OBJECTIVES: Limited perioperative treatment options exist for patients with resectable GC/GEJC. This study described the current treatment landscape and overall survival (OS) for patients with Stage II-IVa GC/GEJC in the US.

METHODS: Data on adult patients diagnosed with Stage II-IVa GC/GEJC between 01-Jan-2016 and 28‑Feb-2022 were analysed from the Tempus GC/GEJC datasets.

RESULTS: 152 GC and 60 GEJC patients were included. Median (interquartile range) age of patients with GC and GEJC was 62.0 (52.0–71.0) and 68.0 (62.0–73.5) years, with 63.8% and 85.0% male patients, respectively. Most patients had adenocarcinoma (GC:112 [73.7%] and GEJC:54 [90.0%] patients) and ECOG PS ≤1 (GC:95 [62.5%] and GEJC:43 [71.7%] patients). 100 (65.8%) GC and 24 (40.0%) GEJC patients had surgery: 31 (31.0%) and 20 (83.3%) received neoadjuvant treatment, 50 (50.0%) and 7 (29.2%) received adjuvant treatment, 13 (13.0%) and 3 (12.5%) received continuous pre-/post-surgery treatment (not considered neoadjuvant or adjuvant), and 21 (21.0%) and 1 (4.2%) did not receive any perioperative treatment, respectively. Among patients receiving neoadjuvant treatment, 22 (71.0%) and 5 (16.1%) GC patients received FLOT and FOLFOX, respectively, and 16 (80.0%) and 3 (15.0%) GEJC patients received chemoradiotherapy and FLOT, respectively. Among patients receiving adjuvant treatment, 12 (24.0%), 8 (16.0%) and 8 (16.0%) GC patients received FOLFOX, FLOT and chemoradiotherapy, respectively, and 3 (42.9%) and 3 (42.9%) GEJC patients received FOLFOX and immunotherapy, respectively. Median OS (95% CI) from diagnosis for GC and GEJC patients combined who had surgery was 24.1 (20.2–32.5) months, and 15.1 (11.6–27.3) months for patients who did not have surgery.

CONCLUSIONS: Over a third of patients with Stage II-IVa GC or GEJC did not undergo surgery. Among patients who had surgery, >20% of GC patients did not receive perioperative treatment. Irrespective of surgery, median OS was ~2 years or less, indicating an unmet need in GC and GEJC management.