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A Study of Ocular Toxicity Evaluation and Mitigation During Treatment With Mirvetuximab Soravtansine in Participants With Recurrent Ovarian Cancer With High Folate Receptor-Alpha Expression

Phase 2
Recruiting
Conditions
Recurrent Ovarian Cancer
Folate Receptor-Alpha Positive
Interventions
Registration Number
NCT06365853
Lead Sponsor
AbbVie
Brief Summary

The purpose of this study is to evaluate the incidence rate and severity of prespecified mirvetuximab soravtansine (MIRV)-related ocular treatment-emergent adverse events (TEAEs) and assess prophylaxis strategies in all participants (symptomatic and asymptomatic) undergoing prospective ophthalmic evaluation with recurrent ovarian cancer (participants with either platinum-sensitive ovarian cancer \[PSOC\] or platinum-resistant ovarian cancer \[PROC\]) with high folate receptor alpha (FRα) expression.

Detailed Description

Participants will be randomized (1:1) to 1 of 2 ocular adverse event (AE) risk mitigation strategy arms (primary prophylactic steroid eye drops versus primary prophylactic vasoconstricting eye drops).

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
100
Inclusion Criteria
  • Participants must have a confirmed diagnosis of epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC) with high FRα expression.

  • Participant's tumor must be FRα positive (FRα high) as defined by either the VENTANA FOLR1 (FOLR-2.1) IUO Assay, or the VENTANA FOLR1 ( FOLR1-2.1) RxDx Assay (hereafter collectively termed VENTANA FOLR1 Assay) (≥ 75% cells exhibit ≥ 2+ membrane staining intensity).

  • Participants with known breast cancer susceptibility gene (BRCA) mutations (tumor or germline) must have received poly (ADP-ribose) polymerase inhibitors (PARPi).

  • Participants must have completed prior therapy within the specified times below:

    1. Systemic antineoplastic therapy ≥ 5 half-lives or 4 weeks (whichever is shorter) before first dose of MIRV;
    2. Focal radiation completed ≥ 2 weeks before the first dose of MIRV.
  • Participants must have stabilized or recovered (Grade 1 or baseline) from all prior therapy-related toxicities (except alopecia).

  • Women of childbearing potential (WOCBP) must agree to use highly effective contraceptive method(s) while on MIRV and for ≥ 7 months after the last dose; and must have a negative pregnancy test ≤ 4 days before the first dose of MIRV.

Exclusion Criteria
  • Participants with borderline ovarian tumor or non-epithelial histology or mixed histology including borderline or non-epithelial histology will be excluded.
  • PROC participants with primary platinum-refractory disease, defined as disease that did not respond to (complete response [CR] or partial response [PR]) or progressed within ≤ 3 months of the last dose of first line platinum-containing chemotherapy.
  • Participants with > Grade 1 peripheral neuropathy per National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0 (NCI-CTCAE v5.0).
  • Participants with significant active or chronic corneal disorders (for example, corneal dystrophies, degenerations, limbal stem cell deficiency), history of corneal transplantation, significant ocular inflammatory conditions (for example, active or recurrent uveitis), or other active ocular conditions requiring ongoing treatment/monitoring, such as uncontrolled glaucoma, active diabetic retinopathy with macular edema, macular degeneration requiring treatment ≤ 90 days before first dose, presence of papilledema, best corrected visual acuity (BCVA) worse than 20/70 in either eye, or monocular vision.
  • Participants receiving corticosteroid or vasoconstricting eyedrops at baseline or within 5 weeks of Cycle 1 Day 1.
  • Participants who received prior treatment with MIRV or other FRα-targeting agents. Note: Other protocol-defined inclusion and exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Primary Prophylactic Steroid Eye DropsLubricating Eye DropsPrednisolone acetate ophthalmic suspension 1% 6 times daily on Days -1 to 4 and 4 times daily (QID) on Days 5 to 8 of each cycle; Lubricating eye drops QID throughout the entire cycle (doses should follow steroid dosing, when given, by approximately 15 minutes); MIRV 6 milligrams (mg)/kilogram (kg) adjusted ideal body weight (AIBW) every 3 weeks (Q3W) on Day 1 of each cycle. Each cycle length = 21 days.
Primary Prophylactic Steroid Eye DropsPrednisolone acetate ophthalmic suspension 1% eye dropsPrednisolone acetate ophthalmic suspension 1% 6 times daily on Days -1 to 4 and 4 times daily (QID) on Days 5 to 8 of each cycle; Lubricating eye drops QID throughout the entire cycle (doses should follow steroid dosing, when given, by approximately 15 minutes); MIRV 6 milligrams (mg)/kilogram (kg) adjusted ideal body weight (AIBW) every 3 weeks (Q3W) on Day 1 of each cycle. Each cycle length = 21 days.
Primary Prophylactic Vasoconstricting Eye DropsMirvetuximab SoravtansinePrimary prophylactic brimonidine tartrate ophthalmic solution eye drops 3 times daily (TID) on Days 1 to 8 of each cycle (vasoconstricting drops should be started on the day of first infusion and should begin before the first infusion on Cycle 1 Day 1); Lubricating eye drops QID throughout the entire cycle (doses should follow brimonidine dosing, when given, by approximately 15 minutes); MIRV 6 mg/kg AIBW Q3W on Day 1 of each cycle. Each cycle length = 21 days.
Primary Prophylactic Vasoconstricting Eye DropsBrimonidine tartrate ophthalmic solution eye dropsPrimary prophylactic brimonidine tartrate ophthalmic solution eye drops 3 times daily (TID) on Days 1 to 8 of each cycle (vasoconstricting drops should be started on the day of first infusion and should begin before the first infusion on Cycle 1 Day 1); Lubricating eye drops QID throughout the entire cycle (doses should follow brimonidine dosing, when given, by approximately 15 minutes); MIRV 6 mg/kg AIBW Q3W on Day 1 of each cycle. Each cycle length = 21 days.
Primary Prophylactic Vasoconstricting Eye DropsLubricating Eye DropsPrimary prophylactic brimonidine tartrate ophthalmic solution eye drops 3 times daily (TID) on Days 1 to 8 of each cycle (vasoconstricting drops should be started on the day of first infusion and should begin before the first infusion on Cycle 1 Day 1); Lubricating eye drops QID throughout the entire cycle (doses should follow brimonidine dosing, when given, by approximately 15 minutes); MIRV 6 mg/kg AIBW Q3W on Day 1 of each cycle. Each cycle length = 21 days.
Primary Prophylactic Steroid Eye DropsMirvetuximab SoravtansinePrednisolone acetate ophthalmic suspension 1% 6 times daily on Days -1 to 4 and 4 times daily (QID) on Days 5 to 8 of each cycle; Lubricating eye drops QID throughout the entire cycle (doses should follow steroid dosing, when given, by approximately 15 minutes); MIRV 6 milligrams (mg)/kilogram (kg) adjusted ideal body weight (AIBW) every 3 weeks (Q3W) on Day 1 of each cycle. Each cycle length = 21 days.
Primary Outcome Measures
NameTimeMethod
Number of Participants With MIRV-related Corneal TEAEs (≥ Grade 2) in Asymptomatic ParticipantsCycle 1 Day 1 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)

This endpoint will be assessed in the participants receiving MIRV who are asymptomatic .

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Ocular symptom TEAEs in Participants Using Corticosteroid or Vasoconstricting Eye Drop Primary ProphylaxisCycle 1 Day 1 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days
Number of Participants With MIRV-related Corneal TEAEs in Symptomatic ParticipantsCycle 1 Day 1 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
Number of Participants With Ocular exam TEAEs in Asymptomatic Participants and Symptomatic participantsCycle 1 Day 1 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
Number of Participants With MIRV-related Corneal TEAEs (≥ Grade 2) in Participants Using Corticosteroid or Vasoconstricting Eye Drop Primary ProphylaxisCycle 1 Day 1 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
Number of Participants with ocular exam TEAEs in Participants using corticosteroid or vasoconstricting eye drop primary prophylaxisCycle 1 Day 1 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) Composite ScoreAt Cycle 5 Day 1 or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
Area Under the Curve (AUC) of MIRVDay 1 and Day 8 of Cycles 1 through 4 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
Maximum Serum Concentration (Cmax) of MIRVDay 1 and Day 8 of Cycles 1 through 4 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)
Trough Concentration (Ctrough) of MIRVDay 1 and Day 8 of Cycles 1 through 4 up to 18 weeks or at the 30-day follow-up visit, whichever is earlier (cycle length = 21 days)

Trial Locations

Locations (40)

University of California Los Angeles /ID# 269339

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Los Angeles, California, United States

Norton Healthcare /ID# 269070

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Louisville, Kentucky, United States

Holy Cross Hospital - Silver Spring /ID# 269344

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Silver Spring, Maryland, United States

Mercy David C. Pratt Cancer Center /ID# 269350

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Saint Louis, Missouri, United States

The Center Of Hope /ID# 269348

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Reno, Nevada, United States

Holy Name Medical Center /ID# 269340

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Teaneck, New Jersey, United States

New York Oncology Hematology - Albany Cancer Center /ID# 269345

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Albany, New York, United States

Women'S Cancer Care Associates /ID# 269980

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Albany, New York, United States

Duke Cancer Institute /ID# 269342

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Durham, North Carolina, United States

Summa Health /ID# 269349

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Akron, Ohio, United States

UT Southwestern Medical Center /ID# 269341

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Dallas, Texas, United States

Memorial Hermann Southeast Hospital /ID# 269347

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Houston, Texas, United States

Blacktown Hospital /ID# 269305

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Blacktown, New South Wales, Australia

Newcastle Private Hosptial /ID# 269306

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Lambton Heights, New South Wales, Australia

Monash University Clayton Campus /ID# 269304

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Clayton, Victoria, Australia

Universitair Ziekenhuis Antwerpen /ID# 269310

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Edegem, Antwerpen, Belgium

Onze Lieve Vrouw Ziekenhuis Aalst /ID# 269311

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Aalst, Oost-Vlaanderen, Belgium

AZ Sint-Lucas /ID# 269307

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Gent, Oost-Vlaanderen, Belgium

UZ Gent /ID# 269309

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Gent, Oost-Vlaanderen, Belgium

UZ Leuven /ID# 269308

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Leuven, Vlaams-Brabant, Belgium

CHU de Liege /ID# 269312

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Liege, Belgium

Universite de Montreal - Hopital Maisonneuve-Rosemont /ID# 268862

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Montreal, Quebec, Canada

Centre Hospitalier De L'Universite De Montreal - Hopital Saint-Luc /ID# 269314

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Montreal, Quebec, Canada

McGill University Health Centre /ID# 269313

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Montreal, Quebec, Canada

Institut Paoli-Calmettes /ID# 269648

🇫🇷

Marseille, Bouches-du-Rhone, France

Centre Hospitalier Régional Universitaire de Tours - Hôpital Bretonneau /ID# 269301

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Tours, Indre-et-Loire, France

Hopitaux Universitaires Paris Centre-Hopital Cochin /ID# 269330

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Paris CEDEX 14, Paris, France

Hospices Civils de Lyon - Centre Hospitalier Lyon-Sud /ID# 269327

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Pierre Benite, Rhone, France

Clinique Victor Hugo Le Mans /ID# 269985

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Le Mans, Sarthe, France

GH Diaconesses Croix Saint-Simon /ID# 269329

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Paris, France

Mater Misericordiae University Hospital /ID# 269334

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Dublin, Ireland

Beaumont Hospital /ID# 268864

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Dublin, Ireland

Hospital San Pedro de Alcántara /ID# 269320

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Cáceres, Caceres, Spain

Hospital Universitario de Jaén /ID# 269319

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Jaén, Jaen, Spain

Usp Instituto Universitario Dexeus /ID# 269322

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Barcelona, Spain

Hospital Universitario Vall d'Hebron /ID# 269315

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Barcelona, Spain

Hospital Universitario Ramon y Cajal /ID# 269318

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Madrid, Spain

Hospital Universitario 12 de Octubre /ID# 269321

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Madrid, Spain

Hospital Universitario La Paz /ID# 269302

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Madrid, Spain

Hospital Universitario y Politecnico La Fe /ID# 269325

🇪🇸

Valencia, Spain

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