Mirvetuximab Soravtansine Versus Chemotherapy in Platinum-Resistant Ovarian Cancer
Posted: Monday, November 18, 2019
The results of the phase III FORWARD I (GOG 3011) trial suggest that mirvetuximab soravtansine, a folate receptor alpha (FRα)-targeting antibody-drug conjugate, does not seem to improve progression-free survival in patients with platinum-resistant ovarian cancer. However, Kathleen Moore, MD, of the University of Oklahoma, Oklahoma City, and colleagues observed activity and signals of superiority in a subset of patients with high FRα expression. These findings were presented at the European Society for Medical Oncology (ESMO) Congress 2019 in Barcelona (Abstract 992O) and simultaneously published in the Annals of Oncology.
The investigators randomly assigned 366 patients, of whom 248 received mirvetuximab soravtansine and 118 received chemotherapy. Within the study population, 218 patients had high FRα expression.
Among the overall population, the median progression-free survival was 4.1 months in the mirvetuximab soravtansine group versus 4.4 months in the chemotherapy group. For the subset of patients with high FRα expression, patients treated with mirvetuximab soravtansine achieved more favorable outcomes than those treated with chemotherapy. More specifically, progression-free survival and overall response rates were both higher among patients treated with mirvetuximab soravtansine. The progression-free survival was 4.8 months in the mirvetuximab soravtansine group versus 3.3 months in the chemotherapy group (P = .049). The overall response rate was 24% with mirvetuximab soravtansine compared with 10% with chemotherapy.
Adverse events associated with the antibody-drug conjugate included nausea (54%), diarrhea (44%), and blurred vision (43%). The study authors observed fewer treatment-related high-grade adverse events, dose modifications, and treatment discontinuations with the novel therapy.
“These findings suggest a favorable benefit-risk profile for mirvetuximab soravtansine in this biomarker-defined and difficult-to-treat population,” the authors concluded.
Disclosure: For full disclosure information for the study authors, visit academic.oup.com.