Castration-sensitive Prostate Cancer Market Set to Expand at 13.2% CAGR (2020–2034), Fueled by Broader Approvals and Commercial Potential in nmCSPC | DelveInsight
The castration-sensitive prostate cancer (CSPC) market is on track for robust double-digit expansion, driven by aging populations, enhanced screening efforts, and continued innovation in treatment approaches. Despite persistent challenges related to cost and accessibility, emerging therapies such as TRUQAP, TAVT-45, Saruparib, AKEEGA, TALZENNA, and others—combined with expanding global commercialization—are expected to significantly accelerate market growth.
LAS VEGAS, Jan. 5, 2026 /PRNewswire/ -- DelveInsight's Castration-sensitive Prostate Cancer Market Insights report provides an in-depth understanding of current treatment paradigms, emerging drug candidates, therapy market shares, and projected market size from 2020 to 2034 across the United States, EU4 (Germany, France, Italy, Spain), the UK, and Japan.
DelveInsight estimates that the CSPC market across these 7MM regions reached approximately USD 4.3 billion in 2024, with the United States accounting for nearly 66% of the total market share, significantly ahead of EU4, the UK, and Japan. Increasing prevalence driven by PSA screening, earlier diagnosis, aging populations, and improved cancer registries continues to expand the addressable patient pool.
Second-generation androgen deprivation therapies (ADTs) currently dominate the treatment landscape and are expected to maintain their leadership through 2034. PLUVICTO, developed by Novartis, has already achieved blockbuster status in metastatic castration-resistant prostate cancer (mCRPC), generating nearly USD 980 million in 2023. Although radioligand therapies are not yet approved in CSPC, early clinical data suggest strong potential for expansion into earlier disease settings.
Key companies including AstraZeneca, Tavanta Therapeutics, Madison Vaccines, Johnson & Johnson Innovative Medicine, Pfizer, and Novartis are actively advancing next-generation CSPC therapies toward commercialization. Emerging pipeline assets include TRUQAP (capivasertib/AZD5363), TAVT-45 (abiraterone acetate), Saruparib (AZD5305), AKEEGA (niraparib + abiraterone), TALZENNA (talazoparib), and PLUVICTO (177Lu-PSMA-617), among others.
Discover the new CSPC treatment @ Castration-sensitive Prostate Cancer Treatment Market
The market’s expansion is fueled by several key drivers. The rising incidence of prostate cancer, particularly among aging populations, continues to increase demand for effective therapies. Risk peaks among men aged 65–74, and global demographic shifts are significantly enlarging the CSPC patient base. At the same time, competitive intensity is increasing, with leading androgen receptor inhibitors such as XTANDI and ERLEADA maintaining strong positions, while NUBEQA and ORGOVYX continue to gain market share through differentiated clinical profiles.
Innovation in mutation-targeted therapies is further transforming the treatment paradigm. Precision medicines such as AKEEGA for HRR-mutated mCSPC, TALZENNA for DDR-deficient populations, and TRUQAP for PTEN-deficient mHSPC are demonstrating promising efficacy, reinforcing the shift toward biomarker-driven care. Radioligand therapies and PARP inhibitors are emerging as key disruptive modalities, with AKEEGA representing the first PARP inhibitor combined with androgen receptor pathway inhibition in HRR-mutated mCSPC, positioning it as a potential leader in targeted CSPC treatment.
The CSPC treatment landscape spans multiple therapeutic classes, including androgen receptor inhibitors, CYP17 inhibitors, PARP inhibitors, AKT inhibitors, PSMA-targeted radioligands, and GnRH antagonists. AR inhibitors such as ERLEADA, XTANDI, NUBEQA, and ZYTIGA remain foundational therapies. NUBEQA is experiencing rapid growth with strong revenue expansion, while ERLEADA has demonstrated superior real-world survival and PSA response benefits compared with XTANDI and ZYTIGA. XTANDI has shown sustained commercial performance with over 21% year-over-year growth from 2023 to 2024, although upcoming patent expirations in Europe and Japan in 2026 and in the United States in 2027 may impact its long-term trajectory.
ZYTIGA continues to play a key role by suppressing androgen production, while ORGOVYX offers rapid testosterone suppression without the flare risks associated with LHRH agonists. Meanwhile, PARP inhibitors such as Saruparib and TALZENNA target homologous recombination repair (HRR) mutations, including BRCA alterations, and PSMA-targeted radioligands deliver precise radiation to tumor cells. These advances are accelerating the transition toward personalized, biomarker-driven treatment strategies across both non-metastatic and metastatic CSPC settings.
The competitive landscape is expected to evolve significantly with upcoming pipeline therapies. TRUQAP, an AKT inhibitor developed by AstraZeneca, demonstrated positive results in the Phase III CAPItello-281 trial by meeting its radiographic progression-free survival endpoint in PTEN-deficient mHSPC when combined with abiraterone and ADT. TAVT-45, a novel oral suspension formulation of abiraterone designed to improve patient convenience, is currently under regulatory review with partnership discussions ongoing. Saruparib, a next-generation PARP1-selective inhibitor, is advancing through Phase III development in both HRR-mutated and non-mutated mCSPC populations, with key data anticipated after 2026. These innovations are expected to redefine standards of care and drive further market expansion.
Discover more about the CSPC drugs market @ Castration-sensitive Prostate Cancer Drugs
Recent developments underscore the rapid pace of progress in this space. In June 2025, Bayer received FDA approval for NUBEQA in combination with ADT for metastatic CSPC based on the ARANOTE Phase III trial. The same month, Novartis reported topline results from the PSMAddition Phase III study evaluating radioligand therapy in earlier disease settings. Johnson & Johnson Innovative Medicine presented Phase III AMPLITUDE data for AKEEGA plus prednisone in HRR-altered mCSPC at ASCO 2025, while Astellas Pharma and Pfizer shared long-term data from the ARCHES trial evaluating XTANDI plus ADT. In April 2025, real-world TITAN study data comparing ERLEADA versus XTANDI were presented at the Oncology Nursing Society Congress.
Castration-sensitive prostate cancer typically begins as localized disease but can progress to metastatic hormone-sensitive prostate cancer (mCSPC), where tumors still respond to androgen deprivation therapy. The disease is categorized into M0 CSPC, characterized by the absence of detectable metastases, and M1 CSPC, where metastases are present. Non-metastatic CSPC (nmCSPC) remains confined to the pelvic region but is hormone-sensitive. Diagnosis relies on prostate-specific antigen testing, imaging, and histological confirmation.
DelveInsight’s epidemiological analysis provides detailed segmentation of historical, current, and forecasted CSPC patient populations across the 7MM, integrating clinical studies and key opinion leader insights to explain evolving disease trends and future market dynamics.
About DelveInsight
DelveInsight is a leading Business Consultant, and Market Research firm focused exclusively on life sciences. It supports Pharma companies by providing comprehensive end-to-end solutions to improve their performance. It also offers Healthcare Consulting Services, which benefits in market analysis to accelerate the business growth and overcome challenges with a practical approach.
Related report
Castration-sensitive Prostate Cancer (CSPC) – Epidemiology Forecast – 2034
DelveInsight’s “Castration-sensitive Prostate Cancer (CSPC) – Epidemiology Forecast – 2034” report delivers an in-depth understanding of CSPC, historical and forecasted epidemiology in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan. The leading Castration-sensitive Prostate Cancer Companies developing therapies include - Janssen Research and Development, AstraZeneca, Merck, Pfizer, Astellas Pharma, Bayer, Novartis, and others.
Company Name: DelveInsight Business Research LLP
Contact Person: Abhishek kumar
Email: abhishek@delveinsight.com
City: Albany
State: New York
Country: United States
Website: https://www.delveinsight.com