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Survey: Imatinib and Sunitinib Will Continue to Dominate GIST Therapy Through 2023

Report foresees no new treatments

Decision Resources Group, a health care research firm located in Burlington, Mass., finds that the treatment of gastrointestinal stromal tumors (GIST) will not change dramatically through 2023 as no new therapies are expected to launch for this indication.

The treatment of GIST largely depends on tumor size, location, and growth rate. The disease is commonly treated by surgical resection and/or by the use of targeted therapies, such as imatinib (Gleevec, Novartis), sunitinib (Sutent, Pfizer), and regorafenib (Stivarga, Bayer HealthCare).

Imatinib is currently and will remain the most commonly prescribed agent for the treatment of GIST through 2023, the report states. Sunitinib, the second-line standard of care, is approved for patients who are resistant to or intolerant of imatinib.

Regorafenib is the most recent addition to the GIST armamentarium; it is approved in the U.S. for patients with progressive GIST who have received both imatinib and sunitinib. Regorafenib is expected to become the third-line standard of care for unresectable and/or metastatic GIST by the end of the forecast period in all major markets.

The report also finds that the number of incident cases of GIST in the major markets under study will increase by approximately 1.3% annually over the 2013–2023 forecast period, thereby contributing to an increase in the size of drug-treatable populations and providing a greater number of drug-treatment opportunities.

Although new therapies for the treatment of GIST are not expected to be launched during the forecast period, surveyed experts anticipate significant advances in R&D of new therapies for use in this indication.

According to the report, the patent expiry of the patient-share leaders — imatinib and sunitinib — will mark the entry of less costly generic versions of these agents. These events are expected to have a considerable effect over the 10-year study period.

“Although the emerging agents are in early stages of development, interviewed experts state that the combination of emerging agents and current therapies may be the way forward in satisfying the unmet needs in GIST as they may prove more effective than monotherapies, particularly for later line treatment,” said analyst Kirsha Naicker, MSc, PhD.

“Interviewed experts tell us that mutational analysis is becoming increasingly important in the treatment of GIST, influencing treatment decisions based on mutational status, thereby making treatment more personalized,” she added.

Source: Decision Resources Group; August 11, 2014.

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