# MIRASOL: mirvetuximab soravtansine versus chemotherapy in folate receptor alpha-high platinum-resistant ovarian cancer

Source: https://onco.cc/key-papers/paper-mirasol-nejm-2023/  
OnCo record `paper-mirasol-nejm-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The antibody-drug conjugate mirvetuximab soravtansine lengthened survival compared with chemotherapy in platinum-resistant ovarian cancer with high folate receptor alpha expression, the first drug ever to do so in this setting.

## Summary

Phase 3 trial of 453 patients with platinum-resistant high-grade serous ovarian cancer, folate receptor alpha-high tumours and one to three prior regimens, randomised to mirvetuximab soravtansine or investigator's choice chemotherapy (paclitaxel, pegylated liposomal doxorubicin or topotecan).

Median progression-free survival was 5.62 versus 3.98 months (hazard ratio 0.65), objective response 42.3 versus 15.9 percent and median overall survival 16.46 versus 12.75 months (hazard ratio 0.67); ocular toxicity was frequent but mostly low grade.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2023
- DOI: 10.1056/NEJMoa2309169
- Authors: Moore KN, Angelergues A, Konecny GE, et al.
- Findings: Median overall survival 16.46 vs 12.75 months; hazard ratio 0.67.; Objective response 42.3 percent vs 15.9 percent.
- What it means: Folate receptor alpha testing is now standard in platinum-resistant ovarian cancer and mirvetuximab is the preferred treatment for high-expressing tumours, with an eye-care protocol.
- Caveats: Only about 35 to 40 percent of tumours are folate receptor alpha-high.; Blurred vision and keratopathy require ophthalmic monitoring.

## Sources

- N Engl J Med 2023: https://doi.org/10.1056/NEJMoa2309169
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38055253/

## Connected records

- cancers: [High-grade serous ovarian cancer](https://onco.cc/cancers/high-grade-serous-ovarian-cancer/), [Platinum-resistant ovarian cancer](https://onco.cc/cancers/platinum-resistant-ovarian-cancer/)
- drugs: [Mirvetuximab soravtansine](https://onco.cc/drugs/mirvetuximab-soravtansine/)
- trials: [MIRASOL / GOG-3045](https://onco.cc/trials/mirasol/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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