Gastric cancer is the fourth-most common malignancy in terms of incidence and is the third-most common cause of cancer-related death worldwide. Japan has the highest incidence of gastric cancer among the markets under study, making that country a commercially attractive and lucrative market for gastric cancer treatment. While trastuzumab (Roche/Genentech/Chugai’s Herceptin) for the first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive gastric cancer has paved the way for targeted and personalized treatment driven by molecular biomarkers, the 2014 approval of the angiogenesis inhibitor ramucirumab (Eli Lilly’s Cyramza) promises to partially fulfill the need for more-effective second-line treatment. The gastric cancer late-phase pipeline remains buoyant; the eagerly anticipated emergence of multiple therapies belonging to a wide variety of drug classes is expected to diversify treatment options for unresectable and metastatic gastric cancer during our forecast period.

Questions Answered in This Report:

  • We forecast that the gastric cancer therapy markets will more than triple in size over the 2013-2023 forecast period. What are the key drivers of gastric cancer market growth? What will be the major constraints on growth of the gastric cancer market? What are the drug development activities of note? What challenges and opportunities remain?

  • In April 2014, the angiogenesis monoclonal antibody ramucirumab (Eli Lilly’s Cyramza) was approved as a monotherapy for the second-line treatment of gastric cancer. How do key opinion leaders perceive this agent? Is there a role for angiogenic inhibitors to be used in combination with chemotherapy in gastric cancer? What impact will ramucirumab have on the market and where will it be positioned?

  • Next-generation HER2-targeting agents are in late-stage clinical development for unresectable or metastatic HER2-positive gastric cancer. What are thought leaders’ opinions of these agents? Which HER2-targeted agents hold the greatest promise? How will these agents be positioned, and how will they affect trastuzumab’s uptake? How will the dynamics in managing HER2-positive gastric cancer change over the forecast period?

  • Amgen’s rilotumumab, a c-Met inhibitor, entered Phase III clinical development for unresectable or metastatic c-Met-overexpressing gastric cancer in late 2012, marking a drive toward further personalization of gastric cancer treatment. What are thought leaders’ opinions of this agent and of this drug class? In which patient populations will this agent be positioned? To what extent will this agent satisfy the need for more-effective gastric cancer treatments?


Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.

Primary research: 20 country-specific interviews with thought leaders.

Epidemiology: Diagnosed incident cases of gastric adenocarcinoma (gastric cancer)—with AJCC stage IA, IB, II, III, IV (M0), and IV (M1). Diagnosed incident cases by gastric cancer subsite: cardia and non-cardia.

Population segments in market forecast: Resectable (stage I-III); unresectable locally advanced, HER2-negative; unresectable locally advanced, HER2-positive; first-line metastatic, HER2-negative; first-line metastatic, HER2-positive; second- and third-line metastatic, HER2-negative; and second- and third-line metastatic, HER2-positive.

Emerging therapies: Phase II: 21 drugs; Phase III: 8 drugs. Coverage of 3 select preclinical and Phase I products.

Alternative market scenarios: c-Met inhibitor rilotumumab does not gain approval for c-Met-overexpressing gastric cancer.

Author(s): Sehrish Rafique, M.Sc., Ph.D.
Anouchka Seesaghur, M.B.B.S., M.P.H.

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