Dr Moore on Key 2024 Updates in FRα+ Ovarian Cancer Management

“We have had 2 important [developments] in the past…2 years. The first is mirvetuximab soravtansine, which is now fully FDA approved and is pending global approvals.”

Kathleen N. Moore, MD, MS, professor, Section of Gynecologic Oncology, associate director, Clinical Research, Stephenson Cancer Center, director, Oklahoma TSET Phase I Program, University of Oklahoma College of Medicine, The University of Oklahoma Health Sciences, discusses key updates in 2024 for the management of advanced ovarian cancer.

In the past 1 to 2 years, 2 significant developments in advanced ovarian cancer management have made a substantial effect on the field, Moore begins. The first was the full FDA approval of mirvetuximab soravtansine-gynx (Elahere), which is now also pending global approvals, she explains. This drug is indicated for patients with pretreated platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal tumors that are folate receptor alpha (FRα)–positive, Moore states. In the United States, the National Comprehensive Cancer Network (NCCN) guidelines now recommend mirvetuximab soravtansine, as monotherapy or in combination with bevacizumab (Avastin), for tumors that express FRα, she reports.

The recommendation for mirvetuximab soravtansine plus bevacizumab is based on promising data from the phase 1b/2FORWARD II trial (NCT02606305), Moore continues. As the first antibody-drug conjugate to gain approval and receive a compendium listing in the NCCN Guidelines for ovarian cancer, mirvetuximab soravtansine has significantly enhanced treatment options for patients with this disease, she emphasizes. For patients with FRα-high tumors, this drug has demonstrated improvements in progression-free survival, overall survival, and overall response rate, marking a notable breakthrough, especially given that previous treatments have failed to show survival benefits in this population, Moore notes.

The second key update, although less prominent, is the revised understanding of weekly paclitaxel, with or without bevacizumab, as a treatment option in the platinum-resistant setting, she expands. Historically, this combination was included in investigator-choice arms and associated with a relatively low response rate of approximately 15%, according to Moore. However, recent phase 3 studies have examined weekly paclitaxel alone, providing a clearer picture of its efficacy in this setting, she says. This reevaluation marks a meaningful step forward in refining treatment strategies for platinum-resistant ovarian cancer, Moore concludes.