Dr Miller on the Impact of Mirvetuximab Soravtansine on Clinical Practice in Ovarian Cancer

Eirwen M. Miller, MD, gynecologic oncologist, Allegheny Health Network West Penn Hospital, discusses how the success of mirvetuximab soravtansine-gynx (Elahere) in ovarian cancer has bolstered the development of novel antibody-drug conjugates (ADC) and other drug targets in ovarian cancer.

In 2022, the FDA granted accelerated approval to mirvetuximab soravtansine-gynx (Elahere) for adult patients with folate receptor α (Frα)–positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer, who have received 1 to 3 prior systemic treatment regimens. Findings from the phase 3 SORAYA trial (NCT04296890) supported the regulatory approval, demonstrating improved progression-free survival, objective response rate, and overall survival with the ADC vs investigator’s choice of single-agent chemotherapy.

Additionally, initial results from the phase 3 MIRASOL trial (NCT04209855) showed that mirvetuximab soravtansine demonstrated overall survival benefit vs investigator's choice chemotherapy in patients with platinum-resistant ovarian cancer, Miller reports. The favorable toxicity profile of this agent is noteworthy, especially for heavily pretreated patients who may have experienced significant hematologic adverse effects from prior cytotoxic chemotherapy, Miller states. The agent's approval therefore marks a significant advancement in addressing an unmet need for patients in this challenging setting, she asserts.

Proactive measures are commonly used to address ocular toxicities associated with the agent, including frequent eye exam screening, strong referral algorithms to ophthalmology, and patient education about ocular toxicity symptoms, Miller continues. The increasing comfort and familiarity with managing ocular toxicities has contributed to the successful integration of mirvetuximab soravtansine into clinical practice, she says.

In light of prior difficulty demonstrating OS benefit with therapies in platinum-resistant ovarian cancer, mirvetuximab soravtansine is positioned as a transformative option in this space, Miller states, adding that the agent is already influencing clinical practice,

Furthermore, several clinical trials investigating ADCs targeting FRα and TROP-2 are open or will soon be available for enrollment. The evolving landscape of ADCs and the positive outcomes observed with mirvetuximab soravtansine underscore the potential for further advancements in the management of ovarian cancer, Miller concludes.