Exploring real-world unmet clinical needs among patients on first-line treatment with HER2-negative advanced gastric, gastroesophageal junction or esophageal adenocarcinoma in Asia, Europe and the United States
6 affiliations
- 1Royal Marsden Hospital, London and Surrey
- 2MD Anderson Center
- 3National Cancer Center Hospital East
- 4Gilead Sciences, Inc
- 5Adelphi Real World
- 6Department of Medicine II, University of Leipzig Medical Center, Cancer Center Central Germany
Abstract
Introduction: With a rapidly evolving treatment landscape for gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC), there is a need to understand how novel treatments are implemented and remaining unmet clinical needs in real-world clinical practice. This study sought to identify unmet clinical needs by describing biomarker testing, first-line (1L) treatment patterns, physician-reported real-world treatment response, physician-patient side-effect concordance and its association with HRQoL in HER2-negative GC/GEJC/EAC patients in real-world clinical practice.
Methods: Data were drawn from the Adelphi Real World GC Disease Specific Programme™ (DSP), a cross-sectional survey of physicians and their HER2-negative GC/GEJC/EAC patients, conducted in Asia, Europe and the United States (US) between October 2022−May 2024. Physicians reported patient demographics, biomarker testing, treatment patterns, physician-reported real-world treatment response, and side-effects, while patients reported side-effects and completed the EQ-VAS. Patients were grouped by region, Programmed Death Ligand-1 ( PD-L1) combined positive score (CPS), and 1L treatment received. Kappa analysis assessed physician-patient side-effect concordance and linear regressions assessed associations between side-effect concordance and EQ-VAS scores. Other analyses were descriptive.
Results: Data were drawn for 1623 patients on 1L treatment (Asia: n=492, Europe: n=977, US: n=154) and 643 (Asia: n=226, Europe: n=377, US: n=40) on second line plus (2L+) treatment. Median (IQR) age was 67.0 years (59.0, 71.0) and 70% consulted in an academic setting. PD-L1 testing rates were high (Asia: 81%, Europe: 86%, US:87%). Most patients with CPS score <5 received chemotherapy (CT) at 1L, while 57% with CPS ≥5 received CT+immune checkpoint inhibitors (ICI). Physicians reported that 47% of patients receiving 1L CT and 38% 1L CT+ICI experienced side-effects, and that 48% and 51% of those on 2L+ therapy achieved a complete real-world response. Side-effects were more commonly reported by patients than physicians, with poor−slight concordance reported for most side-effects. An association between physician-patient concordance on shortness of breath and EQ-VAS scores was observed.
Conclusions: Biomarker testing, treatment patterns, real-world treatment response, and physician-patient concordance suggest an unmet clinical need to improve biomarker-guided treatment optimization, access to treatments, timely implementation of new evidence, and physician-patient communication regarding side-effects and HRQoL.
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BibTeX
@article{starling2026exploring,
title = {{Exploring real-world unmet clinical needs among patients on first-line treatment with HER2-negative advanced gastric, gastroesophageal junction or esophageal adenocarcinoma in Asia, Europe and the United States}},
author = {Naureen Starling and Jaffer Ajani and Kohei Shitara and Jin Gu and Shivani K. Mhatre and Cosmina Hogea and Daniel O. Koralek and Chloe Hammond and Annabel Lambert and Florian Lordick},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1863920},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1863920/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Exploring real-world unmet clinical needs among patients on first-line treatment with HER2-negative advanced gastric, gastroesophageal junction or esophageal adenocarcinoma in Asia, Europe and the United States
AU - Naureen Starling
AU - Jaffer Ajani
AU - Kohei Shitara
AU - Jin Gu
AU - Shivani K. Mhatre
AU - Cosmina Hogea
AU - Daniel O. Koralek
AU - Chloe Hammond
AU - Annabel Lambert
AU - Florian Lordick
PY - 2026
DA - 2026/10/19
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1863920
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1863920/full
AB - Introduction: With a rapidly evolving treatment landscape for gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC), there is a need to understand how novel treatments are implemented and remaining unmet clinical needs in real-world clinical practice. This study sought to identify unmet clinical needs by describing biomarker testing, first-line (1L) treatment patterns, physician-reported real-world treatment response, physician-patient side-effect concordance and its association with HRQoL in HER2-negative GC/GEJC/EAC patients in real-world clinical practice. Methods: Data were drawn from the Adelphi Real World GC Disease Specific Programme™ (DSP), a cross-sectional survey of physicians and their HER2-negative GC/GEJC/EAC patients, conducted in Asia, Europe and the United States (US) between October 2022−May 2024. Physicians reported patient demographics, biomarker testing, treatment patterns, physician-reported real-world treatment response, and side-effects, while patients reported side-effects and completed the EQ-VAS. Patients were grouped by region, Programmed Death Ligand-1 ( PD-L1) combined positive score (CPS), and 1L treatment received. Kappa analysis assessed physician-patient side-effect concordance and linear regressions assessed associations between side-effect concordance and EQ-VAS scores. Other analyses were descriptive. Results: Data were drawn for 1623 patients on 1L treatment (Asia: n=492, Europe: n=977, US: n=154) and 643 (Asia: n=226, Europe: n=377, US: n=40) on second line plus (2L+) treatment. Median (IQR) age was 67.0 years (59.0, 71.0) and 70% consulted in an academic setting. PD-L1 testing rates were high (Asia: 81%, Europe: 86%, US:87%). Most patients with CPS score <5 received chemotherapy (CT) at 1L, while 57% with CPS ≥5 received CT+immune checkpoint inhibitors (ICI). Physicians reported that 47% of patients receiving 1L CT and 38% 1L CT+ICI experienced side-effects, and that 48% and 51% of those on 2L+ therapy achieved a complete real-world response. Side-effects were more commonly reported by patients than physicians, with poor−slight concordance reported for most side-effects. An association between physician-patient concordance on shortness of breath and EQ-VAS scores was observed. Conclusions: Biomarker testing, treatment patterns, real-world treatment response, and physician-patient concordance suggest an unmet clinical need to improve biomarker-guided treatment optimization, access to treatments, timely implementation of new evidence, and physician-patient communication regarding side-effects and HRQoL.
SN - 2234-943X
ER -