Abstract
Introduction
Gastric cancer incidence in 2009 is forecast to be 197,000 in the seven major
pharmaceutical markets (US, Japan, Germany, France, Italy, Spain, and UK).
Although, the global incidence has decreased in recent years, mortality
remains high, particularly in the US and Europe. Therefore, predictably a high
unmet need remains for effective therapies to improve mortality.
Scope of this research
- Gastric cancer overview, including definition, risk factors, epidemiology
forecasts and discussion of unmet needs
- Current diagnosis and treatment of gastric cancer, including drug regimens
used by stage and ongoing controversies
- Examination of the late-phase gastric cancer pipeline and market
opportunities for drug developers
- Stakeholder opinions based on qualitative interviews with key opinion
leaders in the field of gastric cancer
Research and analysis highlights
Surgery is the mainstay of gastric cancer treatment. Chemotherapyalone or in
combination with radiotherapyhas a role in the treatment of both early-stage
and locoregional disease. However, its main application is in the treatment of
advanced disease, where it is used with palliative intent and only results in
a poor median survival of 79 months.
The Phase III gastric cancer pipeline comprises six drugs, five of which are
molecular targeted therapies. All the drugs in the pipeline are intended for
use in the first-line treatment of advanced gastric cancer.
The gastric cancer market is currently attracting R&D interest from key
pharmaceutical players. Drugs such as Avastin (bevacizumab;
Genentech/Roche/Chugai), Herceptin (trastuzumab; Genentech/Roche/Chugai), and
Tykerb (lapatinib; GlaxoSmithKline) are seeking line extensions. Approval of
any agents will result in a very competitive market.
Key reasons to purchase this research
- To estimate the number of treatable patients and understand where high
unmet needs exist which may provide opportunity for pipeline agents
- To gain insight into the current dynamics of gastric cancer management
- To analyze the current gastric cancer pipeline drugs and understand
effects of approval on market dynamics
Table of Contents
EXECUTIVE SUMMARY
- Scope of analysis
- Datamonitor insight into the gastric cancer market
- Contributing experts
- Related reports
- Upcoming reports
DISEASE OVERVIEW
- Introduction
- Disease overview
- Anatomy of the stomach
- Gastric cancer
- Definition
- Pathology/histology
- Epidemiology
- Risk factors
- Symptoms
- Screening
- Diagnosis
- Staging
- Prognosis and survival
CURRENT TREATMENT OPTIONS AND CONTROVERSIES
- Introduction
- Treatment guidelines overview
- Gastric cancer treatment by disease stage
- Treatment of early-stage disease
- Treatment of locoregional disease
- Treatment of advanced disease
UNMET NEEDS
- Key findings
- Unmet needs
- Effective systemic therapy for advanced disease
- Second-line treatment options are required across all stages of gastric
cancer
- Education of US and EU surgeons on D2 dissection
- Early diagnosis and treatment of H. pylori infections and other
premalignant lesions may reduce the incidence of gastric cancer
- Markers for asymptomatic disease
PIPELINE ANALYSIS
- Summary
- The gastric cancer pipeline overview
- Phase III pipeline
- Phase II pipeline
- Early-stage pipeline
- Phase III drug profiles
- Avastin (bevacizumab; Genentech/Roche/Chugai)
- Erbitux (cetuximab; ImClone/Merck KGaA/Bristol-Myers Squibb)
- Herceptin (trastuzumab; Genentech/Roche/Chugai)
- Tykerb (lapatinib; GlaxoSmithKline)
- Vectibix (panitumumab; Amgen)
BIBLIOGRAPHY
APPENDIX
TABLES
- Table: Lauren classification system for gastric adenocarcinoma
- Table: Crude incidence rates of gastric cancer in the seven major
pharmaceutical markets, 2002
- Table: Forecast incidence of gastric cancer in the seven major
pharmaceutical markets, 2009 - 2019
- Table: Crude mortality rates of gastric cancer in the seven major
pharmaceutical markets, 2002
- Table: Forecast mortality of gastric cancer in the seven major
pharmaceutical markets, 2009 - 2019
- Table: Risk factors associated with gastric cancer
- Table: Screening methods used in gastric cancer
- Table: TNM classification system for gastric cancer
- Table: US TNM stage grouping system for gastric cancer
- Table: R (residual tumor) classification system for gastric cancer
- Table: Dissection classification for gastric cancer
- Table: Japanese Surgical Classification System for gastric cancer (1 of 2)
- Table: Japanese Surgical Classification System for gastric cancer (2 of 2)
- Table: Japanese Surgical Staging System for gastric cancer
- Table: Type 0 classification of early gastric tumors
- Table: 5-year survival rates by stage for gastric cancer in the US and
Japan
- Table: Currently approved drugs in gastric cancer, 2009
- Table: 5-year survival rates of patients treated with D2 dissection in
Japan
- Table: Chemotherapy study results in the treatment of advanced gastric
cancer
- Table: Phase III gastric cancer pipeline, 2009
- Table: Phase II gastric cancer pipeline, 2009
- Table: Early-phase gastric cancer pipeline, 2009
- Table: Avastin: key historical events, 2004 - 09
- Table: Clinical development of Avastin in gastric cancer, 2009
- Table: Erbitux: key historical events, 2001 - 09
- Table: Clinical development of Erbitux in gastric cancer, 2009
- Table: Herceptin: key historical events, 1998 - 2009
- Table: Clinical development of Herceptin in gastric cancer, 2009
- Table: Tykerb: key historical events, 2003 - 09
- Table: Clinical development of Tykerb in gastric cancer, 2009
- Table: Vectibix: key historical events, 2005 - 09
- Table: Clinical development of Vectibix in gastric cancer, 2009
FIGURES
- Figure: Anatomy of the stomach
- Figure: Percentage distribution of gastric tumors worldwide, 2008
- Figure: Forecast total incidence versus total mortality in the seven major
pharmaceutical markets, 2009
- Figure: Progression rates for premalignant lesions to gastric cancer
- Figure: Gastric cancer stage at presentation in the US, five major EU
markets and Japan, 2008
- Figure: Gastric cancer treatment guidelines by stage of disease in the US,
EU, and Japan, 2009
- Figure: Phase III trial of chemoradiation in non-metastatic
gastroesophageal cancer
- Figure: Phase II trial of adjuvant chemoradiation coupled with D2 node
dissection in Asian patients
- Figure: Phase III study of perioperative chemotherapy in gastric and
gastroesophageal cancer
- Figure: Summary of unmet needs in gastric cancer
- Figure: Phase II trial of Avastin with modified DCF in metastatic gastric
cancer
- Figure: Phase II study of Avastin, irinotecan and cisplatin in patients
with metastatic gastric or gastroesophageal cancers
- Figure: Phase II study of Erbitux plus modified FOLFOX6 in metastatic
gastric cancer
- Figure: Phase II study of Erbitux and FUFOX in metastatic gastric cancer
- Figure: Phase II study of Tykerb monotherapy in advanced or metastatic
gastric cancer
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