1 Table of Contents

1 Table of Contents 2
1.1 List of Tables 3
1.2 List of Figures 3

2 Executive Summary 4
2.1 Significant Unmet Needs in the Gastric Cancer Market 4
2.2 High Proportion of First-in-Class Innovation Offers Promise in Gastric Cancer 4
2.3 Deal Activity Varies with First-in-Class Status 4

3 The Case for Innovation 5
3.1 Growing Opportunities for Biologic Products 6
3.2 Diversification of Molecular Targets 6
3.3 Innovative First-in-Class Product Development Remains Attractive 6
3.4 Regulatory and Reimbursement Policy Shifts Favor First-in-Class Product Innovation 7
3.5 Sustained Innovation 7
3.6 GBI Research Report Guidance 8

4 Clinical and Commercial Landscape 9
4.1 Disease Overview 9
4.2 Disease Symptoms 9
4.3 Epidemiology and Etiology 9
4.4 Pathophysiology 9
4.4.1 Helicobacter Pylori 10
4.4.2 Oncogenes 10
4.4.3 Tumor Suppressor Genes 10
4.4.4 Cell Adhesion Molecules and Metastasis-Related Genes 10
4.4.5 Cell Cycle Regulators 10
4.4.6 Microsatellite and Chromosomal Instability 10
4.4.7 Growth Factor and Cytokines 11
4.5 Diagnosis and Staging 11
4.6 Classification 12
4.6.1 Intestil Subtype 12
4.6.2 Diffuse Subtype 12
4.7 Prognosis 12
4.8 Treatment Options 13
4.8.1 Surgery 13
4.8.2 First-Line Therapy 13
4.8.3 Second-Line Therapy 16
4.9 Overview of Marketed Products in Gastric Cancer 17
4.9.1 Molecule Type and Target Alysis 17
4.9.2 Innovative Products in Gastric Cancer Market 19
4.9.3 Unmet Needs 19

5 Assessment of Pipeline Product Innovation 20
5.1 Gastric Cancer Pipeline by Molecule Type, Phase and Therapeutic Target 20
5.2 Comparative Distribution of Programs between the Gastric Cancer Market and Pipeline by Therapeutic Target Family 24
5.3 First-in-Class Pipeline Programs Targeting Novel Molecular Targets 24

6 Sigling Network, Disease Causation and Innovation Alignment 31
6.1 Complexity of Sigling Networks in Oncology 31
6.2 Sigling Pathways and First-in-Class Molecular Target Integration 32
6.3 First-in-Class Matrix Assessment 32

7 First-in-Class Target Evaluation 35
7.1 Pipeline Programs Targeting HER 3 35
7.2 Pipeline Programs Targeting Ataxia Telangiectasia Mutated 37
7.3 Pipeline Programs Targeting L1 Cell Adhesion Molecule 38
7.4 Pipeline Programs Targeting Akt 1, 2 and 3 40
7.5 Pipeline Programs Targeting Fibroblast Growth Factor receptor 3 44
7.6 Pipeline Programs Targeting 3-Phosphoinositide-Dependent Protein Kise 1 46
7.7 Conclusion 47

8 Deals and Strategic Consolidation 48
8.1 Industry-Wide First-in-Class Deals 48
8.2 Licensing Deals 49
8.2.1 Licensing Deals by Molecule Type 51
8.2.2 Licensing Deals by Molecular Target 52
8.2.3 Conclusion 53
8.3 Co-development Deals 54
8.3.1 Co-development Deals by Molecule Type 57
8.3.2 Co-development Deals by Molecular Target 57
8.3.3 Conclusion 58
8.4 First-in-Class Programs Not Involved in Licensing or Co-development Deals 59

9 Appendix 62
9.1 References 62
9.2 Abbreviations 66
9.3 Research Methodology 68
9.4 Secondary Research 69
9.4.1 Marketed Product Heatmaps and Treatment Algorithm 69
9.4.2 Pipeline Alysis 69
9.4.3 First-in-Class Matrix Assessment 69
9.4.4 First-in-Class Target Profiles 70
9.4.5 Licensing and Co-Development Deals 70
9.5 Contact Us 70
9.6 Disclaimer 70