AbbVie's Elahere (mirvetuximab soravtansine) has received marketing authorization from the European Commission for the treatment of adult patients with folate receptor-alpha (FRα) positive, platinum-resistant high grade serous epithelial ovarian, fallopian tube, or primary peritoneal cancer who have received one to three prior systemic treatment regimens. This approval marks a significant advancement, as Elahere is the first and only folate receptor alpha (FRα)-directed antibody-drug conjugate (ADC) approved in the European Union (EU) for this indication.
The approval is based on data from the Phase 3 MIRASOL trial, a global, open-label, randomized, controlled study. The trial compared Elahere to investigator's choice chemotherapy in patients with platinum-resistant, high-grade serous ovarian cancer whose tumors express high levels of FRα. Participants had previously received one to three lines of prior therapy.
Clinical Trial Results
Results from the MIRASOL trial, presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting, demonstrated a significant improvement in progression-free survival (PFS) for patients treated with Elahere. Specifically, the data showed a 35% reduction in the risk of tumor progression or death in the Elahere arm compared to the investigator's choice chemotherapy arm (HR 0.65, 95% CI: 0.52, 0.81; p<0.0001).
Furthermore, Elahere demonstrated an improvement in overall survival (OS) compared with investigator's choice chemotherapy, representing a 33% reduction in the risk of death in the Elahere arm (HR 0.67, 95% CI: 0.50, 0.89; p=0.0046).
Companion Diagnostic
The VENTANA FOLR1 (FOLR1-2.1) RxDx Assay, developed by Roche Diagnostics, also received CE Mark approval. This immunohistochemistry (IHC) companion diagnostic test identifies patients with FRα-positive tumors who may be eligible for Elahere treatment. High FRα expression is defined as ≥75% of tumor cells with ≥2+ membrane staining intensity.
Safety Profile
The most common adverse reactions observed with Elahere in clinical trials were blurred vision (43%), nausea (41%), diarrhea (39%), fatigue (35%), and abdominal pain (30%). Serious adverse reactions included pneumonitis (4%), small intestinal obstruction (3%), and intestinal obstruction (3%).
Addressing Unmet Needs
Ovarian cancer remains a significant cause of death among gynecological cancers worldwide. Most patients are diagnosed with late-stage disease and eventually develop platinum-resistant disease. Historically, treatment options for these patients have been limited, often resulting in adverse events that negatively impact quality of life. Elahere offers a much-needed targeted treatment option for this patient population.
