Oncology’s Next Decade: The Therapies and Players Reshaping a $400bn Future

Either way, how’s this? Oncology accounts for around 18% of global drug sales. By 2032, Evaluate Pharma puts the oncology market forecast at close to $400bn. But the landscape is evolving. Patent cliffs threaten today’s leaders, new modalities are taking share fast, and China has emerged as a serious force in development and commercialization. This report maps the oncology competitive landscape of the next decade. Who and what comes out on top?

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Oncology’s Next Decade: The Therapies and Players Reshaping a $400bn Future

Drawing on Evaluate Pharma consensus forecasts and analysis from the In Vivo editorial team, this report looks at the oncology competitive landscape and where the market is heading through 2032.

The report covers:

  • The shifting therapy mix, from chemotherapy’s declining share to the rise of targeted agents, immunotherapies, and cell and gene therapies, which could reach ~7% of oncology spend by 2032
  • The cancer types commanding the largest and fastest-growing drug markets, and what that means for oncology portfolio strategy
  • How regional dynamics are evolving, including China’s rapid emergence as both a development and commercial market
  • The oncology competitive landscape among the top companies, and how patent expirations are set to redraw the rankings by 2032
  • Where the next wave of oncology revenues may come from; bispecific antibodies, mRNA cancer vaccines, and next-generation CAR-T therapies

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China Pipelines, Western Portfolios

Western pharma committed close to $2 billion in licensing deals and acquisitions for China-originated assets in Q1 2026 alone.

Frequently Asked Questions

Oncology is the pharmaceutical industry’s largest therapeutic area, representing around 18% of global prescription and OTC sales. At approximately $220bn in 2024, Evaluate Pharma’s oncology market forecast projects the market to nearly double to around $400bn by 2032, growing at 5-9% annually.

Targeted therapies remain the largest segment, forecast to hold around 55% market share through 2032. Immunotherapies, led by PD-(L)1 checkpoint inhibitors — have become a core treatment pillar across multiple tumor types. Cell and gene therapies represent the fastest-growing segment by proportion, with Evaluate consensus forecasts projecting combined revenues of $29bn by 2032, from less than 2% of oncology spend in 2023. Chemotherapy’s share is projected to fall to around 4% by 2032.

Lung and breast cancers generate the largest drug revenues. Lung cancer saw more than 25 FDA approvals in non-small cell lung cancer alone between 2020 and 2025. Multiple myeloma is a notable outlier: despite relatively low incidence, it commands a large drug market due to the number and cost of treatment lines. Pancreatic cancer illustrates the reverse — high mortality, limited treatment options, and correspondingly low drug spend.

China has shifted from a generics-focused market to a significant oncology innovator. Nearly 70% of oncology drug launches in 2024 involved assets developed by or in partnership with Chinese companies. National Reimbursement Drug List negotiations — delivering price cuts averaging 44-61% — are accelerating patient access while creating high-volume commercial opportunities for manufacturers willing to accept lower margins than in Western markets.

At roughly $220bn in 2024 and projected to approach $400bn by 2032, oncology remains the most significant therapeutic area for life sciences investment. But growth is not uniform, and understanding where value is concentrating matters as much as the headline numbers. Cell and gene therapies are forecast to grow from under 2% to around 7% of oncology spend by 2032, representing significant upside for early-stage investors in that space. Meanwhile, the oncology competitive landscape is being reshaped by patent cliffs. Evaluate forecasts show Merck falling to 10th in the sales rankings by 2032, creating both risk for portfolios heavily weighted toward incumbent PD-(L)1 players and opportunity for those tracking the next wave of ADC, bispecific and mRNA-based assets. China’s expanding role in oncology development and commercialization adds a further dimension for investors assessing global market exposure.

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