Tashanna K. Myers, MD, is a professor of obstetrics and gynecology at the UMass Chan Medical School—Baystate

Dr Myers on Mitigation Strategies for Ocular AEs in Platinum-Resistant Ovarian Cancer

“[It is] very important to tell women that they can live longer with [mirvetuximab soravtansine] when they have platinum-resistant ovarian cancer that is Frα positive, and they don’t have to sacrifice QOL.”

Tashanna K. Myers, MD, a professor of obstetrics and gynecology at the UMass Chan Medical School—Baystate, discussed the clinical implications of findings from a health-related quality of life (HRQOL) analysis of the phase 3 MIRASOL trial (NCT04209855) investigating mirvetuximab soravtansine-gynx (Elahere) in patients with Frα-positive, platinum-resistant ovarian cancer.

This study found that treatment-emergent ocular adverse effects (AEs)—including blurred vision and keratopathy—among patients who received mirvetuximab soravtansine in MIRASOL were not significantly associated with HRQOL detriments. Additionally, investigators saw no significant QOL differences between patients with treatment-emergent blurred vision or keratopathy and those who did not experience treatment-emergent ocular AEs. Furthermore, a broadened sensitivity analysis showed no statistically significant differences between select patient-reported HRQOL outcomes among patients who experienced any treatment-emergent ocular AEs and those who did not experience treatment-emergent ocular AEs.

Ocular AE mitigation strategies include close collaboration between oncologists and ophthalmologists, as well as the use of lubricating eye drops and/or steroid eye drops during treatment, Myers said. Notably, in this study, 93% of patients achieved complete or partial resolution of ocular AEs by the data cutoff date, she explained.

These findings are exciting because the goal of ovarian cancer treatment is for patients to live longer without detriment to their QOL, Myers emphasized. Although ocular AEs were a relatively novel phenomenon when mirvetuximab soravtansine was first under investigation, oncologists better understand these toxicities now, she asserted. Accordingly, it is important to counsel patients with FRα-positive platinum-resistant ovarian cancer on the survival and QOL benefits associated with this agent, she concluded.

Myers reported receiving grants or contracts from GSK; receiving payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from ImmunoGen, Inc; and participating in a Data Safety Monitoring Board or Advisory Board at Gilead.

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Tashanna K. Myers, MD, discusses the importance of telling patients with ovarian cancer about the HRQOL outcomes associated with mirvetuximab soravtansine.

Dr Myers on HRQOL Outcomes With Mirvetuximab Soravtansine in Ovarian Cancer

“I’m happy to say that what we found is there was no implication on QOL scores in patients who exhibited ocular [adverse] effects [AEs]. That’s a big important feature for patients, as this was a unique AE of the drug and made patients hesitant, either for the acute effect of the ocular AE, or whether it would affect their QOL.”

Tashanna K. Myers, MD, a professor of obstetrics and gynecology at the UMass Chan Medical School—Baystate, discusses findings from an analysis of the phase 3 MIRASOL trial (NCT04209855) evaluating the effects of treatment-emergent ocular adverse effects (AEs) on health-related quality of life (HRQOL) in patients with folate receptor alpha–positive platinum-resistant ovarian cancer who received mirvetuximab soravtansine-gynx (Elahere).

This analysis used patient-reported outcome (PRO) data from MIRASOL to compare HRQOL outcomes between patients treated with mirvetuximab soravtansine who experienced treatment-emergent blurred vision or keratopathy (cohort 1) vs those who did not experience treatment-emergent ocular (cohort 2). PROs were collected at screening and at every 3-week cycle for up to 21 weeks. The select HRQOL measures included in this analysis included the EORTC Quality of Life Questionnaire Core Questionnaire (EORTC-QLQ-C30) Global Health Scale (GHS)/Quality of Life (QOL) and physical functioning subscales, as well as the EuroQol (EQ) 5D-5L measures for mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

The primary PRO analysis from MIRASOL showed no statistically significant differences in HRQOL measures between cohorts 1 and 2 at 9, 15, and 21 weeks following treatment initiation. The mean EORTC QLQ-C30 GHS/QOL least squares (LS) scores in cohorts 1 and 2, respectively, were 64.92 (standard error [SE], 2.35) vs 67.14 (SE, 2.45) at week 9, 65.23 (SE, 2.58) vs 66.18 (SE, 2.79) at week 15, and 65.46 (SE, 2.62) vs 64.48 (SE, 3.12) at week 21. The mean EORTC QLQ-C30 physical functioning LS scores in these respective cohorts were 78.44 (SE, 1.99) vs 75.14 (SE, 2.07) at week 9, 80.39 (SE, 2.32) vs 76.31 (SE, 2.47) at week 15, and 78.99 (SE, 2.15) vs 77.41 (SE, 2.55) at week 21. The mean EQ-5D-5L utility scores in these respective cohorts were 0.76 (SE, 0.03) vs 0.70 (SE, 0.03) at week 9, 0.75 (SE, 0.03) vs 0.73 (SE, 0.03) at week 15, and 0.73 (SE, 0.03) vs 0.71 (SE, 0.03) at week 21.

A sensitivity analysis that used a broader definition of treatment-emergent ocular AEs demonstrated consistent select HRQOL results between the population of patients with any treatment-emergent ocular effects and those with no treatment-emergent ocular effects.

Tashanna K. Myers, MD, discusses HRQOL findings in patients with platinum-resistant ovarian cancer who received mirvetuximab soravtansine in MIRASOL.

Tashanna K. Myers, MD

Articles

Dr Myers on Mitigation Strategies for Ocular AEs in Platinum-Resistant Ovarian Cancer

Dr Myers on HRQOL Outcomes With Mirvetuximab Soravtansine in Ovarian Cancer