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

Sarah Crafton, MD, gynecologic oncologist, Allegheny Health Network, discusses the integration of mirvetuximab soravtansine-gynx (Elahere) into clinical practice in the treatment of ovarian cancer, highlighting how the agent has bolstered interest in evaluating other antibody-drug conjugates (ADCs) in earlier settings.

ADCs represent a promising class of anti-cancer therapies with notable success in ovarian cancer, Crafton begins. This is exemplified by the FDA's accelerated approval of mirvetuximab soravtansine for pretreated adult patients with folate receptor α (Frα)–positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer in November 2022.

The regulatory decision was based on findings from the phase 3 MIRASOL trial (NCT04209855), in which progression-free survival, objective response rates, and overall survival was increased with the ADC compared with single-agent chemotherapy.

The Allegheny Health Network has since participated in several clinical trials evaluating mirvetuximab soravtansine, assisting in the familiarization with the agent before its widespread adoption, Crafton says. As a result, the integration of mirvetuximab soravtansine into clinical practice has been relatively seamless, she asserts. The integration of this agent is supported by established infrastructure and close collaboration with ophthalmologists to manage ocular toxicities associated with this medication, Crafton adds.

Although mirvetuximab soravtansine is currently available for use in the platinum-resistant setting, ongoing trials are exploring its potential use in earlier lines of treatment, Crafton continues. The phase 3 GLORIOSA trial (NCT05445778) is investigating mirvetuximab soravtansine with or without bevacizumab (Avastin) as maintenance therapy in patients with platinum-sensitive disease, offering insights into expanded treatment options, Crafton states. The trial is ongoing and recruiting patients. Additionally, a phase 2 investigator-initiated trial (NCT04606914) at the University of Alabama Birmingham is assessing mirvetuximab soravtansine with carboplatin in the neoadjuvant setting, Crafton details.

These ongoing trials hold promise in advancing the use of mirvetuximab soravtansine for patients with ovarian cancer, potentially expanding its therapeutic benefits to patients in earlier stages of the disease, she states. Investigators remain optimistic about the prospects of integrating this novel ADC into various treatment paradigms to improve outcomes for patients with ovarian cancer, Crafton concludes.