Gastric cancer is cancer that starts anywhere inside the stomach or the stomach wall. Advanced gastric cancer can be locally advanced (has spread into the tissues around the stomach) or metastatic (has spread to at least one other part of the body such as the liver). Most gastric cancer cases are diagnosed at a late stage and in people aged 75 years and over. Advanced cancers have poor prognosis and usually cannot be cured. However, they may be controlled, and symptoms can be relieved through treatment.
Trifluridine in combination with tipiracil in a single oral tablet, is in development for the treatment of metastatic gastric cancer, in patients who are refractory (resistant) to two prior standard treatments for the advanced disease. Trifluridine is incorporated into the DNA where it prevents cells from dividing and multiplying. The addition of tipiracil helps increase the level of trifluridine in the blood by slowing its breakdown. If licensed, trifluridine in combination with tipiracil will be an additional treatment option for patients with gastric cancer who have failed two prior therapies, who currently have very few treatment options available.
Selinexor is the first treatment option that targets XPO1, a protein that is responsible for exporting tumour suppressor proteins from the cell nucleus. It belongs to a new family of therapies called selective inhibition of nuclear export (SINE) compounds that blocks XPO1 leading to controlled death of myeloma cells. Currently there is no standard of care for the fifth line treatment of MM. Selinexor and low-dose dexamethasone are being developed as an oral treatment. If licensed, this combination could be an effective treatment option for a patient group with clear unmet need.