There are over 100 different types of cancer. Some of the more prominent forms include lung, breast, brain, blood, prostate, and colon cancer. Current approved products include Kymriah, Provenge, Yescarta, Gendicine, Immuncell-LC, Abecma, CreaVax-RCC, Apceden, and Breyanzi.

The immune system plays a primary role in the body's defense against malignancy. Although a tumor is derived from the body's own cells and is expected to possess proteins that are recognized as "self" and nonantigenic, neoplastic cells can express antigens that are not recognized as self. These cells are often eliminated by the immune system.

Treating cancer is difficult because, one, it is not a single disease and, two, all the cells in a single tumor do not behave in the same way. Although most cancers are thought to be derived from a single abnormal cell, by the time a tumor reaches a clinically detectable size, it may contain a diverse population of cells.

Cancer cells secrete angiogenesis factors that stimulate the development of blood vessels to supply the tumor. Basic fibroblast growth factor, which stimulates endothelial cell proliferation, is one angiogenesis factor produced by tumors. Tumors produce metalloproteases and collagenases that facilitate the invasion of adjacent structures. The digestion of collagen and the basement membrane facilitates the invasion of lymphatics and capillaries and the metastasis of tumors to distant sites.

Specific types of tumors metastasize to characteristic tissues or organs. Prostate cancer, for example, characteristically spreads to the bones. Elevation of serum acid phosphatase and alkaline phosphatase occurs in this disorder.

Breast and lung cancer commonly metastasize to the brain. In some cases, the symptoms produced by the metastatic lesion are the first indication that a malignancy has developed. The first indication of a metastatic brain tumor, for example, might be a seizure or a change in personality.

Cell and Gene Therapy Business Outlook's analysis of the oncology cell and gene therapy market includes the following observations:

• There have been strong increases in the CAR T therapy market, rising from $16 million in 2017 to $1.081 billion in 2020. The market is projected to climb to $7.391 billion in 2025 and $17.490 billion by 2030.
• Blood cancers are the leading driver, representing 68% of total sales. It is expected to represent 80% of sales by 2025.
• The U.S. and Europe are the largest markets for cell and gene therapies due to product approvals and costs associated with the therapies. The U.S. represented nearly 77% of the market, while Europe represented 19% in 2020.
• Gilead and Novartis combined represent 68% of the market for cell and gene therapies used in oncology.

Bruce Carlson is senior vice president of publications at Science and Medicine Group.

Disclosure: Cell and Gene Therapy Business Outlook is a sister company of ScienceBoard.net.

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