Kong Beihua, Zheng Wenxin
Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China.
Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
J Hematol Oncol. 2025 Mar 18;18(1):33. doi: 10.1186/s13045-025-01686-2.
Ovarian epithelial cancer (OEC), particularly high-grade serous carcinoma (HGSC), remains a clinical challenge due to its late-stage diagnosis, high recurrence rates, and poor survival outcomes. Mirvetuximab soravtansine (MIRV), an antibody-drug conjugate targeting folate receptor alpha (FRα), has demonstrated promising efficacy in platinum-resistant OEC, particularly in high FRα-expressing populations, as evidenced by key clinical trials such as FORWARD I, FORWARD II, SORAYA, and MIRASOL. These trials highlight MIRV's ability to improve progression-free survival, response rates, and quality of life in advanced disease settings. Emerging data suggest that FRα is also highly expressed in serous tubal intraepithelial carcinoma (STIC), a non-invasive precursor lesion to HGSC. Although MIRV has not yet been studied for STIC management, we propose its potential application in this context to prevent progression to invasive carcinoma, particularly in high-risk populations undergoing risk-reducing bilateral salpingo-oophorectomy. This novel use could bridge the gap between prevention and treatment, offering a proactive strategy for hereditary cancer management. Furthermore, MIRV's therapeutic versatility extends to other FRα-positive tumors, such as endometrial and breast cancers, broadening its clinical relevance. Despite challenges such as accessibility and cost, MIRV represents a significant advancement in precision medicine, with potential to redefine prevention and treatment strategies for hereditary and sporadic cancers.
卵巢上皮癌（OEC），尤其是高级别浆液性癌（HGSC），由于其晚期诊断、高复发率和较差的生存结果，仍然是一个临床挑战。Mirvetuximab soravtansine（MIRV）是一种靶向叶酸受体α（FRα）的抗体药物偶联物，在铂耐药的OEC中显示出有前景的疗效，特别是在高FRα表达人群中，如FORWARD I、FORWARD II、SORAYA和MIRASOL等关键临床试验所证明。这些试验突出了MIRV在晚期疾病环境中改善无进展生存期、缓解率和生活质量的能力。新出现的数据表明，FRα在浆液性输卵管上皮内癌（STIC）中也高度表达，STIC是HGSC的一种非侵袭性前驱病变。虽然尚未对MIRV用于STIC治疗进行研究，但我们提出其在这种情况下的潜在应用，以预防进展为侵袭性癌，特别是在接受降低风险的双侧输卵管卵巢切除术的高危人群中。这种新用途可以弥合预防和治疗之间的差距，为遗传性癌症管理提供一种积极主动的策略。此外，MIRV的治疗多功能性扩展到其他FRα阳性肿瘤，如子宫内膜癌和乳腺癌，扩大了其临床相关性。尽管存在可及性和成本等挑战，但MIRV代表了精准医学的重大进展，有可能重新定义遗传性和散发性癌症的预防和治疗策略。
