Spain Multiple Myeloma Therapeutics Market Analysis

1. Executive Summary
1.1 Disease Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Patient Journey
1.6 Health Insurance Coverage in Country
1.7 Active Pharmaceutical Ingredient (API)
1.8 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Epidemiology of Disease
2.2 Market Size (With Excel & Methodology)
2.3 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Diagnosis
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Multiple Myeloma Therapeutics Market Segmentation

By Treatment

• Chemotherapy
• Immunotherapy
• Targeted therapy
• Radiation therapy
• Stem cell transplant

By Distribution Channel

• Hospitals
• Retail
• Online

By End User (Revenue, USD Bn):

• Hospitals
• Clinics
• Cancer Research Centers

By Drug Class

Immunomodulatory drugs (IMiDs)

One of the most common therapies used to treat myeloma are immunomodulatory drugs, or IMiDs. These drugs work by modifying the immune system to attack myeloma cells and have been a significant advance in the treatment of multiple myeloma. Some of the commonly used IMiDs in multiple myeloma include:

• Lenalidomide (Revlimid): Lenalidomide is an oral medication that is used in the treatment of multiple myeloma, as well as other blood cancers such as myelodysplastic syndromes (MDS). It may help the immune system in eliminating cancerous or abnormal blood cells. Moreover, it might stop the development of new blood vessels that tumours require to expand.
• Pomalidomide (Pomalyst): Pomalidomide is an oral medication that is used to treat multiple myeloma. It works in a similar way to lenalidomide, by enhancing the immune system's ability to target cancer cells. Also, it makes it easier for immune cells to eliminate faulty myeloma cells, aiding in the production of healthy blood cells in the myeloma.
• Thalidomide (Thalomid): Thalidomide was the first IMiD to be used in the treatment of multiple myeloma. It works by modulating the immune system and preventing the growth of blood vessels that supply the tumor
• CC- 4047 (Actimid): CC-4047 is a newer IMiD that is still under investigation for the treatment of multiple myeloma. It works by inhibiting the growth of cancer cells and promoting their death.

Proteasome inhibitors

Proteasome inhibitors are a class of drugs that are commonly used in the treatment of multiple myeloma. They work by blocking the activity of proteasomes, which are cellular structures that break down proteins. This leads to the accumulation of proteins within the myeloma cells, ultimately causing their death. Some proteasome inhibitors used in multiple myeloma include:

• Bortezomib (Velcade): Bortezomib was the first proteasome inhibitor approved for the treatment of multiple myeloma. It is given by injection and is often used in combination with other drugs, such as chemotherapy or immunomodulatory drugs. Bortezomib is highly effective in inducing remissions in newly diagnosed and relapsed/refractory multiple myeloma patients.
• Carfilzomib (Kyprolis): Carfilzomib is a newer proteasome inhibitor that is approved for the treatment of multiple myeloma. It is given by injection and can be used as a single agent or in combination with other drugs. Carfilzomib has shown excellent results in heavily pretreated patients with relapsed/refractory multiple myeloma.
• Ixazomib (Ninlaro): Ixazomib is an oral proteasome inhibitor that is approved for use in combination with lenalidomide and dexamethasone for the treatment of multiple myeloma. It is the first oral proteasome inhibitor and offers the convenience of home administration.

Monoclonal antibodies:

Monoclonal antibodies, target specific proteins on the surface of myeloma cells, causing them to be destroyed by the immune system. Some of the commonly used monoclonal antibodies in multiple myeloma include:

• Daratumumab (Darzalex): Daratumumab is a monoclonal antibody that targets a protein called CD38, which is highly expressed on the surface of myeloma cells. By binding to CD38, daratumumab triggers the immune system to attack and destroy the cancer cells. It is approved for use in multiple myeloma in combination with other drugs, such as lenalidomide or bortezomib.
• Elotuzumab (Empliciti): Elotuzumab is a monoclonal antibody that targets a protein called SLAMF7, which is also expressed on the surface of myeloma cells. By binding to SLAMF7, elotuzumab enhances the immune system's ability to attack the cancer cells. It is approved for use in combination with lenalidomide and dexamethasone for the treatment of multiple myeloma.
• Isatuximab (Sarclisa): Isatuximab is a monoclonal antibody that targets a protein called CD38, similar to daratumumab. By binding to CD38, isatuximab triggers the immune system to attack and destroy the cancer cells. It is approved for use in combination with pomalidomide and dexamethasone for the treatment of multiple myeloma.

Chemotherapy drugs

Chemotherapy drugs work by killing rapidly dividing cells, including cancer cells. Chemotherapy is often used in combination with other drugs, such as steroids, immunomodulatory drugs, or proteasome inhibitors, to improve their effectiveness. Here are some chemotherapy drugs used in multiple myeloma:

• Melphalan: Melphalan is an alkylating agent that is commonly used in the treatment of multiple myeloma. It is used as a preventative measure before having a stem cell transplant to treat multiple myeloma. It works by damaging the DNA of cancer cells, leading to their death. Melphalan is often used in combination with other drugs, such as prednisone, to treat newly diagnosed multiple myeloma.
• Cyclophosphamide: Cyclophosphamide works by damaging the DNA of cancer cells, leading to their death. Cyclophosphamide is often used in combination with other drugs, such as dexamethasone, to treat relapsed or refractory multiple myeloma. Cyclophosphamide inhibits cancer cell proliferation, causing the body to kill the cancer cells.
• Doxorubicin: Doxorubicin works by inhibiting the synthesis of DNA and RNA, leading to the death of cancer cells. Doxorubicin is often used in combination with other drugs, such as bortezomib or dexamethasone, to treat newly diagnosed or relapsed/refractory multiple myeloma. Doxorubicin belongs to the anthracycline class of chemotherapeutic drugs, which also includes daunorubicin, idarubicin, and epirubicin.
• Etoposide: Etoposide is a topoisomerase inhibitor chemotherapy drug that is used in the treatment of multiple myeloma. It works by inhibiting the activity of topoisomerase enzymes, which are necessary for DNA replication and repair. Etoposide is often used in combination with other drugs, such as cisplatin, to treat relapsed or refractory multiple myeloma. It works by reducing or preventing cancer cell proliferation in your body.

Steroids

Steroids such as dexamethasone and prednisone are often used in combination with other drugs to treat multiple myeloma. They can reduce inflammation, suppress the immune system, and promote the death of myeloma cells.

• Dexamethasone: Dexamethasone works by reducing inflammation and suppressing the immune system. Dexamethasone is often used in combination with other drugs to treat relapsed or refractory multiple myeloma.
• Prednisone: Prednisone works by suppressing the immune system and reducing inflammation. Prednisone is often used in combination with other drugs, such as chemotherapy, to treat newly diagnosed multiple myeloma.
• Methylprednisolone: Methylprednisolone is a steroid that is similar to prednisone and is also used in the treatment of multiple myeloma. It works by suppressing the immune system and reducing inflammation. Methylprednisolone is often used in combination with other drugs to treat relapsed or refractory multiple myeloma.

Steroids are effective in reducing inflammation and suppressing the immune system, which can help to control the growth of myeloma cells. However, they can have side effects, such as weight gain, mood changes, and increased risk of infection, so their use needs to be carefully monitored.

Others

Other drug classes used to treat multiple myeloma include:

• Histone deacetylase inhibitors- A new class of cytostatic drugs that suppress tumour cell proliferation in vitro and in vivo by inducing cell cycle arrest, differentiation, and/or apoptosis
• Immune checkpoint inhibitors- Checkpoint proteins are produced by some immune system cells, such as T cells, as well as some cancer cells. These checkpoints prevent too aggressive immune responses and, in some cases, prevent T cells from destroying cancer cells.
• Targeted therapies- Proteasome inhibitors are one type of targeted therapy for multiple myeloma. Proteasome inhibitors include bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro). They target proteasomes, which are enzymes that breakdown proteins in cells.

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