This up-and-coming cancer treatment could be a $25 billion market opportunity — it's already a hotbed for M&A

This up-and-coming cancer treatment could be a $25 billion market opportunity — it's already a hotbed for M&A

  • Targeted radiopharmaceuticals has caught the eye of big pharma.
  • The therapy delivers radiation directly into tumors by attaching a radioactive particle to a targeting molecule.
  • RBC Capital Markets sees a $25 billion market opportunity for the space.

Big pharma is betting billions on an up-and-coming class of cancer treatments that some on Wall Street are calling a "massive opportunity."

It's called targeted radiopharmaceuticals. The therapy essentially delivers radiation directly into tumors by attaching a radioactive particle to a targeting molecule.

RBC Capital Markets sees a $25 billion market opportunity for the space.

"We believe TRT development is still in its early stages, and next-generation technologies that enable improvements in therapeutic potency and address a wider range of cancer targets have the potential to drive value creation in the space," analyst Gregory Renza, M.D., wrote in a February note.

Four acquisitions in the space were announced in just the last several months. The latest was by Novartis, which already has two targeted radiotherapies on the market. Pluvicto treats a certain type of advanced prostate cancer, while Lutathera targets neuroendocrine tumors.

Pluvicto, which faced some now-resolved supply constraints last year, is nearing blockbuster status, bringing in $980 million in sales in 2023. By 2028, the two drugs combined are expected to generate $5 billion in revenue, Renza said.

A market leader with 'an aggressive strategy'

Earlier this month, Novartis said it entered into an agreement to acquire Mariana Oncology for $1 billion. The preclinical-stage company is focused on developing radiopharmacutical programs, also known as radioligand therapies, that treat breast, prostate and lung cancers. One candidate, known as MC-339, is being researched for small cell lung cancer.

"They're clearly the market leader in this space with an aggressive strategy, both successfully commercializing their products, expanding the market opportunities for those products, and having a pipeline behind that," said Oppenheimer analyst Jeff Jones. "Acquiring Mariana ... gives them even greater discovery capabilities."

Shares are up about 1% year to date. The average analyst rating is hold, with 8% upside to the average analyst price target, according to FactSet.

Novartis' success has lit a fire under its competitors. Piper Sandler analyst Edward Tenthoff characterizes it as "FOMO," or the fear of missing out.

"I think that's what's happening and big pharma is accumulating capabilities in this new modality," he said.

Eli Lilly, which has benefited from the excitement in the GLP-1 space with its diabetes drug Mounjaro and weight-loss treatment Zepbound, completed its $1.4 billion acquisition of radiopharmaceutical company Point Biopharma in December.

Just before the deal closed, Point Biopharma's targeted radiation drug, known as PNT2002, met its primary endpoint in a phase three trial for metastatic castration-resistant prostate cancer.

In addition, earlier this week Eli Lilly announced it will pay Aktis Oncology $60 million to use its novel miniprotein technology platform to generate anticancer radiopharmaceuticals.

Eli Lilly has an average analyst rating of overweight and 8.3% upside to the average analyst price target, per FactSet. Shares have already run up nearly 38% so far this year.

"Obviously, investors are very focused on obesity right now, I believe, but we think with their acquisition, they have opportunities certainly on the supply side, which is one of the challenges facing radiopharma companies," said investor Dan Lyons, a portfolio manager and research analyst at Janus Henderson Investors.

Bristol-Myers Squibb has also joined the fray, completing its $4.1 billion acquisition of RayzeBio in February. The company now has RazyeBio's pipeline, including its late-stage targeted radiopharma therapy, RYZ101, for gastroenteropancreatic neuroendocrine tumors. It is also in a phase one trial for small cell lung cancer.

The deal's announcement in December came shortly after Bristol-Myers Squibb said it would spend $14 billion to buyout schizophrenia drug developer Karuna Therapeutics. At the time, William Blair analyst Matt Phipps said the deals show Bristol's urgency to bring in more products since some of its older therapies are set to lose their patent protections later this decade.

Shares of the big pharma company have been on a losing streak, down more than 18% year to date. It has an average analyst rating of hold, per FactSet.

Lastly, in March, AstraZeneca announced plans to purchase clinical-stage biopharmaceutical company Fusion Pharmaceuticals for $2.4 billion. Fusion currently has a phase two clinical trial underway for a potential new treatment, called FPI-2265, for patients with metastatic castration-resistant prostate cancer.

AstraZeneca shares have an average analyst rating of overweight and nearly 6% upside to the average analyst price target, per FactSet.

"All these companies had manufacturing presence, more or less, built out or are in the process of building out and becoming operational very soon on a commercial scale," said Jefferies analyst Andrew Tsai. "They've got that locked down and I think that's, in part, what big pharma wanted."

There are also some smaller publicly-traded biopharma companies still standing, although not many.

In addition, there are several private companies in the space that have have been attracting private investors, especially of late. Innovative radiopharmaceutical drugs nabbed in $518 million in venture financing last year, a whopping 722% increase from the $63 million they received in 2017, according to GlobalData's Pharma Intelligence Center Deals Database.

Both those public and private names could be ripe for an acquisition at some point, said Janus Henderson's Lyons.

"There are several large pharma companies that don't yet have radiopharma programs that may be interested in this space," he said. "In addition, I think some of the players that already have programs will be interested in finding additional targets and pipeline programs to augment their portfolio."

'Massive opportunity'

Everyone, including big pharma, is working on either improving on existing treatments or looking to expand into attacking different cancer tumors.

Novartis, for instance, got FDA approval in April for Lutathera for pediatric patients. It also said last month that it will file for a label expansion for Pluvicto in earlier treatment of prostate cancer.

"There's a clear path and strategy by Novartis to expand the market opportunity for those two products," Jones said.

Then there are companies that are developing therapies against those same targets. Some, like Bristol's RayzeBio, are turning to using an alpha emitter like actinium instead of the beta emitter lutetium used by Pluvicto and Lutathera.

"These alpha [emitters] have a much stronger punch and are very localized, literally, to a cell length," said Piper Sandler's Tenthoff.

Radiopharmaceuticals are also being looked at to use in conjunction with other treatments, such as immunotherapy.

Depending on the outcome of current and future clinical trials, the therapy could also eventually be used to treat any cancers like ovarian, breast or brain, he said.

"Anywhere where radiation therapy is used, but not necessarily in a targeted approach, makes a lot of sense because these are radiosensitive tumors," Tenthoff said.

Companies can also turn the decades of research they've already done in the field to identify new opportunities, Jones said.

"You can really leverage all the work we've done in cancer over the last 30 to 40 years to identify targets on cancer cells that are not expressed, or much more highly expressed on cancer cells versus normal cells —and really, any of those are an opportunity for targeted radiotherapy," he said.

"I see the massive opportunity for targeted radiotherapies," he added. "We have two products today, two targets and you have essentially the entire universe of cancer research and cancer targeting."

  • CNBC Pro scoured Goldman Sach's May conviction lists for stocks with further upside of 50% or more, based on the bank's price targets.

OTHER NEWS

31 minutes ago

Playwright James Graham: ‘We’re still living in Thatcher’s country’

31 minutes ago

Kate Middleton - latest: Prince William shares sweet message day after Princess returns to public duties

31 minutes ago

Poland vs Netherlands LIVE: Euro 2024 team news and line-ups ahead of Group D clash as Robert Lewandowski out

32 minutes ago

China is getting too much rain in the south and not enough rain, plus a heat wave, in the north

33 minutes ago

As the Raspberry Pi share price soars, is it set to be a great UK growth success?

33 minutes ago

World leaders condemn Putin's 'dictatorial' Ukraine ceasefire proposal

33 minutes ago

Richie Sambora on Bon Jovi docuseries: 'That's one person's perspective'

33 minutes ago

With a forward P/E of 3.28x, could this FTSE 250 stock make me rich?

33 minutes ago

NASCAR radio station: Channel, live streams to listen to 2024 Iowa race broadcast

33 minutes ago

Matt Shirvington reveals what he REALLY thinks of 'fast-paced' Sunrise

33 minutes ago

LISTEN to It's All Kicking Off! Why it's criminal to leave Trent Alexander-Arnold out of the England team

33 minutes ago

Axed Match of the Day pundit Mark Lawrenson claims BBC bosses threatened to drop him from the World Cup final over a 'handbag' joke

33 minutes ago

Alisha Lehmann and Douglas Luiz 'set for historic double transfer to Juventus' this summer... as Italian club continues negotiations for the Aston Villa power couple

33 minutes ago

Married At First Sight's Jules Robinson throws wild baby shower complete with nappy-sniffing challenge and VERY racy games

33 minutes ago

Video: Lady Elliot Island boat capsize: Desperate search for missing man after boat overturned ends in tragedy off Queensland coast near Bundaberg after Life Flight winched a father and son to safety

33 minutes ago

Lady Elliot Island boat capsize: Desperate search for missing man after boat overturned ends in tragedy off Queensland coast near Bundaberg after Life Flight winched a father and son to safety

33 minutes ago

Man City are 'prepared to take Joao Cancelo on pre-season tour' after 17-month absence... as Premier League champions demand Barcelona meet £25m asking price

33 minutes ago

Video: FA 'warn England fans will have their Euro 2024 tickets confiscated if they misbehave in Germany'... as footage emerges of supporters singing '10 German bombers' in the streets ahead of clash with Serbia

33 minutes ago

Brave Kate releases Father's Day photo of William and the children - after Princess of Wales attended Trooping the Colour amid her cancer battle in boost to the nation

36 minutes ago

Why Hollow Knight: Silksong Referencing the Original Now Could Be a Boon

36 minutes ago

Texas continues to use controversial recruiting method despite outcry

36 minutes ago

Heatwave in Middle East makes power shortages hot topic during Eid Al Adha

36 minutes ago

Dragon Age: The Veilguard Dwarf Companion Has Magical Powers

37 minutes ago

Ex-presidential candidate Anies gets boost for Jakarta polls from Indonesia’s largest party

37 minutes ago

South-East Asia’s carbon storage dreams: Visionary climate solution or folly?

37 minutes ago

With future sorted, France’s Mbappe will be ‘unstoppable’ at Euro 2024, says Djibril Cisse

39 minutes ago

Does Donald Trump have a shot in appealing his hush money conviction?

39 minutes ago

Video: Brave Kate is a beacon of light in new behind-the-scenes Trooping the Colour video - as Waleses reveal they are 'in awe' at 'incredible' ceremony that included Princess' Buckingham Palace balcony appearance

39 minutes ago

Concerns grow as 'gigantic' bird flu outbreak runs rampant in US dairy herds

39 minutes ago

Trump confuses doctor's name whilst accusing Biden of cognitive decline

39 minutes ago

Election diary: a tax on disco music, a levy on punctuation – and VAT terror stalking rural England

39 minutes ago

England vs Serbia referee had 'disaster' at World Cup which led to Lionel Messi glory

39 minutes ago

Hynes axed as new-look Blues squad confirmed

39 minutes ago

England vs Serbia: Date, kick-off time and TV channel for Euro 2024 group-stage game

39 minutes ago

Is Poland v Netherlands on TV? Kick-off time, channel and how to watch Euro 2024 match today

39 minutes ago

As Boeing looks to buy a key 737 supplier, a whistleblower says the problems run deep

39 minutes ago

A Swiss museum will remove 5 paintings potentially looted by Nazis

41 minutes ago

UK Conservatives getting ‘smashed’ in the polls

47 minutes ago

GT Aston Martin Exits Le Mans In a Dramatic Rollover Crash

47 minutes ago

Fernando Alonso knows the moment it will be ‘bye bye’ from F1 for good