Prostate Cancer: Incidence Growth and Radioligand Adoption | Market Intelligence

Description

List of Tables

Prostate cancer is the clearest aging-curve story in Japanese oncology: already the most common cancer in men, its incidence climbs mechanically as the male population grows older, pulling surgery capacity, hormone-therapy volumes, and imaging demand up with it. The disease also carries the newest modality question in Japanese cancer care. Pluvicto's NHI listing in November 2025 made radioligand therapy a reimbursed reality for metastatic castration-resistant disease, but the treatment is deliverable only at certified sites with nuclear-medicine infrastructure - a capacity question that will govern how quickly Japanese practice converts the global evidence into routine care.

The tension is a three-way sorting problem. Upstream, PSA testing practice in Japan remains opportunistic rather than programmatic, so stage at diagnosis varies widely by region and channel. Midstream, the androgen-receptor pathway inhibitors - abiraterone, enzalutamide, apalutamide, darolutamide - have layered onto androgen deprivation across non-metastatic and metastatic hormone-sensitive settings, with Japanese label timing and co-promotion structures shaping real use. Downstream, the castration-resistant space now stacks PARP inhibitors for HRR-altered disease, cabazitaxel, Xofigo for bone-dominant disease, and Pluvicto for PSMA-positive disease - each with its own diagnostic gate, and each competing for patients who are older and more comorbid than the trial populations that defined them.

This report maps prostate cancer in Japan from PSA testing to radioligand delivery. It lays out the detection and staging structure, the ARPI layer with its pivotal programs - LATITUDE, ARCHES, EMBARK, ARANOTE, TALAPRO-2, PROpel, STAMPEDE - and the mCRPC decision tree including VISION, PSMAfore, and the SPLASH challenger program from Lilly's POINT Biopharma. Dedicated chapters cover PSMA PET imaging supply from Lantheus, Telix, Curium, and Blue Earth Diagnostics, domestic radiopharmaceutical roles of PDRadiopharma, certified-site capacity formation, and the sequencing disputes that arise when radioligand therapy meets ARPI rechallenge.

The report serves uro-oncology BD and medical-affairs teams, hospital planners weighing RLT investment, imaging and nuclear-medicine suppliers, and investors tracking the modality's Japanese buildout. It connects the epidemiological driver to the infrastructure question, which is where Japanese prostate care will actually be decided.

Scope and Coverage: The report covers prostate cancer epidemiology, detection, staging, and treatment in Japan across hormone-sensitive and castration-resistant settings, including ARPI, PARP, radiopharmaceutical, and radioligand therapy options plus PSMA imaging infrastructure. It profiles Novartis, Johnson & Johnson, Astellas, Pfizer, Bayer, Lilly, AstraZeneca, Lantheus, Curium, Telix, Blue Earth Diagnostics, and PDRadiopharma.

Report Highlights:

Maps the aging-driven incidence structure and PSA detection practice in Japan
Profiles the ARPI layer: Zytiga, Xtandi, Erleada, and Nubeqa with pivotal programs
Details the mCRPC decision tree: PARP inhibitors, cabazitaxel, Xofigo, and Pluvicto
Explains Pluvicto's NHI listing, VISION and PSMAfore evidence, and certified-site requirements
Covers PSMA PET imaging supply and the theranostic workflow
Frames sequencing disputes between radioligand therapy and ARPI rechallenge

Product Code: JPH-038

Table of Content

1. Executive Summary

2. Prostate Cancer: Overview and Clinical Background

3. Epidemiology and Patient Population: US, EU5, Japan, and China

4. Current Treatment Landscape and Standard of Care

5. Pipeline and Development Activity

6. Regulatory Pathways: FDA, EMA, PMDA, and NMPA Considerations

7. Reimbursement and Pricing Analysis with a Focus on Japan's NHI System

8. Competitive Landscape and Key Companies

9. Unmet Needs and Commercial Opportunities in Japan

10. Appendix: Methodology and Sources

Companies Mentioned

Novartis (CH) - Pluvicto radioligand therapy; NHI listed November 2025
Johnson & Johnson (US) - Erleada and Zytiga ARPI franchise
Astellas (JP) - Xtandi (enzalutamide) co-promotion in Japan
Pfizer (US) - Xtandi global partner
Bayer (DE) - Nubeqa (darolutamide) and Xofigo
Lantheus (US) - Pylarify PSMA PET imaging
Curium (FR) - nuclear medicine and PSMA imaging supply
Telix (AU) - Illuccix PSMA PET imaging and RLT pipeline
Eli Lilly (US) - POINT Biopharma PNT2002 RLT program
AstraZeneca (UK) - Fusion Pharmaceuticals Ac-225 prostate program
Blue Earth Diagnostics (UK) - PSMA PET imaging agents
PDRadiopharma (JP) - domestic Japanese radiopharmaceutical developer

Product Code: JPH-038

List of Tables

Table 1. Prostate Cancer Epidemiology in Japan: Aging-Curve Framework and Data Sources
Table 2. PSA Testing Practice in Japan: Opportunistic Screening Structure
Table 3. Regional Variation in Detection Channel and Stage at Diagnosis
Table 4. Biopsy, Gleason Grading, and Risk-Stratification Standards
Table 5. Imaging Standards for Staging: MRI, Bone Scan, and PSMA PET Roles
Table 6. Active Surveillance Protocols in Japanese Practice
Table 7. Robotic and Open Surgical Standards for Localized Disease
Table 8. Radiation Therapy Options: EBRT, Brachytherapy, and Particle Therapy Context
Table 9. Androgen Deprivation Therapy Backbones in Japanese Practice
Table 10. Zytiga (Abiraterone): LATITUDE Program and Japanese Positioning
Table 11. Xtandi (Enzalutamide): ARCHES and EMBARK Programs; Astellas-Pfizer Japan Structure
Table 12. Erleada (Apalutamide): SPARTAN and TITAN Program Context
Table 13. Nubeqa (Darolutamide): ARASENS and ARANOTE Program Designs
Table 14. ARPI Selection Framework Across Hormone-Sensitive Settings
Table 15. HRR Testing Practices and the PARP Gate in Japan
Table 16. PROfound and TRITON3: PARP Inhibitor Program Designs
Table 17. TALAPRO-2 and PROpel: ARPI-PARP Combination Programs
Table 18. Cabazitaxel and Chemotherapy Sequencing in mCRPC
Table 19. Xofigo (Radium-223): Bone-Dominant Disease Positioning in Japan
Table 20. Pluvicto (Lu-177 PSMA-617): Japanese Label and November 2025 NHI Listing
Table 21. VISION Program: Design and Its Role in the Japanese Label
Table 22. PSMAfore Program: Earlier-Line Radioligand Evidence Framework
Table 23. SPLASH: Lilly POINT Biopharma PNT2002 Program Design
Table 24. AstraZeneca Fusion Pharmaceuticals Ac-225 Prostate Program
Table 25. Alpha-Emitter Follow-On Programs Relevant to Prostate Cancer
Table 26. PSMA PET Imaging Agents in Japan: Pylarify, Illuccix, and Blue Earth Portfolio
Table 27. Curium Nuclear Medicine and Imaging Supply Roles
Table 28. PDRadiopharma Domestic Radiopharmaceutical Position
Table 29. Theranostic Workflow: From PSMA Imaging to Radioligand Eligibility
Table 30. Certified-Site Requirements for Pluvicto Administration
Table 31. RLT Capacity Formation: Site Pipeline and Bottleneck Framework
Table 32. Referral Network Design from Urology to Certified RLT Centers
Table 33. Sequencing Disputes: Radioligand Therapy vs ARPI Rechallenge
Table 34. mCRPC Decision Tree by Biomarker and Disease Pattern
Table 35. Bone-Health Management in Advanced Prostate Cancer
Table 36. Geriatric and Comorbidity Considerations in Japanese Prostate Populations
Table 37. NHI Pricing and Cost-Effectiveness Treatment of Prostate Regimens
Table 38. Hospital Economics of Prostate Cancer Service Lines
Table 39. Competitive Positioning Matrix: Prostate Assets by Setting
Table 40. Deal Benchmarks for Prostate and Radiopharma Licensing
Table 41. Trial-Enrollment Dynamics in Japanese Prostate Studies
Table 42. Scenario Framework: RLT Integration into Japanese Prostate Care
Table 43. Risk Register: Capacity Bottlenecks, Imaging Gaps, and Pricing Pressure
Table 44. Indicator Dashboard for Prostate Theme Monitoring
Table 45. Due-Diligence Checklist for Prostate and RLT Assets
Table 46. Stakeholder Position Map: Urology, Nuclear Medicine, Payers, and Sponsors
Table 47. Real-World Data Sources for Japanese Prostate Cancer
Table 48. Patient Journey from PSA Test to Advanced-Disease Care
Table 49. Horizon Scan: Earlier-Line Radioligand and Combination Development
Table 50. Analytical Appendix: Registries, Guidelines, and Pricing Sources

List of Figures

Figure 1. Prostate Cancer Aging-Curve Framework
Figure 2. PSA Testing Channel Structure in Japan
Figure 3. Regional Detection Variation Framework
Figure 4. Biopsy and Risk-Stratification Workflow
Figure 5. Staging Imaging Roles: MRI, Bone Scan, PSMA PET
Figure 6. Active Surveillance Protocol Diagram
Figure 7. Surgical Standards for Localized Disease
Figure 8. Radiation Therapy Option Map
Figure 9. ADT Backbone Structure
Figure 10. LATITUDE Program Schematic
Figure 11. ARCHES and EMBARK Program Map
Figure 12. SPARTAN and TITAN Program Context
Figure 13. ARASENS and ARANOTE Design Schematics
Figure 14. ARPI Selection Framework by Setting
Figure 15. HRR Testing Gate Diagram
Figure 16. PROfound and TRITON3 Program Trees
Figure 17. TALAPRO-2 and PROpel Combination Schematics
Figure 18. Chemotherapy Sequencing Framework in mCRPC
Figure 19. Xofigo Bone-Dominant Positioning Diagram
Figure 20. Pluvicto Label and NHI Listing Timeline
Figure 21. VISION and PSMAfore Program Schematics
Figure 22. SPLASH Challenger Program Map
Figure 23. Fusion Pharmaceuticals Ac-225 Program Diagram
Figure 24. Alpha-Emitter Follow-On Program Map
Figure 25. PSMA PET Imaging Agent Landscape
Figure 26. Curium and PDRadiopharma Supply Roles
Figure 27. Theranostic Workflow Diagram
Figure 28. Certified-Site Requirement Checklist
Figure 29. RLT Capacity Formation Framework
Figure 30. Referral Network Diagram to Certified Centers
Figure 31. Radioligand vs ARPI Rechallenge Sequencing Map
Figure 32. mCRPC Decision Tree by Biomarker
Figure 33. Bone-Health Management Protocol
Figure 34. Geriatric Consideration Framework
Figure 35. NHI Pricing Pathway for Prostate Regimens
Figure 36. Hospital Service-Line Economics Diagram
Figure 37. Competitive Positioning Map by Setting
Figure 38. Prostate and Radiopharma Deal Benchmarks
Figure 39. Enrollment Dynamics in Japanese Prostate Studies
Figure 40. Scenario Tree: RLT Integration Paths
Figure 41. Risk Map: Capacity, Imaging, and Pricing
Figure 42. Prostate Theme Monitoring Dashboard
Figure 43. Asset Due-Diligence Flow
Figure 44. Stakeholder Position Map
Figure 45. Real-World Data Source Map
Figure 46. Patient Journey from PSA Test to Advanced Care
Figure 47. Earlier-Line Radioligand Horizon Diagram
Figure 48. Investor KPI Dashboard for the Prostate Theme
Figure 49. Synthesis: What Decides Prostate Care Structure in Japan
Figure 50. Report Roadmap: Chapter Linkages to Reader Decisions

Prostate Cancer: Incidence Growth and Radioligand Adoption | Market Intelligence | US, EU5, Japan & China

Description

Table of Contents

List of Tables

Table of Content

1. Executive Summary

2. Prostate Cancer: Overview and Clinical Background

3. Epidemiology and Patient Population: US, EU5, Japan, and China

4. Current Treatment Landscape and Standard of Care

5. Pipeline and Development Activity

6. Regulatory Pathways: FDA, EMA, PMDA, and NMPA Considerations

7. Reimbursement and Pricing Analysis with a Focus on Japan's NHI System

8. Competitive Landscape and Key Companies

9. Unmet Needs and Commercial Opportunities in Japan

10. Appendix: Methodology and Sources

Companies Mentioned

List of Tables

List of Figures