The incidence of gastroesophageal cancer—encompassing gastric cancer, esophageal cancer, and gastroesophageal junction (GEJ) adenocarcinoma— continues to rise; however, treatment options remain limited. Targeted therapies, including Herceptin (Roche / Genentech / Chugai [for HER2-positive patients only]) and Cyramza (Eli Lilly), have been approved exclusively for gastric and GEJ adenocarcinoma patients across the major markets. Additional agents are also approved for later-line treatments in certain geographies, such as Keytruda (Merck & Co.), Opdivo (Bristol-Myers Squibb), and Lonsurf (Taiho). A plethora of agents including immunotherapies, vaccines, and a variety of targeted therapies are vying for approval in underserved patient segments, such as resectable disease or the first-line metastatic setting.

Questions Answered

  • How do current treatment practices differ among esophageal, gastric, and GEJ cancer patients? Do these practices differ by geography, and which populations provide the greatest drug-treatment opportunities?
  • What are interviewed experts’ insights on the use of currently approved agents? What clinical needs remain unfulfilled, and on what opportunities can developers capitalize?
  • Which drugs in late-phase development are poised to change the treatment landscape for gastroesophageal cancer? How are these agents being assessed, and how will they impact the gastroesophageal cancer market?
  • What are the key market drivers and constraints in the gastroesophageal market, and how will the market evolve over the forecast period?

Content Highlights

Geographies: United States, EU5, Japan.

Primary research: 23 country-specific interviews with thought-leading medical oncologists supported by survey data collected for this and other DRG research.

Epidemiology: Diagnosed and recurrent incidence of gastroesophageal cancer by country, segmented by HER2 status, histology, stage I-IV, and line of therapy.

Forecast: 10-year, annualized, drug-level sales and patient share of key gastroesophageal cancer therapies through 2028, segmented by brands / generics and market-relevant drug treatable populations.

Emerging therapies: Phase III: 9 drugs; Phase I / II: ~30 drugs.

Product Description

Disease Landscape & Forecast provides comprehensive market intelligence with world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary research.

Table of contents

  • Gastroesophageal Cancer - Landscape & Forecast - Disease Landscape & Forecast
    • Key Updates
      • Q1 2021
        • March 2021
        • February 2021
        • January 2021
      • Q4 2020
        • December 2020
      • Q3 2020
        • August 2020
      • Q2 2020
        • May 2020
      • Q1 2020
        • February 2020
    • Key Findings
      • Market Outlook
        • Key Findings
          • Major-Market Share of Drug Classes in Gastroesophageal Cancer: 2019
          • Major-Market Share of Drug Classes in Gastroesophageal Cancer: 2029
          • Major-Market Sales of Key Therapies for Gastroesophageal Cancer: 2019-2029
          • Major-Market Sales for Gastroesophageal Cancer by Population Segment: 2019-2029
          • Drug-Treatable Population Share and Major-Market Sales Share in Gastroesophageal Cancer: 2019
          • Drug-Treatable Population Share and Major-Market Sales Share in Gastroesophageal Cancer: 2029
          • Population Positioning of Therapies in Gastroesophageal Cancer: United States and Europe
          • Population Positioning of Therapies in Gastroesophageal Cancer: Japan
          • Gastroesophageal Cancer SWOT Analysis
        • COVID-19: Areas of Potential Forecast Impact
          • COVID19: Expert insights
        • Market Drivers and Constraints
          • What Factors Are Driving the Market for Gastroesophageal Cancer?
          • What Factors Are Constraining the Market for Gastroesophageal Cancer?
        • Segment-Specific Trends
          • Patient Share Dynamics of Key Players in Resectable Gastric and Gastroesophageal Junction Adenocarcinoma in the United States: 2019-2029
          • Patient Share Dynamics of Key Players in Resectable Gastric and Gastroesophageal Junction Adenocarcinoma in Japan: 2019-2029
          • Patient Share Dynamics of Key Players in Resectable Esophageal Cancer in the United States: 2019-2029
          • Patient-Share Dynamics of Key Players in First-Line Metastatic HER2-Negative Gastric and Gastroesophageal Junction Adenocarcinoma in the United States: 2019-2029
          • Patient-Share Dynamics of Key Players in First-Line Metastatic HER2-Negative Gastric and Gastroesophageal Junction Adenocarcinoma in Japan: 2019-2029
          • Patient Share Dynamics of Key Players in First-Line Metastatic HER2-Positive Gastric and Gastroesophageal Junction Adenocarcinoma in the United States: 2019-2029
          • First-Line Metastatic Esophageal Cancer
          • Patient-Share Dynamics of Key Players in First-Line Metastatic Esophageal Cancer in the United States: 2019-2029
          • Patient-Share Dynamics of Key Players in Second- and Third-Line Metastatic Esophageal Cancer in the United States: 2019-2029
          • Patient-Share Dynamics of Key Players in Third- and Fourth-Line Metastatic HER2-Negative Gastric and Gastroesophageal Junction Adenocarcinoma in the United States: 2019-2029
      • Forecast
        • Market Forecast Assumptions
        • Market Forecast Dashboard
      • Etiology and Pathophysiology
        • Disease Overview
          • Disease Pathophysiology
            • Anatomy of the Stomach and the Gastroesophageal Junction
            • Anatomy of the Esophagus
            • Histological Subtypes and Development of Gastric and Gastroesophageal Junction Adenocarcinoma
            • Key Stages in the Development of Intestinal and Diffuse Types of Gastric and Gastroesophageal Junction Adenocarcinoma
            • Histological Subtypes and Development of Esophageal Cancer
          • Staging and Classification
            • AJCC / UICC TNM Classification System for Gastroesophageal Cancer
            • AJCC / UICC Clinical Staging Classification System for Gastroesophageal Cancer
            • AJCC / UICC Pathological Staging Classification System for Gastroesophageal Cancer
            • AJCC / UICC Postneoadjuvant Therapy Staging Classification System for Gastroesophageal Cancer
          • Key Pathways and Drug Targets
            • Drug Targets and Potential Therapies for Gastroesophageal Cancer
            • Drug Targets for Gastroesophageal Cancer
            • Biology of Immune Checkpoint Inhibitors and Modulators
        • Epidemiology
          • Introduction
            • Key Findings
          • Epidemiology Populations
            • Disease Definition
            • Methods
            • Sources Used for Diagnosed Incidence of Gastroesophageal Cancer
            • Number of Diagnosed Incident Cases of Gastroesophageal Cancer
            • Definition
            • Methods
            • Sources Used for Stage Distribution of Gastroesophageal Cancer
            • Diagnosed Incident Cases of Gastric and GEJ Adenocarcinoma by Stage Distribution
            • Diagnosed Incident Cases of Esophageal Adenocarcinoma by Stage Distribution
            • Diagnosed Incident Cases of Esophageal Squamous Cell Carcinoma by Stage Distribution
            • Definition
            • Methods
            • Sources Used for Recurrent Incidence of Gastroesophageal Cancer
            • Recurrent Incident Cases of Gastroesophageal Cancer
            • Definition
            • Methods
            • Sources
            • Molecular Subtype
            • Gastric and Gastroesophageal Junction Adenocarcinoma Patient Flow
            • Drug-Treatable Cases of Gastric and Gastroesophageal Junction Adenocarcinoma: 2019-2029
            • Esophageal Adenocarcinoma Patient Flow
            • Drug-Treatable Cases of Esophageal Adenocarcinoma: 2019-2029
            • Esophageal Squamous Cell Carcinoma Patient Flow
            • Drug-Treatable Cases of Esophageal Squamous Cell Carcinoma: 2019-2029
            • Drug-Treated Populations
            • Drug-Treated Cases of Gastroesophageal Cancer: 2019-2029
        • Current Treatment
          • Key Findings
            • Treatment Goals
              • Key Endpoints Used in Clinical Trials for Gastroesophageal Cancer
            • Key Current Therapies
              • Overview
              • Mechanism of Action of Key Current Drug Classes Used for Gastroesophageal Cancer
              • Current Treatments Used for Gastroesophageal Cancer
              • Market Events Impacting the Use of Key Current Therapies for Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Cyramza for the Treatment of Gastroesophageal Cancer
              • Ongoing Clinical Development of Cyramza
              • Key Ongoing Clinical Trials of Cyramza in the Treatment of Gastroesophageal Cancer
              • Expert Insight: Cyramza
              • Key Results from Select Clinical Trials Investigating Herceptin for the Treatment of Gastroesophageal Cancer
              • Ongoing Clinical Development of Herceptin
              • Expert Insight: Herceptin
              • Key Results from Select Clinical Trials Investigating Keytruda for the Treatment of Gastroesophageal Cancer
              • Ongoing Clinical Development of Keytruda
              • Key Ongoing Clinical Trials of Keytruda in the Treatment of Gastroesophageal Cancer
              • Expert Insight: Keytruda
              • Key Results from Select Clinical Trials Investigating Opdivo for the Treatment of Gastroesophageal Cancer
              • Ongoing Clinical Development of Opdivo
              • Key Ongoing Clinical Trials of Opdivo in the Treatment of Gastroesophageal Cancer
              • Expert Insight: Opdivo
              • Lonsurf
              • Key Results from Select Clinical Trials Investigating Lonsurf for the Treatment of Gastroesophageal Cancer
              • Ongoing Clinical Development of Lonsurf
              • Expert Insights: Lonsurf
            • Medical Practice
              • Localized and Resectable Locally Advanced Gastroesophageal Cancer
              • Unresectable Locally Advanced Gastroesophageal Cancer
              • First-Line Metastatic Gastroesophageal Cancer
              • Second-Line Gastroesophageal Cancer
              • Third- and Fourth-Line Metastatic Gastroesophageal Cancer
              • Country-Specific Gastroesophageal Cancer Treatment Guidelines
              • Patient Characteristics Influencing Drug Selection in Gastroesophageal Cancer
              • Region-Specific Treatment Practices
              • Treatment Decision Tree for Locally Advanced and Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
              • Treatment Decision Tree for Locally Advanced and Metastatic Esophageal Cancer: United States
              • Treatment Decision Tree for Locally Advanced and Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
              • Treatment Decision Tree for Locally Advanced and Metastatic Esophageal Cancer: Europe
              • Treatment Decision Tree for Locally Advanced and Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Japan
              • Treatment Decision Tree for Locally Advanced and Metastatic Esophageal Cancer: Japan
          • Unmet Need Overview
            • Current and Future Attainment of Unmet Needs in Gastroesophageal Cancer
            • Top Unmet Needs in Gastroesophageal Cancer: Current and Future Attainment
          • Emerging Therapies
            • Key Findings
              • Pipeline Trends in Gastroesophageal Cancer
            • Key Emerging Therapies
              • Key Therapies in Development for Gastroesophageal Cancer
              • Estimated Market Authorization Dates of Key Emerging Therapies for the Treatment of Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Bavencio for the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Bavencio
              • Expert Insight: Bavencio
              • Expectations for Market Authorization and Sales Opportunity of Bavencio in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Tislelizumab for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Tislelizumab in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Tislelizumab
              • Expert Insight: Tislelizumab
              • Expectations for Market Authorization and Sales Opportunity of Tislelizumab in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Imfinzi for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Imfinzi in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Imfinzi
              • Expectations for Market Authorization and Sales Opportunity of Imfinzi in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Tecentriq for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Tecentriq in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Tecentriq
              • Expectations for Market Authorization and Sales Opportunity of Tecentriq in Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Tiragolumab
              • Expectations for Market Authorization and Sales Opportunity of Tiragolumab in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Tyvyt for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Tyvyt in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Tyvyt
              • Expectations for Market Authorization and Sales Opportunity of Tyvyt in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Enhertu for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Enhertu in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Enhertu
              • Expert Insight: Enhertu
              • Expectations for Market Authorization and Sales Opportunity of Enhertu in Gastroesophageal Cancer
              • Margetuximab
              • Key Results from Select Clinical Trials Investigating Margetuximab for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Margetuximab in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for margetuximab
              • Expert Insight: Margetuximab
              • Expectations for Market Authorization and Sales Opportunity of Margetuximab in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Rivoceranib for the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Rivoceranib
              • Expert Insight: Rivoceranib
              • Expectations for Market Authorization and Sales Opportunity of Rivoceranib in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Stivarga for the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Stivarga
              • Expert Insight: Stivarga
              • Expectations for Market Authorization and Sales Opportunity of Stivarga in Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Pamiparib in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Pamiparib
              • Expert Insight: Pamiparib
              • Expectations for Market Authorization and Sales Opportunity of Pamiparib in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating TAS-118 for the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for TAS-118
              • Expert Insight: TAS-118
              • Expectations for Market Authorization and Sales Opportunity of TAS-118 in Gastroesophageal Cancer
              • Key Results from Select Clinical Trials Investigating Zolbetuximab for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Zolbetuximab in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Zolbetuximab
              • Expert Insight: Zolbetuximab
              • Expectations for Market Authorization and Sales Opportunity of Zolbetuximab in Gastroesophageal Cancer
              • Bemarituzumab
              • Key Results from Select Clinical Trials Investigating Bemarituzumab for the Treatment of Gastroesophageal Cancer
              • Key Ongoing Clinical Trials of Bemarituzumab in the Treatment of Gastroesophageal Cancer
              • Analysis of Clinical Development Program for Bemarituzumab 
              • Expert Insight: Bemarituzumab
              • Expectations for Market Authorization and Sales Opportunity of Bemarituzumab in Gastroesophageal Cancer
            • Early-Phase Pipeline Analysis
              • Select Compounds in Early-Phase Development for Gastroesophageal Cancer
          • Access and Reimbursement Overview
            • Region-Specific Reimbursement Practices
              • Key Market Access Considerations in Gastroesophageal Cancer: United States
              • General Reimbursement Environment: United States
              • Key Market Access Considerations in Gastroesophageal Cancer: EU5
              • General Reimbursement Environment: EU5
              • Key Market Access Considerations in Gastroesophageal Cancer: Japan
              • General Reimbursement Environment: Japan
          • Appendix
            • Key Abbreviations Related to Gastroesophageal Cancer
            • Brands, Marketers, and Generic Availability of Key Therapies for Gastroesophageal Cancer by Market
            • Gastroesophageal Cancer Bibliography

        Author(s): Angela Diana; Mudasir Khan, M.P.H.

        Angela Diana, Ph.D., is an analyst on the Oncology team at DRG, part of Clarivate. Previously, she was a research assistant at Stemgen, a biotech company focused on developing stem cell treatments for cancer and neurodegenerative diseases. She received a Ph.D. in radiation oncology from the University of Oxford with a thesis focused on better understanding the effects of radiotherapy on the tumor microenvironment. Her project was funded by the European Union's Horizon 2020 research and innovation program and received a Marie-Sklodowska Curie grant. She also holds M.Sc. and B.Sc. degrees from the University of Milan in Italy.

        Mudasir Khan, M.P.H., is a senior epidemiologist at DRG, part of Clarivate. He received his M.P.H. from the Tata Institute of Social Sciences in Mumbai.


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