Computational modeling of ovarian cancer dynamics suggests optimal strategies for therapy and screening
Significance
The optimal timing of surgery/chemotherapy and the benefits of earlier diagnosis of HGSC remain controversial. We developed a mathematical framework of tumor dynamics, populated the model with primary clinical data, and reliably recapitulated clinical observations. Our model predicts that 1) PDS is superior to NACT with relatively small tumor burden and when complete debulking is feasible, 2) timely adjuvant chemotherapy is critical for the outcome of PDS with <1-mm residual tumors, 3) earlier detection of relapse is unlikely beneficial with current therapies, and 4) earlier detection of primary HGSC could have substantial benefit. These results provide insights into the evolutionary dynamics of HGSC, argue for new clinical trials to optimize therapy, and are potentially applicable to other tumor types.
