Safety and efficacy of mirvetuximab soravtansine, a folate receptor alpha (FR?)-targeting antibody-drug conjugate (ADC), in combination with bevacizumab in patients with platinum-resistant ovarian cancer

Purpose. Evaluate the antitumor activity and safety profile of the combination of mirvetuximab soravtansine and bevacizumab in patients with platinum-resistant ovarian cancer.Methods. Patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, whose most recent platinum-free interval was <= 6 months, were administered mirvetuximab soravtansine (6 mg/kg adjusted ideal body weight) and bevacizumab (15 mg/kg), intravenously, once every 3 weeks. Eligibility included FR alpha ex-pression by immunohistochemistry (IHC; >= 25% of cells with >= 2+ intensity). Prior bevacizumab and/or PARP in-hibitor (PARPi) treatment were permitted. The primary endpoint was confirmed objective response rate (ORR). Secondary endpoints included duration of response (DOR), progression-free survival (PFS), and safety.Results. Ninety-four patients received combination treatment with mirvetuximab soravtansine and bevaciz-umab. Median age was 62 years (range, 39-81). Fifty-two percent had >= 3 prior therapies; 59% had prior bevaciz-umab; and 27% had prior PARPi. ORR was 44% (95% CI 33, 54) with 5 complete responses, median DOR 9.7 months (95% CI 6.9, 14.1), and median PFS 8.2 months (95% CI 6.8, 10.0). Treatment-related adverse events were consistent with the profiles of each agent, with the most common being blurred vision (all grades 57%; grade 3, 1%), diarrhea (54%; grade 3, 1%), and nausea (51%; grade 3, 1%). Conclusion. The mirvetuximab soravtansine plus bevacizumab doublet is an active and well-tolerated regi-men in patients with FR alpha-expressing platinum-resistant ovarian cancer. Promising activity was observed for pa-tients regardless of level of FR alpha expression or prior bevacizumab. These data underscore the potential for mirvetuximab soravtansine as the combination partner of choice for bevacizumab in this setting. (c) 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

The combination of mirvetuximab soravtansine and bevacizumab demonstrated antitumor activity and safety in patients with platinum-resistant ovarian cancer. The treatment achieved high objective response rate (44%) and prolonged duration of response (median 9.7 months). The study suggests that mirvetuximab soravtansine could be a potential combination partner for bevacizumab in this patient population.