Mirvetuximab soravtansine (MIRV), an anti-folate receptor 1/alpha (FRα, FOLR1) antibody-drug conjugate (ADC) with a companion diagnostic immunohistochemical (IHC) biomarker using VENTANA FOLR1 assay represents a precisely targeted chemotherapy for treating platinum-resistant recurrent epithelial ovarian cancer (PR-rEOC) patients with overexpression of FRα and possibly for platinum-sensitive rEOC (PS-rEOC) patients, regardless of status of FRα expression. The global phase III randomized clinical trial (RCT, MIRASOL) enrolling 453 highly FRα expressed PR-rEOC patients demonstrated that MIRV treatment provided statistically significant improvements in clinical outcomes compared to investigator's choice of chemotherapy (ICC), which included not only the progression free-survival (median PFS 5.6 months vs. 4.0 months, hazard ratio HR 0.65) but also the overall survival (median OS 16.5 months vs. 12.8 months, HR 0.67). Additionally, overall response rate (ORR) was significantly higher in MIRV treatment (42.3 % vs. 15.9 %). Moreover, the severe adverse events (AEs) and treatment-related AEs (TRAEs)-associated discontinuation in MIRV group were dramatically fewer (41.7 % vs. 54.1 %) and lower (9.2 % vs. 15.9 %), respectively compared to ICC group. These findings suggest that the treatment of choice may be the utilizing MIRV as the front-line for treating PR-rEOC patients if FRα expression of Pr-rEOC patients is high. Finally, any-grade ocular adverse events (OAEs) are particularly common in patients during MIRV treatment, arising in 125 (57 %); grade ≥3 in 34 (16 %), most frequently, blurred vision (18 8 %), keratopathy (21 10 %), cataract (11 5 %), and dry eye (8 4 %); however, fortunately, over 90 % with OAEs had either full resolution or documented final grade 1 or better. The current review also discusses OAE, based on its high incidence, frequent cause responsible to dose reduction and delaying therapy with impacting 11-35 % of patients and of the most importance, relative unfamiliarity to most gynecological oncologists in the routine clinical practice.
Wang et al. (Thu,) studied this question.