Gynecological Cancers: Treatment Updates and Expert Perspectives - Episode 4
Panelists discuss how mirvetuximab soravtansinerepresents a significant advancement for platinum-resistant ovarian cancer with folate receptor alpha expression, providing unprecedented overall survival benefits despite manageable ocular toxicities that are reversible with proper monitoring and dose modifications.
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Mirvetuximab soravtansine represents a breakthrough in platinum-resistant ovarian cancer treatment, demonstrating unprecedented overall survival (OS) benefits in patients with high folate receptor alpha expression. The final OS analysis confirms the drug’s efficacy with a hazard ratio of 0.68, indicating 32% reduction in death risk at any given time. Rebecca C. Arend, MD, MPH, emphasizes using mirvetuximab as monotherapy for patients with ≥75% folate receptor expression and combining with bevacizumab for those with ≥25% expression levels.
Ocular toxicity management has evolved significantly since initial approval, with prophylactic eye drops and monitoring protocols making adverse effects highly manageable and reversible. The panel reports varied experiences with ocular complications, emphasizing the importance of baseline ophthalmologic screening and patient counseling about reversibility. Despite initial patient hesitancy regarding eye-related adverse effects, the drug’s tolerability profile, including absence of alopecia and favorable patient-reported outcomes, makes it well-accepted once treatment begins.
Clinical experience demonstrates remarkable durability of response, with patients remaining on treatment for 18 to 24 months in platinum-resistant disease—previously unheard of in this setting. The drug’s waterfall plots show dramatic tumor responses compared to standard chemotherapy, translating into meaningful survival benefits. Stable disease represents success given the drug’s mechanism of action, and the overall survival benefit validates mirvetuximab soravtansine as a paradigm-shifting treatment for patients with folate receptor-positive ovarian cancer.