Introduction

Immune checkpoints are proteins that play an important role in regulating the immune system. In cancer, the immune checkpoints are activated to suppress the anti-tumor activity of the immune system thereby suppressing the immune response against the cancer cells. The study of these proteins and pathways has led to the development of a number of immune checkpoint inhibitors as therapies against cancer. Initial preclinical studies showed that antibody blockade of the immune checkpoint molecule CTLA-4 resulted in successful anti-tumor immune responses in the murine cancer models. This was then followed by studies targeting the PD-1/PD-L1 pathway.

Ipilimumab and Yervoy were the first immune checkpoint inhibitors introduced in the market. With the promising results of Yervoy, several anti-PD-1 and anti-PD-L1 antibodies have been developed. Although there are number of other checkpoints that have been studied, such as LAG-3 and TIM-3, the only approved immune checkpoint inhibitors include CTLA-4, PD-1 and PD-L1.

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Global immune checkpoint inhibitors market

The FDA-approved immune checkpoint inhibitors include Yervoy, Bavencio, Tecentriq, Imfinzi, Opdivo and Keytruda. Yervoy is the only CTLA-4 immune checkpoint inhibitors available in the global immune checkpoint inhibitors market. The PD-L1 immune checkpoint inhibitors is relatively new in the global market, which includes products such as Bavencio, Tecentriq, and Imfinzi. The blockbuster products in the immune checkpoint inhibitors market (Keytruda and Opdivo) are of the PD-1 drug class.

The growing prevalence of cancer and increased FDA approvals are the prime factors expected to drive the growth of the immune checkpoint inhibitors market over the forecast period.

However, the high cost associated with the research and development of the products consequently increases the cost of the final product and associated treatment, which is a factor expected to hamper the growth of the immune checkpoint inhibitors market. Besides, the high cost of the immune checkpoint inhibitors has led to regulatory price capping. The regulatory price capping of immune checkpoint inhibitors is also expected to hamper the growth of the immune checkpoint inhibitors market.

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Global immune checkpoint inhibitors market:Overview

Of all the immune checkpoint proteins, CTLA-4 is the best understood mechanism. However, under the CTLA-4 immune checkpoint inhibitors there is only one product currently available, i.e., Yervoy by Bristol-Myers Squibb. The CTLA-4 immune checkpoint inhibitors segment is expected to account sluggish growth in the global market, as nearly 20% of patients who used CTLA-4 have shown an allergic reaction, which is expected to restrict the adoption of the product for cancer treatment.

Until 2017, there was only one PD-L1 immune checkpoint inhibitor available, i.e., Tecentriq by Roche Holdings AG. The immune checkpoint inhibitors market has two blockbuster products namely, Opdivo and Keytruda. Both Opdivo and Keytruda are PD-1 immune checkpoint inhibitors. Both the PD-1 immune checkpoint inhibitors products were launched in 2014 and are currently the only immune checkpoint inhibitors launched in China in early 2018.

In terms of revenue, the global immune checkpoint inhibitors market is expected to be valued at US$ 35,178.0 Mn by the end of 2026. In terms of value, North America is expected to be the dominant regional market for immune checkpoint inhibitors by 2018 end and is expected to expand at a healthy CAGR over the forecast period. Asia Pacific is expected to witness significant growth in the global immune checkpoint inhibitors market.

Examples of some of the key players covered in the report of the immune checkpoint inhibitors market are AstraZeneca, Bristol-Myers Squibb, Roche Holdings AG, Novartis AG, Pfizer, and Sanofi, among others. Companies such as Novartis AG, Sanofi and Incyte have their immune checkpoint inhibitor candidate in the pipeline and are expecting approvals in the near future.

Most manufacturers in the immune checkpoint inhibitors market have a key strategy of entering into collaboration and agreement with other companies for better geographical reach for distribution of the product as well as for approvals to expand the indications of the products. For an instance, Bristol-Myer Squibb and Ono Pharmaceuticals have a distribution agreement where Ono will hold the rights to distribution on Japan, Taiwan and South Korea.

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Market Segmentation

Attribute	Details
Drug Class	PD-1 PD-L1 CTLA-4
Therapeutic Application	Lung Cancer Melanoma Squamous Cell Carcinoma Urothelial Carcinoma Blood cancer Other Cancers
Distribution Channel	Hospital Pharmacies Retail Pharmacies
Region	North America U.S. Canada Latin America Brazil Mexico Rest of Latin America Europe Germany Russia U.K. France Italy Spain Rest of Europe Asia Pacific India China Australia & New Zealand ASEAN Rest of APEJ Japan Middle East & Africa (MEA) GCC Countries South Africa Rest of MEA