Gastric Cancer Market

Key Highlights

• Gastric cancer represents the fifth most prevalent malignant tumor, and the incidence of gastric cancer varies geographically across the globe. The highest incidence rates are observed in Eastern Asia and Eastern Europe. Japan has the highest rates of gastric cancer among the 7MM, with around 129,500 cases in 2024.
• Despite the high incidence of gastric cancer, most patients are unfortunately diagnosed at advanced stages with poor prognoses due to the absence of distinguishing clinical indicators. Notably, in Western countries such as the US, Germany, Italy, France, and the UK, a higher proportion of cases are diagnosed at late stages (Stage IV), in contrast to that in Japan, the majority of cases are diagnosed at an early stage (Stage I). At the time of diagnosis, metastatic disease is present in about 35% of patients in the United States.
• Gastric cancer is 2.2 times more likely to be diagnosed in males than females.
• Historically, platinum-based chemotherapy has been the standard of care for patients with early-stage gastric cancer, highlighting the need for more effective treatment options. The mainstay of treatment for these patients includes gastrectomy (curative surgical resection) along with chemotherapy, targeted-based therapies, and other treatment approaches.
• Several approved drugs for gastric cancer include ENHERTU (AstraZeneca/Daiichi Sankyo), CYRAMZA (Eli Lilly), OPDIVO (Bristol-Myers Squibb), KEYTRUDA (Merck), AYVAKIT (Blueprint Medicines), HERCEPTIN (Genentech), VYLOY (Astellas Pharma), TEVIMBRA (BeOne Medicines [BeiGene]), and others.
• ENHERTU represents a significant advancement in 2L treatment of gastric cancer, offering superior outcomes compared to chemotherapy, and is now being evaluated as 1L therapy for HER2-positive gastric cancer.
• In December 2024, the US FDA approved TEVIMBRA, in combination with platinum and fluoropyrimidine-based chemotherapy, for the 1L treatment of unresectable or metastatic HER2-negative gastric or Gastroesophageal Junction Adenocarcinoma (GEJ) in adults whose tumors express PD-L1 (=1).
• In March 2024, Japan’s Ministry of Health, Labour and Welfare (MHLW) approved VYLOY (zolbetuximab), an anti-claudin 18.2 (CLDN18.2) monoclonal antibody for patients with CLDN18.2-positive, unresectable, advanced or recurrent gastric cancer. VYLOY is the first and only CLDN18.2-targeted therapy approved by any regulatory agency in the world.
• Pharmaceutical companies developing therapies for treating gastric cancer include Amgen (Bemarituzumab), ALX Oncology (Evorpacept), Jazz Pharmaceuticals, BeiGene, and Zymeworks (ZIIHERA), Enliven Therapeutics (ELVN-002), Ambrx and NovoCodex (ARX788), AstraZeneca (Rilvegostomig and AZD0901), KLUS Pharma (A166), Pfizer (TUKYSA), and others with their candidates in different stages of clinical development.

DelveInsight's “Gastric Cancer – Market Insight, Epidemiology and Market Forecast – 2034” report delivers an in-depth analysis of gastric cancer epidemiology, market, and clinical development in gastric cancer. In addition to this, the report provides historical and forecasted epidemiology and market data as well as a detailed analysis of the gastric cancer market trends in the United States, EU4 (Germany, France, Italy, and Spain ), and the United Kingdom, and Japan.

Gastric cancer market report provides real-world prescription pattern analysis, emerging drugs assessment, market share, and uptake/adoption pattern of individual therapies, as well as historical and forecasted gastric cancer market size from 2020 to 2034 in 7MM. The report also covers current gastric cancer treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market’s underlying potential.

Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Gastric Cancer Understanding and Treatment Algorithm

Gastric Cancer Overview

Gastric (stomach) cancer occurs when cancer cells form in the stomach's lining. There are 5 layers in the stomach wall: mucosa, submucosal, muscularis propria, subserosa, and serosa. The location of the tumour and the layers involved play an important role in determining the stage (extent) of cancer, which can affect a person’s treatment options and prognosis. As cancer grows from the mucosa into deeper layers, the stage becomes more advanced and demands extensive treatment.

Gastric Cancer Diagnosis

To diagnose gastric cancer, doctors may review personal and family medical history, perform a physical exam, and run blood and stool tests for signs of anemia or bleeding. Key diagnostic procedures include upper endoscopy with biopsy, where a thin, lighted tube examines the esophagus, stomach, and duodenum, and barium swallow x-rays to visualize the digestive tract. Advanced imaging tests like CT scans, endoscopic ultrasound, PET-CT scans, and MRI help stage the cancer, guiding treatment decisions. The gastric cancer report provides an overview of gastric cancer pathophysiology and diagnostic approaches, along with a real-world scenario of a patient’s journey from the first symptom, the time taken for diagnosis, and the entire treatment process.

Further details related to country-based variations in diagnosis are provided in the report

Gastric Cancer Treatment

The treatment of gastric cancer involves a combination of methods tailored to the cancer's stage and location. Surgical options include endoscopic mucosal resection for early-stage cancers and gastrectomy (partial or total) for more advanced cases. Preoperative (neoadjuvant) and postoperative (adjuvant) therapies, such as chemotherapy and chemoradiation, help shrink tumors and reduce recurrence risk. Endoluminal stent placement and laser therapy can manage blockages, while gastrojejunostomy reestablishes digestive tract continuity. Radiation therapy, systemic chemotherapy, targeted therapies, immunotherapy, and hyperthermic intraperitoneal chemotherapy (HIPEC) provide additional avenues to kill cancer cells and enhance patient outcomes. Many drugs are approved for the treatment of gastric cancer, including ENHERTU, CYRAMZA, OPDIVO, KEYTRUDA, AYVAKIT, HERCEPTIN, VYLOY, TEVIMBRA, and others.

Gastric Cancer Epidemiology

The gastric cancer epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented as total incident cases of gastric cancer, stage-specific cases of gastric cancer, gender-specific cases of gastric cancer, biomarker-specific cases of gastric cancer, and total treatable cases of gastric cancer in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan from 2020 to 2034.

• The total number of incident cases of gastric cancer (including GEJ) in the 7MM accounted for approximately 211,550 in 2024. These cases are expected to increase by 2034.
• Among the 7MM, Japan had the highest number of incident cases of gastric cancer in 2024, i.e., 129,500.
• Around 37% of cases are diagnosed in distant stages of gastric cancer in the US.
• The average age of people when they are diagnosed is 68. About 6 of every 10 people diagnosed with stomach cancer each year are 65 or older.

Gastric Cancer Drug Chapters

The drug chapter segment of the gastric cancer report encloses a detailed analysis of gastric cancer marketed drugs and late-stage (Phase III and Phase II) pipeline drugs. It also deep dives into gastric cancer's pivotal clinical trial details, recent and expected market approvals, patent details, the latest news, and recent deals and collaborations.

Marketed Drugs

ENHERTU (Fam-Trastuzumab Deruxtecan-nxki): AstraZeneca/Daiichi Sankyo

ENHERTU is a HER2-directed antibody and topoisomerase inhibitor conjugate approved for treating adult patients with locally advanced or metastatic HER2-positive (IHC 3+ or IHC 2+/ISH positive) gastric or gastroesophageal junction adenocarcinoma who have previously received a trastuzumab-based regimen. Additionally, it is approved for other solid tumors.

In 2021, ENHERTU received FDA approval in the US for treating patients with previously treated HER2-positive advanced gastric cancer, followed by European Commission approval in 2022. The FDA granted ENHERTU Breakthrough Therapy designation in 2020. In April 2024, ENHERTU was approved in the US as the first tumor-agnostic HER2-directed therapy for previously treated patients with metastatic HER2-positive solid tumors.

OPDIVO (nivolumab): Bristol-Myers Squibb

OPDIVO is a prescription medicine used in combination with chemotherapy that contains fluoropyrimidine and platinum to treat adults with cancer of the stomach (gastric), a junction between the stomach and esophagus (gastroesophageal junction), and esophagus that is a type called adenocarcinoma and cannot be removed with surgery or has spread to other parts of the body.

In May 2021, the FDA approved OPDIVO as an adjuvant treatment for patients with completely resected esophageal or gastroesophageal junction cancer with residual pathologic disease who have received neoadjuvant chemoradiotherapy. The approval is based on the data from Phase III trials (CHECKMATE-577/NCT02743494).

Note: Detailed current therapies assessment will be provided in the full report of gastric cancer

Emerging Drugs

Bemarituzumab: Amgen

Bemarituzumab is a monoclonal antibody that inhibits fibroblast growth factor receptor 2b (FGFR2b). It is being investigated for the treatment of advanced gastric and gastroesophageal junction (GEJ) Cancers. In April 2021, Amgen announced that the US FDA granted breakthrough therapy designation for bemarituzumab. Bemarituzumab is also in Phase I and Phase II development for the treatment of advanced gastric and gastroesophageal cancers in combination with other therapies.

According to Amgen’s recent presentations published in May 2025, the company expects to release results from the FORTITUDE-101 Phase III trial, which is testing bemarituzumab in first-line gastric cancer, in the second quarter of 2025. Results from another Phase III trial, FORTITUDE-102, are expected in the second half of 2025.

ZIIHERA (zanidatamab): Jazz Pharmaceuticals, BeiGene, and Zymeworks

ZIIHERA is a bispecific HER2-directed antibody that binds to two extracellular sites on HER2. In November 2024, the FDA granted accelerated approval to ZIIHERA for adult patients with previously treated, unresectable, or metastatic HER2+ (immunohistochemistry 3+) Biliary Tract Cancer (BTC), as detected by an FDA-approved test. Currently, the drug is in Phase III of clinical trial for HER2+ unresectable locally advanced or metastatic gastroesophageal adenocarcinoma.

Jazz Pharmaceuticals is looking forward to the potential further development of zanidatamab in the neoadjuvant/adjuvant GEA population. Furthermore, Jazz and BeiGene are developing Zanidatamab under license agreements from Zymeworks, which first developed the molecule.

Jazz Pharmaceuticals anticipates a top-line data readout in the second quarter of 2025 from the pivotal Phase III HERIZON-GEA-01 trial (NCT05152147), which is evaluating zanidatamab in combination with chemotherapy, with or without tislelizumab, as a first-line treatment for HER2-expressing metastatic GEA.

Additionally, according to Jazz Pharmaceuticals’ presentation published in January 2025, the company anticipates the path to approval in first-line GEA with an anticipated sBLA submission in 2025.

Note: Detailed emerging therapies assessment will be provided in the final report.

Drug Class Insights

Targeted therapies—including ENHERTU, OPDIVO, CYRAMZA, KEYTRUDA, AYVAKIT, HERCEPTIN, VYLOY, TEVIMBRA, among others—currently play a dominant role in the treatment landscape of gastric cancer.

HER2+ directed therapies

HERCEPTIN and ENHERTU are approved for HER2+ mutated gastric cancer. While trastuzumab and other HER2-targeting drugs are widely used for breast cancer treatment, research over the past decade has revealed elevated HER2 levels in other cancers, including stomach cancer and gastroesophageal junction (GEJ) cancer (which occurs at the junction where the esophagus and stomach meet). Approximately 15% of individuals with advanced stomach cancer and 30% with advanced GEJ cancer have HER2-positive tumors. HER2 remains an important biomarker for the treatment of gastric cancer. With ENHERTU, significant progress has been made for the first time since the introduction of trastuzumab into the palliative treatment of metastatic gastric cancer. Other drugs are underway to improve clinical outcomes further and to face the challenges of HER2 treatment, such as resistance mechanisms and HER2 heterogeneity. Many drugs are in the emerging pipeline targeting gastric cancer, such as zanidatamab, evorpacept, and others, which will face competition with already approved drugs.

Claudin-18.2 (CLDN18.2) directed therapies

CLDN18.2 has emerged as a promising target for treating digestive malignancies, including gastric, gastroesophageal junction, esophageal, and pancreatic cancers. This is due to its limited expression in healthy tissues and abnormal overexpression in various cancers. In March 2024, VYLOY was the first approved CLD18.2 inhibitor in Japan, and the US FDA approved in October 2024. In the emerging pipeline, AZD0901 is targeting CLDN18.2.

American Society of Clinical Oncology (ASCO) 2025

Gastric Cancer Market Outlook

The market outlook for gastric cancer treatment is promising, driven by advancements in targeted therapies and immunotherapies. Historically, platinum-based chemotherapy has been the standard of care for patients with early-stage gastric cancer, highlighting the need for more effective treatment options. The mainstay of treatment for these patients includes gastrectomy (curative surgical resection) along with chemotherapy, targeted-based therapies, and other treatment approaches.

ENHERTU, a HER2-directed antibody and topoisomerase inhibitor, has expanded treatment options for HER2-positive advanced gastric cancer, receiving FDA approval in 2021 and European Commission approval in 2022. Similarly, OPDIVO (nivolumab) has gained traction as an adjuvant treatment for esophageal and gastroesophageal junction cancers, with FDA approval in 2021 based on phase III trials. Emerging drugs like bemarituzumab, which targets FGFR2b, and zolbetuximab, a first-in-class monoclonal antibody targeting Claudin 18.2, are showing significant potential in clinical trials. Bemarituzumab has been granted breakthrough therapy designation by the FDA, while zolbetuximab has recently been approved in Japan, marking it as the first CLDN18.2-targeted therapy. These developments indicate a robust pipeline and a growing market for innovative gastric cancer treatments, with ongoing regulatory reviews and approvals expected to enhance patient outcomes globally.

Key players, such as Amgen, ALX Oncology, Jazz Pharmaceuticals, BeiGene, and Zymeworks, Enliven Therapeutics, Ambrx and NovoCodex, AstraZeneca, KLUS Pharma, Pfizer, and others, are evaluating their lead candidates in different stages of clinical development. They aim to investigate their products for the treatment of gastric cancer.

• The total market size of HER2+ gastric cancer (including GEJ) in the 7MM is approximately USD 700 million in 2024 and is projected to increase during the forecast period (2025–2034).
• Among EU4 countries, Germany accounts for the maximum market size in 2024, while the United Kingdom occupies the bottom of the ladder in 2024.
• In 2024, among the current therapies for HER2+ gastric cancer, the largest revenue was generated by Trastuzumab ± Chemotherapy, i.e., USD ~140 million in the United States.
• By 2034, among all the emerging therapies in the EU4 and the UK, the highest revenue is expected to be generated by ENHERTU.

Further details will be provided in the report….

Key Updates

• In February 2025, Signet Therapeutics announced that the FDA granted fast track designation to SIGX1094 for treating diffuse gastric cancer.
• In February 2025, AstraZeneca anticipates a data readout from the Phase Ib/II (NCT04379596, DESTINY-Gastric03) trial, focused on treating metastatic or unresectable HER2+ gastric cancer, GEJ, and GEA, in 2026.
• In February 2025, AstraZeneca expects the first patient dosing of ENHERTU (NCT06731478, DESTINY-Gastric05) for HER2+ first-line locally advanced or metastatic gastric cancer or GEJ adenocarcinoma to begin in Q1 2025, with data anticipated to be available after 2026.
• AstraZeneca anticipates data from the DESTINY-Gastric04 (NCT04704934) trial, which is focused on treating HER2+ gastric cancer or GEJ adenocarcinoma patients who have progressed on or after a trastuzumab-containing regimen and have not received any additional systemic therapy, to be available in H2 2025.
• In the January 2025 presentation, Jazz Pharmaceuticals anticipates the potential approval and launch of zanidatamab as a first-line treatment for GEA in 2026. Additionally, the company is also looking forward to expanding its market strategy for zanidatamab in 2026.
• In January 2025, ALX Oncology presented positive updated data from the ASPEN-06 Phase II clinical trial at the 2025 ASCO Gastrointestinal Cancers Symposium, demonstrating that the company's investigational CD47-blocker, evorpacept, produces a durable clinical response and exhibits a well-tolerated safety profile in patients with previously treated HER2+ advanced gastric cancer or GEJ cancer.

Gastric Cancer Drug Uptake

Zolbetuximab's uptake is expected to be strong due to its status as the first monoclonal antibody targeting Claudin 18.2 (CLDN18.2), addressing a key unmet need in CLDN18.2-positive, HER2-negative gastric and gastroesophageal junction cancers. Positive results from the Phase III SPOTLIGHT trial and recent approval by Japan’s Ministry of Health, Labour and Welfare (MHLW) enhance its credibility.

This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2020–2034, which depends on the competitive landscape, safety, and efficacy data, along with the order of entry. It is important to understand that the key players evaluating their novel therapies in the pivotal and confirmatory trials should remain vigilant when selecting appropriate comparators to stand the greatest chance of a positive opinion from regulatory bodies, leading to approval, smooth launch, and rapid uptake.

Further detailed analysis of emerging therapies drug uptake in the report…

Gastric Cancer Pipeline Development Activities

The report provides insights into different therapeutic candidates in the Phase III and Phase II stages. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities

The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for gastric cancer therapies.

KOL Views

To keep up with the real-world scenario in current and emerging market trends, we take opinions from Key Industry Leaders working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts were contacted for insights on the evolving treatment landscape, patient reliance on conventional therapies, patient therapy switching acceptability, and drug uptake, along with challenges related to accessibility, including Medical/Scientific Writers, Professors, and Others.

DelveInsight’s analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as UT Health San Antonio MD Anderson Cancer Center, etc., were contacted. Their opinion helps understand and validate current and emerging therapy treatment patterns or gastric cancer market trends.

Qualitative Analysis

We perform Qualitative and market Intelligence analysis using various approaches, such as SWOT Analysis and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of gaps in disease diagnosis, patient awareness, physician acceptability, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided.

Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.

In efficacy, the trial’s primary and secondary outcome measures are evaluated; for instance, in event-free survival, one of the most important primary outcome measures is event-free survival, progression-free survival (PFS), and overall survival.

Further, the therapies’ safety is evaluated, wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the probability of success and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.

Market Access and Reimbursement

• Germany

Scope of the Report

• The report covers a segment of key events, an executive summary, a descriptive overview of gastric cancer, explaining its causes, signs and symptoms, pathogenesis, and currently available therapies.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of the diagnosis rate, and disease progression along treatment guidelines.
• Additionally, an all-inclusive account of both the current and emerging therapies, along with the elaborative profiles of late-stage and prominent therapies, will have an impact on the current treatment landscape.
• A detailed review of the gastric cancer market, historical and forecasted market size, market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach.
• The report provides an edge while developing business strategies, by understanding trends, through SWOT analysis and expert insights/KOL views, patient journey, and treatment preferences that help in shaping and driving the 7MM gastric cancer market.

Gastric Cancer Report Insights

• Patient Population
• Therapeutic Approaches
• Gastric Cancer Pipeline Analysis
• Gastric Cancer Market Size and Trends
• Existing and future Market Opportunity

Gastric Cancer Report Key Strengths

• Ten-Years Forecast
• 7MM Coverage
• Gastric Cancer Epidemiology Segmentation
• Key Cross Competition
• Conjoint analysis
• Drugs Uptake and Key Market Forecast Assumptions

Gastric Cancer Report Assessment

• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Market Attractiveness
• Qualitative Analysis (SWOT and Conjoint Analysis)

FAQs

• What is the historical and forecasted gastric cancer patient pool/patient burden in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• Which combination of treatment approaches will have a significant impact on the gastric cancer drug treatment market size?
• How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?
• What are the current and emerging options for the treatment of gastric cancer?
• What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitations of existing therapies?
• Patient acceptability in terms of preferred treatment options as per real-world scenarios?
• What are the country-specific accessibility issues of expensive, recently approved therapies?
• How many key players are developing therapies for HER2+ gastric cancer?
• Which drug is the major contributor gastric cancer market by 2034?

Reasons to buy

• The report will help in developing business strategies by understanding the latest trends and changing treatment dynamics driving the gastric cancer market.
• Insights on patient burden/disease Incidence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• Understand the existing market opportunities in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of approved products in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.
• Detailed analysis and ranking of class-wise potential current and emerging therapies under the conjoint analysis section to provide visibility around leading classes.
• Highlights of access and reimbursement policies of approved therapies, barriers to accessibility of expensive off-label therapies, and patient assistance programs.
• To understand Key Opinion Leaders’ perspectives around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.