Market Research Report
Marginal Zone Lymphoma Market Insight, Epidemiology and Market Forecast -2030
|Marginal Zone Lymphoma Market Insight, Epidemiology and Market Forecast -2030|
DelveInsight Business Research LLP
Content info: 279 Pages
Delivery time: 2-10 business days
DelveInsight's 'Marginal Zone Lymphoma-Market Insights, Epidemiology, and Market Forecast-2030' report deliver an in-depth understanding of the MZL, historical and forecasted epidemiology as well as the MZL market trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan.
The Marginal Zone Lymphoma market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM MZL market size from 2017 to 2030. The Report also covers current MZL treatment practice, market drivers, market barriers, SWOT analysis, reimbursement, and market access, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.
Study Period: 2017-2030
Marginal Zone Lymphoma Overview
Marginal zone B-cell lymphoma or Marginal Zone Lymphoma (MZL) is a group of indolent (slow-growing) NHL B-cell lymphomas, which account for approximately 5-17% of all NHL cases. In the World Health Organization classification, there are three different MZL entities with specific diagnostic criteria, behavior, and therapeutic implications: the extranodal MZL of mucosa-associated lymphoid tissue (MALT) type (MALT lymphoma), the splenic MZL (SMZL), and the nodal MZL (NMZL).
Extranodal marginal zone B-cell lymphoma, also known as mucosa-associated lymphoid tissue (MALT) lymphoma: This is the most common type of marginal zone lymphoma. It starts in places other than the lymph nodes (extranodal). Nodal MZL (sometimes called monocytoid B-cell lymphoma) occurs within the lymph nodes and accounts for about 10% of all MZL cases. In most cases, it is not known what causes nodal MZL. It is more common in people who have been infected with the hepatitis C virus and some autoimmune conditions than others. Splenic MZL occurs most often in the spleen and blood. It has been associated with hepatitis C virus (HCV) infection. It is a low-grade B-cell non-Hodgkin's lymphoma characterized by massive splenomegaly, moderate lymphocytosis with or without villous lymphocytes, rare involvement of peripheral lymph nodes, and indolent clinical course.
Marginal Zone Lymphoma Diagnosis
To make a diagnosis, the doctor would need to stage the disease. Staging is also how the doctor decides the right treatment. It involves evaluating the location and size of the tumors and determining whether cancer has spread to other parts of the body. The diagnosis can be established based on the endoscopic appearance. The endoscopist must take specimens from the antrum and the corpus for the urease test. If the examined segments are unsuspicious, a biopsy must be performed from each quadrant of the fundus, the corpus, and the antrum and ten biopsies if they are suspicious, to request a histological workup.
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Marginal Zone Lymphoma Treatment
Treatment selection for a patient with Marginal Zone Lymphoma (MZL) depends on the type, stage, and location of the disease. Since gastric MALT lymphoma is often the result of an infection with H. pylori, the initial treatment is antibiotic therapy, usually combined with proton pump inhibitors (PPIs). The most commonly used regimen is triple therapy: a proton pump inhibitor (omeprazole) in association with amoxicillin and clarithromycin. Metronidazole can be substituted for amoxicillin in penicillin-allergic individuals. If the lymphoma relapses (disease returns after treatment) or becomes refractory (disease does not respond to treatment) after antibiotic therapy, there are many additional treatment options available, including rituximab, radiation therapy, and surgery. For SMZL, the recognized therapeutic options are splenectomy, chemotherapy (ChT), rituximab alone, or rituximab plus chemotherapy. Nodal MZL usually responds well to chemotherapy. It may be given as a single drug or a combination of drugs and is often given with a targeted therapy drug. Single drugs that may be used for nodal MZL are fludarabine (Fludara), bendamustine (Treanda). Combinations of chemotherapy drugs that may be used are: CHOP,R-CHOP,CVP,R-CVP and BR.
The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Total incident cases of Non-Hodgkin lymphoma, Total incident cases of Marginal Zone Lymphoma, Gender-specific incident cases of MZL, Subtype-specific incident cases of MZL and Stage-specific incident cases of MZL scenario of MZL in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom) and Japan from 2017-2030.
The epidemiology segment also provides the MZL epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan.
The drug chapter segment of the MZL report encloses the detailed analysis of MZL marketed drugs, mid-phase, and late-stage pipeline drugs. It also helps to understand the MZL clinical trial details, expressive pharmacological action, agreements and collaborations, approval, and patent details of each included drug and the latest news and press releases.
Marginal Zone Lymphoma Marketed Drugs
Revlimid (lenalidomide) in combination with rituximab: Celgene Corporation, Bristol-Myers Squibb
Revlimid is an immune-modulating therapy with proven anti-myeloma efects. It is an oral therapy that was shown to work in three ways in animal models and in vitro, it helps the immune system recognize and destroy myeloma cells. It has the ability to targets and kills myeloma cells and helps prevent new myeloma cell growth by starving them of blood. In May 2019, FDA approved lenalidomide Revlimid in combination with a rituximab product for previously treated FL and previously-treated MZL.
Products detail in the report…
Imbruvica (ibrutinib): AbbVie, Janssen Biotech
Ibrutinib is a small-molecule inhibitor of BTK. The drug forms a covalent bond with a cysteine residue in the BTK active site, leading to inhibition of BTK enzymatic activity. BTK is a signaling molecule of the B-cell antigen receptor (BCR) and cytokine receptor pathways. BTK's role in signaling through the B-cell surface receptors results in the activation of pathways necessary for B-cell trafficking, chemotaxis, and adhesion. Nonclinical studies show that ibrutinib inhibits malignant B-cell proliferation and survival in vivo as well as cell migration and substrate adhesion in vitro.
The recommended dose of Imbruvica for MCL and MZL is 560 mg orally once daily until disease progression or unacceptable toxicity.
Products detail in the report…
Marginal Zone Lymphoma Emerging Drugs
Umbralisib (TGR-1202): TG Therapeutics
Umbralisib (TGR-1202) is an orally administered, investigational dual inhibitor of PI3K delta and CK1 epsilon, which is administered orally once daily. The phosphoinositide-3-kinases (PI3Ks) are a family of enzymes involved in many important cellular functions, including cell proliferation and survival, cell differentiation, intracellular trafficking, and immunity. There are four isoforms of PI3K (alpha, beta, delta, and gamma), of which the delta isoform is highly expressed in hematopoietic cells. Dysregulation of the PI3K pathway is among one of the most commonly mutated pathways across all of cancer biology.
Currently, TG Therapeutics is investigating the drug in Phase II/III clinical in a combination of ublituximab, with or without Bendamustine, and TGR-1202 alone in patients with previously treated non-Hodgkin's lymphoma (NHL).
Products detail in the report…
Aliqopa (Copanlisib): Bayer
Aliqopa (Copanlisib) is an intravenously administered, small molecule with inhibitory activity against all four isoforms including the PI3K-alpha and PI3K-delta isoforms expressed in malignant B cells. The PI3K pathway is involved in cell growth, survival, and metabolism, and its dysregulation plays an important role in the development of lymphoma. The drug is also the only PI3K inhibitor administered intravenously on an intermittent schedule: on days 1, 8, and 15 of a 28-day treatment cycle. Treatment should be continued until disease progression or unacceptable toxicity. Copanlisib is currently approved in the US and Taiwan under the brand name Aliqopa for relapsed follicular lymphoma (FL). In September 2017, the US FDA granted accelerated approval to the drug for the treatment of adult patients with relapsed follicular lymphoma who have received at least two prior systemic therapies. The drug is currently in phase III for MZL.
Products detail in the report…
Ublituximab: TG Therapeutics
Ublituximab (TG-1101) is an investigational glycoengineered monoclonal antibody that targets a unique epitope on CD20-expressing B-cells. When ublituximab binds to the B-cell, it triggers a series of immunological reactions (including antibody-dependent cellular cytotoxicity [ADCC] and complement-dependent cytotoxicity [CDC]), leading to the destruction of the cell. Additionally, ublituximab is uniquely designed, to lack certain sugar molecules normally expressed on the antibody. Removal of these sugar molecules, a process called glycoengineering, has been shown to enhance the potency of ublituximab, especially the ADCC activity.
Products detail in the report…
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A Marginal zone lymphomas (MZL) involves immune cells known as B-cells and accounts for between 5% and 17% of all non-Hodgkin lymphomas (NHL). The three main subtypes of MZL are extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), nodal MZL, and splenic MZL. Of these, MALT lymphoma is the most common. The symptoms that may be caused by MZL depend on the type and location of the MZL. MALT lymphoma commonly involves the stomach, and patients may report abdominal pain, heartburn, and indigestion. MALT lymphoma may also develop in other areas of the body, such as the area around the eye, the salivary glands, or the lungs. Splenic MZL may be detected because of the enlargement of the spleen or abnormal blood cell counts. These types of lymphoma tend to be indolent (slow-growing).
Due to the slow nature of progression, most patients tend to present before developing significant complications. In the rare cases of life or organ-threatening MZL, high-dose corticosteroids (for example, dexamethasone 40 mg daily) can be used to temporize matters before starting more definitive (Immuno) chemotherapy or radiotherapy. Treatment of indolent lymphoma should be individualized according to the disease subtype, presentation, comorbid conditions, and patient preferences. When possible, the goal of therapy is to cure the disease and/or prolong survival. In all cases, the goal should be to improve quality of life; care must be taken to avoid overtreatment.
There are several different treatment approaches for SMZL, including single-agent rituximab, splenectomy, and traditional chemotherapy. For localized disease, local therapy is recommended such as triple therapy for H. pylori in gastric extranodal MZL, splenectomy for splenic MZL, and radiotherapy for nodal MZL. Also, most patients with nodal MZL present with advanced-stage disease and are not likely to achieve a cure, even with aggressive chemotherapy regimens. For a disseminated disease with a low tumor burden, a watch and wait or single-agent rituximab can be used. However, for symptomatic disease, a similar approach to follicular lymphoma (FL) can be used with chemoimmunotherapy approaches such as bendamustine and rituximab.
Patients with the relapsing disease after at least one CD20-based therapy have several recently approved chemotherapy-free options including B-cell receptor inhibitors such as ibrutinib (approved specifically in MZL) and immunomodulatory agents, such as lenalidomide and rituximab (FDA approved in MZL and FL). Phosphoinositide 3-kinase (PI3K) inhibitors have shown excellent activity in iNHL, specifically in MZL, with breakthrough designation status for copanlisib and umbralisib, allowing off label use of this class of agents in clinical practice.
Patients with early-stage MALT lymphoma with no underlying infectious etiology, or those for whom antibiotic therapy has failed, can be effectively managed with external beam radiotherapy. Rarely, marginal zone lymphoma can transform into a more aggressive lymphoma, typically DLBCL. These patients require aggressive therapy and may benefit from autologous stem cell transplantation. Although the aggressive subtype may resolve completely, patients are often left with a persistent low-grade lymphoma.
This section provides the total MZL market size and; market size by line of therapies in the United States.
The total MZL market size and market size by line of therapies in Germany, France, Italy, Spain, and the United Kingdom are provided in this section.
The total MZL market size and market size by line of therapies in Japan are provided.
This section focusses on the rate of uptake of the potential drugs recently launched in the MZL market or expected to get launched in the market during the study period 2017-2030. The analysis covers the MZL market uptake by drugs; patient uptake by therapies; and sales of each drug.
This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs, and allows the comparison of the drugs based on market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.
Marginal Zone Lymphoma Development Activities
The report provides insights into different therapeutic candidates in phase II, and phase III stage. It also analyzes key players involved in developing targeted therapeutics.
Pipeline Development Activities
The report covers the detailed information of collaborations, acquisition, and merger, licensing, and patent details for Marginal Zone Lymphoma emerging therapies.
Reimbursement Scenario in Marginal Zone Lymphoma
Approaching reimbursement proactively can have a positive impact both during the late stages of product development and well after product launch. In the report, we consider reimbursement to identify economically attractive indications and market opportunities. When working with finite resources, the ability to select the markets with the fewest reimbursement barriers can be a critical business and price strategy.
Competitive Intelligence Analysis
We perform competitive and market Intelligence analysis of the Marginal Zone Lymphoma market by using various competitive intelligence tools that include-SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.
Current Treatment Scenario, Marketed Drugs, and Emerging Therapies: