"Gastric Cancer - Market Outlook and Competitive Landscape Report 2015 – 2030 "

Report Snapshot:
• Gastric cancer is considered one of the leading causes of mortality in the world, Most of this burden occurs in developing countries. Among other type cancer gastric cancer is considered the most common type of upper gastrointestinal cancers, according to Globocan 2016, this disease was the fifth most common cancer with the incidence of about one million new cases in the world. It has indicated a significant change in the incidence rate in recent years. Concerning 773,100 deaths (8.8% of total cancer deaths), it is the third most common cause of cancer mortality in both sexes worldwide. This multifactorial disease, with both environmental and genetic factors diagnosed in the advanced stage of the disease

Market landscape:
• According to Thelansis the global Gastric cancer (GC) market was estimated at ~$1.45 BN in 2015 and expected to reach at ~$ 3.85 BN by the end of 2030(15 years of markets projections; four years of historical data, current and eleven years of future market projections)

• Globally, there are ~257K advanced GC patients getting the treatment out of which 5.2% of patients are treated with targeted therapies and by 2030, this is expected to reach ~485K patients getting the treatment and 11% of the patients on targeted therapies

• The current market for advanced GC is at $1.45BNincluding HER2, which is the mostly target biomarker currently considered as the choice of treatment however the ramucirumab, a monoclonal antibody VEGFR-2 antagonist, preferred as second line in the palliative setting. Aapproximately ~18% of gastric cancers, is more common in intestinal type than diffuse type gastric cancer and more common in EGJ cancer than distal gastric cancer.

• Major unmet needs in the advanced gastric cancer market are unavailability of targeted therapies for ~75% of the patients, resistant/2nd line patients. By 2030, advanced GC market in G8 countries is expected to be reach $2.65BN out of which targeted therapies would contribute around 53%

• The growth in the advanced GC market will be driven by the launch of targeted therapies, novel techniques of testing multiple biomarkers and newer methods of assessing the products for reimbursement

Epidemiology and patient segmentation:
• Incidence rates for stomach cancer are highest in Eastern Asia (China and Japan) and lowest in Africa, Australia, New Zealand and North America. Japan has the highest rates of stomach cancer followed by Korea due to high salt intake and consumption of fewer fresh fruits and vegetables. An increased risk of stomach cancer is seen in people with diets that have large amounts of smoked foods, salted fish and meat, and pickled vegetables. More than 70% of gastric cancer new cases are reported in East Asia (Japan, and China), however Japan has high incidence rates are majorly due to high consumption of salted food such as salted fish roe and salted fish preserves which are strongly associated with an increased risk of gastric cancer. Helicobacter pylori infection is one of the major cause of almost all cases of stomach cancer, high rate of this infection have been found in China and Gastric cancer is the second most common cause of cancer death worldwide (774, 000 deaths, 10% of the total)

• Total number of new gastric cancer patients diagnosed in 2015 is estimated to be around 783,893 (split by stage). Among this, China contributes to 70.6% of the total patients within 8MM (USA, Germany, France, Italy, Spain, UK, Japan and China) of interest, while EU5 accounts for 9.5%. By 2030, around 1 million new gastric cancer patients will be diagnosed in defined countries with a CAGR of 2.6% (2015-30). Early diagnosis of gastric cancer in Localized(stg. 1a/b) is being evident in Japan (~ 50%) followed by Italy, however the other countries are consistent across different stages level (Regional(stg. IIa-IIIa), Distant(stg. IIIb - IV), Distant (stg. IV), and unknown type)

Gastric Cancer (GC) - biomarker level patient segmentation:
• Molecular epidemiology study of specific biomarker mutations across country level has been given an clear understanding on patient pool across different biomarker targets (EGFR Mutation, AKTexpression, BRAF Mutation, FGFR2 amplification, HER2 amplifications, KRAS mutation, MET amplification, PIK3CA mutation, m-TOR expression, PD- L1 Expression, and EPCAM)

Gastric Cancer (GC) - biomarker level patient segmentation:
• The survival of patients with gastric cancer is substantially worse than that of patients with most other solid malignancies, and the only treatment that offers a potential cure is complete resection of the tumor. However, in most of countries, the majority of patients is diagnosed at advanced stages and has a poor prognosis. Despite the improvement of surgical techniques and the recent availability of new chemotherapy regimens, outcome of the patients with advanced disease is usually poor, the median overall survival (OS) is approximately 8 to 10 months, and the median progression-free survival (PFS) is 6 to 7 months. These results suggested that even the most widely accepted regimens, such as fluoropyrimidine and/or platinum based chemotherapy regimens, have not been able to achieve satisfactory survival. Thus, there is an urgent need to develop more efficient therapies.

• HER2 overexpression is observed in 10% to 35% of gastric cancer tumor samples, and it is more frequent in intestinal type compared with that in diffuse type GC and in cancers of the gastroesophageal junction (GEJC) compared with that in cancers located elsewhere in the stomach

• The EGFR is overexpressed in about 25% of gastric cancer and has been associated with more aggressive phenotype and poorer survival, which suggests that EGFR could be target in gastric cancer, however VEGFR2 is emerging as therapeutic options for the patients eligible for 2ndline or greater

Emerging therapies:
• As per Thelansis, based on tumor mutation evidence some of key player are into developing therapies for the treatment of Gastric such as: AB Science , Amgen , Daiichii Sankyo, Roche, Jiangsu HengRui Medicine, Eli Lilly, Pfizer/ SFJ Pharmaceuticals, ACT Biotech, Mirati Therapeutics, Merrimack Pharmaceuticals, Immatics, J-Pharma, Immunomedic, Amgen , MethylGene, Novartis, MacroGenics , AstraZeneca, Seattle Genetics, Pfizer, Bayer, Hanmi Pharmaceutical, ImmunoGen, Ganymed Pharmaceuticals, BMS, Boehringer Ingelheim , Puma Biotechnology, Inc. , GlaxoSmithKline, Aslan Pharmaceuticals, Exelixis, Takeda,

Annual cost of therapy:
• According to the published literature review, and data from real world evidences the average per-patient treatment and supportive care cost is USD 46,904 to 78,865, of which 52% was related to cancer-related treatment and48% is associated with supportive care. Cost of chemotherapy is accounted for around USD 9,650 of the total gastric cancer-related treatment costs, however the cost is varied on the basis of line of therapy, duration of therapy and dose of the drug. Biologics and targeted therapies are considered to be the most expensive modalities which actually build the disease burden.

KOL’s Prerospective:
• Multiple biomarker screening and testing is the key area of development, which will play a key role in the treatment pattern decision making

• More than73% of the disease population diagnosed in their advance stage of the disease, so the diagnosis cost to be brought down so that population can opt for a random diagnosis

• Major unmet needs in the advanced Gastric cancer market are unavailability of targeted therapies for to be used in as 1stline and 2nd line of therapy in the patients diagnosed with advance stage of disease condition

Payers prerspective:
• Providers pay a single payment to cover all related services needed by patient for an entire cancer treatment program instead of the current “Fee for service” approach. Oncologists will get reimbursement for patient visit, chemo drugs at manufacturer’s cost & drugs will get reimbursed at cost, which eliminates the profit margin

• Physicians get higher reimbursement rates on the basis of adherence to the clinical pathway steps as set by MCOs. Reducing variability in the delivery of care by incentivizing clinicians to follow the same pathway for majority of patients. Reduce cost by excluding non-superior drugs, maximizing opportunity for bulk discounts

• Involve the supplier to provide a guarantee relating to outcome, which are evaluated based on clinical parameters; Quality of Life, Resource Usage, Financial and Economic outcomes

• Redistribute the risk balance between payer and technology supplier by admitting new treatments into national formularies and by enabling faster uptake

Gastric cancer (GC) – Unmet needs
• The lack of targeted therapies is a barrier to providing the best treatment option for patients who do not carry HER2 or VEGFR in gastric cancer. There is a high unmet need for therapies to target biomarkers like AKT, mTOR and EpCAM in GC

• Targeted therapies such as HER2, is used in majority of the patients in Gastric cancer, however, the resistance has been developed for this targeted therapies and very few options are available for these patients in the second and third line

• Approximately half of the patients in gastric cancer have unknown biomarker status and there are no targeted therapies which can address the needs of this segment. There is a high level of unmet need in this segment of the patient pool

• Current molecular testing length of time prevents a portion of mutation-positive patients from receiving first-line therapy. There is significant opportunity to develop faster and more efficient testing procedures to accommodate increased rates of testing in GC patients

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This release was published on openPR.