Monday, October 7, 2013

Therapies and Diagnostics for Ovarian Cancer

Therapies and Diagnostics for Ovarian Cancer










London (PRWEB) October 07, 2013

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

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 & 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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Therapies and Diagnostics for Ovarian Cancer

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