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Alexander Olawaiye, MD, of the University of Pittsburgh, discusses the need to increase the proportion of patients with ovarian cancer that can be cured, including finding ways to diagnose ovarian cancer at earlier stages or finding more effective treatment at later stages.

Following is a transcript of his remarks:

We still are unable to diagnose the vast majority of ovary cancer patients early, and this is so critical. We are not aware of precancer stages for ovarian cancer, so that makes it difficult to aspire to picking up precancer stages, at which time we can prevent the cancer. The only time we can anticipate or have a preventive strategy is for patients who are at very, very high risk of ovary cancer based on genetic heritage like [BRCA1] and 2 mutation carriers. But those are different, and those form about 15% of the ovary cancer population anyway.

But for the vast majority, 80% of them are diagnosed as stages III and IV. And the future really is being able to have a way, a scientifically valid way of picking up ovary cancer early. Because if we pick it up early in stage I or maybe even stage II, the outcome of therapy, the number or proportion of patients that we cure, will be vastly increased.

Now, beyond that -- and understanding that the vast majority of patients are still diagnosed in stages III and IV, that is approximately 75% of patients, maybe 80% -- the question is, OK, if we pick them up as stages III and IV, how do we cure an increased proportion of these patients? We think right now we may be curing somewhere between 15% and 20%. It used to be 15% or less, but probably with the advent or introduction of PARP inhibitors, we may be curing a little more. So we're prepared to use figures at 15% to 20%.

But if you think about it, that's like one in five that we're curing; that is just way too small. So whatever we can do in the first-line setting, and there's a lot of investigations going on in the first line, i.e., the first time the ovary cancer is being treated, that we can leverage these investigations or their findings to cure more people with ovary cancer.

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