Folliculotropic mycosis fungoides (FMF), one type of cutaneous T-cell lymphoma is a rare disease in which white blood cells, namely lymphocytes become harmful or cancerous causing adverse effect on skin. Red patches on skin without any injury can be a sign of the disease. The disease is more prominent in males than in females with a ratio between 1.6 and 2. Several treatments are there but they are performed based on how severe the disease is and previous medical treatments. Treatments such as Irradiation, Photochemotherapy, using ultraviolet A, light treatment enhanced with psoralen (PUVA), photodynamic therapy, carbon dioxide laser surgery are performed. Performing surgery first has its own benefit as providing radiation to the same location at a later time preserves options for future therapy.
Growing Prevalence of Radiation Therapy as a Treatment
Radiation therapy uses radiations to destroy the cancer cells. Radiation therapy can be performed to get rid of the cancerous cells entirely or to control the symptoms in severe stages. A study by Thomas et al reported that a single dose of radiation (700-800cGy) results in giving much more palliations than multiple fraction radiation treatment among patients with cutaneous T-cell lymphoma (CTCL). The International Lymphoma Radiation Oncology Group Network advices total dose of 8-12Gy to be given to patients of CTCL. According to redjournal.org, radiation therapy doses provide good clinical response and less toxicity.
Among 270 lesions on which radiation treatment was performed, 97% were treated with 700cGy of radiation. The complete response rate was among 94.4% lesions and partial response was witnessed in 3.7% of patients. Only 1 lesion showed zero response. Therefore, radiation treatment may be a good response for mycosis fungoids and thus, its demand may fuel in the treatment sector.
Effectiveness of Extracorporeal Photopheresis (ECP) may Help Grow the Treatment Market
Many patients suffering from advanced cutaneous T-cell lymphomas may be treated by ECP. It is a painless procedure that treats the white blood cells improving the symptoms. Besides, CTCL, ECP is used for treating lung transplant rejection, heart transplant rejection, and chronic graft versus host disease. The procedure is safe and typically takes 2 hours in total. The procedure can be performed with a single piece of equipment and is easier to evaluate the quality and quantity of treated mononuclear cells. Slight side effects can be observed such as numbness or headache and eyes and skin is more sensitive to sunlight after the treatment. Moreover, ECP treatment is cost effective as compared to other treatments.
Thus, comfortable and speedy treatment plays a crucial role in encouraging the patients to adopt the procedure. Awareness regarding these treatments is another factor why the market may fuel growth.
High Cost of Treatment may Impact the Market
Chemotherapies or any other treatment for cancer is high in cost and large population of the world cannot afford that which cause deaths and may impact the treatment market also. For instance, an article by ncbi.nlm.nih.gov reports, phototherapy with psoralens and ultraviolet A light (PUVA) cost almost 3,187 Euros for 6 months, electron beam therapy costs around 7,913 Euros for 6 months. Also, higher incidences of the diseases are reported in Spain only.
India is also the region where a large number of population do not have health insurance and they cannot pay out of pocket medical expenses due to lack of resources. India spends only 3.89% of GDP on health care as compared to US which spends 17.8%. Thus, in developing economies, the treatment market may be hampered due to lack of awareness and less resources available.
Competitive Landscape
Major companies in the global mycosis fungoids market are Astellas Pharma, Inc, Bayer AG, Novartis AG, Pfizer Inc, Merck Co., Inc., GlaxoSmithKline plc, Abbott, Mylan N.V, etc. Many innovations and researches are being performed to develop more painless and cost effective treatments for patients. For instance,
In July 2020, Mallinckrodt plc, a global pharmaceutical company, and Termo BCT, a global leader in blood component in Australia announced that the Medical Services Advisory Committee and Pharmaceutical Benefits Advisory Committee recommended UVADEX for extracorporeal administration with the THERAKOS CELLEX Photopheresis System. UVADEX is indicated for the treatment of the skin manifestation of CTCL and steroid refractory and steroid intolerant chronic graft versus HSC transplantation.
A research article by zaad.org, in April 2020 focuses on CADMI molecule. Based on research findings, the report states that CADMI might contribute to the pathogenesis of mycosis fungoids by inducing TCR signalling and interaction between neoplastic cells and microenvironment. Its therapeutic applications and quality of directly interacting with T-cell receptor to enhance phosphorylation, may be valuable and promising in diagnosis.
In June 2020, the 4th World Congress of Cutaneous Lymphoma suggested the use of chlormethine gel which is a topical therapy for mycosis fungoids. It is an alkylating agent which mechanism of action including cross linking of DNA in rapidly dividing cells, leading to death of the cell. The pivotel 201 study reported that the gel can be an advantage for early stage mycosis fungoides.
Regional Outlook
The demand for the treatment market is increased due to many factors such as good health care infrastructure, large population suffering from cancer, increasing geriatric population, etc.
North America is expected to dominate the FMF market due to rising prevalence and awareness related to T-cell lymphoma. According to cutaneous lymphoma foundation, CTCL is a rare disease and around 3000 new cases are recorded in US each year in adult population of above 50 years specifically and FMF can be found in 16,000-20,000 of them. In US, almost 95% of population have health insurance and thus, restrain of high cost is not effective there and high class healthcare infrastructure with every latest facility is the factor for growth of the treatment market.
Asia Pacific is also the leading region for the treatment as the region comprise of 60% of global population and 50% of patients suffering from different types of cancer. Lack of awareness and late diagnosis result in higher number of cancer patients in the region. Development of treatments and medications in the region, for example Takeda China in May 2020 announced their approved ADCETRIS for use in adult patients with relapsed or refractory systematic Anaplastic Large Cell Lymphoma. The development is aimed to lower the mortality rate of patients due to Hodgkin lymphoma.
According to report of Europe’s beating cancer plan published by Europa.eu, Europe is one of the leading regions for cancer population in the world with over 2.7 million people diagnosed with cancer in 2020 and over 1.3 million people lost their life due to the disease. Stringent regulations and actions have been taken by the government for its treatment, investment in research and innovation in European Union are the factors for growth for the treatment market. European Digital Strategy for the treatment of cancer using powerful tools such as Artificial Intelligence, and high performance computing to help patients to securely access and share their health data in an integrated format in the electronic health records is going to be proposed in 2021 as stated in the aforementioned report. It will highly benefit every type of cancer treatment market.
Segmentation
By Treatment
- Chemotherapy
- Radiation Therapy
- Immunotherapy
- Targeted Therapy
By Drug Type
- Topical Steroids
- Mechlorethamine
- Interferons
By End-user
- Hospitals
- Private Clinics
- Specialty Clinics
By Region
- North America
- Europe
- Asia Pacific
- Middle East and Africa
Key Questions Answered
- What are the drugs recommended for FMF? Topical steroids, mechlorethamine and interferons are specially recommended for FMF disease.
- Who are the leading companies in the FMF treatment market? Bayer AG, Novartis AG, Pfizer Inc, Merck Co., Inc., GlaxoSmithKline plc, etc. are the leading companies.
- Which region to hold the largest market share? North America and Europe are the most advanced regions in health care infrastructure and treatment also.
- Which treatment is highly effective and comfortable? Radiation therapy and ECP.
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