Dr Cosgrove on the FDA Approval of Mirvetuximab Soravtansine for Frα+ Ovarian Cancer

Casey M. Cosgrove, MD, gynecologic oncologist, assistant professor, The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center—James Cancer Hospital and Solove Research Institute, discusses the FDA approval of the antibody-drug conjugate (ADC) mirvetuximab soravtansine-gynx (Elahere) for the treatment of adult patients with folate receptor α (Frα)–positive, platinum-resistant epithelial ovarian cancer.

Currently, ADCs are being used across different disease sites in ovarian cancer, Cosgrove begins. Mirvetuximab soravtansine targets Frα by delivering a chemotherapy payload specifically to cancer cells that overexpress Frα, a common occurrence in ovarian cancer. The FDA approval of this agent was based on findings from the pivotal phase 3 MIRASOL trial (NCT04209855), which demonstrated the agent’s efficacy in platinum-resistant ovarian cancer with Frα expression levels of 75% or greater, he reports. Mirvetuximab soravtansine has emerged as a new standard of care for this patient population, according to Cosgrove.

Preceding MIRASOL, earlier-phase studies investigated combinations with mirvetuximab soravtansine and bevacizumab (Avastin), showing benefits even in tumors with lower Frα expression, Cosgrove expands. These findings indicate that combining mirvetuximab soravtansine with bevacizumab could benefit patients with intermediate Frα expression levels, he notes. MIRASOL also highlighted the favorable safety profile of mirvetuximab soravtansine, with most patients experiencing low or no adverse effects (AEs) and ocular toxicities being effectively managed using mitigation strategies, Cosgrove explains.

Mirvetuximab soravtansine's clinical utility is expanding beyond platinum-resistant disease, potentially into the platinum-sensitive and neoadjuvant chemotherapy settings, he continues. Additionally, this agent is being evaluated in combination with bevacizumab as maintenance therapy in the phase 3 GLORIOSA trial (NCT05445778) in platinum-sensitive ovarian, fallopian tube, or peritoneal tumors with high Frα expression. Although other Frα-targeting agents are under investigation, mirvetuximab soravtansine represents an exciting treatment opportunity for patients with ovarian cancer, Cosgrove elucidates. Its efficacy, combined with manageable AEs and ongoing research in various clinical settings, underscores its growing importance in the ovarian cancer field, according to Cosgrove. The development of ADCs such as mirvetuximab soravtansine highlights the evolution of strategies to improve outcomes and expand treatment options for patients with ovarian cancer, he concludes.