Despite the effect of smoking cessation limiting growth in the number of non-small-cell lung cancer (NSCLC) cases, the market for drugs to treat NSCLC will increase to more than $6 billion in 2021, from $4.6 billion in 2011, says new research.

The entry into the market of seven new NSCLC drug treatments, and particularly of two immunotherapies in addition to increased use of Pfizer's Xalkori (crizotinib), will drive this growth, which will occur despite generic and biosimilar erosion of key agents used in the management of this cancer, according to the report, from Decision Resources.

Sales of Eli Lilly's Alimta (pemetrexed), a branded drug that dominated the NSCLC market in 2011, will weaken significantly during the second half of the forecast period, following the entry of generics, it adds.

The treatment of NSCLC is becoming increasingly personalised, the study finds. The co-development of drugs and companion diagnostics will help developers achieve success in patient populations that had not appeared to be commercially viable.

"The potential success of such an approach is exemplified by Xalkori and by Abbott Molecular's Vysis ALK Break Apart FISH Probe Kit," says Decision Resources analyst Orestis Mavroudis-Chocholis. "The high response rates seen in patients selected using the companion diagnostic underlie the premium pricing and potential reimbursement hurdles, turning a seemingly small and unprofitable patient subset into a lucrative and well-served market segment," he adds.

Most agents currently in the NSCLC pipeline are being developed for specific molecular targets and to improve the safety and efficacy of currently-available chemotherapeutic approaches. In the next 10 years, Decision Resources says it expects the launch of several agents that are positioned to treat specific subpopulations of patients - these drugs include Boehringer Ingelheim's Tomtovok (afatinib), Pfizer's dacomitinib, Genentech/Roche/Chugai's MetMAb and Bristol-Myers Squibb/Ono Pharmaceutical's nivolumab.

Decision Resources also finds that, despite the downward effect on risk associated with smoking cessation, the number of lung cancer cases will continue to increase when aggregated across all seven largest mature markets - the US, France, Germany, Italy, Spain, the UK and Japan - as a result of the effect of population ageing outweighing the effect of smoking cessation. 

However, this scenario varies considerably between these seven countries, with cases in Spain showing a 74% increase to 2031, while the UK will experience an 8% decrease over the same period.