Roisin E. O’Cearbhaill, MD
Formal discussant of this late-breaking presentation, Roisin E. O’Cearbhaill, MD, of Memorial Sloan Kettering Cancer Center, New York, commented: “MIRASOL is confirmatory of SORAYA, the trial that led to FDA accelerated approval. The impressive data of MIRASOL show an overall survival advantage in the extremely difficult-to-treat disease setting of platinum-resistant ovarian cancer with high folate receptor–alpha including those treated with prior bevacizumab.”
Dr. O’Cearbhaill continued: “We saw improved response rates, progression-free survival, and overall survival [with mirvetuximab soravtansine compared with investigator’s choice of chemotherapy]. The response rates including those with stable disease equate to a disease control rate of 80%. Mirvetuximab soravtansine may have a place in the treatment of recurrent platinum-resistant ovarian cancer,” she stated. “However, we still need more treatment options that translate to meaningful and durable responses for our patients.”
Challenges and Next Steps
Remaining challenges include addressing both intrinsic and acquired resistance; understanding heterogeneous tumor antigen expression; and improving symptoms related to both disease as well as treatment toxicity.
“Other antibody-drug conjugates are being studied as well. We need to determine the optimal disease setting for these agents and how best to sequence them. Ongoing trials are evaluating their role earlier in the disease course. The GLORIOSA study is investigating the role of mirvetuximab soravtansine in combination with bevacizumab as a potential maintenance strategy for patients with platinum-sensitive disease. We also need to develop reliable predictive biomarkers that will identify those patients most likely to benefit from the treatment,” Dr. O’Cearbhaill added.
“We need to figure out how to deliver these agents safely and provide patient-friendly education. We must create new partnerships, in this case with eye specialists, so that we can mitigate the ocular toxicity,” she noted.
Dr. O’Cearbhaill shared these comments with ASCO attendees: “Antibody-drug conjugates open a new wealth of opportunities for oncologists that we haven’t even imagined. Six are currently approved in the U.S. for solid tumors and two more worldwide. There are four antibody-drug conjugates for ovarian cancer in late stages of development.” She pointed out that some of the newer ones may also be able to treat a broader range of patients (such as those with low expression of folate receptor–alpha) and that the various antibody-drug conjugates may have different side effect profiles. “With so many new agents on the horizon, we may envision a future where there will be a ‘best-in-class’ for new targeted drugs.
DISCLOSURE: Dr. O’Cearbhaill has received honoraria from Curio Science, GlaxoSmithKline, MLH Life Sciences, and MLH/PER; has served as a consultant or advisor to Aptitude Health, Bayer, Carina Biotech, Fresenious Kabi, GlaxoSmithKline, GOG Foundation, Immunogen, R-Pharm, Regeneron, Miltenyi Biotec, 2seventy bio, and Seagen; has received institutional research funding from Acrivon Therapeutics, AstraZeneca, Atara Biosciences, Bristol Myers Squibb, Genentech, Genmab, GlaxoSmithKline, GOG Foundation, Juno Therapeutics, Kite/Gilead, Ludwig Institute for Cancer Research, Merck/Genentech, Regeneron, Sellas Life Sciences, Syndax TapImmune, and TCR2 Therapeutics; and has received reimbursement for travel expenses from Gathering Around Cancer Hitech Health and the Society of Gynecologic Oncology.
