Mirvetuximab soravtansine in ovarian cancer therapy: expert opinion on pharmacological considerations

Cancer Chemother Pharmacol. 2024 Feb;93(2):89-105. doi: 10.1007/s00280-023-04575-y. Epub 2023 Aug 18.

Abstract

ImmunoGen developed mirvetuximab soravtansine as an antibody-drug conjugate comprising of a humanized anti-folate receptor-α (FRα) monoclonal antibody of IgG1k subtype, a cleavable linker, and a cytotoxic payload, DM4. Mirvetuximab soravtansine was granted accelerated approval by the US FDA on November 14, 2022, for the treatment of adult patients with FRα positive, platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer who have received 1-3 prior systemic treatment regimens. The approval of mirvetuximab soravtansine represents a breakthrough for addressing the unmet medical needs of ovarian cancer, especially for up to 80% of patients who relapse and become resistant to platinum-based chemotherapy, resulting in poor prognosis and limited treatment options. However, it is my impression that addressing several pharmacological factors could improve the safety and efficacy of mirvetuximab soravtansine. This article summarizes the current pharmacological profile of mirvetuximab soravtansine and provides an expert opinion on pharmacological strategies for optimizing its safety and efficacy profile for the treatment of platinum-resistant ovarian cancer.

Keywords: Antibody–drug conjugate; COVID-19; Cleavable linker; Combination therapy; Disease—drug interactions; Disease—drug—drug interactions; Drug—drug interactions; Folate receptor—α; Mirvetuximab soravtansine; Non-cleavable linker; Ovarian Cancer; Platinum resistance; Precision dosing.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized*
  • Drug Resistance, Neoplasm
  • Expert Testimony
  • Female
  • Humans
  • Immunoconjugates* / adverse effects
  • Maytansine* / analogs & derivatives
  • Neoplasm Recurrence, Local / drug therapy
  • Ovarian Neoplasms* / chemically induced
  • Ovarian Neoplasms* / drug therapy
  • Platinum / therapeutic use

Substances

  • mirvetuximab soravtansine
  • Immunoconjugates
  • Platinum
  • Maytansine
  • Antibodies, Monoclonal, Humanized