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The antibody drug conjugate received FDA approval in November 2022.
Clinicians now have more nuanced information on how the antibody drug conjugate mirvetuximab soravtansine (Elahere, Immunogen) works in patients with folate receptor alpha-high (FRα-high) platinum-resistant ovarian cancer based on their prior exposure to bevacizumab (Avastin), thanks to updated data from the phase 3 SORAYA trial (NCT04296890) presented recently.1
Final overall survival (OS) and additional efficacy data were presented last month at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer in Tampa, Florida. This followed the November 14, 2022, FDA accelerated approval of mirvetuximab soravtansine for adult patients with FRα-high platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer, who have received 1 to 3 prior systemic treatments regimens.2
Approval was based on initial SORAYA results, which reported the primary end point, overall response rate (ORR), was 31.7% % (95% CI, 22.9-41.6) and the key secondary end point, median duration of response, (DOR), was 6.9 months (95% CI; 5.6-9.7) in 104 patients.3
All patients in the study had received prior bevacizumab—some in the frontline setting, some in the platinum-sensitive setting, and some in the platinum-resistant setting. (Six patients had bevacizumab in more than 1 setting). Results for 105 patients published in the Journal of Clinical Oncology (JCO) in January, after a median follow-up of 13.4 months, showed that 51% of the patients in SORAYA had 3 prior lines of therapy and 48% and a prior poly-ADP-ribose polymerase (PARP) inhibitor.4
Robert L. Coleman, MD, FACOG, FACS, presented the subgroup analysis of the SORAYA trial. The updated data showed a confirmed ORR of 32.4% (95% CI, 23.6%-42.2%), including 5 complete responses.1 In the subgroup analysis involving previous bevacizumab exposure, results were as follows:
The presentation noted that updated safety outcomes for mirvetuximab soravtansine were consistent with prior data from SORAYA. Data reported after a median follow-up of 13.4 months in JCO showed that the most common treatment-related adverse events, all grade and grade 3-4, were blurred vision (41% and 6%), keratopathy (29% and 9%), and nausea (29% and 0%). Treatment-related AEs led to discontinuations in 9% of patients.4
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