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Gastric Cancer

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Published Date : Sep 2023
Category : Oncology
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Global Burden and Trends in Gastric Cancer Market and its Innovations

Gastric cancer (GC) is a prevalent disease that has remained one of the leading causes of cancer-related deaths worldwide. Although its incidence varies greatly by geographic region, it was listed by WHO as the fifth most prevalent cancer and as the fourth main cause of cancer death worldwide. In order to develop effective preventive, early detection, and treatment plans, it is essential to understand the epidemiology of stomach cancer.

An Overview of Gastric Cancer and its Epidemiology

A tumor that appears in the stomach lining is called gastric cancer, commonly referred to as stomach cancer. It is one of the most prevalent cancers worldwide. There are various morphological subtypes of gastric cancer, but the two most prevalent subtypes are intestinal and diffuse. While diffuse-type gastric cancer is frequently related to genetic factors and intestinal-type gastric cancer is typically connected with ongoing gastritis and H. pylori infection.

There are two primary anatomical subsites for gastric tumors. While the majority of gastric cancers develop in the distal (non-cardia) areas of the stomach, the cardia, or area of the stomach next to the oesophageal-gastric junction, is where ~18% of all gastric cancers worldwide develop. Obesity and gastroesophageal reflux have been linked to cardiac gastric cancer, whereas Helicobacter pylori (H. pylori) infection was responsible for 90% of non-cardia malignancies.

According to the WHO, those older than the age of 65 have the greatest incidence rates of stomach cancer, which primarily affects elderly people. Globally, men are more likely to be afflicted than women; the prevalence of H. pylori infection in men was 46.3%, compared to 42.7% in women.

The bacteria Helicobacter pylori are a significant risk factor for stomach cancer, especially the intestinal variety. Gastric cancer risk is also elevated in diets high in salty, smoked, or pickled foods. Studies have shown that heavy drinking and smoking both contribute to the development of stomach cancer. Another risk factor for stomach cancer is a family history of the disease.

According to recent statistics, the incidence and death of gastric cancer have been steadily declining worldwide, especially in developed countries.

However, there is a large geographic variance in the incidence of GC, with more than ~50% of new cases appearing in underdeveloped nations. The incidence and death rates in Asian nations are typically much greater than those in other nations. Eastern Asia has recently been discovered to contain more than ~60% of GC.

As per DiseaseLandscape Insights analysis, East Asia (China and Japan), Eastern Europe, and Central and South America are the areas with the highest danger. On the other hand, Southern Asia, North and East Africa, North America, Australia, and New Zealand have a reduced risk.

According to the American Cancer Society, there are estimated to be about 26,500 new instances of stomach cancer in the US in 2023 (15,930 of these cases will be in men and 10,570 will be in women). This form of cancer causes approximately 11,130 fatalities (6,690 males and 4,440 women).

The survival rate for patients with gastric cancer is still low, despite some advancements made by major players in the field of cancer treatments. This indicates the need for primary and secondary prevention strategies with variations in incidence rates based on geography, age, gender, and risk factors.

Due to the importance of early detection and intervention in improving outcomes for those with stomach cancer, health insurers' understanding of risk factors and access to healthcare services have become significant elements of the disease's epidemiological treatment for all market players for better outcomes.

DiseaseLandscape Insights assists the stakeholders by providing data related to the gastric cancer marketplace, knowledgeable choices in healthcare equipment, therapies, and diagnostic techniques where various new technologies and innovations are impacting the market of disease and driving higher expansion.

The Vital Role of Early Detection in Gastric Cancer Management

Diagnostic Analysis

A variety of diagnostic techniques are generally used to find stomach cancer, including the following:

Physical Exam that is medical practitioners perform a comprehensive physical examination to check for the physical manifestations of stomach cancer, such as abdominal discomfort, lumps that can be felt, and swollen lymph nodes.

The epidemiological management of stomach cancer has made it crucial for health payers to be aware of risk factors and have access to healthcare services.

  1. Laboratory Testing:

  • Blood Tests: There might be an increase in some blood markers in gastric cancer, including Carcinoembryonic Antigen (CEA) and Cancer Antigen 19-9 (CA 19-9). These tests are used for tracking and measuring disease progression. Specific indicators linked to gastric cancer, such as carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA 19-9), are measured by some blood tests. Increased levels could be a sign of malignancy.
  • Fecal Occult Blood Test (FOBT): The test finds for any hidden bleeding in the stool, which could be a sign of internal bleeding, particularly bleeding from gastric cancer.
  1. Imaging Studies:

  • Endoscopy (Esophagogastroduodenoscopy or EGD): This involves inserting an endoscope—a flexible tube with a camera—into the upper portion of the small intestine, through the oesophagus, in the stomach to enable and detect tissue samples to be taken for biopsies
  • Endoscopic Ultrasound (EUS): This test is used to evaluate the severity of cancer invasion into the stomach wall and adjacent lymph nodes, EUS combines endoscopy with ultrasound imaging
  • Computed Tomography (CT) Scan: CT scans provide detailed cross-sectional images of the abdomen and chest, helping determine the extent of cancer, lymph node involvement, and potential metastasis
  • Magnetic Resonance Imaging (MRI): MRIs offer high-resolution images of the stomach and surrounding tissues, aiding in cancer staging
  • Positron Emission Tomography (PET) Scan PET scans, often combined with CT (PET-CT), help identify areas of increased metabolic activity, indicating potential cancer spread.
  1. Surgical Procedures:

  • Laparoscopy: In some cases, this procedure is sometimes used to make a diagnosis. It involves inserting a camera through tiny abdominal incisions to look for indications of cancer spread within the abdominal cavity.
  • Exploratory Laparotomy: This surgery is performed through an open abdominal procedure known as an exploratory laparotomy that is used to determine the degree of metastasis in circumstances when substantial cancer spread is suspected.
  • Peritoneal Lavage: Peritoneal lavage, also known as peritoneal washings, is a surgical procedure where fluid from the abdominal cavity is collected and analyzed for the presence of cancer cells.
  1. Biopsy:

    Tissue samples (biopsies) are taken during endoscopy from infected regions of the stomach lining. These are delivered to a pathology lab for histological analysis, which establishes the existence of cancer and establishes its type and stage.

The following table lists the names of the market leaders who are redefining healthcare with their forefront diagnostic innovations:

                                                                                  Market Players

Endoscopy

CT Scan and MRI

PET Scanners

Antibiotics

Olympus Corporation

Siemens Healthineers

Neusoft Medical Systems

Abbott Laboratories

Fujifilm Holdings Corporation

General Electric (GE) Healthcare

Hitachi Healthcare

GlaxoSmithKline

PENTAX Medical

Philips Healthcare

Toshiba Medical

Pfizer

KARL STORZ SE & Co. KG

Toshiba

Siemens Healthineers

 

 

 

GE Healthcare

 

 

 

 

 

 

                                                                                          Products

Endoscopy

CT Scan and MRI

PET Scanners

Antibiotics

EVIS EXERA III

SOMATOM CT Scanners

Biograph PET-CT scanners

Augmentin

Fujifilm ELUXEO

Revolution CT

SCENARIA View PET-CT scanners

Klacid

EG-29-i10 & EG-27-i10

IQon Spectral CT

NeuSight PET-CT scanners

Biaxin

KARL STORZ

Aquilion CT Scanners

uMI 780 PET-CT scanners

 

EG-530UR2

MAGNETOM MRI Scanners

Celesteion PET-CT scanners

 

 

SIGNA MRI Systems

Discovery PET-CT scanners

 

 

Ingenia MRI Systems

 

 

 

Treatment Analysis

Depending on the stage and severity of the disease, treatment for gastric cancer frequently entails a combination of various methods. Although they are not the mainstay of treatment for stomach cancer, treatments and drugs are essential. Here are several different approaches to treating stomach cancer:

  1. Surgery:

    There are various surgeries that are performed to eradicate cancerous cells from the stomach lining, depending on the stages and severity of cases following types of surgery are used.
  • Gastrectomy: This surgery is used to remove part or all of the stomach and is often the primary treatment for gastric cancer, especially in the early stages of cancer.
  • Lymph Node Dissection: This surgery involves the removal of nearby lymph nodes and is usually performed to check for cancer spread.
  1. Therapies:

  • Chemotherapy: Adjuvant Chemotherapy and Neoadjuvant Chemotherapy are used for patients whose infections are not cured totally: So, after surgery, Adjuvant chemotherapy may be given to kill any remaining cancer cells depending on the infections. Additionally, Neoadjuvant Chemotherapy is Administered to patients before surgery to shrink tumors and make them easier to remove
  • Radiation Therapy: This therapy works on External Beam Radiation as High-energy beams are directed at the tumor to destroy cancer cells for elderly people and Radioactive sources are placed inside the body, often through an endoscope, to target cancer within the stomach
  • Targeted Therapy: Drugs like Trastuzumab (Herceptin) are used in cases where tumors overexpress specific proteins or receptors, such as HER2, which is more common in certain gastric cancers
  • Immunotherapy: While there are no specific vaccines for gastric cancer, immunotherapy drugs like pembrolizumab and nivolumab have been approved for advanced gastric cancer treatment. They help the immune system to recognize and attack cancer cells
  • Targeted Chemotherapy: In targeted chemotherapy drugs like Ramucirumab (Cyramza) are used to target specific blood vessels that supply nutrients to the tumor and help in fast recovery.
  1. Antibiotics (for H. pylori Infection):

For individuals with H. pylori infection-associated gastric cancer, antibiotics like Clarithromycin, Amoxicillin, And Metronidazole are prescribed to eradicate the bacteria and its infection in the stomach.

  1. Supportive Care:

Additionally, palliative care and symptom management are crucial for improving the quality of life in advanced cases of gastric cancer This includes pain management, nutritional support, and addressing the side effects of treatment.

Treatment plans for gastric cancer are highly individualized and depend on factors such as the stage of cancer, the patient's overall health, and the specific characteristics of the tumor. The likelihood of a favourable outcome is considerably increased by early detection and prompt action.

The below table shows the market leaders who are reshaping the landscape and driving innovation in the pursuit of improved health outcomes and their product names for the treatment of Strep Throat Disease.

                                                                                  Market Players for Treatment

Surgical Instruments

Targeted and Immunotherapy drugs

Antibiotics

Endoscope

Ethicon

Bristol Myers Squibb (BMS)

Abbott Laboratories

Olympus Corporation

Medtronic

Merck

GlaxoSmithKline

(Hoya Corporation)

Stryker

Roche/Genentech

Pifzer

Richard Wolf GmbH

Olympus

Eli Lilly and Company

 

Stryker Corporation

KARL STORZ

AstraZeneca

 

Fujifilm Holdings Corporation

B. Braun Melsungen AG

Pfizer

 

KARL STORZ GmbH & Co. KG

Intuitive Surgical

Novartis

 

Pentax Medical

Richard Wolf GmbH

Taiho Oncology

 

 

Aesculap

 

 

 

KLS Martin Group

 

 

 

 

                                                                                      Products

Surgical Instruments

Targeted and Immunotherapy drugs

Antibiotics

Endoscope

Medtronic LigaSure™

Cyramza (Ramucirumab)

Amoxil Trimox, Moxatag,

Evis Exera III Gastrointestinal Videoscope

Ethicon Endo-Surgery Harmonic™

Tagrisso (Osimertinib)

Biaxin, Biaxin XL,

Pentax Medical EG-2990i

ECHELON FLEX™

Vizimpro (Dacomitinib)

Opdivo (Nivolumab)

Fujifilm EG-600WR Endoscope

Olympus Thunderbeat™

Lonsurf (Trifluridine/Tipiracil)

Keytruda (Pembrolizumab)

Fujinon EG-740N Gastroscope

 

Rydapt (Midostaurin)

Flagyl, Metrogel,

 

 

Herceptin (Trastuzumab)

 

 

 

Market Dynamics and Future Prospects in Gastric Cancer

Early detection and screening programs are receiving more attention, especially in areas with high incidence rates of GC. The odds of detecting stomach cancer at an earlier, more treatable stage are expected to increase as a result of advancements in endoscopy and non-invasive screening techniques id driving the market.

Significant progress has been made in the field of treating stomach cancer, including the development of targeted treatments and immunotherapies. Patients with advanced or metastatic disease now have new hope thanks to these cutting-edge medicines innovated by Pharma-Biotech companies.

For the removal of stomach tumors, safe surgical methods like laparoscopy are becoming more and more common and driving the market force for the surgical segment. These methods offer quicker healing times and less surgical discomfort. It is clear that there is a growing emphasis on providing supportive care and raising patients' quality of life.

Gastric cancer incidence is increasing in emerging economies. The market for diagnostic and treatment options is expanding in these areas as the healthcare infrastructure does. An important trend is the ongoing study of trustworthy biomarkers for early diagnosis, prognosis, and therapeutic response. These biomarkers can aid in directing therapy choices.

In order to improve treatment outcomes and successfully treat aggressive cancers, combination therapies combining chemotherapy, targeted therapy, and immunotherapy are being researched of which some have received approval from the FDA. New treatments and diagnostics for stomach cancer are being developed because of international partnerships in research and clinical trials and reshaping the market for the Oncology segment
DiseaseLandscape Insights assists companies by giving extensive knowledge about all current market players, their inventions, tactics, and partnerships, as well as assisting in the selection of the appropriate marketplace to grow exponentially.

Competitive Analysis

The competitive landscape of the gastric cancer market is marked by a range of players, including pharmaceutical companies, diagnostic technology providers, and research institutions. Key players in this market are involved in the development of innovative treatments and diagnostic tools, often through collaborations and partnerships.

Here's an overview of some notable deals and key players in the gastric cancer market.

The competitiveness in the market for the diagnosis and treatment of gastric cancer is driven by a combination of factors, including growth opportunities, market penetration, advancements, and innovations.

Companies involved with detection and treatment have seen growth potential as a result of the rising incidence of stomach cancer in various locations. There is a need for more efficient and creative solutions as the disease burden rises.

Gastric cancer diagnosis and treatment are more popular in emerging economies with developing healthcare infrastructure. Businesses are reaching further to enter these markets to grow exponentially.

Key pharmaceutical companies are in competition to develop and market effective drugs for gastric cancer. Market penetration often involves gaining approval for specific indications, like MSI-H or dMMR, to expand the patient population.

The development and approval of immunotherapies, such as pembrolizumab (Keytruda), have transformed gastric cancer treatment. Companies are investing in further research on immunotherapeutic agents.

Diagnostic technology companies are continually developing new products, such as advanced endoscopes with enhanced imaging capabilities. For Instance, in order to collaboratively develop and market Lynparza (olaparib), a PARP inhibitor, for several cancer types, including gastric cancer, AstraZeneca, Merck, and Taiho Pharmaceutical partnered together.

Roche's diagnostics division has developed innovative tests and companion diagnostics for gastric cancer, contributing to personalized treatment approaches.

The market for diagnosing and treating stomach cancer is very competitive due to efforts to enhance patient outcomes, identify more potent treatments, and broaden the market. Companies that are effective at innovating, creating precision medicine methods, and working together on research projects are better equipped to meet the changing demands of people with stomach cancer.

Regulatory Framework Analysis

The FDA has continued to approve drugs for gastric cancer with specific biomarker indications. For example, pembrolizumab received accelerated approval for use in patients with unresectable or metastatic solid tumors, including gastric cancer with high Microsatellite Instability (MSI-H) or deficient DNA Mismatch Repair (dMMR).

Some therapies for gastric cancer have been granted breakthrough therapy designations, expediting their development and review process. This includes targeted therapies and immunotherapies.

The FDA has approved companion diagnostic tests alongside certain drugs for gastric cancer to identify patients with specific genetic mutations or biomarkers.

  • Merck's immunotherapy drug, Keytruda, received FDA approval for the treatment of gastric cancer with specific biomarker indications (MSI-H or dMMR). This marked a significant advancement in precision medicine for gastric cancer.

Some drugs for rare forms of gastric cancer have received orphan drug designation in the EU, providing incentives for their development and approval.

The EMA has granted marketing authorizations for several drugs for gastric cancer, reflecting advancements in precision medicine and immunotherapy.

Companies are collaborating on clinical trials to test combination therapies, including immunotherapy with targeted agents, to improve treatment efficacy. For Instance,

  • BMS and Exelixis collaborated on clinical trials to evaluate the combination of immunotherapy (nivolumab) with targeted therapy (cabozantinib) for the treatment of advanced gastric cancer.

Clinical Trial Assessments

The crucial role of clinical trials in the practice of evidence-based medicine and health care reform is highlighted by the government's increasing concentration on comparing the effectiveness of studies. One of the main aims of reforming healthcare is achieved by the market participants accurately examining medical therapy with the use of clinical data.

The table below includes the study names of the ongoing clinical trials at phase I, II, and IV.

Phase1

Phase2

Phase3

Phase4

A Phase 1 Open-Label, Dose-Escalation, Safety, Pharmacokinetic, and Pharmacodynamic Study of Minnelide™ Capsules Given Alone or in Combination with Paclitaxel in Patients with Advanced Gastric Cancer

Neoadjuvant FOLFIRINOX in the Treatment of Locally Advanced Gastric Cancer

XELOX for 4 Months Versus 6 Months as Adjuvant Chemotherapy in Gastric Cancer After D2 Resection (LOMAC)

The Effect of Chemoradiotherapy on Gastric Perfusion in Patients with Gastric Cancer

A Phase I Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Preliminary Efficacy of Disitamab Vedotin Combined with RC98 in the Treatment of Subjects with HER2-expressing Locally Advanced or Metastatic Gastric Cancer (Including AEG).

Clinical Outcomes of Indocyanine Green Tracer Using in Laparoscopic Gastrectomy with Lymph Node Dissection for Remnant Gastric Cancer

Compare S-1 for 9 Months to 1 Year as Adjuvant Chemotherapy in Stage II Gastric Cancer (SMAC)

Yiqi Wenyang Jiedu Prescription in the Prevention and Treatment of Postoperative Metastasis and Recurrence of Gastric Cancer: A Randomized, Double-blind, Controlled and Multi-center Clinical Study

An Open-Label, International, Multicenter, Phase 1b Study to Assess the Safety, Tolerability, and Efficacy of IDX-1197 in Combination with XELOX (Capecitabine and Oxaliplatin) or Irinotecan in Patients with Advanced Gastric Cancer

A Study of Compared Adjuvant Serplulimab and Trastuzumab and Chemotherapy vs Chemotherapy Only in Her-2 Positive Gastric Cancer With II-III Stage Following Curative Resection

Three Drugs in Advanced Gastric Cancer Neoadjuvant Chemotherapy for Stage Ⅲ Multicenter, Open, Randomized, Controlled Clinical Study

A Multi-center, Phase IV, Extension Study in PEGASUS-D Trial to Evaluate Efficacy of Ursodeoxycholic Acid (UDCA) for the Prevention of Gallstone Formation After Gastrectomy in Patients with Gastric Cancer

da VINci Study (OTSGC-A24 Therapeutic Peptide Vaccine + Ipilimumab + Nivolumab) Nivolumab, Ipilimumab and OTSGC-A24 Therapeutic Peptide Vaccine in Gastric Cancer - a Combination Immunotherapy Phase Ib Study.

A Multicentre Randomised Phase II Trial of Neo-adjuvant Chemotherapy Followed by Surgery vs. Neo-adjuvant Chemotherapy and Subsequent Chemoradiotherapy Followed by Surgery vs. Neo-adjuvant Chemoradiotherapy Followed by Surgery in Resectable Gastric Cancer

Phase III Study of Adjuvant Capecitabine vs Observation Alone in Curatively Resected Stage IB (by AJCC 6th Edition) Gastric Cancer (KCSG ST14-05)

Multicentric Randomized Study of H. Pylori Eradication and Pepsinogen Testing for Prevention of Gastric Cancer Mortality

An Exploratory Clinical Study of Lenvatinib Combined with Single-agent Taxanes as Second-line Therapy for the Treatment of HER2-negative Advanced Gastric Cancer

Phase II Study of Toripalimab Combined with Fluorouracil, Leucovorin, Oxaliplatin, and Docetaxel (FLOT) in Patients with Locally Advanced, Resectable Gastric Cancer or Gastroesophageal Junction Adenocarcinoma

A Randomized Phase 3 Clinical Trial Investigating Optimal Duration of Oxaliplatin Administration in Postoperative XELOX (Oxaliplatin + Capecitabine) Adjuvant Chemotherapy for the Patients with Stage II/III Gastric Cancer

The Effect of Carboxymethyl Starch (Oozfix) on Preventing Postoperative Complication After Gastrectomy: Single-center, Non-inferiority, Open-label Randomized Trial

Safety and Efficacy of XELOX Regimen Combined With GLS-010 and Lenvatinib in Patients with Advanced AFP-positive Gastric Cancer: A Single Center, Prospective, Open-Label Phase I Study

A Phase 2 Study to Evaluate the Safety and Immunological Efficacy of Therapeutic Cancer Vaccine (AST-301, pNGVL3-hICD) in Patients with HER2 Expressing Gastric Cancer (CORNERSTONE-003)

Randomized, Controlled, Multicenter Phase III Clinical Study Evaluating the Efficacy and Safety of RC48-ADC for the Treatment of Locally Advanced or Metastatic Gastric Cancer with HER2-overexpression

PERIOP-FOLFIRINOX: A Pilot Trial of Perioperative Genotype-guided Irinotecan Dosing of gFOLFIRINOX for Locally Advanced Gastroesophageal Adenocarcinoma

 

Conclusion

The urgent need for efficient strategies in the detection and treatment of gastric cancer is highlighted by all the market players due to the rising prevalence of stomach cancer in the world.

By ensuring access to early screening, cutting-edge treatments, and comprehensive care, healthcare payers play a crucial role in managing this challenge, and improving patient outcomes, by minimizing the burden of this disease worldwide.

So DiseaseLandscape Insight (DLI) is here to assist the industry players in addressing the critical challenge of reducing the prevalence of stomach cancer. DLI helps pharmaceutical companies, healthcare providers, and policymakers develop strategic solutions and approaches for novel treatments and optimize diagnostic approaches.

To foster greater awareness, enhance the overall management of gastric cancer, and improve patient outcomes. This is accomplished through DLI services on strategic insights, data-driven approaches, and collaborative solutions to expand globally.

SUMMARY
VishalSawant
Vishal SawantBusiness Development
vishal@diseaselandscape.com

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