Dr Pothuri on the Use of ADCs in Ovarian Cancer

Bhavana Pothuri, MD, gynecologic oncologist, professor, Department of Obstetrics and Gynecology, New York University (NYU) School of Medicine, director, gynecologic oncology clinical trials, NYU Langone Health, discusses the use of antibody-drug conjugates (ADCs) in patients with ovarian cancer and AEs to be aware of when treating patients with these therapies.

In an OncLive® State of the Science Summit™, Pothuri and colleagues from NYU Langone Health each gave presentations on topics spanning gynecologic cancer care. At the event, presenters discussed ADCs in ovarian cancer. ADCs represent the next frontier in targeted therapy, as they focus on a specific tumor biomarker, Pothuri begins. In ovarian cancer, mirvetuximabsoravtansine-gynx (Elahere) is approved by the FDA for the treatment of patients with recurrent platinum-resistant ovarian cancer with high folate receptor α (FRα) expression, defined as expression greater than 75%, Pothuri explains. Although this is an exciting development, it's worth noting that the window for FRα expression in patients with ovarian cancer is relatively narrow, she adds. Nevertheless, investigators are conducting FRα expression tests for all patients with recurrent ovarian cancer to potentially leverage this new treatment option, Pothuri notes.

Importantly, mirvetuximab soravtansine and other novel therapies are associated with novel AEs, such as ocular toxicities, which remain a significant concern, she expands. When treating patients with mirvetuximab soravtansine, oncologists must remain vigilant about ocular toxicity and advocate for an eye care plan, including consultations with optometrists or ophthalmologists throughout the treatment, Pothuri emphasizes. 

Ongoing studies are exploring ADCs that target FRα at lower expression levels. For instance, a phase 1 trial (NCT05200364) is evaluating the FRα-directed ADC STRO-002 plus bevacizumab in patients with epithelial ovarian cancer. Furthermore, there are other ADCs, including upifitamab rilsodotin (UpRi; XMT-1536), which target NaPi2b. The field of ADCs in ovarian cancer is rapidly expanding, and a variety of ADCs may soon be available to treat patients with ovarian cancer in the future, she concludes.