Therapies and Diagnostics for Ovarian Cancer

  • June 2013
  • -
  • BCC Research
  • -
  • 225 pages

STUDY GOALS AND OBJECTIVES

This report, Therapies and Diagnostics for Ovarian Cancer, provides an overview of the current and potential global market for ovarian cancer and treatments and testing technologies. The report provides comprehensive information on ovarian cancer and highlights treatment guidelines. It identifies and analyses the key trends driving the global ovarian cancer therapeutics market. The key objective is to present a comprehensive analysis of the current ovarian cancer technology and utilization of the various therapeutic and diagnostic modalities. The report’s focus is on treatment strategies and drugs, chemotherapy and other treatment modalities and testing and screening methods in regard to ovarian disorders. Important trends in the field, research, new developments and sales forecasts by treatment and screening categories from 2013 through 2018 are provided in this report. Issues and trends addressed in this report are based on information from industry sources, regulatory and healthcare policies, demographics and other factors that directly affect the ovarian cancer market.

It also focuses on the treatment usage patterns in the global ovarian cancer therapeutics market, competitive landscape and the emerging players, pipeline products. The report also details opportunity for future players.

REASONS FOR DOING THIS STUDY

This study was conducted to provide detailed information regarding screening, testing and treatment options for ovarian disorders and cancer. There is an increasing need for new and innovative technologies. This industry is experiencing tremendous growth. Many diseases discussed in this report are global issues, and a need exists for newer diagnostic and treatment strategies. This study looks at most types of diagnostic and treatment strategies for the clinical management of ovarian disorders and related cancers.

This BCC market research report will increase the awareness of current and emerging drugs and technologies for ovarian cancers, including therapeutics, chemotherapy and surgical therapy.

INTENDED AUDIENCE

This report is an exhaustive study on the global ovarian cancer market, with important statistics and analysis on existing drugs and diagnostic technologies, latest trends, market structure, market size, key drug segments and trends in technology. This study contributes to the areas of market growth in ovarian cancer prevention and treatment strategies from the point of view of manufacturers, product suppliers, healthcare providers and consumers of hematological disorder and cancer products and services. This study will be of interest largely to the pharmaceutical and biotechnology industries, but will also benefit clinics, hospitals and research institutes. This report may also prove crucial for investment firms in the concerned sector. The report shows tests currently being used for ovarian disorders and cancer diagnosis and prognosis, new developments, spending trends and revenue prospects for these technologies. The report provides market data for 2012 to 2018 and also covers commercial prospects, ovarian cancer diagnostic assays, current tests in use and the future of all these areas of interest.

SCOPE OF THE STUDY

The scope of this study is testing and screening technology and also therapeutics markets for ovarian cancers. The report also includes the regulatory environment, current technologies, new technologies, ovarian cancer incidence, market projections and market share along with latest trends and new developments.

METHODOLOGY

Both primary and secondary research methodologies were used in preparing this report. Secondary sources include books, newspapers, trade journals, white papers, industry portals, government agencies, trade associations, industry news and developments, and paid and free databases. The base year of the report is 2012, with forecast data provided through 2018. Historical, base year and forecast data are provided for each market segment covered in this report. The report provides a comprehensive review of prostate cancer, incidence and development of the disease, drugs currently being used and diagnostic technologies. The report also reviews technological developments, product innovations/introductions and recent strategic industry activity of major players across various product categories. Growth rates, global incidence and projections are determined through a compilation of data including past trends, future trends, demographics, incidence, mortality, products in R&D and current product growth. Forecasts and projections were based on estimates such as the current trends, potential users, mergers and acquisitions, and market trends.

A comprehensive and exhaustive search of the literature on ovarian disorders and cancers, marketed products, global incidence and drug developments was conducted. These secondary sources included scientific journals and articles, textbooks, press releases, marketing literature, other product/promotional literature, annual reports, security analyst reports and other publications. A patent search and analysis were also conducted. Some informal interviews were also conducted with experts and personnel in this area at biotech and pharmaceutical companies. Other resources included academics, technology and consulting companies.

INFORMATION SOURCES

Many companies within the industry were surveyed to obtain data for this study. Included were manufacturers and end users of products, such as the pharmaceutical and biotechnical industries and research institutes. Data were gathered from various industry sources. BCC spoke with officials within the industry and consulted newsletters, company literature, product literature and a host of technical articles, journals, indexes and abstracts. Exhaustive investigations of databases by key terminology were completed. In addition, data were compiled from current financial, trade and government sources.

ABOUT THE AUTHOR

Usha Nagavarapu is an experienced pharmaceutical professional with scientific and business development experience. She has managed preclinical discovery programs from target identification including IND enabling studies and assisted out-licensing and portfolio development activities. Her strong focus areas include oncology, dermatology and cardiovascular diseases. She has extensive experience working with early startups to fulfill operational obligations while minimizing overall operational cost and burden.

REPORT HIGHLIGHTS

This report provides:
• An overview of the global market for diagnostics and therapies for ovarian cancer, the fifth most common cancer in American women and the fourth most common cause of female cancer deaths.
• Analyses of global market trends, with data from 2012, estimates for 2013, and projections of compound annual growth rates (CAGRs) through 2018.
• A breakdown of the markets by diagnostics and test, surgery, radiation therapy, and drug therapy.
• Discussion of ovarian cancer biology.
• Delineation of drugs approved to treat the disease, including chemotherapeutic and immunotherapeutic.
• Evaluation of the patent landscape.
• Comprehensive profiles of key companies.

Table Of Contents

TABLE OF CONTENTS

CHAPTER 1 INTRODUCTION 2

STUDY GOALS AND OBJECTIVES 2
REASONS FOR DOING THIS STUDY 2
INTENDED AUDIENCE 2
SCOPE OF THE STUDY 3
METHODOLOGY 3
INFORMATION SOURCES 3
ABOUT THE AUTHOR 4
RELATED BCC REPORTS 4
BCC ON-LINE SERVICES 4
DISCLAIMER 4

CHAPTER 2 SUMMARY 6

SUMMARY TABLE OVARIAN CANCER DRUGS AND DIAGNOSTICS-GLOBAL MARKETS,
THROUGH 2018 ($ MILLIONS) 7
SUMMARY FIGURE OVARIAN CANCER DRUGS AND DIAGNOSTICS-GLOBAL MARKETS,
2012-2018 ($ MILLIONS) 8

CHAPTER 3 OVERVIEW 10

OVARIAN CANCERS 10
TABLE 1 OVARIAN CANCER FACTS 10
TABLE 2 TYPES OF OVARIAN CANCERS 11
EPITHELIAL TUMORS 11
GERM CELL TUMORS 11
STROMAL TUMORS 11
METASTASIS 11
TABLE 3 OVARIAN TUMORS METASTASIS 12
OVARIAN DISORDERS 12
RISK FACTORS 12
TABLE 4 MAIN RISK FACTORS FOR OVARIAN CANCER 12
TABLE 5 HIGH-RISK FACTORS 13
PREVENTION 14
TABLE 6 PREVENTIVE FACTORS 14
PREVENTIVE STRATEGIES FOR HIGH-RISK WOMEN 15
SYMPTOMS 15
TABLE 7 OVARIAN CANCER SYMPTOMS 16
SIGNS OF CANCER 16
DIAGNOSIS AND SYMPTOM PROGRESSION 17
Early Detection 17
DIAGNOSIS 17
TUMOR MARKERS 18
VITAMIN D AND OVARIAN CANCER 18
PROGNOSIS 18
PROGNOSIS BY STAGE 19
TREATMENT 19
CHEMOTHERAPY 19
TARGETED THERAPY 19
IMMUNOTHERAPY 20
RESEARCH AND NEW DEVELOPMENTS 20
CONCLUSIONS 21

CHAPTER 4 OVARIAN CANCER: BIOLOGY 23

OVERVIEW 23
REPRODUCTIVE BIOLOGY 23
TABLE 8 HOW OVARIAN CANCER CAN PROGRESS 23
TABLE 9 COMMON HISTOLOGICAL SUBTYPES OF OVARIAN CANCERS 24
TABLE 10 OVARIAN CANCER ORIGINS 25
BORDERLINE TUMORS OF THE OVARY 26
BIOMARKERS 26
MOLECULAR ANALYSIS IN OVARIAN CANCER 27
TABLE 11 MUTATED GENES IN HIGH-GRADE SEROUS OVARIAN CANCER 27
Mutations and Different Subtypes of Ovarian Cancer 28
Potential Biomarkers and Mutations for Ovarian Cancer 28
Biomarkers and Future 29
Ovarian Cancer Biomarkers: Potential Use 29
Combining CA-125 with Other Biomarkers 30
Prognostic Biomarkers 30
TABLE 12 GLOBAL PROGNOSTIC OVARIAN CANCER BIOMARKERS 30
Novel Biomarkers 31
TABLE 13 ACOG GUIDELINES 2002 32
UPDATED ACOG GUIDELINES 33
CA-125: A QUESTION OF USE 33
DIAGNOSTIC TESTS BASED ON BIOMARKERS 33
MODIFIED ACOG REFERRAL GUIDELINES 34
A PROMISING CANDIDATE 35
HE4 AND THE ALGORITHM FOR RISK OF OVARIAN MALIGNANCY 35
OVA1 VERSUS ROMA 36
OVARIAN CANCER AND STEM CELLS 36
TABLE 14 GENES IN TYPE I EPITHELIAL OVARIAN CANCER CELLS 37
CONCLUSIONS 37

CHAPTER 5 OVARIAN CANCER DIAGNOSIS 40

CURRENT PRACTICES 40
PREVENTION 40
SYMPTOMS AND DIAGNOSIS 41
TABLE 15 OVARIAN CANCER SYMPTOMS 41
DIAGNOSIS 41
TUMOR MARKERS 42
CA-125 42
INITIAL SURGERY 42
EXPLORATORY LAPAROTOMY 43
PROGNOSIS 43
COMPLETE RESPONSE 43
RECURRENCE 44
MINIMALLY-INVASIVE PROCEDURE 44
ROUTINE OVARIAN CANCER SCREENING 44
STAGING 45
TABLE 16 STAGES OF OVARIAN CANCER 45
TABLE 17 STAGING OF OVARIAN CANCER 46
OVARIAN CANCER GRADING 46
OVARIAN CANCER DIAGNOSIS 47
PHYSICAL EXAM 47
PELVIC EXAM 47
TABLE 18 DIAGNOSTIC TESTS FOR OVARIAN CANCER 47
BLOOD TESTS 47
ULTRASOUND 47
BIOPSY 48
IMAGING STUDIES 48
ULTRASOUND 48
COMPUTED TOMOGRAPHY 49
BARIUM ENEMA X-RAY 49
MAGNETIC RESONANCE IMAGING 49
CHEST X-RAY 49
POSITRON EMISSION TOMOGRAPHY (PET SCAN) 50
OTHER TESTS 50
LAPAROSCOPY 50
COLONOSCOPY 50
BIOPSY 50
BIOMARKERS AND TESTS 51
RISK OF OVARIAN MALIGNANCY ALGORITHM 51
BLOOD TESTS 51
CA-125 BLOOD TEST 52
CA-125 Test to Monitor the Status of Ovarian Cancer 54
OTHER BIOMARKER-BASED BLOOD SCREENING TESTS FOR OVARIAN CANCER 54
TABLE 19 TUMOR BIOMARKER-BASED TESTS FOR OVARIAN CANCER DIAGNOSIS 54
HE4 BLOOD TEST 54
THE RISK OF OVARIAN MALIGNANCY ALGORITHM (ROMA) TEST 55
TABLE 20 TEST FEATURES OF ROMA 58
OVA1 TEST 58
OVADX 59
TABLE 21 OVADX FEATURES 59
GENETIC TESTING 60
NOVEL TEST PREDICTED PRESENCE OF BRCA MUTATIONS 60
SECOND TEST 61
Decision Tool for Women with BRCA Mutations 61
CURRENT SCREENING METHODS 62
NEED FOR A SCREENING STRATEGY 63
TO SCREEN OR NOT TO SCREEN 64
NEW DIAGNOSTIC TESTS 65

CHAPTER 6 TREATMENT STRATEGIES FOR OVARIAN CANCER 67

CURRENT TREATMENT PRACTICES 67
MAJOR MARKETED PRODUCTS 68
TABLE 22 DRUGS FOR OVARIAN CANCER 68
TABLE 23 OTHER MAJOR THERAPEUTIC AGENTS 69
SURGERY 69
TABLE 24 CURRENT TREATMENT STRATEGY: OVARIAN CANCER 70
CHEMOTHERAPY 70
Intraperitoneal Chemotherapy 72
TABLE 25 CHEMOTHERAPEUTIC DRUGS FOR OVARIAN CANCER 72
IV Chemotherapy 72
TABLE 26 CHEMOTHERAPY ADMINISTRATION 73
Side Effects 73
TARGETED THERAPY 73
IMMUNOTHERAPY 74
STAGING 74
TREATMENT OF OVARIAN EPITHELIAL CANCER 75
Stage I 75
TABLE 27 TREATMENT OPTIONS BY STAGE 75
Stage II 75
Stage III 75
Stage IV 76
RADIATION THERAPY 76
PALLIATIVE/SUPPORTIVE CARE 76
RECURRENT OVARIAN CANCER 76
METASTATIC OVARIAN CANCER 77
OVARIAN CANCER DRUGS PIPELINE 77
TABLE 28 PIPELINE DRUG CLASSES 77
TABLE 29 OVARIAN CANCER DRUGS: DELIVERY TECHNOLOGIES 78
SURVEILLANCE AFTER TREATMENT 78
TABLE 30 OPTIMAL SURVEILLANCE STRATEGY 78
RECURRENT OVARIAN EPITHELIAL CANCER 78
SECOND-LOOK SURGERY 79
TREATMENT OF RECURRENT CANCER 79
TABLE 31 TREATMENT PLAN FOR RECURRENT CANCER 80
MULTIDRUG RESISTANCE 80
TABLE 32 PLATINUM RESISTANCE 81
TABLE 33 REASONS FOR THE ONSET OF MDR 81
TREATMENT OF SENSITIVE CANCER 82
TREATMENT OF RESISTANT CANCER 82
SECONDARY-CHEMOTHERAPY DRUGS 83
TOPOTECAN 83
SINGLE-AGENT ETOPOSIDE 84
DOCETAXEL 84
GEMCITABINE 85
OXALIPLATIN 85
5-FU AND LEUCOVORIN 86
LIPOSOMAL DOXORUBICIN 87
HIGH-DOSE CHEMOTHERAPY 87
DRUGS APPROVED FOR OVARIAN CANCER 87
TABLE 34 DRUGS APPROVED FOR OVARIAN CANCER 88
PROMISING NEW THERAPIES 88
AVASTIN 88
TABLE 35 NEW OVARIAN CANCER DRUGS 89
DRUG THERAPIES IN CLINICAL TRIALS 89
TABLE 36 OVARIAN CANCER DRUGS IN CLINICAL TRIALS 90
BEVACIZUMAB AND RECURRENT OVARIAN CANCER 90
Combining Chemotherapy with Bevacizumab Improves Outcomes for
Ovarian Cancer Patients 91
PARP INHIBITORS 92
FUTURE TACTICS: THE ROLE OF BIOMARKERS 92
MOLECULAR THERAPEUTICS PROGRAM 92
BRCA1/2 ONCOGENES 93
VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF) 93
The EGFR/ErbB Family of Receptor Tyrosine Kinases 94
MUCIN 16 (MUC16) 94
LEWIS X MUCIN DETERMINANT (OVX1) 95
IL-6R-JAK-STAT3 AXIS AND NUCLEAR FACTOR KAPPA-B (NF-KB) 95
PI3K/AKT/MTOR CELL-SIGNALING PATHWAY 96
ATP-BINDING CASSETTE (ABC) DRUG TRANSPORTERS 97
TABLE 37 OVARIAN CANCER: BIOMARKERS AS DRUG CANDIDATES 97
OUTLOOK 99

CHAPTER 7 OVARIAN CANCER INCIDENCE 102

CANCER AND THE GLOBAL IMPACT 102
TABLE 38 GLOBAL CANCER INCIDENCE 103
TABLE 39 GLOBAL CANCER INCIDENCE ESTIMATES, 2008 AND 2030 (MILLIONS) 103
FIGURE 1 GLOBAL CANCER INCIDENCE ESTIMATES, 2008 AND 2030 (MILLIONS) 104
TABLE 40 CANCER KEY FACTS 106
THE FUTURE OF CANCER 106
TABLE 41 INCREASE IN CANCER BURDEN: FACTORS 107
OVARIAN CANCER INCIDENCE 108
TABLE 42 OVARIAN CANCER INCIDENCE BY REGION, 2008 109
FIGURE 2 OVARIAN CANCER INCIDENCE BY REGION, 2008 109
TABLE 43 OVARIAN CANCER INCIDENCE GLOBAL, 2008 109
TABLE 44 ESTIMATED GLOBAL OVARIAN CANCER INCIDENCE, 2010-2018 110
FIGURE 3 ESTIMATED GLOBAL OVARIAN CANCER INCIDENCE, 2010-2018 110
TABLE 45 OVARIAN CANCER INCIDENCE BY LOCATION, 2008 (NUMBER OF CASES) 111
FIGURE 4 OVARIAN CANCER INCIDENCE BY LOCATION, 2008 (NUMBER OF CASES) 111
NORTH AMERICA 112
TABLE 46 ESTIMATED OVARIAN CANCER INCIDENCE IN NORTH AMERICA,
2010-2018 113
FIGURE 5 ESTIMATED OVARIAN CANCER INCIDENCE IN NORTH AMERICA,
2010-2018 113
OVARIAN CANCER INCIDENCE IN UNITED STATES 113
TABLE 47 OVARIAN CANCER - U.S. INCIDENCE, 2012 114
TABLE 48 NEW CASES AND DEATHS FROM OVARIAN CANCER IN THE U. S., 2013 114
FIGURE 6 NEW CASES AND DEATHS FROM OVARIAN CANCER IN THE U.S., 2013 115
TABLE 49 ESTIMATED OVARIAN CANCER INCIDENCE IN THE U.S., 2012-2018 115
FIGURE 7 ESTIMATED OVARIAN CANCER INCIDENCE IN THE U.S. 2012-2018 115
TABLE 50 OVARIAN CANCER: INCIDENCE AND MORTALITY IN UNITED STATES,
2009-2013 116
FIGURE 8 OVARIAN CANCER: INCIDENCE AND MORTALITY IN U.S., 2009-2013 116
TABLE 51 OVARIAN CANCER SURVIVAL RATES COMPARED TO OTHER CANCERS 117
Survival and Stage 118
TABLE 52 STAGE DISTRIBUTION AND FIVE-YEAR RELATIVE SURVIVAL BY STAGE AT
DIAGNOSIS, 2002-2008 (%) 118
EUROPE AND OVARIAN CANCER 118
TABLE 53 OVARIAN CANCER - EUROPEAN AGE-STANDARDIZED INCIDENCE RATES
IN EU-27 COUNTRIES, 2008 ESTIMATES 119
FIGURE 9 OVARIAN CANCER EUROPEAN AGE-STANDARDIZED INCIDENCE IN EU-27
COUNTRIES, 2008 ESTIMATES 119
TABLE 54 ESTIMATED OVARIAN CANCER INCIDENCE IN EUROPE, 2012-2018 121
FIGURE 10 ESTIMATED OVARIAN CANCER: INCIDENCE IN EUROPE 2012-2018 121
TABLE 55 ESTIMATED INCIDENCE, MORTALITY AND PREVALENCE IN EUROPEAN
UNION, 2008 122
OVARIAN CANCER IN UK 123
TABLE 56 HOW MANY WOMEN DIE FROM OVARIAN CANCER? 123
TABLE 57 OVARIAN CANCER - NUMBER OF NEW CASES PER 100,000 POPULATION
IN THE U.K., 2008 124
TABLE 58 GYNECOLOGICAL CANCERS - NUMBER OF NEW CASES PER 100,000
POPULATION IN THE U.K., 2008 124
FIGURE 11 GYNECOLOGICAL CANCERS - NUMBERS OF NEW CASES PER 100,000
POPULATION IN THE U.K., 2008 124
Trends 125
TABLE 59 OVARIAN CANCER STATISTICS IN THE U.K., 2010 125
FIGURE 12 OVARIAN CANCER STATISTICS IN THE U.K., 2010 126
THE MIDDLE EAST AND OVARIAN CANCER 126
OVARIAN CANCER AND CHINA 126
OVARIAN CANCER AND AUSTRALIA 126
OVARIAN CANCER AND INDIA 127
TYPES OF OVARIAN CANCERS AND INCIDENCE 128
PRIMARY PERITONEAL AND PRIMARY FALLOPIAN TUBE CANCERS 129
OVARIAN EPITHELIAL CANCER 129
TABLE 60 PROGNOSIS FOR OVARIAN CANCER 130
OVARIAN GERM CELL TUMORS 130
DYSGERMINOMAS 130
OVARIAN TUMORS OF LOW MALIGNANT POTENTIAL 130
SUMMARY 131

CHAPTER 8 MARKET 133

GLOBAL IVD MARKET 133
OVARIAN CANCER: DIAGNOSTIC TESTS 134
TABLE 61 GLOBAL OVARIAN CANCER DIAGNOSTIC TESTS AND MARKET SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 134
FIGURE 13 OVARIAN CANCER DIAGNOSTIC TESTS AND MARKET SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 134
GENETIC TESTING 135
SURGICAL BIOPSY 135
OVARIAN CANCER: CURRENT SCREENING PRACTICES 135
TABLE 62 OVARIAN ABNORMALITIES 135
THE FUTURE OF OVARIAN CANCER SCREENING 136
CURRENT BIOMARKER-BASED TESTS 136
TRANSVAGINAL SONOGRAPHY 137
Drawbacks 137
TABLE 63 GLOBAL MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN
CANCER, THROUGH 2018 ($ MILLIONS) 138
FIGURE 14 GLOBAL MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN
CANCER, 2012-2018 ($ MILLIONS) 138
TABLE 64 U.S. MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN CANCER,
THROUGH 2018 ($ MILLIONS) 139
FIGURE 15 U.S. MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN CANCER,
2012-2018 ($ MILLIONS) 139
SERUM CA-125 IN COMBINATION WITH TRANSVAGINAL ULTRASOUND 139
PROTEOMICS 140
IMAGING TECHNIQUES 140
TABLE 65 IMAGING TESTS 140
BLOOD TESTS AND MARKET 140
TABLE 66 OVARIAN CANCER - RISK TYPES 141
TABLE 67 OVARIAN CANCER - WOMEN WITH INCREASED RISK 141
TABLE 68 OVARIAN CANCER: INHERITED RISK DUE TO KNOWN GENETIC
MUTATIONS 141
OVARIAN CANCER TESTS AND MARKET DYNAMICS 142
TABLE 69 GLOBAL MARKET FOR LAB TESTS FOR OVARIAN CANCER, THROUGH
2018 ($ MILLIONS) 142
FIGURE 16 GLOBAL MARKET FOR LAB TESTS FOR OVARIAN CANCER, 2012-2018 ($
MILLIONS) 142
TABLE 70 U.S. MARKET FOR LAB TESTS FOR OVARIAN CANCER, THROUGH 2018 ($
MILLIONS) 143
FIGURE 17 U.S. MARKET FOR LAB TESTS FOR OVARIAN CANCER, 2012-2018 ($
MILLIONS) 143
CA-125 TEST MARKET 144
TABLE 71 ELEVATED CA-125 LEVEL 145
TABLE 72 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125, THROUGH
2018 ($ MILLIONS) 146
FIGURE 18 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125,
2012-2018 ($ MILLIONS) 146
TABLE 73 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125, THROUGH
2018 ($ MILLIONS) 147
FIGURE 19 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125, 2012-2018
($ MILLIONS) 147
HE4 TEST MARKET 147
TABLE 74 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
THROUGH 2018 ($ MILLIONS) 148
FIGURE 20 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
2012-2018 ($ MILLIONS) 148
TABLE 75 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
THROUGH 2018 ($ MILLIONS) 149
FIGURE 21 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
2012-2018 ($ MILLIONS) 149
WHY HE4 TEST AND CA-125 COMBINED? 149
TABLE 76 WHY HE4 AND CA-125 COMBINED? 150
TABLE 77 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA TEST,
THROUGH 2018 ($ MILLIONS) 150
FIGURE 22 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA TEST,
2012-2018 ($ MILLIONS) 151
TABLE 78 UNITED STATES OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA
TEST, THROUGH 2018 ($ MILLIONS) 151
FIGURE 23 UNITED STATES OVARIAN CANCER DIAGNOSTIC MARKET FOR THE
ROMA TEST, 2012-2018 ($ MILLIONS) 151
OVA1 BLOOD TEST AND MARKET 153
TABLE 79 GLOBAL OVA1 MARKET, THROUGH 2018 ($ MILLIONS) 153
FIGURE 24 GLOBAL OVA1 MARKET, 2011-2018 ($ MILLIONS) 154
Why OVA1? 155
OvaSure 155
OvaCheck 155
Onko-Sure 156
New Test 156
RECOMMENDATIONS FOR OVARIAN CANCER SCREENING 157
MOLECULAR DIAGNOSTICS MARKET 158
TABLE 80 THE GLOBAL MOLECULAR DIAGNOSTICS MARKET, THROUGH 2018 ($
MILLIONS) 158
FIGURE 25 THE GLOBAL MOLECULAR DIAGNOSTICS MARKET, 2012-2018 ($
MILLIONS) 158
ARRAYIT'S EARLY OVARIAN CANCER DIAGNOSTIC 159
TABLE 81 GLOBAL MARKET FOR OVADX, THROUGH 2018 ($ MILLIONS) 160
FIGURE 26 GLOBAL MARKET FOR OVADX, 2012-2018 ($ MILLIONS) 160
TABLE 82 U.S. MARKET FOR OVADX, THROUGH 2018 ($ MILLIONS) 160
FIGURE 27 U.S. MARKET FOR OVADX - SALES AND FORECAST 2012-2018 ($
MILLIONS) 160
PAP TESTS AND OVARIAN CANCERS 161
SURGERY MARKET 161
TABLE 83 GLOBAL OVARIAN CANCER SURGERY MARKET, THROUGH 2018 ($
MILLIONS) 162
FIGURE 28 GLOBAL OVARIAN CANCER SURGERY MARKET, 2010-2018 ($ MILLIONS) 163
TABLE 84 U.S. OVARIAN CANCER SURGERY MARKET, THROUGH 2018 ($ MILLIONS) 163
FIGURE 29 U.S. OVARIAN CANCER SURGERY MARKET, 2012-2018 ($ MILLIONS) 163
COMPUTED TOMOGRAPHY 164
TABLE 85 GLOBAL COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN
CANCER, THROUGH 2018 ($ MILLIONS) 164
FIGURE 30 GLOBAL COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN
CANCER, 2012-2018 ($ MILLIONS) 164
TABLE 86 U.S. COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN CANCER,
THROUGH 2018 ($ MILLIONS) 165
FIGURE 31 U.S. COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN
CANCER, 2012-2018 ($ MILLIONS) 165
MOLECULAR DIAGNOSTICS 166
CONCLUSIONS 166

CHAPTER 9 GLOBAL OVARIAN CANCER TREATMENT MARKET 169

OVARIAN CANCER: CURRENT SCENARIO 169
TABLE 87 KEY HIGHLIGHTS OF THE THERAPEUTIC MARKET 169
GLOBAL SPENDING ON MEDICINES 169
GLOBAL TREATMENTS AND FUTURE TRENDS 170
MARKET DYNAMICS 170
TABLE 88 NEW LAUNCHES IN 2012 170
CANCER TREATMENT MARKET 171
CANCER THERAPY: GOOD AND BAD 172
TABLE 89 MAJOR PLAYERS 172
CYTOTOXIC THERAPIES MARKET 173
TABLE 90 CYTOTOXIC THERAPIES MARKET INDICATIONS 173
TABLE 91 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 173
FIGURE 32 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 174
TABLE 92 U.S. CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 174
FIGURE 33 U.S. CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 174
TABLE 93 EUROPEAN CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 175
FIGURE 34 EUROPEAN CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 176
TABLE 94 JAPANESE CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 176
FIGURE 35 JAPANESE CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 177
GLOBAL OVARIAN CHEMOTHERAPY CANCER MARKET 177
TABLE 95 GLOBAL OVARIAN CANCER CHEMOTHERAPY MARKET, THROUGH 2018 ($
MILLIONS) 177
FIGURE 36 GLOBAL OVARIAN CANCER CHEMOTHERAPY MARKET, 2012-2018 ($
MILLIONS) 177
TABLE 96 OVARIAN CANCER CHEMOTHERAPY MARKET IN KEY COUNTRIES
THROUGH 2018 ($ MILLIONS) 178
FIGURE 37 OVARIAN CANCER CHEMOTHERAPY MARKET IN KEY COUNTRIES,
2012-2018 ($ MILLIONS) 178
OVARIAN CANCER TREATMENT STRATEGIES: CURRENT TRENDS 179
CURRENT TREATMENT PRACTICES FOR OVARIAN CANCER: IMPACT ON THE
MARKET 180
TABLE 97 STANDARD INITIAL CHEMOTHERAPY 180
TABLE 98 DRUGS FOR RECURRENT OVARIAN CANCER 180
TABLE 99 HORMONAL THERAPY DRUGS 181
CHEMOTHERAPY AND DRAWBACKS 181
Drugs Used in Chemotherapy 182
Paclitaxel 182
TABLE 100 KEY OVARIAN CANCER DRUGS - SALES, 2010 ($ MILLIONS) 182
Carboplatin 182
TABLE 101 CARBOPLATIN: SALES, THROUGH 2012 ($ MILLIONS) 183
Doxil 183
Taxotere/Docetaxel 183
TABLE 102 TAXOTERE GLOBAL SALES AND FORECAST 2010-2012 ($ MILLIONS) 184
Cisplatin 184
Gemzar 184
TABLE 103 GEMZAR REVENUE, 2010 AND 2011 ($ MILLIONS) 185
Future for Gemcitabine as a Drug 185
Hycamtin 186
Navelbine 186
Carboplatin 186
TREATMENT OPTIONS FOR RELAPSED OR REFRACTORY OVARIAN CANCER:
MARKET ANALYSIS 186
TABLE 104 DRUGS FOR REFRACTORY OVARIAN CANCER 187
TABLE 105 HORMONAL THERAPY DRUGS 187
RADIATION THERAPY 187
CURRENT COMPETITION IN OVARIAN CANCER DRUGS 187
NEW MOLECULES 188
TABLE 106 PROMISING MOLECULES 188
Avastin 189
TABLE 107 AVASTIN-REVENUES, THROUGH 2013 ($ MILLIONS) 189
TABLE 108 AVASTIN-OVARIAN CANCER MARKET FORECAST BY REGION, THROUGH
2018 ($ MILLIONS) 191
Abagovomab 191
TABLE 109 NEW MOLECULES - ESTIMATED SALES, 2018 ($ MILLIONS) 192
Pazopanib 192
Nintedanib 192
Opt-821 192
Paclical (Paclitaxel) 192
Opaxio 193
AMG 386 193
Vintafolide (EC145) 193
Karenitecin 193
Farletuzumab 193
FUTURE FOR OVARIAN CANCER MARKET 194
TABLE 110 PROMISING BIOLOGIC DRUG TREATMENTS 195
OVARIAN CANCER - COSTS AND MARKET OUTLOOK 195
MARKET OVERVIEW - GLOBAL PERSPECTIVES 196
THE PIPELINE - NEW RESEARCH AREAS 197
TABLE 111 DRUG CATEGORIES IN DEVELOPMENT MOLECULES IN THE PIPELINE 197
CONCLUSIONS: UNMET NEEDS 198

CHAPTER 10 PATENT LANDSCAPE 200

TABLE 112 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2013 200
TABLE 113 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2014 201
TABLE 114 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2015 202
TABLE 115 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2016 202
GLOBAL IMPACT OF PATENT EXPIRIES 203
PATENT LANDSCAPE 203
GEMZAR 204
TABLE 116 OVARIAN CANCER CHEMOTHERAPY DRUGS: PATENT EXPIRY 204
DOXIL 205
CISPLATIN 205

CHAPTER 11 LATEST NEWS AND DEVELOPMENTS 207

LILLY'S EARLY ONCOLOGY PIPELINE 207
LPATH AND DIAGNOSTICS 207
ROCHE 208
EARLY STAGE OVARIAN CANCER DIAGNOSTIC 209
NEW CHEMOTHERAPY STRATEGY EMERGES IN OVARIAN CANCER 209
Court Reaffirms Right of Myriad Genetics to Patent Genes 210
NANOTECHED RNA DRUG REDUCES OVARIAN CANCER TUMORS 211
VERASTEM LAUNCHES OVARIAN CANCER TRIAL 212
SCIENTISTS UNRAVEL GENETIC CAUSES OF PROSTATE, BREAST AND
OVARIAN CANCER 212
OVARIAN CANCER VACCINE 213
NOVOTTF THERAPY 213

CHAPTER 12 SELECTED COMPANIES 215

ABBOTT LABORATORIES 215
AMGEN 215
APP PHARMACEUTICALS 215
ARRAYIT CORP. 216
ASTRAZENECA 216
BIONUMERIK PHARMACEUTICALS 216
BOEHRINGER INGELHEIM GMBH 217
BRISTOL-MYERS SQUIBB 217
CELL THERAPEUTICS, INC. 217
CHUGAI PHARMACEUTICAL 218
EISAI INC. 218
ELI LILLY AND COMPANY 218
ENDOCYTE 219
FUJIREBIO DIAGNOSTICS 219
GE HEALTHCARE 219
GLAXOSMITHKLINE 220
GOLD STANDARD DIAGNOSTICS 221
JOHNSON and JOHNSON 221
LPATH 222
MENARINI GROUP 222
MYRIAD GENETICS 222
NOVOCURE 223
OASMIA PHARMACEUTICAL 223
OPTIMER PHARMACEUTICALS 223
PFIZER 224
PROVISTA DIAGNOSTICS 224
RADIENT PHARMACEUTICALS 225
ROCHE DIAGNOSTICS 225
SANOFI 225
TAJ PHARMACEUTICALS 226
TELIK, INC. 226
TEVA PHARMACEUTICAL INDUSTRIES LTD. 226
VERMILLION 227

CHAPTER 13 REFERENCES 229



LIST OF TABLES

SUMMARY TABLE OVARIAN CANCER DRUGS AND DIAGNOSTICS-GLOBAL MARKETS,
THROUGH 2018 ($ MILLIONS) 7
TABLE 1 OVARIAN CANCER FACTS 10
TABLE 2 TYPES OF OVARIAN CANCERS 11
TABLE 3 OVARIAN TUMORS METASTASIS 12
TABLE 4 MAIN RISK FACTORS FOR OVARIAN CANCER 12
TABLE 5 HIGH-RISK FACTORS 13
TABLE 6 PREVENTIVE FACTORS 14
TABLE 7 OVARIAN CANCER SYMPTOMS 16
TABLE 8 HOW OVARIAN CANCER CAN PROGRESS 23
TABLE 9 COMMON HISTOLOGICAL SUBTYPES OF OVARIAN CANCERS 24
TABLE 10 OVARIAN CANCER ORIGINS 25
TABLE 11 MUTATED GENES IN HIGH-GRADE SEROUS OVARIAN CANCER 27
TABLE 12 GLOBAL PROGNOSTIC OVARIAN CANCER BIOMARKERS 30
TABLE 13 ACOG GUIDELINES 2002 32
TABLE 14 GENES IN TYPE I EPITHELIAL OVARIAN CANCER CELLS 37
TABLE 15 OVARIAN CANCER SYMPTOMS 41
TABLE 16 STAGES OF OVARIAN CANCER 45
TABLE 17 STAGING OF OVARIAN CANCER 46
TABLE 18 DIAGNOSTIC TESTS FOR OVARIAN CANCER 47
TABLE 19 TUMOR BIOMARKER-BASED TESTS FOR OVARIAN CANCER DIAGNOSIS 54
TABLE 20 TEST FEATURES OF ROMA 58
TABLE 21 OVADX FEATURES 59
TABLE 22 DRUGS FOR OVARIAN CANCER 68
TABLE 23 OTHER MAJOR THERAPEUTIC AGENTS 69
TABLE 24 CURRENT TREATMENT STRATEGY: OVARIAN CANCER 70
TABLE 25 CHEMOTHERAPEUTIC DRUGS FOR OVARIAN CANCER 72
TABLE 26 CHEMOTHERAPY ADMINISTRATION 73
TABLE 27 TREATMENT OPTIONS BY STAGE 75
TABLE 28 PIPELINE DRUG CLASSES 77
TABLE 29 OVARIAN CANCER DRUGS: DELIVERY TECHNOLOGIES 78
TABLE 30 OPTIMAL SURVEILLANCE STRATEGY 78
TABLE 31 TREATMENT PLAN FOR RECURRENT CANCER 80
TABLE 32 PLATINUM RESISTANCE 81
TABLE 33 REASONS FOR THE ONSET OF MDR 81
TABLE 34 DRUGS APPROVED FOR OVARIAN CANCER 88
TABLE 35 NEW OVARIAN CANCER DRUGS 89
TABLE 36 OVARIAN CANCER DRUGS IN CLINICAL TRIALS 90
TABLE 37 OVARIAN CANCER: BIOMARKERS AS DRUG CANDIDATES 97
TABLE 38 GLOBAL CANCER INCIDENCE 103
TABLE 39 GLOBAL CANCER INCIDENCE ESTIMATES, 2008 AND 2030 (MILLIONS) 103
TABLE 40 CANCER KEY FACTS 106
TABLE 41 INCREASE IN CANCER BURDEN: FACTORS 107
TABLE 42 OVARIAN CANCER INCIDENCE BY REGION, 2008 109
TABLE 43 OVARIAN CANCER INCIDENCE GLOBAL, 2008 109
TABLE 44 ESTIMATED GLOBAL OVARIAN CANCER INCIDENCE, 2010-2018 110
TABLE 45 OVARIAN CANCER INCIDENCE BY LOCATION, 2008 (NUMBER OF CASES) 111
TABLE 46 ESTIMATED OVARIAN CANCER INCIDENCE IN NORTH AMERICA, 2010-2018 113
TABLE 47 OVARIAN CANCER - U.S. INCIDENCE, 2012 114
TABLE 48 NEW CASES AND DEATHS FROM OVARIAN CANCER IN THE U. S., 2013 114
TABLE 49 ESTIMATED OVARIAN CANCER INCIDENCE IN THE U.S., 2012-2018 115
TABLE 50 OVARIAN CANCER: INCIDENCE AND MORTALITY IN UNITED STATES,
2009-2013 116
TABLE 51 OVARIAN CANCER SURVIVAL RATES COMPARED TO OTHER CANCERS 117
TABLE 52 STAGE DISTRIBUTION AND FIVE-YEAR RELATIVE SURVIVAL BY STAGE AT
DIAGNOSIS, 2002-2008 (%) 118
TABLE 53 OVARIAN CANCER - EUROPEAN AGE-STANDARDIZED INCIDENCE RATES IN
EU-27 COUNTRIES, 2008 ESTIMATES 119
TABLE 54 ESTIMATED OVARIAN CANCER INCIDENCE IN EUROPE, 2012-2018 121
TABLE 55 ESTIMATED INCIDENCE, MORTALITY AND PREVALENCE IN EUROPEAN
UNION, 2008 122
TABLE 56 HOW MANY WOMEN DIE FROM OVARIAN CANCER? 123
TABLE 57 OVARIAN CANCER - NUMBER OF NEW CASES PER 100,000 POPULATION IN
THE U.K., 2008 124
TABLE 58 GYNECOLOGICAL CANCERS - NUMBER OF NEW CASES PER 100,000
POPULATION IN THE U.K., 2008 124
TABLE 59 OVARIAN CANCER STATISTICS IN THE U.K., 2010 125
TABLE 60 PROGNOSIS FOR OVARIAN CANCER 130
TABLE 61 GLOBAL OVARIAN CANCER DIAGNOSTIC TESTS AND MARKET SALES AND
FORECAST, THROUGH 2018 ($ MILLIONS) 134
TABLE 62 OVARIAN ABNORMALITIES 135
TABLE 63 GLOBAL MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN CANCER,
THROUGH 2018 ($ MILLIONS) 138
TABLE 64 U.S. MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN CANCER,
THROUGH 2018 ($ MILLIONS) 139
TABLE 65 IMAGING TESTS 140
TABLE 66 OVARIAN CANCER - RISK TYPES 141
TABLE 67 OVARIAN CANCER - WOMEN WITH INCREASED RISK 141
TABLE 68 OVARIAN CANCER: INHERITED RISK DUE TO KNOWN GENETIC MUTATIONS 141
TABLE 69 GLOBAL MARKET FOR LAB TESTS FOR OVARIAN CANCER, THROUGH 2018
($ MILLIONS) 142
TABLE 70 U.S. MARKET FOR LAB TESTS FOR OVARIAN CANCER, THROUGH 2018 ($
MILLIONS) 143
TABLE 71 ELEVATED CA-125 LEVEL 145
TABLE 72 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125, THROUGH
2018 ($ MILLIONS) 146
TABLE 73 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125, THROUGH 2018
($ MILLIONS) 147
TABLE 74 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
THROUGH 2018 ($ MILLIONS) 148
TABLE 75 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
THROUGH 2018 ($ MILLIONS) 149
TABLE 76 WHY HE4 AND CA-125 COMBINED? 150
TABLE 77 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA TEST,
THROUGH 2018 ($ MILLIONS) 150
TABLE 78 UNITED STATES OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA
TEST, THROUGH 2018 ($ MILLIONS) 151
TABLE 79 GLOBAL OVA1 MARKET, THROUGH 2018 ($ MILLIONS) 153
TABLE 80 THE GLOBAL MOLECULAR DIAGNOSTICS MARKET, THROUGH 2018 ($
MILLIONS) 158
TABLE 81 GLOBAL MARKET FOR OVADX, THROUGH 2018 ($ MILLIONS) 160
TABLE 82 U.S. MARKET FOR OVADX, THROUGH 2018 ($ MILLIONS) 160
TABLE 83 GLOBAL OVARIAN CANCER SURGERY MARKET, THROUGH 2018 ($
MILLIONS) 162
TABLE 84 U.S. OVARIAN CANCER SURGERY MARKET, THROUGH 2018 ($ MILLIONS) 163
TABLE 85 GLOBAL COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN
CANCER, THROUGH 2018 ($ MILLIONS) 164
TABLE 86 U.S. COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN CANCER,
THROUGH 2018 ($ MILLIONS) 165
TABLE 87 KEY HIGHLIGHTS OF THE THERAPEUTIC MARKET 169
TABLE 88 NEW LAUNCHES IN 2012 170
TABLE 89 MAJOR PLAYERS 172
TABLE 90 CYTOTOXIC THERAPIES MARKET INDICATIONS 173
TABLE 91 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 173
TABLE 92 U.S. CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 174
TABLE 93 EUROPEAN CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 175
TABLE 94 JAPANESE CYTOTHERAPEUTICS MARKET, THROUGH 2018 ($ MILLIONS) 176
TABLE 95 GLOBAL OVARIAN CANCER CHEMOTHERAPY MARKET, THROUGH 2018 ($
MILLIONS) 177
TABLE 96 OVARIAN CANCER CHEMOTHERAPY MARKET IN KEY COUNTRIES THROUGH
2018 ($ MILLIONS) 178
TABLE 97 STANDARD INITIAL CHEMOTHERAPY 180
TABLE 98 DRUGS FOR RECURRENT OVARIAN CANCER 180
TABLE 99 HORMONAL THERAPY DRUGS 181
TABLE 100 KEY OVARIAN CANCER DRUGS - SALES, 2010 ($ MILLIONS) 182
TABLE 101 CARBOPLATIN: SALES, THROUGH 2012 ($ MILLIONS) 183
TABLE 102 TAXOTERE GLOBAL SALES AND FORECAST 2010-2012 ($ MILLIONS) 184
TABLE 103 GEMZAR REVENUE, 2010 AND 2011 ($ MILLIONS) 185
TABLE 104 DRUGS FOR REFRACTORY OVARIAN CANCER 187
TABLE 105 HORMONAL THERAPY DRUGS 187
TABLE 106 PROMISING MOLECULES 188
TABLE 107 AVASTIN-REVENUES, THROUGH 2013 ($ MILLIONS) 189
TABLE 108 AVASTIN-OVARIAN CANCER MARKET FORECAST BY REGION, THROUGH
2018 ($ MILLIONS) 191
TABLE 109 NEW MOLECULES - ESTIMATED SALES, 2018 ($ MILLIONS) 192
TABLE 110 PROMISING BIOLOGIC DRUG TREATMENTS 195
TABLE 111 DRUG CATEGORIES IN DEVELOPMENT MOLECULES IN THE PIPELINE 197
TABLE 112 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2013 200
TABLE 113 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2014 201
TABLE 114 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2015 202
TABLE 115 DRUGS SCHEDULED TO LOSE U.S. MARKET PROTECTION, 2016 202
TABLE 116 OVARIAN CANCER CHEMOTHERAPY DRUGS: PATENT EXPIRY 204



LIST OF FIGURES

SUMMARY FIGURE OVARIAN CANCER DRUGS AND DIAGNOSTICS-GLOBAL MARKETS,
2012-2018 ($ MILLIONS) 8
FIGURE 1 GLOBAL CANCER INCIDENCE ESTIMATES, 2008 AND 2030 (MILLIONS) 104
FIGURE 2 OVARIAN CANCER INCIDENCE BY REGION, 2008 109
FIGURE 3 ESTIMATED GLOBAL OVARIAN CANCER INCIDENCE, 2010-2018 110
FIGURE 4 OVARIAN CANCER INCIDENCE BY LOCATION, 2008 (NUMBER OF CASES) 111
FIGURE 5 ESTIMATED OVARIAN CANCER INCIDENCE IN NORTH AMERICA, 2010-2018 113
FIGURE 6 NEW CASES AND DEATHS FROM OVARIAN CANCER IN THE U.S., 2013 115
FIGURE 7 ESTIMATED OVARIAN CANCER INCIDENCE IN THE U.S. 2012-2018 115
FIGURE 8 OVARIAN CANCER: INCIDENCE AND MORTALITY IN U.S., 2009-2013 116
FIGURE 9 OVARIAN CANCER EUROPEAN AGE-STANDARDIZED INCIDENCE IN EU-27
COUNTRIES, 2008 ESTIMATES 119
FIGURE 10 ESTIMATED OVARIAN CANCER: INCIDENCE IN EUROPE 2012-2018 121
FIGURE 11 GYNECOLOGICAL CANCERS - NUMBERS OF NEW CASES PER 100,000
POPULATION IN THE U.K., 2008 124
FIGURE 12 OVARIAN CANCER STATISTICS IN THE U.K., 2010 126
FIGURE 13 OVARIAN CANCER DIAGNOSTIC TESTS AND MARKET SALES AND
FORECAST, 2012-2018 ($ MILLIONS) 134
FIGURE 14 GLOBAL MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN
CANCER, 2012-2018 ($ MILLIONS) 138
FIGURE 15 U.S. MARKET FOR TRANSVAGINAL ULTRASOUND IN OVARIAN CANCER,
2012-2018 ($ MILLIONS) 139
FIGURE 16 GLOBAL MARKET FOR LAB TESTS FOR OVARIAN CANCER, 2012-2018 ($
MILLIONS) 142
FIGURE 17 U.S. MARKET FOR LAB TESTS FOR OVARIAN CANCER, 2012-2018 ($
MILLIONS) 143
FIGURE 18 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125,
2012-2018 ($ MILLIONS) 146
FIGURE 19 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR CA-125, 2012-2018 ($
MILLIONS) 147
FIGURE 20 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
2012-2018 ($ MILLIONS) 148
FIGURE 21 U.S. OVARIAN CANCER DIAGNOSTIC MARKET FOR THE HE4 TEST,
2012-2018 ($ MILLIONS) 149
FIGURE 22 GLOBAL OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA TEST,
2012-2018 ($ MILLIONS) 151
FIGURE 23 UNITED STATES OVARIAN CANCER DIAGNOSTIC MARKET FOR THE ROMA
TEST, 2012-2018 ($ MILLIONS) 151
FIGURE 24 GLOBAL OVA1 MARKET, 2011-2018 ($ MILLIONS) 154
FIGURE 25 THE GLOBAL MOLECULAR DIAGNOSTICS MARKET, 2012-2018 ($
MILLIONS) 158
FIGURE 26 GLOBAL MARKET FOR OVADX, 2012-2018 ($ MILLIONS) 160
FIGURE 27 U.S. MARKET FOR OVADX - SALES AND FORECAST 2012-2018 ($
MILLIONS) 160
FIGURE 28 GLOBAL OVARIAN CANCER SURGERY MARKET, 2010-2018 ($ MILLIONS) 163
FIGURE 29 U.S. OVARIAN CANCER SURGERY MARKET, 2012-2018 ($ MILLIONS) 163
FIGURE 30 GLOBAL COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN
CANCER, 2012-2018 ($ MILLIONS) 164
FIGURE 31 U.S. COMPUTED TOMOGRAPHY IMAGING MARKET FOR OVARIAN CANCER,
2012-2018 ($ MILLIONS) 165
FIGURE 32 GLOBAL CYTOTHERAPEUTICS MARKET, 2010 AND 2017 ($ MILLIONS) 174
FIGURE 33 U.S. CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 174
FIGURE 34 EUROPEAN CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 176
FIGURE 35 JAPANESE CYTOTHERAPEUTICS MARKET, 2012-2018 ($ MILLIONS) 177
FIGURE 36 GLOBAL OVARIAN CANCER CHEMOTHERAPY MARKET, 2012-2018 ($
MILLIONS) 177
FIGURE 37 OVARIAN CANCER CHEMOTHERAPY MARKET IN KEY COUNTRIES,
2012-2018 ($ MILLIONS) 178

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