MIRASOL: mirvetuximab soravtansine versus chemotherapy in folate receptor alpha-high platinum-resistant ovarian cancer
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.
Overview
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.
- Median overall survival 16.46 vs 12.75 months; hazard ratio 0.67.
- Objective response 42.3 percent vs 15.9 percent.
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.
- Only about 35 to 40 percent of tumours are folate receptor alpha-high.
- Blurred vision and keratopathy require ophthalmic monitoring.
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