Gastric and gastroesophageal junction (GEJ) adenocarcinoma is characterized by poor prognosis. Japan has the highest incidence of gastric and GEJ adenocarcinoma among the markets under study, making that country a commercially attractive and lucrative market for gastric cancer treatment. The disease’s rapid progression, most patients’ poor performance status, and the large number of elderly patients result in lower treatment rates than those of other cancer indications. Therapeutic options for gastric and GEJ adenocarcinoma are limited. Thus, opportunity in this market is largely untapped; in the HER2-positive patient segment an agent able to demonstrate statistically significant efficacy compared with that of the standard of care, Herceptin (Roche/Genentech/Chugai’s trastuzumab), is likely to gain regulatory approval and enjoy strong uptake. The 2014 approval of the angiogenesis inhibitor, Cyramza (Eli Lilly’s ramucirumab), is forecast to partially fulfill the need for effective and targeted second-line treatment, particularly for patients who are HER2-negative. The gastric and GEJ adenocarcinoma late-stage pipeline is buoyant; the eagerly anticipated emergence of multiple therapies belonging to a wide variety of drug classes is expected to diversify treatment options in all population segments during our forecast period.

Questions Answered in This Report:

  • We forecast that the gastric and GEJ adenocarcinoma therapy markets will grow exponentially during the 2014-2024 forecast period. What are the key drivers of gastric and GEJ adenocarcinoma market growth? What will be the major constraints on growth of the gastric and GEJ adenocarcinoma market? What are the drug development activities of note? What challenges and opportunities remain?

  • In 2014, Cyramza (Eli Lilly’s ramucirumab) was approved for second- and later-line treatment of advanced gastric and GEJ adenocarcinoma. This agent is also in development as a first-line therapy for HER2-negtive patients. How do key opinion leaders perceive this agent? What impact will Cyramza have on the market during the 2014-2024 forecast period? Where will Cyramza show the strongest uptake?

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

  • Two anti-PD-1 therapies, Opdivo (Ono Pharmaceutical’s nivolumab) and Keytruda (Merck & Co.’s pembrolizumab), entered Phase III clinical development for unresectable or metastatic gastric and GEJ adenocarcinoma in late 2014 and early 2015, respectively. What is thought-leader opinion of these agents and of this drug class? In which patient populations will these agents be positioned? How will their use change over the next ten years? How will use of these agents affect prescribing of other agents in the gastric and GEJ adenocarcinoma market?


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

Primary research: 21 country-specific interviews with thought leaders.

Epidemiology: diagnosed incident cases of gastric and GEJ adenocarcinoma—with AJCC stage IA, IB, II, IIIA-B, IIIC, and IV.

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

Emerging therapies: Phase II: 17 drugs; Phase III: 8 drugs. Coverage of 7 select preclinical and Phase I products.

Author(s): Sehrish Rafique, M.Sc., Ph.D.
Michael Hughes, M.Sc., Ph.D.

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