Brain Tumors Market in the seven major markets was estimated to be USD 2,089.4 Million in 2020

The Brain Cancer Market is expected to surge due to the disease's increasing prevalence and awareness during the forecast period. Furthermore, launching various multiple-stage Brain Cancer pipeline products will significantly revolutionize the Acute Brain Cancer Market dynamics.

The Brain Cancer market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM Brain Cancer market size from 2018 to 2030. The report also covers current Brain Cancer treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.

Key takeaways from the Brain Cancer Market
• The total incident population of Primary Brain Tumors in the seven major markets was estimated to be 60,246 in 2020. In case of Primary Brain Tumors patients in the United States, the incident cases were 23,056 in 2020.
• The total incident population of Primary Brain Tumors in the 7MM is expected to increase at a CAGR of 0.96% during the forecast period 2021-2030.
• Brain Tumors can be divided into, Low-grade (I and II) and High-grade (III and IV) tumors. In the United States, these cases were band 16,139, respectively, in 2020.
• In the United States, the incidence of Brain Tumors was 13,534 in males and 9,522 in females, in 2020.
• There are many types of Brain Tumors; however, the types that are considered in this report include Pilocytic Astrocytoma, Diffuse Astrocytoma, Anaplastic Astrocytoma, Oligodendrogliomas, Glioblastoma Multiforme (GBM), Diffuse midline glioma (Earlier called as DIPG), and others, which represented 1,383, 3,458, 1,844, 1,614, 11,989, 853, and 1,914 cases, respectively, in the United States, in 2020.
• In the United States, the highest incidence of Brain Tumors was in the age-group 40-64 years with 10,144 cases, followed by the age-group ≥65 years with 8,992 cases in 2020. The lowest incidence of Brain Tumors was reported in the age-group 0-39 years with 3,919 cases in 2020.
• In the EU5 countries, the incident population of Primary Brain Tumors was maximum in Italy with 7,320 cases, followed by the Germany with 7,173 cases in 2020. While, the United Kingdom accounted for the lowest incident population of the indication with 4,433 cases in 2020.
• As per Delvelnsight's analysis, Japan had 8,275 incident cases of Primary Brain Tumors in 2020.
• The leading Brain Cancer Market Companies include Genentech, Merck, Orbus Therapeutics, VBL Therapeutics, Bayer, MedImmune, DNAtrix, Oncoceutics, Karyopharm Therapeutics, Ziopharm, Novartis, and others.
• Promising Brain Cancer Pipeline Therapies incudes Nivolumab, Temozolomide, Radiotherapy, GLIADEL, hCRF, Afatinib, Dexanabinol, and others

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Brain Cancer Overview
A brain tumor, known as an intracranial tumor, central nervous system (CNS) tumors represent a group of diseases that have in common the abnormal development of mass lesions in the brain, spinal cord or its coverings. A brain tumor can be classified into two main groups, i.e. primary and metastatic. A primary brain tumor is often described as "low grade" or "high grade." A low-grade tumor generally grows slowly, but it can turn into a high-grade tumor, whereas a high-grade tumor is more likely to grow faster. Secondary brain tumors, also called brain metastases, are much more common than primary tumors in adults. The most common types of primary tumors in adults are meningiomas and astrocytomas, such as glioblastomas. In children, the most common types of brain tumors include medulloblastomas, low-grade astrocytomas (pilocytic), ependymomas, craniopharyngiomas, and brainstem gliomas. All types of brain tumors produce symptoms that vary depending on the part of the brain involved. These symptoms may include headaches, seizures, problems with vision, vomiting and mental changes. Even though the exact cause of most brain tumors is unknown, some uncommon risk factors include exposure to chemicals, radiation, and family history of brain tumors.

Brain Cancer Epidemiology Segmentation in the 7MM
• Total Primary Brain Tumors Incidence
• Primary Brain Tumors Grade-specific Incidence
• Primary Brain Tumors Type-specific Incidence
• Primary Brain Tumors Gender-specific Incidence
• Primary Brain Tumors Age-specific Incidence

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Brain Cancer Treatment Market
Treatment options for brain cancers include surgery, radiation therapy, chemotherapy, and targeted therapy. The treatment options and recommendations depend on several factors like the size, type, and grade of the tumor, whether the tumor is putting pressure on vital parts of the brain, if the tumor has spread to other parts of the CNS or the body, the possible side effects and finally, the treatment preferences and overall health of the patient. For a low-grade brain tumor, surgery may be the only treatment needed, especially if all of the tumor can be removed. If there is visible tumor remaining after surgery, radiation therapy and chemotherapy may be used. For higher-grade tumors, treatment usually begins with surgery, followed by radiation therapy and chemotherapy.

Brain Cancer Market Outlook
Brain tumors are solid tumors arising from transformed cells of the brain. These tumors can be of low grade (Grade I and II) or high grade (Grade III and IV). Of these, high grade tumours tend to grow rapidly and spread faster than tumours of a lower grade. Though, there are several subtypes of these tumours but DelveInsight has only considered the most common ones for which certain pipeline therapies are being investigated.

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Brain Cancer Marketed Drugs

Avastin: Genentech
Avastin (Bevacizumab) is a recombinant humanized monoclonal IgG1 antibody, which acts as angiogenesis inhibitor by blocking its target, vascular endothelial growth factor (VEGF). Bevacizumab binds to the vascular endothelial growth factor (VEGF) with its receptor VEGFR-1 and VEGFR-2, which are present on the surface of endothelial cells. This helps in reducing the activity of VEGF and regressing the vascularization of tumors, which normalizes the tumor vasculature and inhibits the formation of new tumor vasculature, thereby preventing the tumor growth. VEGF is a chemical signal that stimulates angiogenesis in a variety of diseases, especially in cancer. Bevacizumab was the first clinically available angiogenesis inhibitor in the United States. Avastin is indicated for the treatment of glioblastoma with progressive disease in adult patients following prior therapy as a single agent.

Temodar/Temodal: Merck
The active pharmaceutical ingredient in Temodar/Temodal, is an imidazotetrazine derivative of the alkylating agent dacarbazine, used for the treatment of newly diagnosed glioblastoma multiforme and refractory anaplastic astrocytoma. The therapeutic benefit of temozolomide is due to its ability to alkylate/methylate DNA. This alkylation/methylation destroys the DNA and triggers the death of the tumor cells. Temozolomide targets selectively tumoral tissues; it has an anti-neoplastic effect; it has minimum influence on adjacent brain tissues; it has no severe systemic toxicity, and it is eliminated rapidly. Temodar/Temodal was initially commercialized by Merck in the different countries, whereas Baxter Oncology was responsible for the manufacture of Temodar injection. However, due to patent expiry, the market holds the generic version of the drug. Recently, the gel formulation of Temozolomide has also been approved by Double Bond Pharmaceuticals.

Brain Cancer Emerging Drugs

Eflornithine + Lomustine: Orbus Therapeutics
Eflornithine (α-difluoromethylornithine or DFMO) is an orally bioavailable small molecule and an irreversible inhibitor of ornithine decarboxylase (ODC) that presents a cytostatic effect in rapidly dividing cells. ODC is a key enzyme in the first step of the synthesis of polyamines, converting ornithine to putrescine and it is known that ODC is up-regulated in certain types of cancer. Eflornithine has already been approved by the FDA in intravenous form to treat patients with African trypanosomiasis (sleeping sickness) and was subsequently approved by FDA in a topical form to treat patients with excessive facial hair, or hirsutism. Historically, the company has investigated this drug in several combinations for recurrent malignant gliomas, AA and anaplastic oligoastrocytoma, as well as for recurrent or progressive gliomas.

Ofranergene obadenovec (VB-111): VBL Therapeutics
Ofranergene obadenovec (VB-111) is a first-in-class, targeted anticancer gene-therapy agent that is being developed by VBL Therapeutics to treat a wide range of solid tumors such as GBM. It is a non-replicating adenovirus 5 (Ad-5, El-deleted) carrying a proapoptotic human Fas-chimera transgene that targets angiogenic blood vessels and leads to vascular disruption. In patients, improvement has been experienced in post treatment fever suggesting that VB-111's mode of action involves induction of a tumor-directed immune response. This mechanism retains activity regardless of baseline tumor mutations or the identity of the proangiogenic factors secreted by the tumor. VB-111 is the first agent, based on transcriptional targeting of tumor endothelium, to be assessed in a clinical trial. The drug is being investigated using VBL's proprietary Vascular Targeting System (VTS) platform Technology to target endothelial cells in the tumor vasculature for cancer therapy, which is conveniently administered as an intravenous infusion once every 2 months.

Regorafenib: Bayer
Regorafenib is an oral multi-kinase inhibitor that potently blocks multiple protein kinases involved in tumor angiogenesis (VEGFR1, -2, -3, TIE2), oncogenesis (KIT, RET, RAF-1, BRAF), metastasis (VEGFR3, PDGFR, FGFR) and tumor immunity (CSF1R). It is an inhibitor of multiple membrane-bound and intracellular kinases involved in normal cellular functions and pathologic processes such as oncogenesis, tumor angiogenesis, and maintenance of the tumor microenvironment. Regorafenib is already approved under the brand name Stivarga in more than 90 countries, including the US, countries of the European Union, China and Japan for metastatic colorectal cancer, metastatic gastrointestinal stromal tumors and hepatocellular carcinoma.

Durvalumab (MEDI4736): MedImmune
Durvalumab is an investigational human monoclonal antibody directed against the programmed cell death ligand 1 (PD-L1) protein in development by MedImmune. Signals from PD-L1 help tumors avoid detection by the immune system. Durvalumab blocks these signals, countering the tumor's immune-evading strategies. The antibody belongs to an emerging class of immunotherapies commonly referred to as checkpoint inhibitors; because they remove checks, the body places on immune activation. The mechanism of action of Durvalumab includes PD-L1 expression on tumor cells and tumor-associated immune cells in the tumor microenvironment that can be induced by inflammatory signals and cytokines. PD-L1 blocks T-cell function and activation by interacting with PD-1 and CD80 (B7.1) and reduces cytotoxic T-cell activity, proliferation, and cytokine production.

Tasadenoturev (DNX-2401): DNAtrix
DNX-2401, explored by DNAtrix, is oncolytic immunotherapy designed to fulfill the dual requirements of high potency and safety. In order to achieve this, two stable genetic changes in the adenovirus genome were engineered that cause it to replicate selectively in retinoblastoma (Rb) pathway deficient cells and infect tumor cells efficiently. Results from preclinical and clinical studies indicate that DNX-2401 replicates in human tumors, elicits tumor necrosis, triggers intratumoral immune cell infiltration and can lead to long term tumor destruction.

DNAtrix is planning a Phase III study to investigate the drug as a monotherapy for glioblastoma patients. Additionally, the company is also evaluating DNX-2401 in a Phase I study for the treatment of diffuse intrinsic pontine glioma, where the company received FDA Fast Track and Rare Pediatric Disease designations.

ONC201: Oncoceutics
A novel therapeutic intervention of Imipridone class is in development by Oncoceutics, i.e., ONC201, which is a highly selective antagonist of dopamine receptor D2 (DRD2) and ClpP agonist that can penetrate the blood-brain-barrier effectively. ONC201 engages proven anticancer pathways that lead to apoptosis in cancer cells. It is a small molecule originally identified as TNF-related apoptosis-inducing ligand (TRAIL)-inducing compound. It has a unique ability to induce expression of both pro-death ligand TRAIL and its receptor DR5 through the engagement of the cellular integrated stress response (ISR) pathway. ONC201 has demonstrated single-agent efficacy in eliminating cancer stem cells CSCs in glioblastoma, colorectal, and prostate cancer models.

Selinexor (KPT-330): Karyopharm Therapeutics
Selinexor (KPT-330) is a first-in-class, oral Selective Inhibitor of Nuclear Export/SINE compound in development by Karyopharm Therapeutics. It functions by binding with and inhibiting the nuclear export protein XPO1 (also called CRM1), leading to the accumulation of tumor suppressor proteins in the cell nucleus, which subsequently reinitiates and amplifies their tumor suppressor function; this is supposed to lead to the selective induction of apoptosis in cancer cells, while largely sparing normal cells. The drug has been approved with a brand name Xpovio for patients in combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti‐CD38 monoclonal antibody.

Ad-RTS-hIL-12 + Veledimex: Ziopharm
Ad-RTS-hIL-12 plus veledimex is gene therapy with an Adenoviral vector (Ad) providing the vehicle engineered to express IL-12 under the control of the RheoSwitch Therapeutic System (RTS). IL-12 is a protein that can improve the body's natural response to disease by enhancing the immune system's ability to kill tumor cells that may interfere with blood flow to the tumor. The drug is being investigated using Ziopharm's Controlled IL-12 platform to help provide therapy for cold tumors-ones that exhibit little or no immune system activity- to hot by calling in an immune response.

Everolimus (RAD001): Novartis
Everolimus (RAD001) is an orally administered drug that works by interrupting the PI3K/Akt/mTOR cell-signaling pathway that is overactive in certain tumors. The drug inhibits explicitly mTOR, a protein that may help many tumors grow, thereby stopping the hyperactivation. It binds to an intracellular protein, FKBP-12, resulting in an inhibitory complex formation with mTOR complex 1 (mTORC1) and thus inhibition of mTOR kinase activity. The drug has already been approved as an anti-cancer agent for other tumor types and is currently being investigated to treat low-grade gliomas..

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Table of Content
1. Key Insights
2. Report Introduction
3. Brain Cancer Market Overview at a Glance
4. Executive Summary of Brain Cancer
5. Key Events
6. SWOT Analysis
7. Disease Background and Overview
8. Treatment
9. National Comprehensive Cancer Network (NCCN) Guidelines for Central Nervous System Cancers (2020)
10. Neurological and vascular complications of primary and secondary brain tumors: EANO-ESMO Clinical Practice Guidelines for prophylaxis, diagnosis, treatment and follow-up (2020)
11. NICE Guidelines: Brain tumors (primary) and brain metastases in adults (2018)
12. Treatment Algorithm
14. Organizations contributing towards Brain Cancer
15. Patient Journey
16. Marketed Drugs
17. Emerging Therapies
18. Potential of Current Therapies and Emerging Therapies
19. Brain Cancer: Seven Major Market Analysis
20. KOL Views
21. Market Drivers
22. Market Barriers
23. Unmet Needs
24. Reimbursement and Market Access
25. Appendix
26. DelveInsight Capabilities
27. Disclaimer
28. About DelveInsight

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