Gastrointestinal cancer

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Gastrointestinal (GI) cancers represent a significant global health burden, accounting for a substantial proportion of cancer incidence worldwide. These cancers are among the most prevalent globally and are associated with rising incidence and significant unmet needs in prevention and treatment.1,2

We are committed to advancing science across early detection, targeted therapies, immunotherapy and biomarkers – driving innovation where it’s needed most and changing the trajectory of GI cancer treatment and care.

[#Gastrointestinal]

Gastrointestinal (GI) cancers today: A complex landscape demanding new solutions

While the overall global cancer mortality rate has been slowly decreasing, the rate of GI cancer deaths is predicted to increase.1,3 Although cancer mortality has declined in some settings, gastrointestinal (GI) cancers remain among the leading causes of cancer-related death globally, emphasising the ongoing need for improved treatment strategies, particularly in earlier stages of disease.1,3

By 2040, it is estimated that there will be1:

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7.5 million

new GI cancer cases

5.6 million

deaths from GI cancers each year

Some GI cancers are linked to lifestyle factors such as diet and excessive alcohol consumption and can carry social stigma that discourages people from seeking timely care - leading to delayed diagnoses and poor health outcomes.1,2,4,5 Further challenges arise from limited screening and detection programmes, as well as the complexity of diagnostic pathways for gastric cancer.6

Through our broad GI cancer program and growing network of partnerships, we’re working to close these gaps - supporting earlier detection, more connected care and better outcomes for people affected by GI cancers with a focus on liver, biliary tract, gastric and pancreatic cancers.

About liver cancer

The liver is a vital organ that filters blood, supports the immune system, and even regenerates itself after damage.7-9 Its immune cells are always on alert to defend the body against blood-borne pathogens and aid in wound healing.10-13 However long-term liver damage – such as excessive and prolonged alcohol intake – can cause chronic inflammation, weakening the immune response.14,15 This persistent immune suppression enables abnormal cells to grow unchecked, which can lead to cancer.15,16

Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, representing around 75 percent of all cases.17 Most HCC cases develop as a result of cirrhosis (a condition characterised by scarring of the liver), often caused by chronic hepatitis B or C infection.18

However, screening for HCC remains a challenge. Many signs and symptoms appear only once the disease has advanced, limiting the potential for curative treatment. Early detection is the goal, but more innovation is needed to bring it within reach for more patients.17,18

About biliary tract cancer (BTC)

The biliary tract is a system of organs and ducts, including the liver, gallbladder, and bile ducts, that work together to produce, store, and transport bile, a fluid essential for digesting fats and eliminating waste.19 When this system is affected by long-term inflammation, infections such as liver fluke infection or structural abnormalities, it can lead to uncontrolled cell growth and, in some cases, cancer.20

BTC is a group of rare and aggressive GI cancers that form in the cells of the bile ducts (cholangiocarcinoma), gallbladder or ampulla of Vater (where the bile duct and pancreatic duct connect to the small intestine).21-23

Survival rates remain low27,28

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5–15%

survive 5 years after diagnosis28

Survival drops to
< 5%

For metastatic cases27

The global burden of BTC24-26

~50,000

people are diagnosed each year in the US, Europe, and Japan

~210,000

cases diagnosed worldwide annually

Early-stage BTC affecting the bile ducts and gallbladder often presents without clear symptoms and most new cases of BTC are therefore diagnosed at an advanced stage, when treatment options are limited and the prognosis is poor. 28,29

About gastric cancer

Gastric cancer (also known as stomach cancer) and gastroesophageal junction (GEJ) cancer develop when healthy cells in the stomach or the area where the oesophagus connects to the stomach begin to grow uncontrollably, forming a tumour.

Gastric cancer is a significant global health burden, ranking among the leading causes of cancer-related mortality worldwide.30

The global burden of gastric cancer30,31

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5th most common

cancer worldwide

5th leading

cause of cancer-related deaths

Incidence increasing

in people under 50 years old

In 2022 alone…

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~1 million

new cases diagnosed

~660,000 deaths

reported globally

Disease recurrence is common, especially in patients with resectable gastric cancer despite undergoing surgery with curative intent and treatment with neoadjuvant (before surgery) and adjuvant (after surgery) chemotherapy.32 Approximately one in four patients with gastric cancer who undergo surgery develop recurrent disease within one year reflecting high unmet medical need.32,33 

About pancreatic cancer

The pancreas, a gland in the abdomen near the liver, helps control blood sugar by releasing hormones into the bloodstream and supports digestion by sending enzymes into the small intestine to break down food and absorb nutrients.34

Pancreatic cancer is the 6th leading cause of cancer death globally, largely due to the complexities in its biology and management.35-37 Pancreatic cancer is classified into two main tumour types depending on whether the tumour forms in the exocrine cells, or in the endocrine cells.34

Pancreatic ductal adenocarcinoma (PDAC)34,38

  • The most common type of pancreatic cancer, accounting for about 95 percent of cases
  • One of the most aggressive solid tumours, with a one-year survival rate of only around 20 percent across all stages

Pancreatic neuroendocrine tumours (PNETs)39-41

  • Rare, making up less than 10 percent of pancreatic cancers
  • Less aggressive tumour and may offer a better prognosis than PDAC
  • Many patients with PNETs still face delays in diagnosis and treatment due to the subtle nature of symptoms

Pancreatic cancer remains one of the most aggressive and lethal cancers worldwide.35-37 It is often diagnosed at an advanced stage, when treatment options are limited and outcomes are poor. 42,43 Around 50 percent of patients are diagnosed after the disease has already spread to other parts of the body.44,45

At all stages, survival remains low.38 Only 9 percent of patients with metastatic pancreatic cancer live beyond five years, and the average survival is less than one year.36,46 Causes are not well understood, though risk factors such as type 2 diabetes, obesity, smoking and chronic pancreatitis have been identified.47 Diagnosis is especially challenging because symptoms are often non-specific, leading some to call pancreatic cancer a ‘silent killer.’48,49

[#OurRD]

Our R&D approach in GI cancer

We are building on our leadership in GI cancer care to develop a new era of treatment approaches, harnessing our breadth of scientific platforms to treat these complex diseases from multiple angles. This includes both direct mechanisms to kill cancer cells and through the activation of the immune system. Our goal is to redefine GI cancer care by advancing medicines that not only prolong life but offer the potential for more durable responses.

A key area of focus is to overcome the immunosuppressive environment that allows GI tumours to evade detection and continue growing. To address this, we are advancing a new generation of immuno-oncology (IO) therapies that aim to restore immune cell function, counteract tumour defences and reactivate the body’s natural ability to fight cancer. These investigational therapies are being evaluated alone and in novel combination regimens to enhance clinical impact.

We are also pioneering personalised approaches to care by investing in novel biomarker-driven research to help ensure patients receive the right treatments at the right time. As emerging new biomarkers add complexity to GI cancer care, the need for standardised biomarker testing and adherence to clinical guidelines becomes more critical.50 We are working to personalise care and expand options beyond traditional chemotherapy, supporting the integration of advanced technologies such as artificial intelligence, genomic profiling and early detection tools, to improve outcomes in cancers that are often diagnosed too late.

To address the varied biology of GI cancers, we are also investigating next-generation treatment modalities. This includes antibody-drug conjugates (ADCs) targeting novel proteins implicated in GI cancers; bispecific immunotherapies that bind to two different targets to help induce a more precise and potent immune response, and T-cell engagers (TCEs) and cell therapies designed to harness and amplify the immune system’s ability to recognise and eradicate tumour cells.

Our robust and diverse GI cancer pipeline, among the largest in the industry, spans multiple tumour types, stages of disease, and mechanisms of action. We are exploring novel treatment combinations to drive more durable responses to overcome treatment resistance, as well as new GI approaches, particularly in earlier, curative-intent stages of disease where novel therapies may offer the greatest opportunity to impact patients’ lives and redefine care. From reversing immunosuppression to unlocking the power of precision medicine, we are pushing the boundaries of science to reshape the future of GI cancer care.

Discover more about our scientific platforms
[#Partneringtoadvance]

Partnering to advance care in gastrointestinal cancers

Transforming outcomes that improve access and healthcare delivery and build more resilient health care systems will require more than scientific breakthroughs. We are actively collaborating with partners across the healthcare ecosystem, including patients, patient advocacy groups, healthcare professionals and their societies, as well as payers and policymakers. Together, we aim to address barriers to early diagnosis, drive personalised care that follows established treatment guidelines and accelerate access to innovation including digital health tools.

Transforming the future of liver cancer care

In 2024, we partnered with a multidisciplinary team of healthcare professionals and patient organisations to develop the HCC Patient Charter, a strategic blueprint designed to help transform care for people with HCC. The Charter sets out seven core principles of quality care that every person should expect, with the goal of improving outcomes and survival by driving progress in policymaking, early diagnosis, equitable access to stigma-free treatment, and comprehensive, personalised care.

The Charter champions a multidisciplinary approach, bringing together hepatologists, oncologists and radiologists to create tailored treatment plans, and promotes shared decision-making, empowering patients to be active participants in their care journey. It also highlights the critical roles of policymaking and greater research investment in transforming HCC care. By urging policymakers to prioritise liver cancer in national strategies, shifting the paradigm towards earlier detection and more effective interventions, and advocating for the elimination of viral hepatitis, the Charter seeks to drive systemic change and improve outcomes and quality of life for patients with HCC.

Find out more about the HCC Patient Charter and the roadmap for change

Other Oncology areas of focus

Lung cancer
Breast cancer
Gynaecological cancer

References

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Veeva ID: Z4-79199
Date of preparation: March 2026