Susan Marie Lang, MD, discusses the incidence of ocular toxicity following treatment with mirvetuximab soravtansine in ovarian cancer. 

Dr Lang on Ocular Toxicities Following ADC Treatment in Ovarian Cancer 

Susan Marie Lang, MD, affiliate, Dean's Office Operations, Dean, Fellow, Medicine, Stanford Medicine, Stanford University, discusses the implications of a real-world evaluation of the incidence of ocular toxicity following treatment with mirvetuximab soravtansine-gynx (Elahere) and other antibody-drug conjugates in patients with pretreated ovarian cancer.

Notably, findings from this investigation were presented at the 

. Lang says she and coinvestigators examined the incidence of patients necessitating escalated care due to ocular adverse effects (AEs) and whether this care manifested as emergency department visits for visual changes or increased visits with ophthalmologists within or outside the Stanford health care system. This analysis revealed that approximately 15% of patients experienced escalated care due to ophthalmologic-related AEs, she elucidates. Lang says it is reassuring that these findings align with data that have been published thus far.

There are always concerns among practitioners regarding the applicability of data derived from rigorously selected patient populations in clinical trials to populations in the real world, she expands. Investigators observed no significant differences between safety outcomes in this study population and that of the pivotal phase 3 SORAYA trial (NCT04296890) population underscores the importance of the ongoing collaboration between oncologists and their ophthalmology colleagues when caring for patients receiving mirvetuximab soravtansine, Lang emphasizes.

Although ocular toxicity rates with mirvetuximab soravtansine remain high, as observed in this study, oncologists can manage this AE through the administration of steroids and lubricating eye drops, along with the expertise of their ophthalmology colleagues, Lang continues. Moving forward, investigators aim to identify patients at the highest risk of experiencing ocular toxicities associated with mirvetuximab soravtansine and elucidate the underlying mechanisms by which this AE develops, she adds. Although data in this area are lacking, the identification and management of risk factors for this AE could enhance the ability to care for patients and contribute to continued success when using this medication, Lang concludes.

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Susan Marie Lang, MD, discusses the incidence of ocular toxicity following treatment with mirvetuximab soravtansine in ovarian cancer. 


Dr Lang on Ocular Toxicities Following ADC Treatment in Ovarian Cancer

 Susan Marie Lang, MD, discusses the evaluation of real-world ocular toxicity on treatment with mirvetuximab soravtansine in pretreated ovarian cancer.

Dr Lang on the Evaluation of Ocular Toxicity With Mirvetuximab in Ovarian Cancer

Susan Marie Lang, MD, affiliate, Dean's Office Operations, Dean, Fellow in Medicine, Stanford Medicine, Stanford University, discusses the evaluation of real-world incidence of ocular toxicity due to treatment with mirvetuximab soravtansine-gynx (Elahere) in patients with pretreated ovarian cancer.

The rationale for this investigation was based on unmet needs in platinum-resistant ovarian cancer. This disease is characterized by the recurrence of ovarian cancer within 6 months from patients’ last platinum-based chemotherapy, and patients with platinum-resistant disease face relatively shorter survival times, Lang begins. Notably, the antibody-drug conjugate (ADC) mirvetuximab soravtansine 

 in November 2022 for patients with folate receptor α–positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer who have received 1 to 3 prior systemic treatment regimens. This regulatory decision positioned mirvetuximab soravtansine as the first approved ADC for patients with platinum-resistant recurrent ovarian cancer, she elucidates.

However, mirvetuximab soravtansine is associated with a notable adverse effect (AE)––ocular toxicity, for which the agent has a black box warning, Lang emphasizes. According to published data from the pivotal phase 3 SORAYA trial (NCT04296890), the reported overall rate of ocular toxicity was 61% in the population of patients who received mirvetuximab soravtansine, she states. Given that findings from clinical trials are often derived in a controlled environment, this real-world evaluation assessed how patient factors may contribute to mirvetuximab soravtansine–associated ocular toxicity outside of a clinical trial setting.

A total of 26 patients, all diagnosed with high-grade serous platinum-resistant recurrent ovarian cancer, were examined, Lang expands. This investigation revealed that the incidence of mirvetuximab soravtansine–related ocular toxicity in the real-world setting closely aligned with that in SORAYA, she elucidates. The most prevalent ocular AE observed in this real-world study was keratopathy, or corneal changes, a finding which aligned with the most common ocular toxicity reported in SORAYA, Lang notes.

One aspect of particular interest in this research was the rate of decreased visual acuity among the patients studied, Lang continues. Literature often aggregates various visual changes reported by patients, including decreased acuity, visual blurriness, and other alterations, according to Lang. In this investigation, a focused examination on the rate of decreased visual acuity uncovered that 24% of patients experienced these visual changes when undergoing treatment with mirvetuximab soravtansine, Lang explains. These nuanced insights contribute to a more comprehensive understanding of the real-world implications of and challenges associated with this novel therapeutic approach, she concludes.

Susan Marie Lang, MD, discusses the incidence of real-world ocular toxicity during treatment with mirvetuximab soravtansine in pretreated ovarian cancer.

Susan Marie Lang, MD

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