The genetic complexity and heterogeneity of gastric and GEJ adenocarcinoma poses a significant challenge for the development of treatment strategies for these cancers. Despite advancements in the treatment algorithm with the use of Keytruda (Merck & Co.) for metastatic gastric and GEJ adenocarcinoma tumors expressing PD-L1 and Herceptin (Roche/Genentech) for HER2-positive metastatic gastric or GEJ adenocarcinoma, therapeutic options for a large proportion of metastatic patients remain severely limited. Cyramza (Eli Lilly), with or without paclitaxel, is frequently prescribed for second- and subsequent-line treatment of metastatic gastric and GEJ adenocarcinoma. Cytotoxic monotherapies and doublet or triplet chemotherapy regimens remain a mainstay of treatment. The substantial unmet medical need for therapeutic management of metastatic gastric and GEJ adenocarcinoma with efficacious and well-tolerated novel therapies presents an attractive opportunity for drug developers.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for metastatic gastric and GEJ adenocarcinoma?
  • What attributes are key influencers, which have limited impact, and which are hidden opportunities for drug developers?
  • How do current therapies perform on key treatment drivers and goals for metastatic gastric and GEJ adenocarcinoma?
  • What are the prevailing areas of unmet need and opportunity in metastatic gastric and GEJ adenocarcinoma?

PRODUCT DESCRIPTION

Provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, France, Germany, United Kingdom.

Primary research: Survey of 60 U.S. and 30 European medical oncologists fielded in June 2018.

Key companies: Roche/Genentech, Eli Lilly, Merck & Co.

Key drugs: Herceptin, Cyramza, Keytruda.

Table of contents

  • Gastroesophageal Cancer - Unmet Need - Detailed, Expanded Analysis (US & EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Rationale for Drug Selection
        • Regimens for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Medical Oncologists' Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma
      • Importance of Efficacy Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Importance of Nonclinical Factors to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Importance of Nonclinical Factors to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Key Findings: Stated vs. Derived Importance
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Overall Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Convenience of Administration Attributes: Europe
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Nonclinical Attributes: United States
      • Relative Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Across Select Nonclinical Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma
      • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma: Europe
      • Key Findings: Unmet Need in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma and Related Indications
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma and Related Indications: United States
      • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market and Emerging Therapy Insights
        • Opportunity: A Novel Therapy with a Substantial Overall Survival Benefit
        • Opportunity: A Novel Therapy with Improved Progression-Free Survival
        • Opportunity: A New Therapy with Improved Tumor Response
        • Opportunity: A Novel Agent with Improved Safety and Tolerability Profile
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
        • Assigned Prohibitions for the Conjoint Module
      • Attribute Importance and Part-Worth Utilities
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Target Product Profile: Attribute Importance
        • Median Overall Survival
        • Median Progression-Free Survival
        • Objective Response Rate
        • Incidence of Grade 3/4 Hematological Toxicities
        • Incidence of Grade 3/4 Cardiovascular Toxicities
        • Incidence of Grade 3/4 Gastrointestinal Toxicities
        • Price Per Course of Treatment
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market Simulations: Target Product Profiles Included in Scenario 1
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • First-Line Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Priti Girotra, M.Pharm., Ph.D

Priti Girotra, M.Pharm., Ph.D., is an analyst in the oncology team at Decision Resources Group and has authored insightful content on multiple indications including Non-Small-Cell Lung Cancer, Colorectal Cancer, Gastroesophageal Cancer, Malignant Melanoma, and Multiple Myeloma. Prior to joining DRG, Dr. Girotra conducted her Ph.D. research on formulation optimization of nanoparticles containing triptan derivatives for effective brain targeting and therapeutic management of migraine, under a DST-INSPIRE Fellowship at G.J. University of Science & Technology, Hisar, India.


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