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Is The Drug Elahere An Option When My Ovarian Cancer Returns?

Publication: SurvivorNet
For too many women, ovarian cancer comes back after initial treatment. A drug called Elahere (also known as mirvetuximab soravtansine) is offering a new option to women whose ovarian cancer has come back, which so often happens after treatment with chemotherapy.

Ovarian cancer is generally broken down into two categories, according to gynecologic oncologist, Dr. Noelle Cloven from Texas Oncology-Fort Worth Cancer Center:

  • Platinum-Sensitive Ovarian Cancer: Your cancer does not return for more than six months after treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
  • Platinum-Resistant Ovarian Cancer: Your cancer returns within six months of treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
“Usually we know that (the cancer’s returned) either based on a tumor marker or blood test. Or maybe something on a CT scan. Or a symptom on a physical exam. If that’s the case, it’s time to talk about a plan,” Dr Cloven told SurvivorNet.

Options For Platinum-Sensitive Ovarian Cancer:
If you have platinum-sensitive ovarian cancer you will likely continue to benefit from chemotherapy. The chemotherapy carboplatin is most commonly used. It is frequently combined with other “non-platinum drugs” (meaning non-chemotherapies) like Taxol, Doxorubicin (also known as Doxil) or Gemzar.

Options For Platinum-Resistant Ovarian Cancer:
If you have platinum-resistant ovarian cancer, another round of chemotherapy is likely not the way to go.

“The mechanism that causes platinum-resistance will cause someone to be resistant to other chemotherapies, as well. That’s why we’re looking for what we call targeted therapies – precision medicine,” Dr. Cloven explained.

Targeted therapies or precision medicine are treatments that specifically target the proteins that control how cancer cells grow, divide, and spread.

“One of the latest targets of interest in ovarian cancer is something called the folate receptor,” Dr. Cloven says. “This is not something new. We’ve been looking at ways to exploit this target for years. And recently we’ve had success.”

Eligibility For Elahere
Elahere (molecular name mirvetuximab) is the “success” Dr. Cloven is referring to. It is a new FDA-approved targeted therapy for patients with platinum-resistant ovarian cancer.

Currently, to be eligible for treatment, a patient must have very high levels (>75%) of the folate receptor-alpha (FRα). Up to 80% of new and recurrent ovarian cancers may carry this protein, but only about 35-40% of platinum resistant cancers test for levels that high.

Your doctor can order a special test called the FOLR1. The test takes part of your originally biopsied tumor to measure your folate receptor levels.

“There is no reason not to do the test, Dr. Cloven says. “Typically, the tissue’s already there. It’s covered by insurance. I would ask for the test if you have not had it done and you’re considering options for treatment in the platinum-resistant setting.”

Watch full video on SurvivorNet.

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