Gastric Cancer Therapeutics in Asia-Pacific Markets to 2022 - Growth Driven by Increasing Prevalence and Launch of Targeted Therapies

Publisher Name :
Date: 01-Sep-2016
No. of pages: 112

Gastric cancer is characterized by the formation of malignant cells in the inner lining of the stomach, and is the fifth most common cancer globally. Due to its indolent nature it is difficult to treat until it’s more advanced stages and as a result remains one of the most common causes of cancer-related deaths worldwide. The incidence rate of gastric carcinoma is high in East Asia – particularly China and Japan – compared with Western markets. There are many types of gastric cancer, but adenocarcinoma is the most common type, and is diagnosed in 95% of cases.

The Asia-Pacific (APAC) gastric cancer market is forecast to grow from $1.3 billion in 2015 to $2.7 billion in 2022, at a Compound Annual Growth Rate (CAGR) of 11.4%. Gastric cancer is often a neglected cancer, as it tends to develop slowly over many years. The majority of gastric cancer cases are diagnosed in the later stages in the countries focused on in this report, with the exception of Japan, where the majority of cases are diagnosed at the early stages. The high number of cases diagnosed at stage I in Japan can be attributed to the country’s increased levels of awareness and screening for gastric cancer (Orditura et al., 2014).

As per Gayathri Kanika, GBI Research, states: “In line with improved diagnosis rates, the anticipated approval of various monoclonal antibodies (mAbs) over the forecast period will drive treatment rates across all lines of therapy and generate higher sales in the gastric cancer market”.

The current treatment landscape of gastric cancer largely comprises generic chemotherapies. However, chemotherapy provides limited clinical benefit, while causing serious side effects. Herceptin (trastuzumab) is the only marketed targeted therapy, and serves as the standard-of-care first-line treatment for HER2-positive patients – HER2-negative gastric cancer patients still receive chemotherapy regimens as the first-line treatment.

The report “Gastric Cancer Therapeutics in Asia-Pacific Markets to 2022 - Growth Driven by Increasing Prevalence and Launch of Targeted Therapies” provides an introduction to gastric cancer, detailing the epidemiology, etiology, diagnostic techniques, pathophysiology, disease staging and prognoses for patients. An analysis of current treatment algorithms and options are also included.

In depth, this report provides the following analysis:
• Detailed analysis of the drugs currently marketed for this indication: trastuzumab, ramucirumab, apatinib, nab-paclitaxel and TS-1. It analyzes key characteristics, covering safety and efficacy, clinical trial outcomes, tolerability, dosing, administration, prices and overall competitive strength. The products are also compared in a comprehensive heat map.
• Analysis of the pipeline for gastric cancer, by stage of development, molecule type, program type, mechanism of action and molecular target.
• Analysis of recent clinical trials in this indication, by enrollment, duration and failure rate. Finally, promising late-stage pipeline molecules are analyzed and assessed in terms of their potential competitive strength.
• Supplies forecasts for the gastric cancer market, including epidemiology, treatment usage patterns, pricing, and market size, for the 2015–2022 period. The five APAC markets are covered, and data is presented at a country level.
• Provides detailed analysis of key market drivers and barriers for the gastric cancer market.
• Describes the major deals that have taken place in the global gastric cancer market in recent years. This coverage analyzes licensing and co-development agreements, segmented by stage of development, year, molecule type, mechanism of action and value.

Gastric Cancer Therapeutics in Asia-Pacific Markets to 2022 - Growth Driven by Increasing Prevalence and Launch of Targeted Therapies

Table of Contents

1 Table of Contents 5
1.1 List of Tables 8
1.2 List of Figures 8

2 Introduction 10
2.1 Disease Introduction 10
2.2 Epidemiology 10
2.3 Symptoms 12
2.4 Etiology 12
2.5 Pathophysiology 12
2.5.1 Helicobacter Pylori 13
2.5.2 Oncogenes 13
2.5.3 Tumor Suppressor Genes 13
2.5.4 Cell Adhesion Molecules and Metastasis-Related Genes 14
2.5.5 Cell Cycle Regulators 14
2.5.6 Microsatellite and Chromosomal Instability 14
2.5.7 Growth Factor and Cytokines 14
2.6 Diagnosis 15
2.6.1 Photofluorography or Barium Study 15
2.6.2 Endoscopy 15
2.6.3 Imaging Tests 15
2.6.4 Endoscopic Ultrasound 16
2.6.5 Laparoscopy 16
2.6.6 Laboratory Analysis 16
2.7 Classification and Disease Staging 16
2.7.1 Intestinal Subtype 16
2.7.2 Diffuse Subtype 16
2.8 Prognosis 18
2.9 Treatment Guidelines and Options 18
2.9.1 Surgery 18
2.9.2 First-Line Therapy 19
2.9.3 Second-Line Therapy 20

3 Marketed Products 21
3.1 Overview 21
3.2 HER2-Targeted Therapy 21
3.2.1 Herceptin (trastuzumab) – Roche/Genentech 21
3.3 Angiogenesis Inhibitors 23
3.3.1 Cyramza (ramucirumab) – Eli Lilly 23
3.3.2 Aitan (apatinib) – Jiangsu HengRui Medicine 24
3.4 Newer Chemotherapies 25
3.4.1 TS-1 (tegafur, gimeracil, oteracil) – Taiho 26
3.4.2 Abraxane (nab-paclitaxel) – Celgene/Taiho 26
3.5 Comparative Efficacy and Safety of Marketed Products 27

4 Pipeline Analysis 29
4.1 Overview 29
4.2 Pipeline by Stage of Development, Molecule Type, Route of Administration and Program Type 29
4.3 Pipeline by Molecular Target 31
4.4 Promising Pipeline Candidates 33
4.4.1 Opdivo (nivolumab) – Ono Pharmaceutical/Bristol-Myers Squibb 33
4.4.2 Keytruda (pembrolizumab) – Merck 35
4.4.3 Perjeta (pertuzumab) – Roche 37
4.4.4 Napabucasin – Boston Biomedical (subsidiary of Dainippon Sumitomo Pharma) 39
4.4.5 Lynparza (olaparib) – AstraZeneca 41
4.4.6 Nimotuzumab – Kuhnil Pharmaceutical/Daiichi Sankyo 43
4.4.7 Avelumab – Merck 44
4.4.8 GS-5745 – Gilead Bioscience 46
4.5 Comparative Efficacy and Safety of Pipeline Products 47
4.6 Product Competitive Framework 48

5 Clinical Trial Analysis 50
5.1 Failure Rate 50
5.1.1 Overall Failure Rate 50
5.1.2 Failure Rate by Phase and Molecule Type 51
5.1.3 Failure Rate by Phase and Molecular Target 53
5.2 Clinical Trial Size 55
5.2.1 Patient Enrollment per Product by Molecule Type, Molecular Target and Stage of Development 55
5.2.2 Patient Enrollment per Trial by Molecule Type, Molecular Target and Stage of Development 56
5.3 Clinical Trial Duration 58
5.3.1 Trial Duration by Stage of Development and Molecule Type 58
5.3.2 Trial Duration by Stage of Development and Molecular Target 59
5.4 Summary of Clinical Trial Metrics 60

6 Multi-Scenario Forecast 62
6.1 Geographical Markets 62
6.2 Asia-Pacific Market 62
6.3 India 64
6.3.1 Treatment Usage Patterns 64
6.3.2 Annual Cost of Therapy 64
6.3.3 Market Size 65
6.4 China 66
6.4.1 Treatment Usage Patterns 66
6.4.2 Annual Cost of Therapy 67
6.4.3 Market Size 68
6.5 Australia 69
6.5.1 Treatment Usage Patterns 69
6.5.2 Annual Cost of Therapy 70
6.5.3 Market Size 71
6.6 South Korea 72
6.6.1 Treatment Usage Patterns 72
6.6.2 Annual Cost of Therapy 73
6.6.3 Market Size 73
6.7 Japan 74
6.7.1 Treatment Usage Patterns 74
6.7.2 Annual Cost of Therapy 75
6.7.3 Market Size 76

7 Market Dynamics 77
7.1 Drivers 77
7.1.1 Increasing Prevalence and Treatment Rate Across All Lines of Therapy in the Metastatic Setting 77
7.1.2 Promising Drug Pipeline Focused on Targeted Therapies 77
7.1.3 Launch of Premium-Priced Drugs for the Metastatic Setting 77
7.1.4 Improved Treatment Options that Extend Duration of Therapy 77
7.1.5 Increasing Screening Programs and Government Reforms 78
7.2 Barriers 78
7.2.1 Lack of Development of Pipeline Agents as Pre-operative and Postoperative Treatments for Resectable Gastric Cancer 78
7.2.2 Patent Expiration of Herceptin and Patient Share Erosion by Trastuzumab Biosimilars 78
7.2.3 Affordability and Reimbursement Issues in India and China 78

8 Deals and Strategic Consolidations 79
8.1 Licensing Deals 79
8.1.1 Deals by Region and Value 79
8.1.2 Number of Disclosed and Undisclosed Deals by Year, Aggregate Deal Value 79
8.1.3 Deal Value by Stage of Development, Molecule Type and Molecular Target 80
8.1.4 Key Licensing Deals 83
8.2 Co-development Deals 84
8.2.1 Deals by Region and Value 84
8.2.2 Number of Deals by Year 84
8.2.3 Deals by Stage of Development, Molecule Type and Molecular Target 85
8.2.4 Key Co-development Deals 87

9 Appendix 89
9.1 All Pipeline Drugs by Stage of Development 89
9.1.1 Discovery 89
9.1.2 Preclinical 90
9.1.3 Investigational New Drug/ Clinical Trial Authorization-filed 92
9.1.4 Phase I 93
9.1.5 Phase II 95
9.1.6 Phase III 97
9.2 Market Forecasts to 2021 97
9.2.1 Asia-Pacific 97
9.2.2 India 98
9.2.3 China 98
9.2.4 Australia 99
9.2.5 South Korea 99
9.2.6 Japan 100
9.3 Bibliography 100
9.4 Abbreviations 106
9.5 Research Methodology 108
9.5.1 Secondary Research 108
9.5.2 Marketed Product Profiles 109
9.5.3 Late-Stage Pipeline Candidates 109
9.5.4 Comparative Efficacy and Safety Heat Map for Marketed and Pipeline Products 109
9.5.5 Product Competitiveness Framework 109
9.5.6 Pipeline Analysis 109
9.5.7 Forecasting Model 110
9.5.8 Deals Data Analysis 111
9.6 Contact Us 112
9.7 Disclaimer 112

List of Tables

Table 1: Gastric Cancer, Tumor, Node and Metastasis Staging 17
Table 2: Gastric Cancer Therapeutics Market, Global, All Pipeline Products, Discovery, 2016 89
Table 3: Gastric Cancer Therapeutics Market, Global, All Pipeline Products, Preclinical, 2016 90
Table 4: Gastric Cancer Therapeutics Market, Global, All Pipeline Products, IND/CTA-Filed, 2016 92
Table 5: Gastric Cancer Therapeutics Market, Global, All Pipeline Products, Phase I, 2016 93
Table 6: Gastric Cancer Therapeutics Market, Global, All Pipeline Products, Phase II, 2016 95
Table 7: Gastric Cancer Therapeutics Market, Global, All Pipeline Products, Phase III, 2016 97
Table 8: Gastric Cancer Therapeutics Market, Asia-Pacific, Market Forecast, 2015–2022 97
Table 9: Gastric Cancer Therapeutics Market, India, Market Forecast, 2015–2022 98
Table 10: Gastric Cancer Therapeutics Market, China, Market Forecast, 2015–2022 98
Table 11: Gastric Cancer Therapeutics Market, Australia, Market Forecast, 2015–2022 99
Table 12: Gastric Cancer Therapeutics Market, South Korea, Market Forecast, 2015–2022 99
Table 13: Gastric Cancer Therapeutics Market, Japan, Market Forecast, 2015–2022 100

List of Figures

Figure 1: Gastric Cancer Therapeutics, Australia, Age-Specific Incidence Rate per 100,000 Population, 2004, 2008 and 2012 11
Figure 2: Gastric Cancer, Stage Grouping 17
Figure 3: Gastric Cancer, Market Heat Map 28
Figure 4: Pipeline for Gastric Cancer, Global, 2016 30
Figure 5: Pipeline for Gastric Cancer by Molecular Target, Global, 2016 32
Figure 6: Pipeline for Gastric Cancer by Molecular Target by Stage of Development, Global, 2016 33
Figure 7: Gastric Cancer Therapeutics Market, Asia-Pacific, Opdivo, Market Forecast ($m), 2018–2022 35
Figure 8: Gastric Cancer Therapeutics Market, Asia-Pacific, Keytruda, Market Forecast ($m), 2019–2022 37
Figure 9: Gastric Cancer Therapeutics Market, Asia-Pacific, Perjeta, Market Forecast ($m), 2018–2022 39
Figure 10: Gastric Cancer Therapeutics Market, Asia-Pacific, Napabucasin, Market Forecast ($m), 2018–2022 41
Figure 11: Gastric Cancer Therapeutics Market, Asia-Pacific, Lynparza, Market Forecast ($m), 2019–2022 43
Figure 12: Gastric Cancer Therapeutics Market, Asia-Pacific, Nimotuzumab, Market Forecast ($m), 2019–2022 44
Figure 13: Gastric Cancer Therapeutics Market, Asia-Pacific, Avelumab, Market Forecast ($m), 2020–2022 46
Figure 14: Gastric Cancer, Pipeline Heat Map 47
Figure 15: Gastric Cancer, Marketed and Pipeline Product Competitiveness Framework 49
Figure 16: Gastric Cancer Therapeutics Market, Global, Overall Clinical Trial Attrition Rates by Stage of Development (%), 2006–2016 51
Figure 17: Gastric Cancer Therapeutics Market, Global, Clinical Trial Attrition Rates by Stage of Development and Molecule Type (%), 2006–2016 52
Figure 18: Gastric Cancer Therapeutics Market, Global, Clinical Trial Attrition Rates by Stage of Development and Molecular Target (%), 2006–2016 54
Figure 19: Gastric Cancer Therapeutics Market, Global, Clinical Trial Size per Product by Molecule Type and Stage of Development, 2006–2016 55
Figure 20: Gastric Cancer Therapeutics Market, Global, Clinical Trial Size per Product by Molecular Target and Stage of Development, 2006–2016 56
Figure 21: Gastric Cancer Therapeutics Market, Global, Clinical Trial Size per Trial by Stage of Development and Molecule Type, 2006–2016 57
Figure 22: Gastric Cancer Therapeutics Market, Global, Clinical Trial Size per Trial by Stage of Development and Molecular Target, 2006–2016 58
Figure 23: Gastric Cancer Therapeutics Market, Global, Clinical Trial Duration by Stage of Development and Molecule Type, 2006–2016 59
Figure 24: Gastric Cancer Therapeutics Market, Global, Clinical Trial Size by Molecular Target by Stage of Development (patients), 2006–2016 60
Figure 25: Gastric Cancer Therapeutics Market, Comparison of Average Trial Metrics by Phase and Molecule Type 60
Figure 26: Gastric Cancer Therapeutics Market, Comparison of Average Trial Metrics by Phase and Molecular Target 61
Figure 27: Gastric Cancer Therapeutics Market, Asia-Pacific, Treatment Patterns (‘000), 2015–2022 63
Figure 28: Gastric Cancer Therapeutics Market, Asia-Pacific, Market Size ($bn), 2015–2022 63
Figure 29: Gastric Cancer Therapeutics Market, India, Treatment Patterns (‘000), 2015–2022 64
Figure 30: Gastric Cancer Therapeutics Market, India, Annual Cost of Therapy ($), 2015–2022 65
Figure 31: Gastric Cancer Therapeutics Market, India, Market Size ($m), 2015–2022 66
Figure 32: Gastric Cancer Therapeutics Market, China, Treatment Patterns (‘000), 2015–2022 67
Figure 33: Gastric Cancer Therapeutics Market, China, Annual Cost of Therapy ($), 2015–2022 68
Figure 34: Gastric Cancer Therapeutics Market, China, Market Size ($bn), 2015–2022 69
Figure 35: Gastric Cancer Therapeutics Market, Australia, Treatment Patterns, 2015–2022 70
Figure 36: Gastric Cancer Therapeutics Market, Australia, Annual Cost of Therapy ($), 2015–2022 71
Figure 37: Gastric Cancer Therapeutics Market, Australia, Market Size ($m), 2015–2022 71
Figure 38: Gastric Cancer Therapeutics Market, South Korea, Treatment Patterns (‘000), 2015–2022 72
Figure 39: Gastric Cancer Therapeutics Market, South Korea, Annual Cost of Therapy ($), 2015–2022 73
Figure 40: Gastric Cancer Therapeutics Market, South Korea, Market Size ($m), 2015–2022 74
Figure 41: Gastric Cancer Therapeutics Market, Japan, Treatment Patterns (‘000), 2015–2022 75
Figure 42: Gastric Cancer Therapeutics Market, Japan, Annual Cost of Therapy ($), 2015–2022 75
Figure 43: Gastric Cancer Therapeutics Market, Japan, Market Size ($bn), 2015–2022 76
Figure 44: Gastric Cancer Therapeutics Market, Global, Licensing Deals by Region and Value, 2006–2016 79
Figure 45: Gastric Cancer Therapeutics Market, Global, Number of Disclosed and Undisclosed Licensing Deals by Year and Aggregate Deal Value ($m), 2006–2016 80
Figure 46: Gastric Cancer Therapeutics Market, Global, Licensing Deals by Stage of Development and Deal Value ($m) 2006–2016 81
Figure 47: Gastric Cancer Therapeutics Market, Global, Licensing Deals by Molecule Type and Stage of Development, 2006–2016 82
Figure 48: Gastric Cancer Therapeutics Market, Global, Licensing Deals by Molecular Target and Aggregate Deal Value ($m), 2006–2016 82
Figure 49: Gastric Cancer Therapeutics Market, Global, Co-development Deals by Region, 2006–2016 84
Figure 50: Gastric Cancer Therapeutics Market, Global, Number of Co-development Deals by Year, 2006–February 2016 85
Figure 51: Gastric Cancer Therapeutics Market, Global, Co-development Deals by Stage of Development, 2006–2016 85
Figure 52: Gastric Cancer Therapeutics Market, Global, Co-development Deals by Molecule Type, Stage of Development, 2006–2016 86
Figure 53: Gastric Cancer Therapeutics Market, Global, Co-development Deals by Molecular Target, 2006–2016 87"

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