Tough challenges ahead for new gastric-cancer treatments
The treatment of gastric cancer (GC) continues to evolve, with novel innovative modalities poised to disrupt current mainstays such as chemotherapy regimens, Herceptin, Cyramza or Keytruda. Nonetheless, many of the new drug candidates feeding through the R&D pipeline face tough challenges in meeting not only regulatory requirements but oncologist and payer expectations for genuinely improved and differentiated treatment options. How, then, will the GC landscape develop over the next few years? With wide availability of trastuzumab biosimilars can Roche's Herceptin maintain its dominance? What are the consequences for Lilly's Cyramza following disappointing overall-survival data from the RAINFALL study? How have KOLs responded to Keytruda's (Merck & Co.) approval for third-line setting in the US? What stands out for oncologists in a late-stage pipeline encompassing immunotherapies such as nivolumab and avelumab, targeted oral therapies including apatinib and olaparib, and targeted biologics such as claudiximab or andecaliximab? Are these agents sufficiently tailored to patient needs, and distinct from their competitors, to make a real impact on the market? Or do early-stage and next-generation candidates such as margetuximab, epacadostat, AZD6738 or DKN-01 hold out more hope of reshaping treatment strategies?
In this fully updated report, 12 of the world's leading KOLs from the US and Europe offer candid insights on current chemotherapy options, three marketed biologics and 16 experimental drugs in Phase II/III trials for GC.
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"All the efforts to pursue the HER2 pathway inhibition have failed in first, second and third line. The updated results of the ToGA trial have not confirmed the original data showing the three-month gain in survival. So the anti-HER2s are no longer seen as something you cannot do without."
EU Key Opinion Leader
"There are probably slight differences between PD-1 drugs and PD-L1 drugs, certainly in their toxicity profile and mechanism of action. The PD-L1s cause less pneumonitis, which is good. As to their efficacy, it's hard to say."
EU Key Opinion Leader
"For PARP inhibitors, the biomarker question has been worked out, which also opens up an opportunity for being more selective in the trials. Usually for the PARP inhibitors, from sequencing, you could select patients who have problems with DNA-repair pathways, which most probably account for around 30 percent of gastric cancer, if not more."
US Key Opinion Leader
Marketed Therapies
Late Stage Pipeline Programmes
Early Stage Pipeline Programmes
KOLs from North America
KOLs from Europe
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