Kyowa Hakko Kirin Co., Ltd. / ProStrakan Group plc

Chemotherapy-Induced Nausea and Vomiting (CINV) / Supportive Oncology Care

$1.3B Global CINV / 5-HT3 antagonist market at Sancuso US launch (2008 reference cited by ProStrakan management) · >$100M Sancuso peak sales potential cited at US launch

Disease Overview

Chemotherapy-induced nausea and vomiting is a debilitating side effect of cytotoxic cancer therapy that, untreated, affects the majority of patients on moderately or highly emetogenic regimens and can drive treatment non-adherence and dose reductions. Supportive-care antiemetics (5-HT3 antagonists, NK1 antagonists, dexamethasone) are standard-of-care prophylaxis but oral and IV burden remain significant for outpatients.

Competitive Landscape

The CINV antiemetic market in 2011 was anchored by 5-HT3 receptor antagonists: ondansetron (Zofran, GSK; first-generation, by then largely generic), granisetron (Kytril, Roche/Genentech; oral and IV), dolasetron (Anzemet, Sanofi) and second-generation palonosetron (Aloxi, Eisai/Helsinn). NK1 antagonists led by aprepitant (Emend, Merck) layered on top for highly emetogenic regimens. Sancuso (granisetron transdermal system), originally approved by the FDA in September 2008, was the first and only patch in the class, delivering up to five days of continuous granisetron exposure for moderately to highly emetogenic multi-day regimens. ProStrakan management framed Sancuso as targeting a $1.3B class-level market with peak-sales potential >$100M. For Kyowa Hakko Kirin the deal added a US/EU specialty oncology supportive-care channel that complemented its Japanese oncology and nephrology presence (Nesp/Regpara) — Sancuso later became the franchise's flagship until divestiture to Cumberland Pharmaceuticals in January 2022.