The Global Peritoneal Cancer Market is estimated to be valued at USD 5.9 Bn in 2024 and is expected to reach USD 15.9 Bn by 2031, growing at a compound annual growth rate (CAGR) of 17.9% from 2024 to 2031.

The market is expected to witness positive growth over the forecast period. Increasing incidence of peritoneal carcinomatosis owing to the rising prevalence of cancers such as ovarian and gastric cancer is expected to drive the market. In addition, growing awareness regarding diagnosis and treatment options for peritoneal carcinomatosis is also anticipated to boost the demand. Further, ongoing clinical trials evaluating the efficacy of several systemic therapies for peritoneal carcinomatosis will contribute to market growth. However, high costs associated with diagnosis and treatment procedures may hamper market growth to some extent. Overall, growth in healthcare expenditure and demand for advanced line of treatment for peritoneal cancer worldwide will continue to support the market expansion over the next few years.

Market Driver - Advances in Targeted Therapies, Including PARP Inhibitors and Targeted Drugs Like Avastin, are Improving Patient Survival and Treatment Options.

Targeted therapies have shown great promise in improving treatment outcomes for peritoneal cancer patients. Drugs like PARP inhibitors and Avastin, which are designed to target specific molecular pathways driving cancer growth and spread, are gaining acceptance as standard treatment options. PARP inhibitors in particular exploit DNA damage repair deficiencies in cancers with BRCA mutations and have demonstrated ability to significantly extend progression-free and overall survival.

Several recent clinical studies have validated the role of PARP inhibitors like olaparib and niraparib in recurrent platinum-sensitive ovarian cancer. Compared to conventional chemotherapy alone, the addition of a PARP inhibitor has resulted in median progression-free survival extending to nearly two years. Researchers are now exploring the potential of neoadjuvant PARP inhibitor therapy, given as part of initial treatment before surgery, to better tackle microscopic cancer spread. Avastin too has proven effectiveness when added to standard chemotherapy. By inhibiting VEGF, this antibody drug starves tumors of the blood supply needed to grow aggressively. Its incorporation in first-line ovarian cancer treatment protocol has led to improved outcomes.

The accumulating evidence highlighting superiority of targeted drug regimens over traditional chemotherapy is prompting medical organizations to update treatment guidelines. PARP inhibitors in particular are receiving approvals for wider use scenarios in later stage as well as early-stage disease settings. This expanded access to precision medicines will empower more peritoneal cancer patients to gain longer remissions and hope for managing their disease as a chronic condition. Such advances are enhancing quality of life by reducing toxic side effects seen with chemo alone. Overall, targeted therapies represent a major driver broadening treatment choices and extending survival.

Market Opportunity- Cytoreductive Surgery Combined with HIPEC.

The emergence of cytoreductive surgery coupled with hyperthermic intraperitoneal chemotherapy (HIPEC) as a potentially curative option for select peritoneal surface malignancies has transformed management of these historically difficult to treat cancers. In this procedure, any visible tumor nodules are surgically removed from within the abdominal cavity along with peritonectomies to scrape away microscopic disease deposits. Heated chemotherapy is then circulated within the open abdomen to directly bathe the peritoneal surfaces and destroy any remaining cancer cells.

Large phase III trials have demonstrated HIPEC combined with optimal debulking surgery can more than double long-term survival rates for pseudomyxoma peritonei and colorectal cancer patients with isolated peritoneal metastases compared to surgery alone. A meta-analysis pooling data from over 3000 patients across multiple tumor types found the procedure improves 5-year survival from approximately 15% with surgery only to over 50%. Impressive long-term survival benefits of over 20 years have been observed in certain patient subsets. Additionally, the treatment controls symptoms by removing tumors causing abdominal distension and obstruction.

Given the mounting evidence, expert consensus panels now recommend consideration of cytoreductive surgery with HIPEC for appropriately selected stage III and IV ovarian, appendix, colorectal and mesothelioma cancer patients. Many high-volume centers have reported low perioperative morbidity and mortality rates of less than 5% when performed by experienced surgical oncologists. While still experimental for some indications, this aggressive multi-modality approach offers potentially curative outcomes for peritoneal surface cancers previously thought untreatable.

Market Challenge - High Costs Associated with Advanced Treatment Options Like Cytoreductive Surgery and Intraperitoneal Chemotherapy.

High costs associated with advanced treatment options like cytoreductive surgery and intraperitoneal chemotherapy.

Peritoneal cancer is a relatively rare but aggressive form of cancer. Treatment options for patients diagnosed with more advanced stage peritoneal cancer typically involve complex multimodal approaches combining surgical removal of all visible tumors through cytoreductive surgery followed by intraperitoneal chemotherapy delivered directly into the abdominal cavity. However, these comprehensive treatment regimens pose significant costs. Cytoreductive surgery is a long and technically demanding procedure that requires highly skilled surgeons. It also carries risks of surgical complications. Similarly, intraperitoneal chemotherapy requires the placement of catheters in the abdominal cavity which is a specialized procedure. The drugs administered also have high price tags. All of these factors contribute to making these advanced treatment approaches cost prohibitive for many healthcare systems and patients. High costs often serve as a barrier limiting access to potentially curative multimodal therapy, especially in smaller centers and developing markets. This remains a major challenge for broader adoption and improved outcomes in peritoneal cancer.

Market Opportunity- Expansion of Targeted Therapies and the Development of New Drugs Like Masitinib Offer Hope for Improving Outcomes in Difficult-To-Treat Cases.

A promising avenue for better management of peritoneal cancer includes the development of targeted therapies and immunotherapies. Several pharmaceutical companies have candidate drugs in clinical trials that aim to block specific pathways driving cancer growth or stimulate the immune system to attack tumor cells. For instance, Masitinib is an investigational oral tyrosine kinase inhibitor being studied for potential use in refractory peritoneal metastatic cancer cases. Preliminary studies show Masitinib may increase progression-free and overall survival in selective patient subgroups. Its oral administration also offers advantages over infused drugs in terms of convenience and cost savings. As research yields new therapeutic options with more affordable and manageable administration approaches, opportunities will grow to enhance outcomes even in patients who cannot undergo intensive surgical treatments or who experience disease recurrence. This could significantly expand the addressable market size over the long term.

Peritoneal cancers are generally treated based on the stage of disease progression. In early-stages (I-II), surgery to remove visible tumors is the primary line of treatment. For more advanced cases, chemotherapy is often prescribed before or after surgery.

In later stages (III-IV), the first line of chemotherapy typically involves a platinum-based regimen. Carboplatin (Paraplatin) combined with Paclitaxel (Taxol) is commonly prescribed due to its efficacy. For patients who cannot tolerate platinum drugs or those who experience disease progression on first-line treatment, the second-line regimen may include Doxil (doxorubicin HCL liposome injection) or Gemzar (gemcitabine HCl).

For recurrent or refractory disease, newer targeted therapies have emerged as third-line options. Lartruvo (olaratumab) in combination with Doxil has shown improved progression-free survival and is frequently prescribed. Another promising alternative is Stivarga (regorafenib), a multikinase inhibitor that has demonstrated overall survival benefit over best supportive care.

Key factors influencing prescriber preferences include drug efficacy based on latest clinical trials, toxicity profile, insurance coverage, cost of treatment, and patient comorbidities/compliance. Surgery may not always be possible based on extent of disease, and tolerance for various chemotherapy regimens also plays a role in line selection.

Peritoneal cancer is diagnosed in four main stages - stage I to stage IV - based on how much the cancer has spread. Treatment depends on the stage of cancer and patient's overall health.

For stage I/II disease, the primary treatment is cytoreductive surgery (CRS), a procedure to remove visible tumors from the peritoneum. This is often combined with hyperthermic intraperitoneal chemotherapy (HIPEC), where a chemotherapy drug like cisplatin is heated and circulated throughout the peritoneal cavity during surgery. HIPEC aims to kill any remaining cancer cells. For stage III/IV disease which has spread extensively, CRS+HIPEC may still be attempted but has lesser chances of cure.

If CRS+HIPEC is not possible, systemic chemotherapy using combinations such as carboplatin plus paclitaxel is the main treatment. This is administered intravenously and travels throughout the body to target cancer cells. For recurrent disease after initial treatment, second line options include regimens with drugs like oxaliplatin or irinotecan, either alone or with 5-FU. Clinical trials of newer targeted therapies or immunotherapy drugs may also be considered.

In conclusion, CRS+HIPEC provides the best chance of cure for early-stage disease due to direct contact of the chemotherapy agent with tumor sites. For advanced or recurrent stages when surgery is not possible, intravenous chemotherapy aims to prolong life by slowing disease progression.

Focus on targeted drug development: Companies like Eisai Co. and Merck & Co. have focused their R&D efforts on developing targeted therapies for peritoneal cancer. Eisai developed Halaven (eribulin), an anti-microtubule agent indicated for metastatic breast cancer. In a Phase 3 study completed in 2011, Halaven showed improved overall survival compared to treatment of physician's choice in women with advanced liposarcoma or leiomyosarcoma. Merck developed Keytruda (pembrolizumab), an anti-PD-1 therapy approved in 2017 for advanced endometrial carcinoma based on results from the KEYNOTE-158 trial showing significant efficacy. Such targeted approaches have improved outcomes compared to traditional chemotherapy.

Partnering for Combination Therapies: Recognizing the need for multi-pronged treatment approaches, firms have partnered to combine existing drugs. For example, in 2017 Roche partnered with Flatiron Health to use real-world data to identify the best use of Tecentriq (atezolizumab) in various cancers, including peritoneal cancers. Combining immunotherapies like Tecentriq with chemotherapy instead of chemo alone has led to improved response rates. Similarly, Genentech combined Tecentriq with chemotherapy in the pivotal IMpassion130 trial, leading to FDA approval in 2019 for first-line treatment of metastatic triple-negative breast cancer.

Geographic Expansion: Companies are expanding their peritoneal cancer drug portfolio globally. For example, after gaining U.S. and EU approval for Tecentriq in various cancer indications including TNBC, Genentech/Roche is now filing for approval across other key markets like China and Japan to address the global market opportunity. This helps increase revenues and serves more patients worldwide.

Insights, By Drug Type, Late-stage Products Accounts for Substantial Share in the Forecast Period.

By drug type, late-stage products are expected to contribute the highest share 70.3% in 2024 owing to an increased clinical efficacy late-stage products, comprising drugs that have progressed through clinical trials and are in late-stage development or have already received regulatory approval, dominate the peritoneal cancer drug type segment. These drugs have demonstrated clear clinical efficacy in treating peritoneal cancer through extensive clinical research. Patients and physicians prefer to use treatments that have been proven to safely and effectively target cancer cells. Late-stage products have accumulated substantial clinical trial data establishing their safety and effectiveness profiles, building trust in their ability to extend patient survival and improve quality of life. Manufacturers continually work to expand the clinical indications and lines of treatment for approved late-stage drugs, allowing them to treat broader patient populations. As new late-stage products receive approvals and existing ones expand their approved uses, this segment grows in importance. Its leadership is further strengthened by physicians' reluctance to widely prescribe drugs that have not yet proven their worth in late-stage trials and regulatory reviews. The extensive clinical evidence behind late-stage peritoneal cancer treatments makes them the logical first option for patients.

Insights, By Route of Administration, Oral Segment is Expected to Grow Remarkably in the Forecast Period

By Route of Administration, oral is expected to contribute the highest market share 45.7% owing to convenience advantages. Within the peritoneal cancer drug administration method segment, oral treatments account for the largest share. A key factor driving the dominance of oral drugs is the substantial convenience they offer patients over other administration routes like intravenous or subcutaneous injections. Not requiring travel to clinics or hospitals for administration makes it easier for patients to fit treatments into their daily routines. This improves compliance with dosage schedules. Oral medications can also generally be self-administered at home. This grants patients a higher degree of independence and control over their care. Not needing infusion related medical procedures also eliminates certain health risks and makes the overall cost of treatment lower. Both patients and providers prefer oral treatment options when they are effective alternatives to injections. As more peritoneal cancer therapies become available in convenient oral dosage forms, their ease of use will continue attracting utilization away from less patient-friendly administration methods.

The Peritoneal Cancer pipeline report reveals significant growth in research and development, with over 60 drugs in various stages of clinical trials. The development is focused on novel therapies aimed at improving the survival rates of patients suffering from this rare and aggressive cancer. Despite challenges in early diagnosis, the advancements in targeted therapies, such as PARP inhibitors and drugs targeting specific kinases, show promise. The report highlights the role of cytoreductive surgery in combination with intraperitoneal chemotherapy as a key treatment method, especially in specialized centers. Clinical trials for drugs like Masitinib and Azenosertib are pushing the boundaries of treatment for peritoneal cancer, offering new hope for patients. The pipeline activity is strong, with collaborations and mergers driving innovation, which is expected to positively impact the market in the coming years.

The major players operating in the Peritoneal Cancer Market include AB Science, Zentalis Pharmaceuticals, ImmunoGen, UT Southwestern Medical Center, Avastin, Roche Holding, Merck & Co Inc, Novartis, GSK, Bayer, AstraZeneca and Synta Pharmaceuticals.

• In May 2024, AB Science’s drug Masitinib, in Phase III clinical trials, targets specific kinases to inhibit tumor growth in peritoneal cancer patients.
• In April 2024, Zentalis Pharmaceuticals advances Azenosertib, a Wee1 inhibitor, in Phase II trials to target DNA repair mechanisms in cancer cells, potentially offering new treatment pathways.
• In March 2024, ImmunoGen’s IMGN151 enters Phase I trials, showing promise in targeting tumor cells expressing folate receptor alpha (FRα), providing new hope for patients with low FRα expression.

• By Drug Type
  • Late-stage Products
  • Mid-stage Products
  • Early-stage Products
• By Route of Administration
  • Oral
  • Subcutaneous
  • Intravenous