Mirvetuximab Soravtansine in Practice: Expert Approaches to Adverse Event Management in Ovarian Cancer

The discussion highlights the importance of early detection and proactive management of ocular toxicities when using mirvetuximab soravtansine. Regular screening and monitoring are emphasized, particularly as the drug transitions from clinical trials to broader clinical use. A routine ocular toxicity questionnaire has been incorporated into practice to identify symptoms such as blurry vision, floaters, or light sensitivity, which are often mild (grade 1). Eye exams before each treatment cycle help monitor for any changes, ensuring timely intervention if necessary.

The management of ocular toxicities involves the use of eye drops and close collaboration with ophthalmologists. Most ocular issues resolve with appropriate care, but some patients may need to temporarily hold therapy or adjust their treatment. A secondary effect observed in the long-term use of mirvetuximab soravtansine is the development of cataracts, often linked to steroid eye drops. Although cataract surgery is a quick fix, this underscores the importance of long-term follow-up for these patients to manage potential complications effectively.

In real-world settings, the use of mirvetuximab soravtansine in patients with preexisting ocular conditions or other comorbidities may present new challenges. These patients were typically excluded from clinical trials, so unexpected adverse effects may arise in the broader population. Continuous reporting of adverse events is crucial to updating the toxicity profiles of medications. Despite these challenges, with careful monitoring and appropriate interventions, ocular toxicities can be effectively managed, minimizing the risk of long-term consequences for patients.