Potential of Moving Mirvetuximab to Earlier Lines in Ovarian Cancer Subtype

In an interview with CancerNetwork^®, Ritu Salani, MD discusses moving mirvetuximab soravtansine-gynx (Elahere) to earlier lines of treatment to capitalize on improved outcomes with less adverse effects among patients with folate receptor–α platinum-resistant ovarian cancer based on findings from the phase 3 MIRASOL trial (NCT04209855).

Investigators presented data from the MIRASOL trial at 2023 American Society of Clinical Oncology (ASCO) Annual Meeting.

According to Salani, the Gynecologic Oncology Fellowship Director at University of California Los Angeles Health and the Gynecologic Oncology editorial board member for the journal ONCOLOGY^®, ongoing trials combining mirvetuximab with agents such as carboplatin may help elucidate the feasibility of treating platinum-sensitive disease in earlier settings while minimizing toxicity among patients.

In the MIRASOL trial, patients treated with mirvetuximab experienced an overall response rate of 42% compared with 16% among those treated with investigator’s choice chemotherapy. Moreover, Salani emphasized that patients who previously received bevacizumab (Avastin) did not respond as well as the overall population, but still showed favorable outcomes.

Transcript:

The one thing we always see is that when we have an active agent, we want to use it as early as possible. One of the things that came out with this trial is that the patients who received bevacizumab before proceeding with mirvetuximab had a little bit of a lower response rate, although it was still a favorable response rate than those who are bevacizumab naïve. One of the concepts of this is maybe we should move mirvetuximab sooner; that is where the trials are headed.

There are currently studies of moving mirvetuximab in combination with carboplatin earlier to the platinum-sensitive [population] and exploring [the question of] if we use a drug sooner, can we even capitalize on these better outcomes, especially for minimizing toxicities? One of the really great things about the ovarian cancer landscape is that patients are living a lot longer. If we can reduce toxicities in these patients and allow them to live better, not just longer, we're really making the impact in this disease.

Reference

Moore KN, Angelergues A, Konecny GE, et al. Phase III MIRASOL (GOG 3045/ENGOT-ov55) study: mirvetuximab soravtansine vs. investigator’s choice of chemotherapy in platinum-resistant, advanced high-grade epithelial ovarian, primary peritoneal or fallopian tube cancers with high folate receptor-alpha (FRα) expression. J Clin Oncol. 2023;41(suppl 17):LBA5507. doi:10.1200/JCO.2023.41.17_suppl.LBA5507