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Colorectal cancer (CRC)

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Published Date : Oct 2023
Category : Oncology
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Colorectal Cancer: Diagnostic and Treatment Analysis, Examining Market Dynamics

“Inventions in Colorectal Cancer: Adopting Health Benefits and Enhancing Business”

Colorectal cancer (CRC) is the third most frequent cancer which accounts for ~10% of total cancer cases and the fourth leading cause of death from cancer. CRC is more common in industrialized nations, and its prevalence is rising in middle- and low-income countries as a result of Westernization.

However, in 2023, the estimated new cases for Colorectal Cancer are 153,020 stated by the National Cancer Institute (NCI). The high number of CRC patients constitutes an increasing worldwide public health problem.  CRC affects both men and women but it is 3rd most common cancer in men and 2nd most common cancer in women.

American Cancer Society states that, by 2040, there should be 3.2 million new instances of colorectal cancer annually (an increase of 63%) and 1.6 million annual deaths (an increase of 73%). However, raising CRC awareness is vital for promoting healthy lifestyle choices, new CRC management options, and the deployment of worldwide screening programs, all of which are critical for lowering CRC morbidity and death.

Colorectal cancer is a form of cancer that affects the rectum or colon (large intestine). In the colon or rectum, abnormal growths known as polyps develop sometimes. Some polyps eventually develop into cancer. It has the potential to cause serious injury and death.

Diarrhea, constipation, cramps, gas or pain, bright red or very dark red blood in the stool, stomach discomfort, unexplained weight loss, exhaustion, and low iron levels are all common symptoms of colorectal cancer.

However, the number of cases of Colorectal Cancer is increasing worldwide. According to NCI, about 1.9 million new cases of colorectal cancer globally were reported out of 18.1 million total cancer cases in 2020. WHO reports that colorectal cancer primarily affects older persons, with most instances occurring in those 50 and older. Whereas, the incidence of CRC is increasing from 1% to 2% per year in younger individuals.

However, Colorectal cancer is caused by several lifestyle factors, including a high diet of processed meats and a low intake of fruits and vegetables, as well as a sedentary lifestyle, obesity, smoking, and binge drinking.

Colorectal Cancer is divided into various types based on the location of the organ it is affecting. The type includes adenocarcinoma, a cancer of cells present at the inner lining of the colon and accounts for more than 90% of total cases. Carcinoid tumors are cancer cells that secret hormone in the intestine, gastrointestinal stromal tumors is cancer of gastrointestinal cells, and Lymphoma is a cancer of the immune system that is found in lymph nodes.

In addition to that, based on the source of mutation, Colorectal Cancer is divided into 3 types that include sporadic CRC measures 70% of cases, inherited CRC accounts for 5% of total CRC cases and familial CRC which measures 25% of cases as stated by NIH.

The number of cases of Colorectal Cancer differs from region to region. According to the WHO report, generally the greatest incidence rates are found in Europe, Australia, and New Zealand, whereas the highest mortality rates are found in Eastern Europe.

Furthermore, in 2023, 106,970 new cases of colon cancer 54,420 men and 52,550 female cases are reported in the US. However, 46,050 cases of rectal cancer including 27,440 men and 18,610 female cases.

At present, there are nearly 1.4 million people in the US who are suffering from Colorectal Cancer.

The death rate for Colorectal Cancer is increasing worldwide. In the US greater than 930,000 deaths were reported due to CRC in 2020. However, according to NCI, total deaths in 2023 are 52,550 up till now. Whereas the 5-year survival rate for Colorectal Cancer is 65% as stated by NCI.

There are various risk factors connected with colorectal cancer. Age, family history, inherited syndrome, racial and ethnic background, and if a patient is suffering from type II diabetes are the risk factors that cannot be altered by an individual. However, obesity, a high red meat diet, smoking, and alcohol use are some risk factors that lead to colorectal cancer. There is a need to develop new diagnostic tools and treatment options for CRC.

A number of factors influence the colorectal cancer market, including high prevalence and a lack of early detection tools. Other factors, such as the rising incidence of medical diseases globally and the challenges in locating the underlying causes of disease development, are driving the growth of the sector.

Early identification of Colorectal cancer has become essential nowadays. The emergence of curative therapies that are less expensive and have fewer side effects is also essential in the Colorectal Cancer landscape. This opens up numerous opportunities for market participants to get involved in this industry and acquire new company value. 

DiseaseLandscape Insights (DLI) here facilitates making informed choices in the field of medical technology, treatments, and diagnostics where different technologies and revolutionary advancements transform the landscape leading to higher growth.

Colorectal Cancer Diagnostic Analysis-

“From Early Diagnosis to Healthy Perfection”

The diagnosis of Colorectal Cancer depends on the type of disease, signs, and symptoms of patients, age, physical health, and the medical history of the patient. The case history is the first step for diagnosis of CRC which includes all the information about patients. According to NIH, around 70% of rectal cancer and 30% of CRCs are identified by case history method. Along with case history, the below tests are performed to diagnose Colorectal Cancer.

  1. Colonoscopy

Colonoscopy is the test used to check the rectum and colon parts of patients. However, if colorectal cancer is discovered, a full diagnosis that precisely identifies the disease's location and spread are not be achievable until the tumor is surgically removed. The physician inserts a surgical instrument with a colonoscope to extract the sample from the organ and check for further parameters.

  1. Biopsy

The biopsy is the extraction of a small portion of an affected organ by using instruments to examine the sample under a microscope. A biopsy is done during a colonoscopy or on any tissue that is removed during surgery. A CT scan or ultrasound is utilized to assist during a needle biopsy. A needle biopsy is a procedure that removes tissue through the skin using a needle that is directed into the tumor.

  1. Biomarker Testing For Tumors

Laboratory tests on the tumor are performed to check for specific genes, proteins, and other unique factors of tumors that cause cells to multiply faster. All colorectal tumors should be screened for mismatch repair protein problems sometimes known as a mismatch repair deficiency (dMMR).

The molecular testing of Tumors helps to look for Lynch syndrome as approximately 5% of CRC cases are due to Lynch syndrome. The other reason for this test to be performed is that it assists clinicians in deciding whether immunotherapy is suitable for patients or not.

  1. Blood Tests

Colorectal Cancer causes internal bleeding so the patient suffering from CRC becomes anemic. A blood test is performed to check the total blood count of patients. However, blood tests also identify the level of a protein called Carcinoembryonic Antigen (CEA). A high level of CFA indicates cancer has spread to other body parts. Only about 60% of patients with CRC shows high CFA level which is why it is not used as a screening test.

  1. Imaging Tests

Imaging tests like computational tomography (CT), magnetic resonance imaging (MRI), ultrasound, chest X-ray, and positron emission tomography (PET) are used to capture the images of colon and rectum of the patients. A CT scan and MRI help to analyze the size of tumors and the spread of cancer to other organs are viewed by CT scan, chest X-ray, and MRI techniques. Endorectal ultrasound is generally used to detect the deep growth of cancer and helps to plan the treatment.

Diagnostic tests are typically performed in public laboratories that are built with the necessary equipment as well as highly experienced workers. The market for skin cancer diagnostics is quite crowded, and many industry companies are contributing to this sector.

Using technology and extensive research, industry companies have the opportunity to develop revolutionary low-cost, accurate, and rapid biopsy procedures. Diagnostic procedure advancements and development increase the benchmark for significant stakeholders.

The below table shows the name of the industry player who is transforming the Colorectal Cancer diagnostic domain with their advanced strategies are listed below.

Diagnostic Market Players

Colonoscopy

Blood Tests

Genetic Tests

Biopsy

Imaging Tests

GI View Ltd

Sun Pharmaceuticals Industries Ltd.

Exact Sciences Corporation

Becton, Dickinson, and Company

DiagnoTech Corporation

FUJIFILM Holdings America Corporation

Cipla Ltd.

QIAGEN MANCHESTER LTD

Innovia Medical

Gastro Diagnostics.Ltd

KARL STORZ SE & Co. KG

Thyrocare Technologies

Epigenomics AG

Cardinal Health Inc.

Radiance Imaging System

HUGER Medical Instrument Co., Ltd

Apollo Diagnostics

Roche Molecular Systems, Inc.

Paramount Surgimed Limited

UltraScan diagnostics

Pro Scope Systems

Fortis Healthcare

Illumina, Inc.

Integra LifeSciences

Med Imaging Solutions

MECAN MEDICAL EQUIPMENT CO LTD

Epigenomics

Ventana Medical Systems

KAI Group

Mindray Medical International Limited

Olympus America

 

23andMe

 

Siemens Healthineers

 

                                                                                    Diagnostic Products

Blood Test

Genetic Tests

Imaging Test

HMX Hematology Analyzer

Cologuard™

PreXion 3D Excelsior CBCT Scanner

Isoton III®

Therascreen KRAS RGQ PCR Kit

Row CT Scanner

COULTER CLENZ®

Therascreen BRAF V600E RGQ PCR Kit

Flash CT Scanner

LYSE S® III

Epi ProColon®

CX CT Scanner

HMX Pak®

Cobas KRAS MUTATION TEST

MAGNETOM Sola

EMS Stat ™

Praxis Extended RAS Panel

MAGNETOM Lumina

StatStrip Xpress®2

VENTANA ANTI-BRAF V600E (VE1) MOUSE MONOCLONAL PRIMARY ANTIBOD

 

Epi proColon®

MUTYH-Associated Polyposis (MAP)

 

 

Colorectal Cancer Treatment Analysis-

“Decoding the Advancements in Colorectal Cancer Treatment”

There are various treatment options available for Colorectal Cancer. Colorectal Cancer is treatable in around 90% of instances if diagnosed early. Depending upon the stage of cancer the treatment is given to the patients. Stages 0, I, II, and III often be treated surgically. To improve the probability of curing the disease, many individuals with stage III colorectal cancer and others with stage II get chemotherapy after surgery.

However, before or following surgery, patients with stage II and stage III rectal cancer also get radiation treatment and chemotherapy. Even though stage IV cancer is rarely curable, it is treatable and the symptoms of the condition are controlled. Below are the stages of CRCs and the treatment options for the particular stage.

Stage 0 Colorectal Cancer is treated by polypectomy in which polyps are removed during colonoscopy. Stage I Colorectal Cancer is treated by surgical methods. The tumors and lymph nodes are removed by surgery. Stage I patients get cured completely post-surgery.

Moreover, stage II Colorectal Cancer is treated firstly with surgery and then adjuvant chemotherapy is given to the patients. Adjuvant chemotherapy, on the other hand, is indicated for some persons with cancer that has invaded surrounding organs, infected the whole intestinal wall, or has characteristics that indicate a high chance of recurrence. In some cases, radiation therapy is also given to patients after surgery.

In addition to that, stage III CRC is treated by surgery followed by adjuvant chemotherapy, radiation therapy, or targeted therapy. Furthermore, stage IV metastatic CRC is cured by a combination of chemotherapy, targeted therapy, immunotherapy, and surgery.

American Society of Clinical Oncology (ASCO) advises beginning with FOLFOX, FOLFIRI, or CAPOX chemotherapy for persons with metastatic colorectal cancer who do not have dMMR or MSI-H and cannot be treated with surgery. However, MSI-H accounts for around 15% of colorectal cancer patients in stages II and III, and 5% in stage IV. FOLFOXIRI may be prescribed alternatively for some persons.

However, the first line of treatment for those with left-sided colorectal cancer that does not show mismatch repair machinery and high microsatellite instability (dMMR/MSI-H) and does not include mutations in the RAS, BRAF, or HER2 genes should consist of an EGFR inhibitor in addition to a two-drug chemotherapy approach.

Moreover, the ASCO advises beginning immunotherapy using Pembrolizumab for patients with metastatic colorectal cancer who have dMMR or MSI-H. Combination targeted therapy utilizing Encorafenib and Cetuximab may be advised if the malignancy has a BRAF V600E mutation and the prior treatment has failed to halt it.

There are multiple opportunities for business firms in the realm of the Colorectal Cancer treatment market. The market players focus on the production of diverse cost-effective therapy products, as well as the redevelopment of current medicines via the use of new technologies to enhance patient health while increasing the profit of the company.

DiseaseLandscape Insights provides extensive research on the treatment domain of Colorectal Cancer disease to keep the stakeholders one step ahead in the market. DLI equips the knowledge about treatment options, novel drugs and techniques, products, and service contributions. DLI also offers extensive research on the competitors who are in the treatment domain and developing new treatment options for better health of patients.

The global Colorectal Cancer treatment market is highly competitive and owns a large market player with a global presence. The below table shows the market player who is reshaping the domain of Colorectal Cancer and driving innovations to improve healthcare outcomes along with their product names.

Treatment Market Players

Products

Genentech

Intelicure Lifesciences

Capecitabine (Xeloda)

Manus Aktteva Biopharma LLP

Fluorouracil (5-FU)

Pfizer

Irinotecan (Camptosar)

Sanofi-aventis

Oxaliplatin (Eloxatin)

Taiho Pharmaceutical Co., Ltd.

Trifluridine/tipiracil (Lonsurf)

Genentech

Roche

Bevacizumab (Avastin)

Eli Lilly and Company

Manus Aktteva Biopharma LLP

Cetuximab (Erbitux)

Amgen

Panitumumab (Vectibix)

Bayer HealthCare Pharmaceuticals Inc.

Regorafenib (Stivarga)

Sanofi and Regeneron Pharmaceuticals, Inc.

Ziv-aflibercept (Zaltrap)

Genentech

XELOX/CAPEOX

Eli Lilly and Company

Ramucirumab (Cyramza)

Merck

Pembrolizumab (Keytruda)

Bristol Myers Squibb India Pvt. Ltd.

Nivolumab (Opdivo)

GlaxoSmithKline LLC

Dostarlimab (Jemperli)

Bristol Myers Squibb India Pvt. Ltd.

Ipilimumab (Yervoy)

 

Regulatory Framework for Skin Cancer–

“Regulatory Program: Ensuring a Better Working Environment”

Colorectal Cancer regulatory requirements from various countries are sorted by DiseaseLandscape Insights. DLI provides empirical insights on risk assessment, monitoring, and regulatory compliance. By investigating the DiseaseLandscape Insights services, organizations and market participants prevent, manage, and respond to Colorectal Cancer flare-ups while also protecting the safety of afflicted people.

However, the FDA approved the drug called Tucatinib in combination with Trastuzumab for the treatment of metastatic Colorectal Cancer on Jan 19, 2023. This assessment was undertaken as part of Project Orbis, an FDA Oncology Center of Excellence effort. Project Orbis establishes a mechanism for worldwide partners to submit and review cancer medications concurrently. The FDA worked with the Australian Therapeutic Goods Administration (TGA) on this evaluation.

Moreover, on August 2, 2023, the Food and Drug Administration approved Trifluridine and Tipiracil with Bevacizumab as an anti-VEGF biological therapy for metastatic colorectal cancer (mCRC) previously treated with Fluoropyrimidine, Oxaliplatin and Irinotecan-based chemotherapy.

Competitive Analysis-

"Setting up Establishments with a Competent Lead in the Colorectal Cancer Market"

To fulfill the increased need for early detection and boost their competitive position, leading global firms have been researching new product introductions. In addition, they are pursuing growth tactics, which largely involve medication research, regulatory approval, acquisition partnerships, and a focus on cooperation, to enhance and extend their product line.

The detection of CRC in the early phase is very important. Research and developments by companies like Epigenomics resulted in the establishment of novel screening tests for Colorectal Cancer. Epi proColon® is the first FDA-approved blood test launched by Epigenomics in the market. The test is available in a few countries like the US, Europe, China, and other selected countries. The invention in the diagnostic domain of CRC has set a benchmark for other key players involved in the same field.

However, Amgen has launched an anti-EGFr antibody product called Vectibix in the market to improve the health of patients and increase the survival rate of metastatic Colorectal Cancer patients. Vectibix is approved by the FDA and under the evaluation of other regulatory agencies. The development of such products has increased the awareness of products and diseases also it can be used for another type of cancer to treat them. The overall revenue of Amgen has increased due to the innovation in the treatment field of CRC. The total sale for 2022 was $ 396.

DiseaseLandscape Insights helps the stakeholders to stay stronger in the domain of skin cancer by providing in-depth knowledge of existing market players, their innovations, plans of work, growth structures, and collaborations and helps in selecting the proper position to grow continuously.

Market Trends-

 “Decoding the Market for Better Business Decisions."

The market for Colorectal Cancer is booming and evolving due to various reasons. Some of the reasons are the high prevalence and incidence of CRC, new technologies, novel therapy developments, and cost-efficient diagnostic kit requirements. However, in-depth research is essential to formulate the advancement in diagnostic and treatment industries.

To promote patient health, researchers have discovered drugs that target the mechanisms through which tumor cells avoid recognition by the immune system. Launching and marketing such immunotherapy drugs is trending nowadays. Market players have tremendous scope in the treatment field such as immunotherapy to grow continuously and establish a stable business.

Moreover, research sponsored by NCI is investigating the use of chemotherapy with or without Atezolizumab in the treatment of patients with stage III colon cancer and poor DNA mismatch repair. Stakeholders have opportunities in the chemotherapy market to formulate the drugs in such a way that the drug will show fewer side effects. Industry players should enter into this field to gain a stronger foothold in the treatment industry and generate tremendous revenue.

Overall, the manufacturing of diagnostic kits, the development of revolutionary therapies, and the production of new medications have raised the market size and, as a result, the income of major competitors. The implementation of laws and regulations in the research business, as well as government attempts to improve patient health and breakthrough technology, have all enhanced the market's influence.

Clinical Trial Assessment-

The relevance of clinical trials in the practice of evidence-based medicine and health care reform is highlighted by the growing emphasis of government on comparative effectiveness studies. One of the main goals of health care reform is accomplished by market participants appropriately comparing medical therapy with the use of clinical data.

The table below displays the study names of the ongoing clinical trials as well as the stages at which they are taking place.

Phase I

Phase II

Phase III

Phase IV

The Efficacy and Safety of Toripalimab Combined With Bevacizumab and Chemotherapy as Neoadjuvant Therapy in Patients With Advanced MSI-H or dMMR Colorectal Cancer: an Open-label, Multicenter, Single-arm, Phase Ib/II Study

The Efficacy and Safety of Toripalimab Combined With Bevacizumab and Chemotherapy as Neoadjuvant Therapy in Patients With Advanced MSI-H or dMMR Colorectal Cancer: an Open-label, Multicenter, Single-arm, Phase Ib/II Study

A Phase III, Multicenter, Open-label, Randomized Study to Assess the Efficacy and Safety of mXELOX Plus Cetuximab Versus FOLFOX Plus Cetuximab in Chinese Patients With RAS and BRAF Wild-type Metastatic Colorectal Cancer

Influence of Peri-operative Opioid Analgesia on Circulating Tumor Cells in Patients Undergoing Open Colorectal Cancer Surgery - Multi-center, Randomized Clinical Trial

A Phase Ib/II Open Label Study to Assess the Safety and Pharmacokinetics of NUC-3373, a Nucleotide Analogue, Given in Combination With Standard Agents Used in Colorectal Cancer Treatment

A Randomized, Open-label, Multicenter, Phase II Clinical Study Evaluating the Efficacy and Safety of Fruquintinib as a Maintenance Therapy Following First-line Treatment for Metastatic Colorectal Cancer

Efficacy Evaluation of Jianpi Huatan Decoction in the Treatment of Advanced Colorectal Cancer and Analysis of Dominant Population Characteristics and Methylation Characteristics

Transanal Endoscopic Surgery: a Randomized Controlled Trial Comparing Fleet Enema vs Oral Mechanical Bowel Prep (TESEO Trial)

An Open-label, Multi-center Phase I/Ib Dose Finding and Expansion Study of HRO761 as Single Agent and in Combinations in Patients With Microsatellite Instability-High or Mismatch Repair Deficient Advanced Solid Tumors.

An Open-label, Multicenter Phase II Study of QL1706 Monotherapy or in Combination With Bevacizumab and XELOX as First-line Treatment of Unresectable Advanced or Metastatic CRC

An Open-label Randomized Phase 3 Study of Tucatinib in Combination With Trastuzumab and mFOLFOX6 Versus mFOLFOX6 Given With or Without Either Cetuximab or Bevacizumab as First-line Treatment for Subjects With HER2+ Metastatic Colorectal Cancer

Influence of Peri-operative Opioid Analgesia on Circulating Tumor Cells in Patients Undergoing Laparoscopic Colorectal Cancer Surgery - Multi-center, Randomized Clinical Trial

A Phase 1b/2 Placebo Controlled, Double Blinded Study on the Efficacy and Safety of BXQ-350 in Combination With mFOLFOX7 and Bevacizumab in Newly Diagnosed Metastatic Colorectal Carcinoma

First-line Treatment of mCapOX Plus Cetuximab Versus mFOLFOX6 Plus Cetuximab for Metastatic Left-sided CRC Patients With Wild-type RAS/BRAF Genes: a Multicenter, Randomised, Phase 2 Study

Study of Sintilimab vs Standard Therapy in Participants With Mismatch Repair Deficient (dMMR) or Microsatellite Instability-High (MSI-H) Stage III Colorectal Cancer

Survival Benefit of Compound Kushen Injection in Treatment of Advanced Colorectal Cancer Based on Real World Registration Platform

Phase I/II Study of the Anti-Programmed Death Ligand-1 Antibody Durvalumab (MEDI4736) in Combination With Olaparib and/or Cediranib for Advanced Solid Tumors and Advanced or Recurrent Ovarian, Triple Negative Breast, Lung, Prostate and Colorectal Cancers

A Single Arm, Open Label, Phase II, Exploratory Study of Fruquitinib Combined With Camrelizumab in Non MSI-H / dMMR Refractory Colorectal Cancer.

Multicenter, Open-label, Randomized, Controlled, Parallel Arms Clinical Study on Performance of SGM-101, a Fluorochrome-labeled Anti-CEA Monoclonal Antibody, for Delineation of Primary/Recurrent Tumor and Metastases in Patients Undergoing Surgery for Colorectal Cancer

Evaluation of Treatment PERSOnalization Based on Its Therapeutic Monitoring in Patients With Metastatic Colorectal Cancer Treated With REgorafenib

 

Conclusion-

DiseaseLandscape Insights (DLI) recognizes the critical importance of understanding the disease, particularly when it comes to fighting Colorectal Cancer. DLI's comprehensive services are intended to help the healthcare sector, its professionals, researchers, and other industry participants improve patient outcomes while strengthening and expanding their businesses.

The key players involved in the production of therapeutic goods get the information and understanding they need from DiseaseLandscape Insights. DiseaseLandscape Insights' support makes it simpler for market participants to organize and run clinical trials for innovative treatments and medications, patient recruiting tactics, and regulatory compliance.

This enables industries to conduct focused R&D, learn about contract manufacturing organizations, find raw material suppliers, and ensure legal compliance. DiseaseLandscape Insights (DLI) supports all market participants to acquire a stronger foothold in the Colorectal Cancer disease category.

SUMMARY
VishalSawant
Vishal SawantBusiness Development
vishal@diseaselandscape.com

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