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Managing An Ovarian Cancer Recurrence: How The New Drug Elahere Is Providing Hope

Publication: SurvivorNet

New Option For Ovarian Cancer Recurrence

  • A new treatment option is available if your ovarian cancer comes back within six months of treatment, meaning it is “platinum resistant.”

  • Elahere (generic name mirvetuximab soravtansine) has shown a 33% improvement in survival for platinum resistant ovarian cancer, according to the Chief Medical Officer of ImmunoGen.

  • To know if you are eligible, you must take a special test called a immunohistochemistry (IHC).

  • The test measures whether your cancer is positive for the folate receptor alpha (FRα) protein.

  • The drug uses the FRα protein to enter the tumor, where it releases a chemotherapy targeting the tumor cell.

  • Side effects include adverse effects on eyes, diarrhea, nausea, tiredness and fatigue.

  • The drug is generally well-tolerated among patients.

A new targeted therapy called Elahere (generic name mirvetuximab soravtansine) is providing much needed hope for ovarian cancer survivors who are platinum resistant. Platinum resistant ovarian cancer is a cancer that comes back within six months of treatment with a platinum-based chemotherapy, like carboplatin and cisplatin.

Before Elahere, effective treatment options did exist for platinum resistant ovarian cancer but the response rates were typically lower. But Elahere, which was given accelerated FDA-approval in November 2022, has shown really hopeful results for those platinum resistant patients who are positive for the folate receptor alpha (FRα) protein.

“It is incredibly exciting to have a targeted therapy for platinum resistant ovarian cancer that has relatively limited treatment options,” Dr. Helen Eshed, a gynecologic oncologist at Texas Oncology in Austin told SurvivorNet.

What Is A Folate-Receptor Protein

Ovarian cancer cells frequently carry folate receptor-alpha (FRα) protein on their surface. Up to 80% of new and recurrent ovarian cancers may carry this protein. Generally, FRα levels tend to be high in more aggressive ovarian cancers.

Dr. Eshed explains: “If you have a folate receptor on your tumor, it has been shown that mirvetuximab can target that folate receptors.”

Mirvetuximab is carried on that folate receptor-alpha (FRα) protein into the tumor cell and releases a chemotherapy that directly targets the cancer cells.

“Mirvetuximab can be effective for treatment of ovarian, fallopian tube, primary peritoneal cancers… Currently mirvetuximab is approved for platinum resistant ovarian cancer,” Dr. Eshed told SurvivorNet.

Who Currently Qualifies For Elahere

  • Your cancer must be folate receptor alpha (FRa) positive

  • You did not respond to treatment with platinum-based chemotherapy

  • You have received 1 to 3 prior types of chemotherapy

What The Data Says

In a MIRASOL trial, intended to evaluate how effective Elahere is, more than one-third of patients (36%) receiving Elahere (who had previously been treated with a drug called bevacizumab) experienced improved progression-free survival and more than one-fourth (26%) experienced improved overall survival.

In another, smaller group of patients who had not previously been treated with bevacizumab, progression-free survival was 34% better and overall survival was 49% better than when patients received standard chemotherapy.

Side Effects of Elahere

The most common side effect of Elahere is the effect on patients eyes. For that reason, if you are taking Elahere, your gynecologic oncologist and ophthalmologist should be in close communication, according to Dr. Eshed. “We work really closely with ophthalmologists who will see you regularly for eye exams to evaluate if you’ve had any adverse effects.”

Eye exams should be conducted before proceeding with treatment. Patients will also be prescribed prescription steroid eye drops and lubricant eye drops. Regardless, Dr. Eshed told SurvivorNet, “many of the concerns in terms of the toxicity for your eyes are reversible.”

Other possible side effects of Elahere, according to various clinical studies, include diarrhea, nausea, tiredness and fatigue.

Other less common side effects include an elevation of liver enzymes, which can indicate liver damage, damage to the cornea of the eyes, dry eyes, numbness, pain, or tingling in the hands and feet and decreased blood cell counts.

Drug side effects are graded on a scale of 1-5, with 1 being mild side effects that do not require any intervention and 5 indicating death. Side effects for Elahere were mostly grade 2 or lower, meaning that they bothered patients but could be managed with supplementary medications.

Participating In Clinical Trials

Dr. Eshed is currently treating multiple patients with mirvetuximab. Many of those patients were part of the clinical trial for the treatment before it received accelerated FDA-approval.

“Patients who received treatments on trial did great, and now all of their fellow ovarian cancer survivors have the opportunity to receive treatments because of their involvement in clinical trials. So it’s a very exciting time to be in this space and it’s always wonderful to see people living longer, feeling better and enjoying their life,” Dr. Eshed told SurvivorNet.

Questions To Ask Your Doctor

  1. Is my cancer platinum resistant?

  2. Has my cancer been tested for the FRα protein?

  3. Can/should you order an immunohistochemistry (IHC) test?

  4. Am I eligible for Elahere?

  5. What additional tests might I need?

  6. What are the side effects?

  7. How do I qualify for a clinical trial?


Watch all six videos on SurvivorNet below featuring Helen Dinkelspiel Eshed, M.D., Texas Oncology-Austin Central and South Austin.

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