食道がん市場 - 市場の洞察、疫学、市場予測：2034年

食道がんは、食道（頸部から胃まで食物を運ぶ中空の長い筋管）に発生します。食道がんは食道がんとも呼ばれ、食道を覆う細胞に発生し、食道の内壁に悪性腫瘍が発生することで発症します。

食道悪性腫瘍は多くの場合、その人の徴候や症状の結果として発見されます。食道がんが疑われる場合、診断の確定には診察、検査、生検（食道細胞の採取）が必要となります。がんが発見された場合は、悪性度を確定するためにさらに多くの検査が行われます。食道がんを同定するためのゴールドスタンダードは胃カメラです。

組織学的に原発性食道がんには扁平上皮がんと腺がんの2つのタイプがあり、小細胞がんは珍しいタイプの食道がんです。小細胞がんは珍しいタイプの食道がんです。これらのいくつかのタイプのがんは食道の様々なタイプの細胞で発生します。これらのがんはそれぞれ異なった経過をたどるため、各個人に合った治療法が必要となります。

食道がんは比較的まれながんであるため、得られる情報やガイダンスは非常に限られており、経験を共有する機会も少ないです。そのため、この病気に対する認識不足に終わっています。また、がんが進行するまでは症状が軽いことが多く、他の病気や消化器疾患と混同されやすいです。

主要7ヶ国のうち、米国が最大の市場規模を占め、市場全体の40％を占めています。EU4ヶ国および英国の中では、イタリアが最も市場規模が小さく、EU4ヶ国および英国全体の市場規模の8%を占めています。日本の食道がん市場規模は、予測期間（2024年～2034年）にCAGR 0.6%で増加すると予測されています。

当レポートでは、主要7ヶ国における食道がん市場について調査し、市場の概要とともに、疫学、患者動向、新たな治療法、2034年までの市場規模予測、および医療のアンメットニーズなどを提供しています。

目次

第1章 重要な洞察

第2章 レポートのイントロダクション

第3章 食道がん市場概要

• 2020年の食道がんの市場シェア（%）分布
• 2034年の食道がんの市場シェア（%）分布

第4章 食道がんのエグゼクティブサマリー

第5章 主要な出来事

第6章 疾患の背景と概要

• イントロダクション
• 食道がんの組織学的分類
• 食道がんの病期分類
• 食道がんの原因
• 食道がんの危険因子
• 食道がんの兆候と症状
• 食道がんにおける主な変異

第7章 診断

• 食道がんの画像検査
• 診断アルゴリズム
• 食道がんの内視鏡検査
• 食道がんの生検と臨床検査
• 血液検査
• 鑑別診断
• 診断ガイドライン

第8章 食道がんの治療と管理

• 食道がんの治療の種類
• 治療アルゴリズム
• 治療ガイドライン

第9章 調査手法

第10章 疫学と患者数

• 主な調査結果
• 前提と根拠：主要7ヶ国
• 主要7ヶ国における食道がんと診断された総症例数
• 米国における疫学シナリオ
• EU4ヶ国と英国における疫学シナリオ
• 日本における疫学シナリオ

第11章 患者動向

第12章 上市済み治療法

第13章 新しい治療法

第14章 食道がん：主要7ヶ国分析

• 主な調査結果
• 属性分析
• 主要な市場予測の前提条件
• 主要7ヶ国市場の見通し
• 主要7ヶ国における食道がんの市場規模
• 米国における食道がんの市場規模
• EU4ヶ国および英国における食道がんの市場規模
• 日本における食道がん市場規模

第15章 KOLの見解

第16章 SWOT分析

第17章 アンメットニーズ

第18章 市場アクセスと償還

• 米国
• EU4ヶ国と英国
• 日本

第19章 付録

第20章 DelveInsightのサービス内容

第21章 免責事項

List of Tables

• Table 1: Summary of Esophageal Cancer, Market and Epidemiology (2020-2034)
• Table 2: Key Events
• Table 3: AJCC Staging of Esophageal Cancer
• Table 4: SEOM-GEMCAD-TTD Clinical Guideline for the Treatment of Esophageal Cancer (2021)
• Table 5: Guidelines for the Management of Esophageal Cancer
• Table 6: Total Diagnosed Incident Cases of Esophageal Cancer in the 7MM (2020-2034)
• Table 7: Total Diagnosed Incident Cases of Esophageal Cancer in the US (2020-2034)
• Table 8: Age-specific Cases of Esophageal Cancer in the US (2020-2034)
• Table 9: Histology-specific Cases of Esophageal Cancer in the US (2020-2034)
• Table 10: Gender-specific Cases of Esophageal Cancer in the US (2020-2034)
• Table 11: Mutation-specific Cases of Esophageal Cancer in the US (2020-2034)
• Table 12: Stage-specific Cases of Esophageal Cancer in the US (2020-2034)
• Table 13: Linewise Treated Cases of Esophageal Cancer in the US (2020-2034)
• Table 14: Total Diagnosed Incident Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 15: Age-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 16: Histology-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 17: Gender-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 18: Mutation-specific cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 19: Total Stage-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 20: Linewise Treated Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Table 21: Total Diagnosed Incident Cases of Esophageal Cancer in Japan (2020-2034)
• Table 22: Age-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Table 23: Histology-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Table 24: Gender-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Table 25: Mutation-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Table 26: Stage-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Table 27: Linewise Treated Cases of Esophageal Cancer in Japan (2020-2034)
• Table 28: Comparison of Marketed Drugs for Esophageal Cancer
• Table 29: ROZLYTREK (entrectinib), Clinical Trial Description, 2024
• Table 30: VITRAKVI (larotrectinib), Clinical Trial Description, 2024
• Table 31: KEYTRUDA, Clinical Trial Description, 2024
• Table 32: Efficacy Results in Patients With Locally Advanced Unresectable or Metastatic Esophageal Cancer in KEYNOTE-590
• Table 33: Efficacy Results in Patients With Recurrent or Metastatic ESCC (CPS = 10) in KEYNOTE-181
• Table 34: CYRAMZA, Clinical Trial Description, 2024
• Table 35: Efficacy Results in REGARD
• Table 36: Efficacy Results in RAINBOW
• Table 37: OPDIVO, Clinical Trial Description, 2024
• Table 38: Efficacy Results - CHECKMATE-577
• Table 39: Efficacy Results - CHECKMATE-648
• Table 40: Efficacy Results - ATTRACTION-3
• Table 41: Efficacy Results - CHECKMATE-649
• Table 42: YERVOY, Clinical Trial Description, 2024
• Table 43: Efficacy Results - CHECKMATE-648
• Table 44: Key cross competition - Emerging Therapies Included in the Model
• Table 45: Key cross competition - Late-stage Emerging Therapies Not Included in the Model
• Table 46: Key cross competition
• Table 47: Zanidatamab Clinical Trial Description, 2024
• Table 48: Sintilimab Clinical Trial Description, 2024
• Table 49: Tislelizumab Clinical Trial Description, 2024
• Table 50: Sotigalimab (APX005M) Clinical Trial Description, 2024
• Table 51: Key Market Forecast Assumptions for OPDIVO + YERVOY
• Table 52: Key Market Forecast Assumptions for Nivolumab + Fluoropyrimidine + Platinum
• Table 53: Key Market Forecast Assumptions for Zanidatamab + chemotherapy +- tislelizumab
• Table 54: Key Market Forecast Assumptions for Sintilimab + (Cisplatin + paclitaxel/Cisplatin + fluorourcil)
• Table 55: Key Market Forecast Assumptions for Tislelizumab + Platinum + 5-FU/Capecitabine/Paclitaxel
• Table 56: Key Market Forecast Assumptions for Pembrolizumab + Fluoropyrimidine + Platinum
• Table 57: Key Market Forecast Assumptions for larotrectinib
• Table 58: Total Market Size of Esophageal Cancer in the 7MM, USD million (2020-2034)
• Table 59: Market size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in the 7MM, USD million (2020-2034)
• Table 60: Market size of Esophageal Cancer by Therapies (First-line) in the 7MM, USD million (2020-2034)
• Table 61: Market size of Esophageal Cancer by therapies (Second-line plus) in the 7MM, USD million (2020-2034)
• Table 62: Total Market Size of Esophageal Cancer in the US, in USD million (2020-2034)
• Table 63: Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in the United States, in USD million (2020-2034)
• Table 64: Market Size of Esophageal Cancer by Therapies (First-line) in the United States, in USD million (2020-2034)
• Table 65: Market Size of Esophageal Cancer by Therapies (Second-line plus) in the United States, in USD million (2020-2034)
• Table 66: Total Market Size of Esophageal Cancer in EU4 and the UK, in USD million (2020-2034)
• Table 67: Market size of Esophageal Cancer by therapies (Adjuvant/Neo-adjuvant) in EU4 and the UK, in USD million (2020-2034)
• Table 68: Market Size of Esophageal Cancer by Therapies (First-line) in EU4 and the UK, in USD million (2020-2034)
• Table 69: Market Size of Esophageal Cancer by Therapies (Second-line plus) in EU4 and the UK, in USD million (2020-2034)
• Table 70: Total Market Size of Esophageal Cancer in Japan, in USD million (2020-2034)
• Table 71: Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in Japan, in USD million (2020-2034)

List of Figures

• Figure 1: Understanding Gastroesophageal Reflux Induced Esophageal Tumorigenesis
• Figure 2: Predominant Types of Primary Esophageal Cancers
• Figure 3: Staging of Esophageal Cancer
• Figure 4: The Risk Factors Profiles for Esophageal Squamous Cell Carcinoma and Esophageal Adenocarcinoma
• Figure 5: Esophageal Cancer Warning Signs
• Figure 6: Top Alterations in Esophageal Squamous Cell Carcinoma
• Figure 7: Esophageal Cancer (Upper Endoscopy)
• Figure 8: Algorithm for the Symptoms Suggestive of Esophageal Cancer
• Figure 9: Imaging Differential Diagnosis
• Figure 10: Esophagectomy
• Figure 11: Treatment Algorithm for Local/Locoregional Resectable Esophageal and OGJ Cancer
• Figure 12: Treatment Algorithm for Advanced Esophageal SCC
• Figure 13: The Algorithm Showing the Surgical Procedure Recommended by the Guideline for Esophageal Carcinomas
• Figure 14: Treatment Algorithm for Stage 0-I Esophageal Cancer
• Figure 15: Treatment Algorithm for Stage II-III Esophageal Cancer
• Figure 16: Treatment Algorithm for Stage IVA Esophageal Cancer
• Figure 17: Treatment Algorithm for Stage IVB Esophageal Cancer
• Figure 18: Chemotherapy Regimen for Stage IVB Esophageal Cancer
• Figure 19: Total Diagnosed Incident Cases of Esophageal Cancer in the 7MM (2020-2034)
• Figure 20: Total Diagnosed Incident Cases of Esophageal Cancer in the US (2020-2034)
• Figure 21: Age-specific Cases of Esophageal Cancer in the US (2020-2034)
• Figure 22: Histology-specific Cases of Esophageal Cancer in the US (2020-2034)
• Figure 23: Gender-specific Cases of Esophageal Cancer in the US (2020-2034)
• Figure 24: Mutation-specific Cases of Esophageal Cancer in the US (2020-2034)
• Figure 25: Stage-specific Cases of Esophageal Cancer in the US (2020-2034)
• Figure 26: Linewise Treated Cases of Esophageal Cancer in the US (2020-2034)
• Figure 27: Total Diagnosed Incident Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 28: Age-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 29: Histology-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 30: Gender-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 31: Mutation-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 32: Total Stage-specific Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 33: Linewise Treated Cases of Esophageal Cancer in EU4 and the UK (2020-2034)
• Figure 34: Total Diagnosed Incident Cases of Esophageal Cancer in Japan (2020-2034)
• Figure 35: Age-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Figure 36: Histology-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Figure 37: Gender-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Figure 38: Mutation-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Figure 39: Stage-specific Cases of Esophageal Cancer in Japan (2020-2034)
• Figure 40: Linewise Treated cases of Esophageal Cancer in Japan (2020-2034)
• Figure 41: Total Market Size of Esophageal Cancer in the 7MM, USD million (2020-2034)
• Figure 42: Market size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in the 7MM, USD million (2020-2034)
• Figure 43: Market size of Esophageal Cancer by Therapies in the 7MM (First-line), USD million (2020-2034)
• Figure 44: Market Size of Esophageal Cancer by Therapies (Second-line plus) in the 7MM, USD million (2020-2034)
• Figure 45: Total Market Size of Esophageal Cancer in EU4 and the UK, USD million (2020-2034)
• Figure 46: Market size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in EU4 and the UK, USD million (2020-2034)
• Figure 47: Market Size of Esophageal Cancer by Therapies (First-line) in EU4 and the UK, USD million (2020-2034)
• Figure 48: Market Size of Esophageal Cancer by Therapies (Second-line plus) in EU4 and the UK, USD million (2020-2034)
• Figure 49: Total Market Size of Esophageal Cancer in Japan, USD million (2020-2034)
• Figure 50: Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in Japan, USD million (2020-2034)
• Figure 51: Market Size of Esophageal Cancer by Therapies (First-line) in Japan, USD million (2020-2034)
• Figure 52: Market Size of Esophageal Cancer by Therapies (Second-line plus) in Japan, in USD million (2020-2034)
• Figure 53: Health Technology Assessment
• Figure 54: Reimbursement Process in Germany
• Figure 55: Reimbursement Process in France
• Figure 56: Reimbursement Process in Italy
• Figure 57: Reimbursement Process in Spain
• Figure 58: Reimbursement Process in the United Kingdom
• Figure 59: Reimbursement Process in Japan

Key Highlights:

• Esophageal cancer occurs in the esophagus - a long hollow muscular tube that transports food from the neck to the stomach. Esophageal cancer, also known as esophagus cancer, develops in the cells that line the esophagus and occurs when a malignant tumor arises in the esophagus lining.
• Esophageal malignancies are often discovered as a result of a person's indications or symptoms. Examinations, testing, and a biopsy (a sample of esophageal cells) will be required to confirm the diagnosis if esophageal cancer is suspected. If cancer is discovered, more tests will be performed to establish the stage of the malignancy. The gold standard for identifying esophageal cancer is Gastroscopy.
• Histologically, there are two forms of primary esophageal cancer: squamous cell carcinoma and adenocarcinoma; small cell carcinoma is an uncommon type of Esophageal Cancer. These several types of cancer arise in various types of cells in the esophagus. They evolve in distinct ways, necessitating therapeutic techniques tailored to each individual.
• The staging system most often used for esophageal cancer is the American Joint Committee on Cancer (AJCC) TNM system, which is based on three key pieces of information, that is the extent of the tumor (T), spread to nearby lymph nodes (N) and spread (metastasis) to distant sites (M).
• The exact cause of esophageal cancer is unknown; however, it is thought to be related to abnormalities (mutations) in the DNA of esophageal cells. The DNA of Esophageal Cancer cells frequently shows changes in many different genes; however, it is unclear if specific gene changes can be found in all Esophageal Cancers.
• In 2023, the market size of esophageal cancer was highest in the US, accounting for approximately USD 450 million, which is further expected to increase by 2034.
• In March 2021, the FDA approved KEYTRUDA (pembrolizumab) for use in combination with platinum and fluoropyrimidine-based chemotherapy for patients with metastatic or locally advanced esophageal or gastroesophageal carcinoma who are ineligible for surgical resection or definitive chemoradiation.
• Esophageal cancer, a relatively uncommon cancer, has very limited information and guidance available, with few opportunities for people to share experiences. This ends up leading to a lack of awareness about the disease. Its symptoms are also often mild until the cancer advances, and symptoms can be easily confused with other illnesses and digestive problems.
• The emerging pipeline for esophageal cancer patients consists of drugs in different lines of therapies, adjuvant, and neoadjuvant settings. It is estimated that potential drugs that can significantly change the market during the forecast period include zanidatamab, sintilimab, tislelizumab, and sotigalimab. These drugs are in the late stages of clinical development, and other players are evaluating their potential candidates in different stages of clinical development.

Report Summary

• The report offers extensive knowledge regarding the epidemiology segments and predictions, presenting a deep understanding of the potential future growth in diagnosis rates, disease progression, and treatment guidelines. It provides comprehensive insights into these aspects, enabling a thorough assessment of the subject matter.
• Additionally, an all-inclusive account of the current management techniques and emerging therapies and the elaborative profiles of late-stage (Phase III and Phase II) and prominent therapies that would impact the current treatment landscape and result in an overall market shift has been provided in the report.
• The report also encompasses a comprehensive analysis of the Esophageal Cancer market, providing an in-depth examination of its historical and projected market size (2020 - 2034). It also includes the market share of therapies, detailed assumptions, and the underlying rationale for our methodology. The report also includes drug outreach coverage in the 7MM region.
• The report includes qualitative insights that provide an edge while developing business strategies, by understanding trends, through SWOT analysis and expert insights/KOL views, including experts from various hospitals and prominent universities, patient journey, and treatment preferences that help shape and drive the 7MM Esophageal Cancer market.

Market

Various key players are leading the treatment landscape of Esophageal Cancer, such as Bayer, Hoffman-La Roche, Merck Sharp & Dohme, Eli lilly, Bristol Myers Squibb, Zymeworks, Innovent Biologics, Beigene, and others. The details of the country-wise and therapy-wise market size have been provided below.

• Among the 7MM countries, the United States comprised the largest market size, accounting for ~40% of the total market size.
• Among the EU4 and the UK, Italy captured the smallest market size, accounting for ~8% of the total market size of EU4 and the UK.
• The esophageal cancer market size in Japan is expected to increase at a CAGR of 0.6% during the forecast period (2024-2034).
• Among the upcoming emerging therapies in the first line, zanidatamab with chemotherapy combination is expected to capture the largest market in the United States.

Esophageal Cancer Drug Chapters

The section dedicated to drugs in the Esophageal Cancer report provides an in-depth evaluation of late-stage pipeline drugs (Phase III and Phase II) related to Esophageal Cancer.

The drug chapters section provides valuable information on various aspects related to clinical trials of Esophageal Cancer, such as the pharmacological mechanisms of the drugs involved, designations, approval status, patent information, and a comprehensive analysis of the pros and cons associated with each drug. Furthermore, it presents the most recent news updates and press releases on drugs targeting Esophageal Cancer.

Marketed Therapies

CYRAMZA (ramucirumab): Eli Lilly and Company

CYRAMZA, as a single agent or in combination with paclitaxel, is indicated for the treatment of patients with advanced or metastatic, gastric or gastroesophageal junction (GEJ) adenocarcinoma with disease progression on or after prior fluoropyrimidine- or platinum-containing chemotherapy. The recommended dosage of CYRAMZA as a single agent or combined with weekly paclitaxel is 8 mg/kg every 2 weeks, administered by IV infusion over 60 min. Ramucirumab is a VEGFR2 antagonist that binds VEGFR2 explicitly and blocks the binding of VEGFR ligands, VEGF-A, VEGF-C, and VEGF-D. As a result, ramucirumab inhibits ligand-stimulated activation of VEGFR2, thereby inhibiting ligand-induced proliferation and migration of human endothelial cells.

VITRAKVI (larotrectinib): Bayer

VITRAKVI (larotrectinib) is an oral TRK inhibitor for the treatment of adult and pediatric patients with solid tumors with an NTRK gene fusion without a known acquired resistance mutation that is either metastatic or where surgical resection will likely result in severe morbidity and have no satisfactory alternative treatments or have progressed following treatment. It is indicated for the treatment of adult and pediatric patients with solid tumors that have a neurotrophic receptor tyrosine kinase (NTRK) gene fusion without a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity, and have no satisfactory alternative treatments or that have progressed following treatment.

Note: Detailed current therapies assessment will be provided in the full report of esophageal cancer.

Emerging Therapies

Zanidatamab: Zymeworks

Zanidatamab is given with chemotherapy plus or minus Tislelizumab as a combination therapy in HER2-Expressing Gastrointestinal (GI) Cancers, including Gastroesophageal Adenocarcinoma (GEA). Zanidatamab is given along with oxaliplatin (CAPOX) or 5-fluorouracil (5-FU) and cisplatin (FP) with or without tislelizumab. This emerging asset has a novel mechanism of action. It uses biparatropic binding as it targets two HER2 epitopes. The drug has also received fast-track designation in combination with SoC chemotherapy for first-line Gastroesophageal Adenocarcinoma. As far as safety is concerned, no severe treatment-related adverse events (TRAE) were observed. The most common Grade =3 TRAE was diarrhea which was manageable in the outpatient setting.

Sintilimab: Innovent Biologics

Sintilimab is an investigational PD-1 inhibitor developed by Innovent and Eli Lilly. The drug is currently in the Phase III stage of clinical development in combination with chemotherapy as first-line treatment in subjects with unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma. It is a first-line treatment option with cisplatin + paclitaxel or cisplatin + fluorouracil regimen for patients with unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma, as per the clinical assessment of sintilimab, a 12-month overall survival of 64% was found as compared to the 88% overall survival rate of zanidatamab. The Objective Response Rate (ORR) was also slightly lesser than zanidatamab. The safety profile of Sinitilimab was not as good as zanidatamab. A decrease in neutrophil count, WBCs, and hypokalemia was observed.

Esophageal Cancer Market Outlook

The therapies used for esophageal cancer include chemotherapy, targeted therapy, and immunotherapy. Chemotherapy uses medications to eradicate cancer cells, often by preventing cancer cells from growing, dividing, and proliferating. Targeted therapy for esophageal cancer includes HER2-targeted therapy and anti-angiogenesis therapy.

A chemotherapy regimen, or schedule, typically consists of a predetermined number of cycles administered over a predetermined period. A patient may be administered one medicine at a time or a mixture of drugs simultaneously. As previously stated, chemotherapy and radiation therapy are frequently used concurrently to treat esophageal cancer, a procedure known as chemoradiotherapy. Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system's ability to attack cancer cells.

Two types of immunotherapy drugs are approved to treat adenocarcinoma and squamous cell carcinoma of the esophagus and the gastroesophageal junction. This cancer grows where the stomach and esophagus meet. Pembrolizumab (KEYTRUDA) and nivolumab (OPDIVO) are both checkpoint inhibitors that target the PD-1/PD-L1 pathway.

As few potential therapies are being investigated to manage esophageal cancer, predicting that the treatment space will experience significant reconstitution during 2024-2034 is safe.

Further details are provided in the report.

Esophageal Cancer Disease Understanding and Treatment

Esophageal Cancer Overview

Esophageal cancer develops when cancer cells form in the esophagus, a tube-like tissue that connects the throat and stomach. The esophagus transports food from the mouth to the stomach. The cancer begins in the esophagus's inner layer and can spread to other layers of the esophagus and other organs of the body (metastasis).

Typically, symptoms of esophageal cancer do not appear until the tumor has grown large enough to impede eating, swallowing, or digesting food. The most common symptom of esophageal cancer is difficulty swallowing, particularly a sensation that food is lodged in the throat; in some individuals, choking on food occurs. These symptoms develop with time, with greater discomfort while swallowing as the esophagus narrows due to cancer growth.

Esophageal Cancer Diagnosis

Esophageal malignancies are often discovered by indications or symptoms. Exams, testing, and a biopsy (a sample of esophageal cells) will be required to confirm the diagnosis; if cancer is identified, more tests will help establish the extent (stage). When diagnosed late, esophageal cancer has a terrible prognosis; however, if diagnosed early, curative therapy is feasible. Before symptoms cause individuals to seek medical assistance, the condition slowly advances. Effective presymptomatic screening procedures may enhance disease outcomes. Recent research has shed light on the early detection of esophageal cancer using blood testing, sophisticated endoscopic imaging, and artificial intelligence.

Further details related to country-based variations are provided in the report.

Esophageal Cancer Treatment

Everyone who has esophageal cancer receives some form of therapy. Several factors, including personal preferences, cancer stage, and overall health, determine the appropriate course of therapy for each patient. Many medical professionals regularly collaborate in cancer care to construct a patient's comprehensive treatment plan, including various treatments.

Esophagectomy is the principal treatment for early-stage esophageal cancer, albeit its precise significance in superficial (T1A) cancers is still unclear, given the introduction of endoscopic mucosal therapy. A multimodal strategy for treating locally advanced cancers, comprising neoadjuvant chemotherapy or combination chemoradiotherapy (CRT) followed by surgery, is strongly recommended.

The cornerstone of contemporary esophageal cancer management is preoperative assessment. Preoperative staging accuracy is critical since the tumor board's decisions on the use of multimodal therapy will be dependent on the precision and specifics of the clinical staging evaluation. Upper endoscopy, high-resolution contrast CT scan, FDG-PET scan, and EUS are all part of the standardized evaluation of a patient undergoing curative treatment for early-stage or advanced esophageal cancer.

Doctors typically recommend combining radiation treatment, chemotherapy, and surgery for a tumor that has not spread beyond the esophagus and lymph nodes. Locally advanced esophageal cancer is usually treated with radiation treatment, chemotherapy, and surgery. Radiation treatment and chemotherapy are often combined in "chemoradiotherapy." Radiation treatment, chemotherapy, and other drug-based therapies are commonly used to treat metastatic esophageal cancer.

Further details related to treatment and management are provided in the report.

Esophageal Cancer Epidemiology

The Esophageal Cancer epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by total diagnosed incident cases, age-specific cases, histology-specific cases, gender-specific cases, mutation-specific cases, stage-specific cases and line wise treated cases of esophageal cancer in the United States, EU4 countries (Germany, France, Italy, Spain) and the United Kingdom, and Japan from 2020 to 2034.

• The total diagnosed incident cases of esophageal cancer in the US comprised ~21,000 cases in 2023 and are projected to increase by 2034 at a CAGR of 1.9%, accounting for the second-highest diagnosed incident cases in the 7MM.
• In 2023, as per the age-specific cases, the 65 and above segment accounted for the highest number of cases of esophageal cancer. In contrast, the <45 age group accounted for the least number of cases in the United States.
• In the United States, ~16,000 cases of esophageal cancer were found in case of males, whereas females accounted for ~4,000 cases of esophageal cancer in 2023.
• As per the Histology-specific incident cases of esophageal cancer, non-squamous esophageal cancer cases accounted for ~7,500 cases of esophageal cancer, whereas ~3,000 cases of squamous esophageal cancer were found in 2023 in the United Kingdom.

KOL Views

To stay abreast of the latest trends in the market, we conduct primary research by seeking the opinions of Key Opinion Leaders (KOLs) and Subject Matter Experts (SMEs) who work in the relevant field. This helps us fill any gaps in data and validate our secondary research.

We have reached out to industry experts to gather insights on various aspects of Esophageal Cancer, including the evolving treatment landscape, patients' reliance on conventional therapies, their acceptance of therapy switching, drug uptake, and challenges related to accessibility. The experts we contacted included medical/scientific writers, professors, and researchers from prestigious universities in the US, Europe, the UK, and Japan.

Our team of analysts at Delveinsight connected with more than 15 KOLs across the 7MM. We contacted institutions such as the Atrium Health's Levine Cancer Institute, National Cancer Center Hospital, Complexo Hospitalario Universitario de Ourense, etc., among others. By obtaining the opinions of these experts, we gained a better understanding of the current and emerging treatment patterns in the Esophageal Cancer market, which will assist our clients in analyzing the overall epidemiology and market scenario.

Qualitative Analysis

We perform Qualitative and Market Intelligence analysis using various approaches, such as SWOT analysis and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.

Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, designation, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.

In efficacy, the trial's primary and secondary outcome measures are evaluated; for instance, in trials for Esophageal Cancer, important primary endpoints are overall survival rate, event-free survival, progression free survival, etc. Based on these parameters, the overall efficacy is evaluated.

Further, the therapies' safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the route of administration, order of entry and designation, probability of success, and the addressable patient pool for each therapy. According to these parameters, a final weightage score is decided, based on which the emerging therapies are ranked.

Market Access and Reimbursement

Because newly authorized drugs are often expensive, some patients escape receiving proper treatment or use off-label, less expensive prescriptions. Reimbursement plays a critical role in how innovative treatments can enter the market. The cost of the medicine, compared to the benefit it provides to patients who are being treated, sometimes determines whether or not it will be reimbursed. Regulatory status, target population size, the setting of treatment, unmet needs, the number of incremental benefit claims, and prices can all affect market access and reimbursement possibilities.

The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.

Esophageal Cancer Report Insights

• Patient Population
• Therapeutic Approaches
• Esophageal Cancer Market Size and Trends
• Existing Market Opportunity

Esophageal Cancer Report Key Strengths

• Ten-year Forecast
• The 7MM Coverage
• Esophageal Cancer Epidemiology Segmentation
• Key Cross Competition

Esophageal Cancer Report Assessment

• Current Treatment Practices
• Reimbursements
• Market Attractiveness
• Qualitative Analysis (SWOT, Conjoint Analysis, Unmet needs)

Key Questions:

• Would there be any changes observed in the current treatment approach?
• Will there be any improvements in Esophageal Cancer management recommendations?
• Would research and development advances pave the way for future tests and therapies for Esophageal Cancer?
• Would the diagnostic testing space experience a significant impact and lead to a positive shift in the treatment landscape of Esophageal Cancer?
• What kind of uptake will the new therapies witness in coming years in Esophageal Cancer patients?

Table of Contents

1. Key Insights

2. Report Introduction

3. Esophageal Cancer Market Overview at a Glance

• 3.1. Market Share (%) Distribution of Esophageal Cancer in 2020
• 3.2. Market Share (%) Distribution of Esophageal Cancer in 2034

4. Executive Summary of Esophageal Cancer

5. Key Events

6. Disease Background and Overview

• 6.1. Introduction
• 6.2. Histological Classification of Esophageal Cancer
• 6.3. Stage-wise Classification of Esophageal Cancer
• 6.4. Causes of Esophageal Cancer
• 6.5. Risk Factors of Esophageal Cancer
• 6.6. Signs and Symptoms of Esophageal Cancer
• 6.7. Major Mutations in Esophageal Cancer
  • 6.7.1. Molecular abnormalities of EAC
  • 6.7.2. Molecular abnormalities of ESCC

7. Diagnosis

• 7.1. Imaging tests for Esophageal Cancer
• 7.2. Diagnostic Algorithm
• 7.3. Endoscopy for Cancer of the Esophagus
• 7.4. Biopsy and Lab Tests for Cancer of the Esophagus
• 7.5. Blood tests
• 7.6. Differential Diagnosis
• 7.7. Diagnostic Guidelines
  • 7.7.1. ESMO Clinical Practice Guideline for Diagnosis (2022)
  • 7.7.2. National Guidelines for the Diagnosis of Esophageal Carcinoma 2022 in China
  • 7.7.3. NCCN Guidelines for Esophageal Cancer (2022)

8. Treatment and Management of Esophageal Cancer

• 8.1. Types of Treatment for Esophageal Cancer
  • 8.1.1. Surgery
  • 8.1.2. Endoscopic Treatments for Esophageal Cancer
  • 8.1.3. Radiation Therapy
  • 8.1.4. Therapies Using Medication
• 8.2. Treatment Algorithm
• 8.3. Treatment Guidelines
  • 8.3.1. ESMO Clinical Practice Guideline for Treatment and Follow-up
  • 8.3.2. SEOM-GEMCAD-TTD Clinical Guideline for the Diagnosis and Treatment of Esophageal Cancer (2021)
  • 8.3.3. The Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, the British Society of Gastroenterology, and the British Association of Surgical Oncology
  • 8.3.4. German S3 Guidelines on Esophageal Cancer
  • 8.3.5. Esophageal Cancer Practice Guidelines 2022 by the Japan Esophageal Society

9. Methodology

10. Epidemiology and Patient Population

• 10.1. Key Findings
• 10.2. Assumptions and Rationale: 7MM
• 10.3. Total Diagnosed Incident Cases of Esophageal Cancer in the 7MM
• 10.4. Epidemiology Scenario in the United States
  • 10.4.1. Total Diagnosed Incident Cases of Esophageal Cancer in the US
  • 10.4.2. Age-specific Cases of Esophageal Cancer in the US
  • 10.4.3. Histology-specific Cases of Esophageal Cancer in the US
  • 10.4.4. Gender-specific Cases of Esophageal Cancer in the US
  • 10.4.5. Mutation-specific Cases of Esophageal Cancer in the US
  • 10.4.6. Stage-specific Cases of Esophageal Cancer in the US
  • 10.4.7. Linewise Treated Cases of Esophageal Cancer in the US
• 10.5. Epidemiology Scenario in EU4 and the UK
  • 10.5.1. Total Diagnosed Incident Cases of Esophageal Cancer in EU4 and the UK
  • 10.5.2. Age-specific Cases of Esophageal Cancer in EU4 and the UK
  • 10.5.3. Histology-specific Cases of Esophageal Cancer in EU4 and the UK
  • 10.5.4. Gender-specific Cases of Esophageal Cancer in EU4 and the UK
  • 10.5.5. Mutation-specific Cases of Esophageal Cancer in EU4 and the UK
  • 10.5.6. Total Stage-specific Cases of Esophageal Cancer in EU4 and the UK
  • 10.5.7. Linewise Treated cases of Esophageal Cancer in EU4 and the UK
• 10.6. Epidemiology Scenario in Japan
  • 10.6.1. Total Diagnosed Incident Cases of Esophageal Cancer in Japan
  • 10.6.2. Age-specific cases of Esophageal Cancer in Japan
  • 10.6.3. Histology-specific Cases of Esophageal Cancer in Japan
  • 10.6.4. Gender-specific Cases of Esophageal Cancer in Japan
  • 10.6.5. Mutation-specific Cases of Esophageal Cancer in Japan
  • 10.6.6. Stage-specific Cases of Esophageal Cancer in Japan
  • 10.6.7. Linewise Treated Cases of Esophageal Cancer in Japan

11. Patient Journey

12. Marketed Therapies

• 12.1. Key Cross Competition
• 12.2. ROZLYTREK (entrectinib): Hoffmann-La Roche
  • 12.2.1. Product Description
  • 12.2.2. Regulatory Milestones
  • 12.2.3. Other Developmental Activities
  • 12.2.4. Clinical Development
  • 12.2.5. Safety and Efficacy
• 12.3. VITRAKVI (larotrectinib): Bayer
  • 12.3.1. Product Description
  • 12.3.2. Regulatory Milestones
  • 12.3.3. Other Developmental Activities
  • 12.3.4. Clinical Development
  • 12.3.5. Safety and Efficacy
• 12.4. KEYTRUDA (Pembrolizumab): Merck Sharp & Dohme
  • 12.4.1. Product Description
  • 12.4.2. Regulatory Milestones
  • 12.4.3. Clinical Developmental Activities
  • 12.4.4. Safety and Efficacy
• 12.5. CYRAMZA (ramucirumab): Eli Lilly and Company
  • 12.5.1. Product Description
  • 12.5.2. Regulatory Milestones
  • 12.5.3. Clinical Developmental Activities
  • 12.5.4. Safety and Efficacy
• 12.6. OPDIVO (nivolumab): Bristol-Myers Squibb/Ono Pharmaceutical
  • 12.6.1. Product Description
  • 12.6.2. Regulatory Milestones
  • 12.6.3. Clinical Developmental Activities
  • 12.6.4. Safety and Efficacy
• 12.7. YERVOY (ipilimumab): Bristol-Myers Squibb/Ono Pharmaceutical
  • 12.7.1. Product Description
  • 12.7.2. Regulatory Milestones
  • 12.7.3. Clinical Developmental Activities
  • 12.7.4. Safety and Efficacy

13. Emerging Therapies

• 13.1. Key Cross Competition
• 13.2. Zanidatamab: Zymeworks
  • 13.2.1. Product Description
  • 13.2.2. Other Developmental Activities
  • 13.2.3. Clinical Development
  • 13.2.4. Safety and efficacy
• 13.3. Sintilimab: Innovent Biologics
  • 13.3.1. Product Description
  • 13.3.2. Other Developmental Activities
  • 13.3.3. Clinical Development
  • 13.3.4. Safety and Efficacy
• 13.4. Tislelizumab: BeiGene
  • 13.4.1. Product Description
  • 13.4.2. Other Developmental Activities
  • 13.4.3. Clinical Development
  • 13.4.4. Safety and Efficacy
• 13.5. Sotigalimab (APX005M): Apexigen
  • 13.5.1. Product Description
  • 13.5.2. Other Developmental Activities
  • 13.5.3. Clinical Development
  • 13.5.4. Safety and Efficacy

14. Esophageal Cancer: 7MM Analysis

• 14.1. Key Findings
• 14.2. Attribute Analysis
• 14.3. Key Market Forecast Assumptions
• 14.4. 7MM Market Outlook
• 14.5. Market Size of Esophageal Cancer in the 7MM
  • 14.5.1. Total Market Size of Esophageal Cancer in the 7MM
  • 14.5.2. Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in the 7MM
  • 14.5.3. Market Size of Esophageal Cancer by Therapies (First-line) in the 7MM
  • 14.5.4. Market Size of Esophageal Cancer by Therapies (Second-line plus) in the 7MM
• 14.6. Market Size of Esophageal Cancer in the United States
  • 14.6.1. Total Market Size of Esophageal Cancer in the United States
  • 14.6.2. Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in the United States
  • 14.6.3. Market Size of Esophageal Cancer by Therapies (First-line) in the United States
  • 14.6.4. Market Size of Esophageal Cancer by Therapies (Second-line plus) in the United States
• 14.7. Market Size of Esophageal Cancer in EU4 and the United Kingdom
  • 14.7.1. Total Market Size of Esophageal Cancer in EU4 and the UK
  • 14.7.2. Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in EU4 and the UK
  • 14.7.3. Market Size of Esophageal Cancer by Therapies (First-line) in EU4 and the UK
  • 14.7.4. Market Size of Esophageal Cancer by Therapies (Second-line plus) in EU4 and the UK
• 14.8. Market Size of Esophageal Cancer in Japan
  • 14.8.1. Total Market Size of Esophageal Cancer in Japan
  • 14.8.2. Market Size of Esophageal Cancer by Therapies (Adjuvant/Neo-adjuvant) in Japan
  • 14.8.3. Market Size of Esophageal Cancer by Therapies (First-line) in Japan
  • 14.8.4. Market Size of Esophageal Cancer by Therapies (Second-line plus) in Japan

15. KOL Views

16. SWOT Analysis

17. Unmet Needs

18. Market Access and Reimbursement

• 18.1. The United States
  • 18.1.1. Centre for Medicare & Medicaid Services (CMS)
• 18.2. EU4 and the UK
  • 18.2.1. Germany
  • 18.2.2. France
  • 18.2.3. Italy
  • 18.2.4. Spain
  • 18.2.5. United Kingdom
• 18.3. Japan
  • 18.3.1. MHLW

19. Appendix

• 19.1. Bibliography
• 19.2. Report Methodology

20. DelveInsight Capabilities

21. Disclaimer