At the dawn of a new decade, we take stock of advances and unmet needs in the oncology pharmaceutical market. What will it take to deliver innovation to patients over the next ten years?

Over the past 50 years, the outcomes for people diagnosed with cancer have transformed. In 1970, of those diagnosed with cancer in the United States, approximately half would have been alive five years later. For those diagnosed in 2009, the figure was closer to 70 percent.1

Such a transformation in outcomes has arrived through a combination of public-health measures (such as smoking education), improved healthcare (such as earlier diagnosis), and novel pharmaceutical therapies. This trifecta has turned select diagnoses, once considered terminal, into chronic conditions.

For example, most patients now diagnosed with multiple myeloma or prostate cancer will have mortality tied to conditions other than their cancer. Furthermore, oncology therapeutics accounted for $143 billion in branded pharmaceutical sales in 2019—approximately 20 percent of global pharmaceutical sales.2

 Analyst consensus figures indicate a robust 12 percent compound annual growth rate (CAGR), and global oncology therapeutics sales are forecasted to hit $250 billion by 2024.

However, there is much more to do. For those who are receiving treatment, five-year survival rates for pancreatic cancer, glioblastoma, and non-small-cell lung cancer (NSCLC, the most common form of lung cancer) remain below 50 percent. These three cancers collectively represent more than 250,000 new diagnoses each year in the United States alone.3 Despite substantial, justified excitement around the use of PD-(L)14 therapies in NSCLC, response rates remain below 50 percent.

Moreover, we see considerable variation in outcomes by geography. Recent EUROCARE-5 results show varying non-Hodgkin lymphoma (NHL) five-year survival rates—63 percent in Northern Europe and 50 percent in Eastern Europe—and a gap in ten-year survival rates for breast cancer—76 percent in Northern Europe and 65 percent in Eastern Europe.5

While outcomes in China still lag behind those in developed markets, Chinese outcomes have dramatically improved; for example, the five-year survival rate across all cancers combined is estimated to be around 40 percent for those diagnosed in 2013, compared with approximately 30 percent for those diagnosed in 2003.6

Yet China still has ample opportunity to bring more innovations to its four million patients diagnosed annually (see sidebar, “China has four million new patients each year with substantial unmet need”).

Innovation in oncology is accelerating. Though it took about eight years between the first therapy for HER2-positive patients in 1999 and the next therapy, the gap between the first-to-market PARP inhibitor in 2013 and the next was less than two years. Globally, the next wave of innovation for patients is underway at an ever-increasing pace.

Continued momentum and innovations for immuno-oncology treatments are expected, and more than 550 active cell- and gene-therapy agents are in clinical development.