21,000 Diagnoses a Year: Why Aviva's Stella Vnook Wants More Women Writing Biotech Checks

Roughly 21,000 American women are diagnosed with ovarian cancer each year, and 12,000 to 13,000 die from it — numbers Stella Vnook, Founding & Managing Partner of Aviva Ventures, uses to explain why she invests where she does. In an interview with The Medicine Maker, the scientist-turned-investor argued that who controls biotech capital shapes which unmet medical needs get funded at all.

Vnook's path runs from scientist and healthcare provider through nearly 20 years in large pharmaceutical companies, then into biotech CEO and board roles. At Kaida Biopharma, she worked on a drug targeting platinum-resistant ovarian cancer. Today she runs Aviva Ventures, a venture studio that builds biotechnology companies from the ground up.

"We are not advisors standing on the sidelines," Vnook said. "We identify high-potential assets, determine what must be true for them to become investable companies, deploy capital and operating expertise against those milestones, and help build the leadership and infrastructure required for the next stage of growth."

How has biotech funding changed since COVID?

Capital is flowing again, but with far more discipline. "If you look at the numbers, capital is flowing again," Vnook said — while noting that founders keep telling her, "Well, it's not flowing to my company."

The bar for evidence has moved sharply. During COVID and immediately after, companies could raise meaningful rounds on limited rodent studies or in vitro data. Now investors want reproducible preclinical results, stronger evidence of translation and, where appropriate, clinical data — even data generated outside the United States.

The investment pitch has changed too. Market size alone no longer carries a deck. Vnook said companies must now show a clear understanding of the unmet patient population, mechanism-of-action support, de-risking evidence, and how the therapy differentiates clinically against the current standard of care.

The takeaway: startups built for the old environment are now asking hard questions about survival.

Why women's oncology?

The numbers frame the problem. Ovarian cancer is often silent, so it's frequently diagnosed at an advanced stage; once patients resist platinum-based therapy, options narrow dramatically. "Why are we still relying on therapeutic approaches that originated decades ago for a disease that continues to affect so many women?" Vnook asked.

Clinical research compounds the gap. Endocrine status, reproductive stage, menstrual variation, pregnancy, lactation, menopause and hormone use can all affect pharmacology — yet women were historically excluded or underrepresented in studies, leaving evidence gaps in oncology and cardiovascular disease alike.

Early detection is where she sees momentum. Diagnosing ovarian or endometrial cancer at stage I or II, she said, changes the clinical picture dramatically — and she's particularly interested in diagnostics that predict these cancers earlier.

What do women founders face?

Vnook points to data, not anecdote. Studies by Boston Consulting Group and MassChallenge, she said, show women-led startups receive substantially less funding than men-led ones — while remaining highly capital efficient.

Her core argument is structural: relatively few women make investment decisions in biotech and venture capital. "That is not an argument that women should simply fund other women," she said. "The more diverse the experience represented around the investment table, the broader the pattern recognition available to investors." Women's health, she added, is still treated as a niche category despite affecting half the population, and she wants women-led companies represented across oncology, neuroscience, immunology and medtech — not confined to one silo.

The barriers compound: women founders often draw on smaller professional networks, and comparatively few women have served as biotech CEOs or venture investors, making experienced advisors harder to reach. "I decided that if I wanted to see change, I needed to help create it," Vnook said. "Ultimately, the strongest way to change perceptions is through performance."

What does she tell founders raising capital?

Two things. First: the asset. "You have to understand exactly what your capital is going to achieve and which value-creating inflection point it is going to get you to," she said — a discipline she applies to non-dilutive and grant funding as much as equity. Every dollar should answer a question, reduce a risk or move toward a milestone.

Second: the team. Investors want leaders who can stop a program, change an indication, redirect an asset or swap leadership when evidence demands it. "Leadership is not measured by how long you hold onto a plan," Vnook said. "It is measured by how quickly you recognize the evidence, make the difficult decision and redirect capital toward the path most likely to reach patients."

Her closing argument doubles as Aviva's thesis: disciplined capital plus diverse pattern recognition finds opportunities others miss — and 21,000 annual ovarian cancer diagnoses suggest the market hasn't run out of them.