10. Astellas

Xtandi's growth will depend on what kind of fight J&J’s Zytiga follow-up, Erleada, puts up. (Astellas)

10. Astellas
2017 cancer sales: $2.85 billion
2024 cancer sales: $5.83 billion
Rank change: +1

Astellas’ Xtandi, which it shares with Pfizer, has been blazing a blockbuster trail in the prostate cancer market for years, even with stiff competition from key Johnson & Johnson rival Zytiga. And that’s only set to continue in future years.

After recording nearly $3 billion in 2017 sales, the product this July picked up an FDA go-ahead to treat patients before their disease spreads through the body, an indication that industry watchers think could generate more than $1 billion on its own. Evaluate has said it expects the drug to churn out $4.71 billion in 2022, which would rank it among the top 15 best-selling cancer drugs that year.

And Astellas isn’t stopping there. It’s already studying Xtandi in additional subpopulations that could widen its patient pool and up its top-line contributions; the Japanese drugmaker and Pfizer are currently running a pair of trials in hormone-sensitive disease, one examining Xtandi’s effects on patients whose cancer has metastasized and one focusing on those whose cancer has yet to spread.

Just how much Xtandi grows, though, will depend on what kind of fight J&J’s Zytiga follow-up, Erleada, puts up. It bears its own approval in nonmetastatic disease, and Barclays analyst Geoff Meacham has said the two nemeses “essentially delivered identical outcomes” in trials.

Astellas also helps Roche’s Genentech market Tarceva, a targeted lung cancer drug. But that product is up against some stiff competition, too; AstraZeneca’s Tagrisso has topped its survival marks in trials, and Pfizer recently crowded the field with an FDA OK for newcomer Vizimpro.

10. Astellas

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