Hormonal Therapy Remains Dominant Segment in Prostate Cancer...

Hormonal Therapy Remains Dominant Segment in Prostate Cancer Management

Posted 2025-07-22 10:32:29

The prostate cancer treatment market, valued at USD 14.01 billion in 2024 and projected to reach USD 31.60 billion by 2034 at a CAGR of 8.5%, is undergoing a structural transformation driven by segment-specific advancements in drug development, radiation modalities, and surgical interventions. Market segmentation reveals distinct performance patterns across therapy types—hormonal therapies, chemotherapy, immunotherapy, targeted radiopharmaceuticals, and minimally invasive surgical techniques—each responding differently to shifts in clinical practice, pricing pressures, and technological maturity. Hormonal therapies remain the cornerstone of treatment, particularly androgen deprivation therapy (ADT) and next-generation androgen receptor pathway inhibitors (ARPIs) such as enzalutamide and apalutamide, which dominate first-line metastatic settings.

These agents continue to exhibit strong segment-wise performance due to proven efficacy, broad label expansions, and integration into combination regimens. However, increasing generic competition, especially for older agents like bicalutamide, is compressing margins and forcing originators to focus on product differentiation through fixed-dose combinations and improved safety profiles.

Radiopharmaceuticals represent one of the fastest-growing segments, led by the approval and commercial rollout of lutetium-177 PSMA-617 (Pluvicto), which demonstrated significant survival benefits in patients with metastatic castration-resistant prostate cancer (mCRPC). This application-specific growth is catalyzing investment in nuclear medicine infrastructure, radiolabeling facilities, and physician training programs, particularly in developed markets. The complexity of logistics and cold chain requirements poses challenges, but also creates opportunities for value chain optimization through centralized dosing centers and strategic partnerships with diagnostic imaging providers.

On the surgical front, robotic-assisted laparoscopic prostatectomy continues to gain traction, supported by long-term data on functional outcomes and reduced recovery times. Segment-specific pricing remains a key differentiator, with premium pricing observed for branded ARPIs and radiopharmaceuticals, while surgical devices face downward pressure due to hospital procurement consolidation and bundled payment models. Immunotherapies, though limited to niche indications such as sipuleucel-T for asymptomatic or minimally symptomatic mCRPC, are being reevaluated in combination trials with checkpoint inhibitors and bispecific antibodies, potentially unlocking new avenues for application-specific growth. As payers demand greater cost-effectiveness, manufacturers are prioritizing real-world evidence generation and health economics modeling to justify premium pricing and secure favorable formulary placement.