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HER2 저발현 암 : 시장 규모, 대상 환자층, 경쟁 구도 및 시장 예측((2036년)

HER2-low Cancers - Market Size, Target Population, Competitive Landscape, and Market Forecast - 2036

발행일: | 리서치사: 구분자 DelveInsight | 페이지 정보: 영문 120 Pages | 배송안내 : 2-10일 (영업일 기준)

    
    
    




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주요 하이라이트 :

  • 2024년, 주요 7개국 중 HER2 저발현 암 시장 규모는 미국이 약 16억 달러로 가장 컸으며, 2036년까지 더욱 확대될 것으로 예상됩니다.
  • 주요 7개국 전체의 HER2 저발현 암 대상 환자 수 중 사례 수가 가장 많았던 것은 유방암이었고, 그 다음은 대장암이었으며, 가장 적었던 것은 난소암이었습니다.
  • 인구 고령화에 따라 고령층의 유방암 유병률은 상승하고 있으며, 기존 유방암 사례의 50% 이상을 HER2 저발현 사례가 차지하고 있습니다.
  • 현재 HER2 저발현 유방암의 1차 치료제로 승인된 HER2 표적 치료제는 없으며, 특히 HR 음성/HER2 저발현 사례의 경우 화학요법이 주요 치료법으로 사용되고 있습니다.
  • 2022년 이전에는 HER2 저발현 환자가 HER2-negative와 동일하게 취급되어 화학요법이나 내분비요법에 의존하고 있었습니다. 2022년 8월, DESTINY-Breast04 임상시험 결과를 바탕으로 ENHERTU(트라스투주맙 델크스테칸)가 FDA의 승인을 받으면서 상황이 일변했습니다.
  • HER2 저발현/초저발현 유방암에 대한 ENHERTU의 최근 FDA 승인으로, HER2 저발현이 중요한 치료 표적임이 입증되었습니다. 조기 치료 단계로의 전환은 규제 측면에서의 추가적인 진전을 촉진할 것으로 예상됩니다.
  • 현재 HER2 저발현 분류는 위암, 요로상피암, 기타 고형암에서도 검토가 진행되고 있으며, 치료 적용 범위가 점차 확대되고 있습니다. 화이자나 드래곤플라이와 같은 기업은 여러 적응증에서 HER2 저발현을 치료 가능한 표적으로 확립하기 위해 노력하고 있습니다.
  • TROP2를 표적으로 하는 ADC(TRODELVY, DATROWAY), 이중특이성 항체(자니다타맙), 면역조절제(에프틸라기모드 알파) 등 몇 가지 새로운 치료법이 개발 중입니다. 이러한 후보 약물이 성공한다면, 치료 선택지가 다양해지고 경쟁이 심화될 가능성이 있습니다.
  • 신흥 치료법 중에서도 에프틸라기모드 알파의 피하 투여는 환자의 편의성과 치료 순응도 측면에서 큰 이점을 제공합니다. 자택에서 자가 투여가 가능해짐에 따라 잦은 병원 방문의 필요성이 줄어들고, 전이성 유방암 환자의 삶의 질(QOL)이 향상될 가능성이 있습니다.
  • 드래곤플라이 테라퓨틱스(Dragonfly Therapeutics)의 DF1001은 동종 최초(First-in-Class)의 NK 세포 및 T 세포 이중 결합제로, HER2 저발현 종양을 가진 다제내성 환자를 대상으로 설계되어 새로운 면역요법 접근법을 제공합니다.
  • 이 분야의 주요 기업으로는 다이이치 산쿄(DATROWAY), 화이자(disitamab vedotin), 길리어드 사이언스(TRODELVY), 듀얼리티 바이오로직스와 바이오엔테크(DB-1303/BNT323), Bliss Biopharmaceutical(BB-1701), Daiichi Sankyo 및 Merck(ifinatamab deruxtecan) 등이 있습니다.
  • 향후 HER2 저발현 암 치료법은 탄탄한 파이프라인, 정밀의학의 발전, 그리고 암 발병률 증가에 힘입어 상당한 성장이 예상됩니다.

‘HER2 저발현 암’ 시장 보고서에서는 현재의 치료 실태, 신흥 의약품, 각 치료법의 시장 점유율에 더해, 2022-2036년까지 주요 7개국의 HER2 저발현 암 시장 현황 및 예측 규모를 수록하고 있습니다. 또한 이 보고서에서는 현재의 HER2 저발현 암 치료 현황·알고리즘 및 미충족 의료 수요에 대해서도 다루며, 최적의 비즈니스 기회를 엄선하고 시장의 잠재적 가능성을 평가하고 있습니다.

대상 지역 :

  • 미국
  • EU4(독일, 프랑스, 이탈리아, 스페인) 및 영국
  • 일본

조사 기간: 2022-2036년

HER2 저발현 암에 대한 이해

HER2 저발현 암 개요

ERBB2 유전자에 의해 암호화되는 막 관통형 티로신 키나아제 수용체인 HER2는 세포의 증식, 분화 및 생존에 중요한 역할을 합니다. 이는 상피 성장인자 수용체 계열에 속하며, 표준 분자생물학적 기법을 사용하여 평가됩니다. 구체적으로, HER2 단백질의 과발현은 IHC를 통해 평가되며, 유전자 증폭은 FISH를 통해 판정됩니다. HER2 저발현은 IHC 점수가 1+ 또는 2+이고, ISH를 통해 증폭이 확인되지 않는(FISH 음성) 것으로 분류됩니다. HER2/neu는 주로 MAPK 및 PI3K 경로를 통해 신호 전달을 수행하며, 증폭되거나 과발현되면 악성 전이를 촉진합니다. 이 단백질의 발현은 유방암, 대장암, 난소암, 자궁내막암, 방광암, 위암, 담도암 등 다양한 암에서 관찰되지만, 그중에서도 유방암에서 가장 흔합니다.

새로운 ADC의 등장으로 HER2 저발현 종양의 치료 상황은 일변하여 생존율이 현저히 향상되었습니다. ENHERTU는 HER2를 표적으로 하는 모노클로널 항체와 토포이소머라제 I 억제제로 구성된 최첨단 ADC입니다.

HER2 저발현 암의 역학

이 보고서에서 다루고 있는 역학 데이터는 미국, EU4(독일, 프랑스, 이탈리아, 스페인), 영국 및 일본을 포함한 주요 7개국을 대상으로 2022-2036년까지의 기간을 다룹니다.

  • 미국의 HER2 저발현 암 환자 수 중 난소암의 발생률이 가장 낮습니다.
  • 2024년, HER2 저발현 유방암의 대상 환자 수는 64,000건이며, 이러한 사례 수는 예측 기간 중 증가할 것으로 예상됩니다.
  • 연령대별로 볼 때, HER2 저발현 유방암 중 60-69세 연령층이 약 30%를 차지하며, 가장 큰 비중을 차지하고 있습니다.
  • EU4 및 영국에서 병기별 유방암 사례 중, 2024년에는 1기 사례가 약 31,000건으로 가장 많은 비중을 차지했습니다.
  • 일본에서는 2024년 ‘요로상피암 ? HER2 저발현’을 대상으로 한 총 환자 수가 약 1만 5,000명이었습니다.

HER2 저발현 암 시장의 최근 동향

  • 2026년 8월,Cipla사와 Sino Biopharmaceutical사의 자회사인 Chia Tai Tianqing Pharmaceutical Group사는 HER2 이중특이성 항체-약물 접합체인 롤디타미그-데우델크스테칸(TQB2102)에 관한 독점 라이선스 및 공급 계약을 체결했습니다. Cipla사는 인도, 남아프리카공화국 및 기타 5개 신흥 시장에서 이 치료법의 개발 및 상용화 권리를 획득했습니다. TQB2102는 HER2 발현 암 전반을 대상으로 평가가 진행 중이며, HER2 저발현 진행성 유방암에서 유망한 활성을 보이고 있습니다.
  • 2026년 5월, 트라스투주맙-델크스테칸의 유럽 규제 심사 과정에는 HER2 저발현 유방암에 대한 적용과 관련된 진전이 포함되어 있으며, 이는 T-DXd가 당초의 HER2 양성 적응증을 넘어 지속적으로 적응증 범위를 확대하고 있음을 반영합니다.

HER2 저발현 암의 시장 전망

위암, 자궁내막암 및 기타 암을 포함한 HER2 저발현 암에 대한 현재의 치료 선택지는 이러한 악성 종양에서 HER2의 역할에 대한 연구가 진행됨에 따라 계속 진화하고 있습니다. 기존의 모노클로널 항체나 저분자 티로신 키나제 억제제(TKI)는 HER2 저발현 유방암에 대해 거의 치료 효과를 보이지 않습니다.

오랫동안 HER2 저발현 유방암은 HR 양성/HER2 음성(HR+/HER2-) 및 삼중 음성 유방암(TNBC)을 포함한 HER2 양성 유방암의 치료 순서에 통합되어 왔습니다. ENHERTU는 HER2 저발현(IHC 1+ 또는 2+/ISH-) 환자에서 유망한 결과를 보여주고 있습니다. DESTINY-Breast04 임상시험의 임상 관행을 변화시킨 결과를 바탕으로, ENHERTU는 2022년 8월 미국 식품의약국(FDA)의 승인을 받았으며, 또한 이전에 치료를 받은 HER2 저발현 전이성 유방암 환자에 대해 미국 국립종합암네트워크(NCCN) 지침에서도 권장되고 있습니다. 본 임상시험의 통계적 설계에 따라 HR 양성 환자 및 HR 음성 환자(즉, TNBC)를 포함한 전체 시험 대상에서 화학요법에 대한 ENHERTU의 유효성이 확인되었습니다. 또한 2023년 1월에는 ENHERTU가 절제 불가능하거나 전이성 HER2 저발현 유방암을 가진 성인 환자,특히 전이성 병태에서 이전에 화학요법을 받은 환자 또는 보조 화학요법 완료 중이거나 완료 후 6개월 이내에 질환 재발을 경험한 환자에 대한 단일제 요법으로 유럽연합(EU)으로부터 승인을 받았습니다. 이에 이어 같은 해 3월에는 일본에서도 승인되었습니다.

또한 최근, 2025년 1월에는 ENHERTU가 미국 식품의약국(FDA)으로부터 FDA 승인 검사를 통해 판정된 절제 불가능하거나 전이성인 HR 양성,HER2 저발현 또는 HER2 초저발현(IHC 0에서 막 염색 있음) 유방암을 가진 성인 환자 중, 전이 병기에서 1회 이상의 내분비 요법을 받은 후 진행된 환자에 대한 치료제로 승인받았습니다. 그 후, 2025년 2월에는 유럽에서 전이성 유방암 상태에서 적어도 1회 이상의 내분비 요법을 받았으며, 다음 치료 단계로 추가 내분비 요법이 적절하지 않다고 판단된, HR 양성,HER2 저발현 또는 HER2 초저발현(IHC 0에서 막 염색 있음) 유방암 환자에 대한 ENHERTU의 승인을 획득했습니다.

HR 음성/HER2 저발현 유방암 환자의 치료에서는 일반적으로 1차 화학요법에 더해, PD-L1 양성인 경우 면역요법을 시행하고, 그 후 단일제제 화학요법을 순차적으로 실시합니다. HR 양성 유방암의 경우, 화학요법에 비해 무진행 생존 기간(PFS)의 우월성이 인정되고 있으므로, 생식세포계열 BRCA 변이를 가진 환자에 대해서는 PARP 억제제 투여가 검토됩니다.

HER2 저발현 유방암 치료의 미래는 혁신적인 치료법, 특히 DATROWAY, TRODELVY, 트라스투주맙-파밀테칸,BB-1701, DF1001, 에밀타투그·레다도틴 등의 ADC(항체-약물 접합체) 개발에 따라 크게 좌우될 전망입니다. 이러한 ADC는 HER2 저발현 암세포를 표적으로 하여 강력한 세포독성 약물을 종양에 직접 전달함으로써, 정상 조직에 대한 손상을 최소화하면서 치료 효과를 향상시키도록 설계되었습니다. 또한 독소루비신을 함유한 면역 리포좀인 HF158K1/HF-K1은 화학요법제를 리포좀에 봉입하여 표적 전달을 수행하는 새로운 접근 방식을 제시하고 있습니다. 또 다른 유망한 치료법인 에프틸라기모드-알파는 APC를 활성화하는 용해성 LAG-3 단백질로, 암에 대한 면역계의 반응을 높이는 것을 목적으로 합니다. 이러한 치료법들을 종합함으로써 HER2 저발현 암 치료 방식에 혁명을 일으킬 가능성을 내포하고 있습니다.

전반적으로 HER2 저발현 암 시장은 예측 기간(2026-2036년) 동안 더욱 확대될 것으로 전망됩니다.

  • 주요 7개국에서 HER2 저발현 암 시장 규모는 2024년 약 32억 달러였으며, 예측 기간(2026-2036년)에 걸쳐 성장할 것으로 전망됩니다.
  • 유방암을 제외하면, 위암 및 담도암이 HER2 저발현 암을 대상으로 한 치료법에서 가장 큰 상업적 잠재력을 가질 가능성이 있습니다.
  • 대상 적응증 중 유방암 및 위암은 HER2 저발현 암 치료제의 임상 개발 및 승인이 가장 진전되어 있으며, 2036년까지 가장 큰 수익을 창출할 것으로 예상됩니다.
  • 모든 치료법 중에서 ‘ENHERTU’가 가장 큰 시장 점유율을 차지할 것으로 예상되며, 그 다음으로 화학요법 및 적응증 외 사용 표적 치료가 뒤를 이을 것으로 전망됩니다.
  • HER2 저발현 유방암에 대한 ENHERTU의 승인은 시장 동향을 크게 변화시켰으며, 매출을 2배로 끌어올렸습니다. 이러한 성장은 그동안 HER2 표적 치료로 치료 효과가 미흡했던 HER2 저발현 전이성 유방암 치료에서 이 약물이 획기적인 효능을 보였기 때문입니다.

자주 묻는 질문

  • 2024년 HER2 저발현 암 시장 규모는 어떻게 되나요?
  • HER2 저발현 유방암의 주요 치료법은 무엇인가요?
  • ENHERTU의 FDA 승인은 어떤 의미를 가지나요?
  • HER2 저발현 암 시장의 주요 기업은 어디인가요?
  • HER2 저발현 암 치료의 미래 전망은 어떻게 되나요?
  • HER2 저발현 유방암 환자의 연령대 분포는 어떻게 되나요?

목차

제1장 주요 인사이트

제2장 서론

제3장 개요

제4장 주요 이벤트

제5장 역학 및 시장 예측의 조사 방법

제6장 HER2-LOW CANCERS : 시장 개요

제7장 질환 배경과 개요

제8장 역학 및 환자 인구

제9장 환자 경과

제10장 일반의약품(OTC)

제11장 신규 치료법

제12장 HER2-LOW CANCERS : 주요 7개국 분석

제13장 미충족 수요

제14장 SWOT 분석

제15장 KOL의 견해

제16장 시장 참여 및 보험 상환

제17장 부록

제18장 DelveInsight의 서비스 내용

제19장 면책사항

제20장 DelveInsight 소개

KSA 26.09.10

Key Highlights:

  • In 2024, the market size of HER2-low cancers was highest in the US among the 7MM, accounting for approximately USD 1,600 million, which is further expected to increase by 2036.
  • Among the total targeted patient pool of HER2-low cancers across the 7MM, the highest number of cases comprised breast cancer, followed by colorectal cancer, and the lowest number of cases comprised ovarian cancer.
  • As the population ages, the prevalence of breast cancer in the elderly is rising, with HER2-low cases comprising over 50% of traditional breast cancers.
  • No HER2-targeted therapies are currently approved for first-line HER2-low breast cancer, leaving chemotherapy as a key treatment, especially for HR-negative/HER2-low cases.
  • Before 2022, HER2-low patients were treated as HER2-negative, relying on chemotherapy or endocrine therapy. The game-changer came in August 2022 with the FDA approval of ENHERTU (trastuzumab deruxtecan), based on the DESTINY-Breast04 trial.
  • Recent FDA approval of ENHERTU in HER2-low/ultralow breast cancer have validated HER2-low as a key therapeutic target. The shift toward earlier-line treatment settings is expected to drive further regulatory momentum.
  • The HER2-low classification is now being explored in gastric, urothelial, and other solid tumors, broadening the therapeutic scope. Companies like Pfizer and Dragonfly are making efforts to establish HER2-low as a treatable target across multiple indications.
  • Several novel therapies are in development, including TROP2-directed ADCs (TRODELVY, DATROWAY), bispecific antibodies (zanidatamab), and immune-modulating agents (eftilagimod alpha). The success of these candidates could diversify the treatment landscape and intensify competition.
  • Among emerging therapies, eftilagimod alpha's subcutaneous administration offers a significant advantage in terms of patient convenience and compliance. The ability to self-administer the drug at home reduces the need for frequent hospital visits, potentially improving the quality of life for patients with metastatic breast cancer.
  • Dragonfly Therapeutics' DF1001, a first-in-class dual NK and T cell engager, is designed for heavily pretreated patients with HER2-low tumors, offering a novel immunotherapeutic approach.
  • Prominent players in this space include AstraZeneca and Daiichi Sankyo (DATROWAY), Pfizer (disitamab vedotin), Gilead Sciences (TRODELVY), Duality Biologics and BioNTech (DB-1303/BNT323), Bliss Biopharmaceutical (BB-1701), Daiichi Sankyo and Merck (ifinatamab deruxtecan).
  • Looking ahead, HER2-low cancers therapies are poised for significant growth, driven by a robust pipeline, precision medicine advancements, and rising cancer incidence.

DelveInsight's " HER2-low Cancers - Market Size, Target Population, Competitive Landscape, and Market Forecast-2036" report delivers an in-depth understanding of the HER2-low Cancers, historical and forecasted epidemiology as well as the HER2-low Cancers market trends in the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan.

HER2-low Cancers market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM HER2-low Cancers market size from 2022 to 2036. The report also covers current HER2-low Cancers treatment practices/algorithms, and unmet medical needs to curate the best of the opportunities and assess the underlying potential of the market.

Geography Covered:

  • The United States
  • EU4 (Germany, France, Italy, and Spain) and the United Kingdom
  • Japan

Study Period: 2022-2036

HER2-low Cancers Understanding

HER2-low Cancers Overview

HER2, a transmembrane tyrosine kinase receptor encoded by the ERBB2 gene, plays a key role in cell growth, differentiation, and survival. It belongs to the epidermal growth factor receptor family and is assessed using standard molecular methods-HER2 protein overexpression is evaluated via IHC, while gene amplification is determined by FISH. HER2-low is classified as an IHC score of 1+ or 2+ without amplification by ISH (FISH-negative). HER2/neu primarily signals through the MAPK and PI3K pathways, driving malignant transformation when amplified or overexpressed. Its expression is observed in various cancers, including breast, colorectal, ovarian, endometrial, bladder, gastric, and biliary tract cancers, with breast cancer being the most common.

The emergence of novel ADCs has transformed the treatment landscape for HER2-low tumors, significantly improving survival. ENHERTU is a cutting-edge ADC composed of a HER2-targeting monoclonal antibody and the topoisomerase I inhibitor.

HER2-low Cancers Epidemiology

The epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by total targeted patient pool of HER2-low cancers, treatment eligible pool of HER2-low cancers, total incident cases of breast cancer, age-specific cases of HER2-low breast cancers, and stage-specific cases of HER2-low breast cancers in the 7MM, covering the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan from 2022 to 2036.

  • In the US HER2-low cancer patient pool, ovarian cancer has the lowest incidence.
  • In 2024, HER2-low breast cancer targeted pool accounted 64,000, these cases are expected to increase during forecast period.
  • Among the age-specific HER2-low breast cancer, 60-69 age group has major contribution about 30%.
  • In EU4 and the UK, among the stage-specific breast cancers cases, Stage I accounted for the highest number of cases with approximately 31,000 in 2024.
  • In Japan, the total number of Urothelial Carcinoma -HER2-low targeted pool was approximately 15,000 in 2024.

HER2-low Cancers Drug Chapters

The drug chapter segment of the HER2-low cancers report encloses a detailed analysis of HER2-low cancers marketed and emerging (Phase III and Phase II and Phase I/II) pipeline drugs. It also helps to understand HER2-low cancers clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug, and the latest news and press releases.

Marketed Drugs

ENHERTU (trastuzumab deruxtecan): Daiichi Sankyo and AstraZeneca

ENHERTU is a HER2-directed ADC. Designed using Daiichi Sankyo's proprietary DXd ADC Technology, ENHERTU is the lead ADC in the oncology portfolio of Daiichi Sankyo and the most advanced program in AstraZeneca's ADC scientific platform. It received FDA approval in August 2022 and 2025, EMA approval in 2023 and 2025, and PMDA approval in 2023. As per AstraZeneca's full-year 2024 clinical trial appendix, published in February 2025, the company anticipates a regulatory decision for ENHERTU (DESTINY-Breast06) in Japan for the treatment of HER2-low and ultralow metastatic breast cancer in the second half of 2025.

Emerging Drugs

DATROWAY (datopotamab deruxtecan/Dato-DXd): AstraZeneca and Daiichi Sankyo

Datopotamab deruxtecan is an investigational TROP2-directed ADC. Designed using Daiichi Sankyo's proprietary DXd ADC Technology, datopotamab deruxtecan is one of six DXd ADCs in the oncology pipeline of Daiichi Sankyo and one of the most advanced programs in AstraZeneca's ADC scientific platform. Recently, in January 2025, DATROWAY received approval in the US for the treatment of adult patients with unresectable or metastatic HR-positive, HER2-negative (IHC 0, IHC 1+ or IHC 2+/ISH-) breast cancer who have received prior endocrine-based therapy and chemotherapy for unresectable or metastatic disease.

In March 2025, Daiichi Sankyo's DATROWAY has been launched in Japan for the treatment of adult patients with HR positive, HER2 negative (IHC 0, IHC 1+ or IHC 2+/ISH-) unresectable or recurrent breast cancer after prior chemotherapy.

According to AstraZeneca's full-year 2024 clinical trial appendix, published in February 2025, the company anticipates the data from Phase I of the TROPION-PanTumor01 (NCT03401385) trial to be available in the second half of 2025.

DB-1303/BNT323 (trastuzumab pamirtecan): Duality Biologics and BioNTech

BNT323/DB-1303 is a third-generation topoisomerase-1 inhibitor-based ADC-targeting HER2, which was built from DualityBio's proprietary Duality Immune Toxin Antibody Conjugates (DITAC) platform. The candidate has exhibited antitumor activity in both HER2-positive and HER2-low tumor models as well as in several solid tumor indications, including patients with breast, gastric, endometrial, biliary tract cancers, and other advanced solid tumors.

BNT323/DB-1303 is currently being evaluated in an ongoing Phase I/II study (NCT05150691) in patients with advanced/metastatic solid tumors and a pivotal Phase III study (NCT06018337) in patients with HR-positive and HER2-low, metastatic breast cancer that has progressed on hormone and/or Cyclin-dependent Kinase 4/6 (CDK4/6) therapy.

Recent Developments in the HER2-low Cancers Market

  • In August 2026, Cipla and Sino Biopharmaceutical's subsidiary Chia Tai Tianqing Pharmaceutical Group entered an exclusive licensing and supply agreement for rolditamig deuderuxtecan (TQB2102), a HER2-bispecific antibody-drug conjugate. Cipla received rights to develop and commercialize the therapy in India, South Africa, and five other emerging markets. TQB2102 is being evaluated across HER2-expressing cancers and has shown encouraging activity in HER2-low advanced breast cancer.
  • In May 2026, the European regulatory pathway for trastuzumab deruxtecan included developments concerning its use in HER2-low breast cancer, reflecting the continuing expansion of T-DXd beyond its original HER2-positive indications.

Drug Class Insights

ADCs have transformed HER2-low cancer treatment, with a breakthrough in 2022 when ENHERTU became the first approved therapy for HER2-low metastatic breast cancer. This game-changing advancement is reshaping precision oncology, setting new treatment benchmarks. Beyond introducing a vital option for tumors with low HER2 expression, ENHERTU secured a stronger position in the treatment sequence, now approved for HER2-low metastatic breast cancer after the failure of one or more endocrine therapies.

In January 2025, the FDA expanded ENHERTU's approval to include patients with unresectable or metastatic hormone receptor-positive, HER2-low, or HER2-ultralow breast cancer based on the DESTINY-Breast06 trial. This approval removed the prior chemotherapy requirement, enabling earlier use after endocrine-based therapy. The trial demonstrated a significant PFS advantage with ENHERTU over standard chemotherapy (13.2 months vs. 8.1 months). Exploratory analysis confirmed comparable efficacy between HER2-low and HER2-ultralow patients. ENHERTU's safety profile remained consistent with previous trials, with no new concerns identified. With this expanded indication, ENHERTU is emerging as a potential new standard of care for HR-positive, HER2-low, or HER2-ultralow metastatic breast cancer. However, it carries a black boxed warning for ILD and embryo-fetal toxicity. Due to black box warning we have given less score in safety.

HER2-low Cancers Market Outlook

The current treatment options for HER2-low cancers, including gastric, endometrial, and other cancers, are evolving as research continues to uncover more about the role of HER2 in these malignancies. Traditional monoclonal antibodies and small molecular Tyrosine Kinase Inhibitors (TKIs) have little therapeutic effect on breast cancer with HER2-low expression.

For a long time, HER2-low breast cancer has been included in the treatment sequence of HER2- breast cancer, including HR+/HER2- and TNBC. ENHERTU has demonstrated promising results in patients with HER2-low expression (IHC 1+ or 2+/ISH-). Based on the practice-changing results of the DESTINY-Breast04 trial, ENHERTU has been approved by the US FDA in August 2022 and has also been recommended in National Comprehensive Cancer Network (NCCN) guidelines for patients with previously treated HER2-low metastatic breast cancer. The statistical design of this trial allowed for confirming the benefit of ENHERTU over chemotherapy both in HR-positive patients and the overall study population, including HR-negative patients (i.e., TNBC). Additionally, in January 2023, ENHERTU received approval from the European Union as a monotherapy for the treatment of adult patients with unresectable or metastatic HER2-low breast cancer, specifically those who had previously undergone chemotherapy in the metastatic setting or experienced disease recurrence during or within six months of completing adjuvant chemotherapy. This was followed by approval in Japan in March of the same year.

Recently, in January 2025, ENHERTU was granted approval by the US FDA for the treatment of adult patients with unresectable or metastatic HR-positive, HER2-low, or HER2-ultralow (IHC 0 with membrane staining) breast cancer, as determined by an FDA-approved test, who have progressed on one or more endocrine therapies in the metastatic setting. Subsequently, in February 2025, ENHERTU received approval in Europe for HR-positive, HER2-low, or HER2-ultralow breast cancer patients who have received at least one endocrine therapy in the metastatic setting and are not deemed suitable for further endocrine therapy as the next-line-of treatment.

For patients with HR-negative/HER2-low breast cancer, treatment commonly involves first-line chemotherapy, plus immunotherapy if PD-L1 positive, followed by sequential lines of single-agent chemotherapy. As for HR-positive breast cancer, given the PFS advantage over chemotherapy, PARP inhibitors is considered for patients with germline BRCA mutation.

The future of HER2-low cancer treatment is set to be significantly influenced by the development of innovative therapies, particularly ADCs like DATROWAY, TRODELVY, trastuzumab pamirtecan, BB-1701, DF1001, and emiltatug ledadotin. These ADCs are designed to target HER2-low-expressing cancer cells, delivering potent cytotoxic agents directly to the tumor, thereby improving efficacy while minimizing damage to healthy tissue. Additionally, HF158K1/HF-K1, an immunoliposome containing doxorubicin, offers a novel approach by encapsulating the chemotherapy drug in liposomes for targeted delivery. Another promising treatment, Eftilagimod alpha, is an APC-activating soluble LAG-3 protein that aims to enhance the immune system's response against cancer. Together, these therapies hold the potential to revolutionize the treatment landscape for HER2-low cancers.

Overall, HER2-low Cancers market is further expected to increase in the forecast period (2026-2036).

  • The total market size of HER2-low cancers in the 7MM was nearly USD 3,200 million in 2024 and is projected to grow during the forecast period (2026-2036).
  • Apart from breast cancer, gastric cancer and biliary tract cancer may offer the most commercial potential for HER2-low cancers based therapy.
  • Of the target indications, breast cancer and gastric cancer are anticipated to generate the most revenue by 2036 due to the highest level of clinical development and authorization of HER2-low cancers therapies.
  • Among all therapies, ENHERTU is expected to capture highest market followed by Chemo & targeted off-label therapies.
  • The approval of ENHERTU for HER2-low breast cancer has significantly transformed its market trajectory, leading to a double of sales. This growth is attributed to its groundbreaking efficacy in treating HER2-low metastatic breast cancer, a category previously underserved by HER2-targeted therapies.

HER2-low Cancers Drugs Uptake

This section focuses on the rate of uptake of the potential drugs expected to be launched in the market during the study period 2022-2036. The analysis covers HER2-low Cancers market uptake by drugs; patient uptake by therapies; and sales of each drug. The emerging pipeline of HER2-low cancer is majorly focused on treating HER2-low breast cancer patients. With zanidatamab already approved for HER2-positive biliary tract cancer, its potential expansion into breast cancer could provide a valuable new treatment option.

HER2-low Cancers Pipeline Development Activities

The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I/II stage. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities

The report covers detailed information on collaborations, acquisitions and mergers, licensing, and patent details for HER2-low Cancers emerging therapies.

KOL- Views

To keep up with current market trends, we take KOLs and' SMEs' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts were contacted for insights on HER2-low Cancers' evolving treatment landscape, patient reliance on conventional therapies, patient therapy switching acceptability, and drug uptake along with challenges related to accessibility.

DelveInsight's analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers and University such as National Cancer Center, Keio University School of Medicine, University of Nottingham, University of California Los Angeles, and other organizations. Their opinion helps understand and validate current and emerging therapies or market trends in HER2-low Cancers. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.

Qualitative Analysis

We perform Qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and Analyst views. 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.

The analyst analyzes multiple emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry.

In efficacy, the trial's primary and secondary outcome measures are 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.

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.

  • ENHERTU Patient Savings Program for commercially insured patients

If a patient has commercial insurance, the ENHERTU Patient Savings Program may help them with out-of-pocket costs.

Eligible patients may pay as little as USD 0 per ENHERTU prescription, up to USD 26,000 annually, to help with ENHERTU out-of-pocket costs. The annual benefit can be used for the cost of the drug itself and may cover up to USD 100 in infusion costs per administration. There are no income requirements to participate in the program.

Eligibility criteria include

  • The patient must be a resident of the United States or Puerto Rico.
  • Patients must have commercial insurance that covers ENHERTU but not the full cost of the medication.
  • Patients are ineligible if prescriptions are paid by any state or other federally funded programs, including, but not limited to, Medicare Part B, Medicare Part D, Medicaid, Medigap, VA, or TRICARE, or where prohibited by law.
  • Offer is invalid for all transactions and claims submitted more than 120 days following the date of service.

Scope of the Report:

  • The report covers a descriptive overview of HER2-low cancers, explaining its signs and symptoms, risk factors, and currently available therapies.
  • Comprehensive insight has been provided into HER2-low Cancers epidemiology and treatment.
  • Additionally, an all-inclusive account of both the current and emerging therapies for HER2-low Cancers is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
  • A detailed review of the HER2-low Cancers market; historical and forecasted is included in the report, covering the 7MM drug outreach.
  • The report provides an edge while developing business strategies, by understanding trends shaping and driving the 7MM HER2-low Cancers market.

HER2-low Cancers Report Insights

HER2-low Cancers Report Insights

  • Patient Population
  • Therapeutic Approaches
  • HER2-low Cancers Pipeline Analysis
  • HER2-low Cancers Market Size and Trends
  • Market Opportunities
  • Impact of Upcoming Therapies

HER2-low Cancers Report Key Strengths

  • 11 Years Forecast
  • 7MM Coverage
  • HER2-low Cancers Epidemiology Segmentation
  • Key Cross Competition
  • Highly Analyzed Market
  • Drugs Uptake

HER2-low Cancers Report Assessment

  • Unmet Needs
  • Pipeline Product Profiles
  • Market Attractiveness
  • Qualitative Analysis (SWOT and Conjoint Analysis)

FAQs:

  • What was the HER2-low Cancers market share (%) distribution by indications in 2020 and what it would look like in 2036?
  • What would be the HER2-low Cancers total market size as well as market size by therapies across the 7MM during the study period (2022-2036)?
  • What are the key findings about the market across the 7MM and which country will have the largest HER2-low Cancers market size during the study period (2022-2036)?
  • At what CAGR, the HER2-low Cancers market is expected to grow at the 7MM level during the study period (2022-2036)?
  • What would be the HER2-low market outlook across the 7MM during the study period (2022-2036)?
  • What would be the HER2-low Cancers market growth till 2036 and what will be the resultant market size in the year 2036?
  • What are the disease risks, burdens, and unmet needs of HER2-low Cancers?
  • What is the historical HER2-low Cancers patient pool in the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?
  • What would be the forecasted targeted patient pool of HER2-low Cancers at the 7MM level?
  • What will be the growth opportunities across the 7MM concerning the patient population about HER2-low Cancers?
  • At what CAGR the population is expected to grow across the 7MM during the study period (2022-2036)?
  • How many emerging therapies are in the mid-stage and late stage of development for HER2-low Cancers?
  • What are the key collaborations (Industry-Industry, Industry-Academia), Mergers and acquisitions, and licensing activities related to HER2-low Cancers?
  • What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitations of existing therapies?
  • What are the key designations that have been granted for HER2-low breast based therapies?
  • What are the 7MM historical and forecasted market of HER2-low Cancers?

Reasons to buy:

  • The report will help in developing business strategies by understanding trends shaping and driving HER2-low Cancers.
  • To understand the future market competition in the HER2-low Cancers market and an Insightful review of the SWOT analysis of HER2-low Cancers.
  • Organize sales and marketing efforts by identifying the best opportunities for HER2-low Cancers in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
  • Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
  • Organize sales and marketing efforts by identifying the best opportunities for HER2-low Cancers market.
  • To understand the future market competition in HER2-low Cancers market.

Table of Contents

1. KEY INSIGHTS

2. REPORT INTRODUCTION

3. EXECUTIVE SUMMARY

4. KEY EVENTS

5. EPIDEMIOLOGY AND MARKET FORECAST METHODOLOGY

6. HER2-LOW CANCERS MARKET OVERVIEW AT A GLANCE

  • 6.1. MARKET SHARE (%) DISTRIBUTION BY THERAPIES OF HER2-LOW CANCERS IN 2025 IN THE 7MM
  • 6.2. MARKET SHARE (%) DISTRIBUTION BY THERAPIES OF HER2-LOW CANCERS IN 2036 IN THE 7MM

7. DISEASE BACKGROUND AND OVERVIEW

  • 7.1. INTRODUCTION
  • 7.2. SYMPTOMS
  • 7.3. RISK FACTORS
  • 7.4. PATHOPHYSIOLOGY OF HER2-LOW CANCERS
  • 7.5. PROGNOSIS
  • 7.6. DIAGNOSIS
  • 7.7. TREATMENT
  • 7.8. GUIDELINES
    • 7.8.1. Diagnostic Guidelines and Recommendations for HER2-low Cancers
      • 7.8.1.1. ASCO Diagnostic Recommendations for HER2 Testing
      • 7.8.1.2. The ASCO-College of American Pathologists (CAP) Recommendations for HER2 Testing
      • 7.8.1.3. ESCO Guidelines for HER2-low Cancers
      • 7.8.1.4. Interpretation by the ASCO/CAP 2018 Guidelines and by the 2025 ESMO Consensus on HER2-low Breast Cancer Regarding Each Pattern of HER2 Staining
      • 7.8.1.5. Pan-Asian Adapted ESMO Guidelines for HER2-low Cancers
      • 7.8.1.6. Japanese Breast Cancer Society Clinical Practice Guidelines for Pathological Diagnosis of Breast Cancer, 2022 Edition
    • 7.8.2. Treatment Guidelines and Recommendations for HER2-low Cancers
      • 7.8.2.1. ESCO Guidelines for HER2-low Cancers
      • 7.8.2.2. Pan-Asian Adapted ESMO Guidelines for HER2-low Cancers

8. EPIDEMIOLOGY AND PATIENT POPULATION

  • 8.1. KEY FINDINGS
  • 8.2. ASSUMPTION AND RATIONALE OF HER2-LOW CANCERS: THE 7MM
  • 8.3. TOTAL TARGETED PATIENT POOL OF SELECTED INDICATIONS FOR HER2-LOW CANCERS IN THE 7MM
  • 8.4. TREATMENT ELIGIBLE POOL OF SELECTED INDICATIONS FOR HER2-LOW CANCERS IN THE 7MM
  • 8.5. THE UNITED STATES
    • 8.5.1. Total Incident Cases of HER2-low Breast Cancers in the United States
    • 8.5.2. Age-specific Cases of HER2-low Breast Cancers in the United States
    • 8.5.3. Stage-specific Cases of HER2-low Breast Cancers in the United States
  • 8.6. EU4 AND THE UK
    • 8.6.1. Total Incident Cases of HER2-low Breast Cancers in EU4 and the UK
    • 8.6.2. Age-specific Cases of HER2-low Breast Cancers in EU4 and the UK
    • 8.6.3. Stage-specific Cases of HER2-low Breast Cancers in EU4 and the UK
  • 8.7. JAPAN
    • 8.7.1. Total Incident Cases of HER2-low Breast Cancers in Japan (2020-2036)
    • 8.7.2. Age specific Cases of HER2-low Breast Cancers in Japan
    • 8.7.3. Stage-specific Cases of HER2-low Breast Cancers in Japan

9. PATIENT JOURNEY

10. MARKETED DRUG

  • 10.1. KEY COMPETITOR
  • 10.2. ENHERTU (TRASTUZUMAB DERUXTECAN): DAIICHI SANKYO AND ASTRAZENECA
    • 10.2.1. Product Description
    • 10.2.2. Regulatory Milestones
    • 10.2.3. Other Developmental Activities
    • 10.2.4. Clinical Development
      • 10.2.4.1. Clinical Trial Information
    • 10.2.5. Safety and Efficacy

11. EMERGING THERAPIES

  • 11.1. KEY CROSS COMPETITION
  • 11.2. DATROWAY (DATOPOTAMAB DERUXTECAN/DATO-DXD): ASTRAZENECA AND DAIICHI SANKYO
    • 11.2.1. Product Description
    • 11.2.2. Other Developmental Activities
    • 11.2.3. Clinical Development
      • 11.2.3.1. Clinical Trials Information
    • 11.2.4. Safety and Efficacy
    • 11.2.5. Analyst Views
  • 11.3. TRODELVY (SACITUZUMAB GOVITECAN): GILEAD SCIENCES
    • 11.3.1. Product Description
    • 11.3.2. Other Developmental Activities
    • 11.3.3. Clinical Development
      • 11.3.3.1. Clinical Trials Information
    • 11.3.4. Safety and Efficacy
    • 11.3.5. Analyst Views
  • 11.4. DB-1303/BNT323 (TRASTUZUMAB PAMIRTECAN): DUALITY BIOLOGICS AND BIONTECH
    • 11.4.1. Product Description
    • 11.4.2. Other Developmental Activities
    • 11.4.3. Clinical Development
      • 11.4.3.1. Clinical Trials Information
    • 11.4.4. Safety and Efficacy
    • 11.4.5. Analyst Views
  • 11.5. AIDIXI (DISITAMAB VEDOTIN): REMEGEN AND PFIZER (SEAGEN)
    • 11.5.1. Product Description
    • 11.5.2. Other Developmental Activities
    • 11.5.3. Clinical Development
    • 11.5.4. Safety and Efficacy
    • 11.5.5. Analyst Views
  • 11.6. EFTILAGIMOD ALPHA (IMP321): IMMUTEP
    • 11.6.1. Product Description
    • 11.6.2. Other Developmental Activities
    • 11.6.3. Clinical Development
      • 11.6.3.1. Clinical Trials Information
    • 11.6.4. Safety and Efficacy
    • 11.6.5. Analyst Views
  • 11.7. IFINATAMAB DERUXTECAN (I-DXD)/MK-2400: DAIICHI SANKYO AND MERCK
    • 11.7.1. Product Description
    • 11.7.2. Other Developmental Activities
    • 11.7.3. Clinical Development
      • 11.7.3.1. Clinical Trials Information
    • 11.7.4. Analyst Views
  • 11.8. BB-1701: BLISS BIOPHARMACEUTICAL (HANGZHOU)
    • 11.8.1. Product Description
    • 11.8.2. Other Developmental Activities
    • 11.8.3. Clinical Development
      • 11.8.3.1. Clinical Trials Information
    • 11.8.4. Safety and Efficacy
    • 11.8.5. Analyst Views
  • 11.9. DF1001: DRAGONFLY THERAPEUTICS
    • 11.9.1. Product Description
    • 11.9.2. Other Developmental Activities
    • 11.9.3. Clinical Development
      • 11.9.3.1. Clinical Trials Information
    • 11.9.4. Safety and Efficacy
    • 11.9.5. Analyst Views
  • 11.1. ZIIHERA (ZANIDATAMAB): ZYMEWORKS/JAZZ PHARMACEUTICALS/ALX ONCOLOGY
    • 11.10.1. Product Description
    • 11.10.2. Other Developmental Activities
    • 11.10.3. Clinical Development
    • 11.10.4. Safety and Efficacy
    • 11.10.5. Analyst Views
  • 11.11. HF158K1/HF-K1: HIGHFIELD BIOPHARMACEUTICALS
    • 11.11.1. Product Description
    • 11.11.2. Other Developmental Activities
    • 11.11.3. Clinical Development
      • 11.11.3.1. Clinical Trials Information
    • 11.11.4. Safety and Efficacy
    • 11.11.5. Analyst Views
  • 11.12. EMILTATUG LEDADOTIN (XMT-1660): MERSANA THERAPEUTICS
    • 11.12.1. Product Description
    • 11.12.2. Other Developmental Activities
    • 11.12.3. Clinical Development
      • 11.12.3.1. Clinical Trials Information
    • 11.12.4. Safety and Efficacy
    • 11.12.5. Analyst Views

12. HER2-LOW CANCERS: SEVEN MAJOR MARKET ANALYSIS

  • 12.1. KEY FINDINGS
  • 12.2. MARKET OUTLOOK
  • 12.3. CONJOINT ANALYSIS
  • 12.4. KEY MARKET FORECAST ASSUMPTIONS
    • 12.4.1. Cost Assumptions
    • 12.4.2. Pricing Trends
    • 12.4.3. Analogue Assessment
    • 12.4.4. Launch Year and Therapy Uptakes
  • 12.5. TOTAL MARKET SIZE OF HER2-LOW CANCERS BY COUNTRY IN THE 7MM
  • 12.6. TOTAL MARKET SIZE OF HER2-LOW CANCERS BY INDICATIONS IN THE 7MM
  • 12.7. MARKET SIZE OF HER2-LOW CANCERS BY THERAPIES IN 7MM
  • 12.8. UNITED STATES MARKET SIZE
    • 12.8.1. Total Market Size of HER2-low Cancers in the United States
    • 12.8.2. Market Size of HER2-low Cancers by Therapies in the United States
  • 12.9. EU4 AND THE UK MARKET SIZE
    • 12.9.1. Total Market Size of HER2-low Cancers in EU4 and the UK
    • 12.9.2. Market Size of HER2-low Cancers by Therapies in EU4 and the UK
  • 12.1. JAPAN
    • 12.10.1. Total Market Size of HER2-low Cancers in Japan
    • 12.10.2. Market Size of HER2-low Cancers by Therapies in Japan

13. UNMET NEEDS

14. SWOT ANALYSIS

15. KOL VIEWS

16. MARKET ACCESS AND REIMBURSEMENT

  • 16.1. UNITED STATES
    • 16.1.1. Centre for Medicare and Medicaid Services (CMS)
  • 16.2. EU4 AND THE UK
    • 16.2.1. Germany
    • 16.2.2. France
    • 16.2.3. Italy
    • 16.2.4. Spain
    • 16.2.5. United Kingdom
  • 16.3. JAPAN
    • 16.3.1. MHLW
  • 16.4. MARKET ACCESS AND REIMBURSEMENT OF HER2-LOW CANCERS

17. APPENDIX

  • 17.1. BIBLIOGRAPHY
  • 17.2. REPORT METHODOLOGY

18. DELVEINSIGHT CAPABILITIES

19. DISCLAIMER

20. ABOUT DELVEINSIGHT

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