Insights

• What was the Esophageal Cancer (EC) total market size, the market size by therapies, market share (%) distribution in 2019, and what would it look like by 2032? What are the contributing factors for this growth?
• What kind of uptake the new therapies approved will witness in Esophageal Cancer (EC) patients in the coming years?
• Which therapy is going to be the largest contributor by 2032?
• What are the pricing variations among different geographies for approved 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 Esophageal Cancer (EC)? What will be the growth opportunities across the 7MM with respect to the patient population pertaining to Esophageal Cancer (EC)?
• What is the historical and forecasted Esophageal Cancer (EC) patient pool in the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, and Japan?
• What is the diagnostic pattern of Esophageal Cancer (EC)?
• Which clinical factors will affect Esophageal Cancer (EC)?
• Which factors will affect the increase in the diagnosis of Esophageal Cancer (EC)?

Current Treatment Scenario, Marketed Drugs, and Emerging Therapies

• What are the current options for the treatment of Esophageal Cancer (EC)? What are the current guidelines for treating Esophageal Cancer (EC) in the US, Europe, the UK, and Japan?
• How many companies are developing therapies for the treatment of Esophageal Cancer (EC)?
• How many emerging therapies are in the mid-stage and late stage of development for treating Esophageal Cancer (EC)?
• What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitation of existing therapies?
• What key designations have been granted for the emerging therapies for Esophageal Cancer (EC)?
• What is the cost burden of approved 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, recently approved therapies?
• What is the 7MM historical and forecasted market of Esophageal Cancer (EC)?

Reasons to Buy

• The report will help develop business strategies by understanding the latest trends and changing treatment dynamics driving the Esophageal Cancer (EC) 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, Spain) and the United Kingdom, and Japan.
• Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.
• Detailed analysis of emerging therapies to provide visibility around leading classes.
• Highlights of Access and Reimbursement policies of approved therapies, barriers to accessibility of expensive 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.