China's Futu Securities has learned that the market for radionuclide ligand therapy (RLT therapy) is expected to experience significant growth by 2030, with Novartis AG's (NVS.US) RLT product Pluvicto expected to take the largest share in the field of prostate cancer therapy.

In over half of the countries around the world, prostate cancer is the most frequently diagnosed cancer among men. The incidence and mortality rates of prostate cancer remain high. A major report on prostate cancer in The Lancet pointed out that the number of global prostate cancer cases is projected to increase from 1.4 million per year in 2020 to 2.9 million per year in 2040, doubling the number of affected individuals. The largest increase is expected in low- and middle-income countries. It is estimated that the number of global deaths from prostate cancer per year will increase from 0.375 million in 2020 to nearly 0.7 million in 2040, an increase of approximately 85%.

RLT therapy is a new method of treating cancer. This therapy uses specific molecules bound to radioactive isotopes to precisely target tumor lesions and eliminate cancer cells using radiation. In recent years, innovative radionuclide ligand therapy (RLT) represented by lutetium-177 has become a focus in the diagnosis and treatment of prostate cancer. This therapy has been proven to be effective and safe in the treatment of gastroenteropancreatic neuroendocrine tumors and prostate cancer. It has notably improved the survival rates of patients with advanced metastatic prostate cancer.

According to data from GlobalData, Pluvicto (177Lu-PSMA-617), which was approved by the U.S. Food and Drug Administration (FDA) in 2022, is rapidly becoming the mainstream RLT product for prostate cancer. In 2023, Pluvicto achieved sales revenue of 0.98 billion USD with a 260% increase, coming close to becoming a billion dollar 'blockbuster' drug. By 2024, the sales revenue of Pluvicto is expected to jump to over 1.5 billion USD, and further reach around 4.3 billion USD by 2030.

Although Pluvicto is not the first RLT therapy approved for prostate cancer—Bayer's Xofigo (radium-223 dichloride) was approved in the United States in 2013—the sales of Xofigo are significantly lower compared to Pluvicto. GlobalData predicts that Xofigo's sales revenue will be only 0.244 billion USD in 2024, and will decrease to 0.161 billion USD by 2030. However, Bayer collaborated with Bicycle Therapeutics (BCYC.US) in May 2023 to develop new radiopharmaceuticals, which are expected to provide more RLT therapies.

Thomas Wales, an oncology and hematology analyst at GlobalData, stated that Pluvicto's strong trial results will drive its growth. It is reported that in March 2022, Pluvicto was approved by the FDA for use in adult patients with metastatic castration-resistant prostate cancer (mCRPC) who have prostate-specific membrane antigen (PSMA) positive tumors and have previously received a hormone receptor pathway inhibitor (APRI) and taxane chemotherapy. The approval of Pluvicto was based on a key phase III clinical trial (VISION) which showed that adding Pluvicto to standard treatment for advanced PSMA-positive mCRPC patients significantly extended both radiographic progression-free survival (rPFS, 8.7 vs 3.4 months) and overall survival (OS, 15.3 vs 11.3 months).

Thomas Wales also added that Novartis recently submitted an application to expand the indications of Pluvicto to patients who have not yet received paclitaxel chemotherapy. If this application is approved, it will expand the potential patient market.

RLT therapies developed by other pharmaceutical companies for prostate cancer are also expected to be on the market in the coming years, including Eli Lilly and Co's lutetium Lu 177 dotatate. This therapy is expected to be approved by 2025. GlobalData predicts that sales revenue of lutetium in 2025 will be only $0.125 billion and is projected to increase to $1.65 billion by 2030. In addition, Eli Lilly and Co acquired radiopharmaceutical company POINT BioPharma for $1.4 billion in 2023, which is developing clinical and preclinical RLT therapies for cancer treatment.

AstraZeneca acquired Fusion Pharma for $2.4 billion to obtain the prostate cancer RLT candidate drug FPI-2265-202. This acquisition was completed earlier in 2024. Although the Phase 2/3 trial plan for this candidate drug targeting PSMA-positive mCRPC patients is expected to be completed in 2026, GlobalData predicts that this therapy will be approved by 2028 with sales revenue of only $0.182 billion by 2030.