According to WHO cancer is one of the most leading causes for death with around 8 million deaths and 14 million new patients in 2012. Chemotherapy, which is received by approximately four million cancer patients each year, is among the most commonly used treatment to fight cancer. However, this mode of treatment has many side effects, an estimate of around 70% – 80% of the patients receiving chemotherapy treatment experience chemotherapy-induced nausea and vomiting (CINV). CINV can be categorized into 4 types – Acute emesis – patient experiencing nausea and vomiting within 24 hours, Delayed emesis – patient experiencing nausea and vomiting after 24 hours of chemotherapy, Anticipatory emesis – occurs in future chemotherapy cycles as a response to the adverse memory of previous treatments. Breakthrough emesis and refractory emesis – occurs in following chemotherapy sessions after failed prophylactic treatment by antiemetics. CINV as the most distressing adverse effect of chemotherapy, is one of the main factor for the discontinuation of the chemotherapy cycle. Even after significant progression in the anti-emetics drug research, CINV remains the most concerned adverse event of the treatment cycle.
Complete understanding of the pathophysiology of CINV is yet to be achieved. However, Chemotrigger Zone and Gastrointestinal tract are two pathways which are anticipated to be involved with nausea and vomiting in chemotherapy. Chemotherapy triggers vomiting through the release of neurotransmitters serotonin, substance P, and dopamine. Advancements in research and development of medications have contributed to a number of effective agents available to manage CINV. The primary objective of antiemetic drugs is the total prevention of CINV in maximum number of patients administering chemotherapy agents.
Rising number of patients undergoing chemotherapy and increasing compliance to chemotherapy drugs due to varied treatment options such as transdermal patches and combination therapies are drivers propelling the growth of the CINV treatment market. Further, influenced by the new technology to discover highly potential newer drugs is generating opportunity for the growth of the CINV treatment market. Pharmaceutical companies are focusing on opportunities to expand their market presence and product portfolio by implementing growth strategies such as alliances and acquisitions. Increase in the investment by pharmaceutical companies in R&D of CINV treatment drugs with enhanced abilities for larger market share is the growing trend for this market. Advanced technologies in the administration of drugs such as needle free, cost-effective, and painless transdermal patches are projected to support the growth of the market.
The availability of a range of non-drugs and drug treatment options helps with the easy management of CINV. The choice of the drugs used to prevent CINV is mainly based on the type of chemotherapy agents used and its vomiting inducing ability. The non-drug treatment is mostly used for anticipatory nausea and vomiting.
On the basis of receptor antagonist, the market is segmented into serotonin receptor antagonists (5-HT3RAs), which block the serotonin receptor; neurokinin-1 receptor antagonists, which block the substance P receptor and corticosteroids. These drugs are used in combination or as single agent depending on the type of CINV. Additional clinical benefits were observed with the use of newer drugs, including palonosetron a second-generation 5-HT3 receptor antagonist and aprepitant NK-1 antagonist to manage moderate to high emetogenic effect. Cannabinoids and benzodiazepines are few other potentially effective drugs. In spite of all these an extensive continuous research with newer drugs and their combinations is required for CINV drugs.
Based on geography, the CINV market is segmented into North America, Europe, Asia Pacific, and Rest of the World. North America would dominate the market and according to the annual report by American Cancer Society approximately 1.6 million population would be effected by cancer in U.S in the year 2017 and thus it would occupy the largest market share for CINV treatment market. The Asia Pacific market is also expected to grow at a considerable rate in the near future owing to a significant rise in cancer patients and increase in the use of chemotherapy drugs. Other factors such as increased expenditure on health care infrastructure are contributing to the growth of the global market.
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Some of the key participants operating in the CINV treatment market are Heron Therapeutics, Inc., Merck & Co, Inc., GlaxoSmithKline plc, Helsinn Holding S.A., and Tesaro, Inc.