Lang Susan M, Vingopoulos Filippos, Beshar Isabel, Somasegar Sahana, Adams Elizabeth V, Sasse Simone A, Ghezelayagh Talayeh, McClung Emily Clair, Karam Amer, Dorigo Oliver, Mruthyunjaya Prithvi, Litkouhi Babak
Division of Gynecology Oncology, Department of Obstetrics & Gynecology, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, USA.
Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Stony Brook Medicine, Stony Brook, NY 11794, USA.
Gynecol Oncol Rep. 2025 Apr 5;59:101738. doi: 10.1016/j.gore.2025.101738. eCollection 2025 Jun.
Mirvetuximab soravtansine (MIRV) recently emerged as a promising therapeutic option for patients with platinum resistant ovarian cancer (PROC). In trials leading up to its approval, several ocular and other toxicities were identified. We report our experience with MIRV in a less-selected "real-world" population.
A retrospective review of patients with folate-receptor alpha positive, recurrent PROC treated with MIRV between December 2022-April 2024 was performed. Demographic, treatment, and toxicity data were abstracted from the medical record. The primary outcomes of interest were the incidence and nature of MIRV-related toxicities, as well as the clinical response to treatment.
25 patients were analyzed, and 44 % had >3 previous lines of treatment. The median duration of MIRV treatment 4.7 months, and 36 % of patients received more than 6 months of MIRV. Ocular events were common and occurred early, resulting in grade 1, 2, and 3 toxicity (28 %, 20 %, and 16 % respectively). As a result, 36 % of patients had an increased frequency of ophthalmologic care, 48 % required a medication change, and 32 % had dose reduction, but none required MIRV discontinuation. Pneumonitis occurred in 24 % of patients, was the leading cause of treatment discontinuation and may be associated with significant underlying cardiopulmonary comorbidities and pulmonary disease burden.
Our real-world experience with MIRV mirrors previously published data and suggests a benefit may also be seen in a more heavily pretreated population. Toxicities were similar to those previously reported, although our increased incidence of pneumonitis suggests care when treating patients with significant underlying cardiopulmonary comorbidities.
mirvetuximab soravtansine（MIRV）最近成为铂耐药卵巢癌（PROC）患者一种有前景的治疗选择。在其获批前的试验中，发现了几种眼部及其他毒性反应。我们报告了在未经过严格筛选的“真实世界”人群中使用MIRV的经验。
对2022年12月至2024年4月期间接受MIRV治疗的叶酸受体α阳性、复发性PROC患者进行回顾性研究。从病历中提取人口统计学、治疗及毒性数据。主要关注的结果是MIRV相关毒性反应的发生率和性质，以及治疗的临床反应。
分析了25例患者，44%的患者既往接受过超过3线治疗。MIRV治疗的中位持续时间为4.7个月，36%的患者接受MIRV治疗超过6个月。眼部事件很常见且发生较早，导致1级、2级和3级毒性反应（分别为28%、20%和16%）。因此，36%的患者眼科护理频率增加，48%的患者需要更换药物，32%的患者需要减量，但无一例需要停用MIRV。24%的患者发生肺炎，是治疗中断的主要原因，可能与显著的潜在心肺合并症和肺部疾病负担有关。
我们在真实世界中使用MIRV的经验与先前发表的数据一致，表明在预处理更充分的人群中也可能看到益处。毒性反应与先前报道的相似，尽管我们的肺炎发生率增加提示在治疗有显著潜在心肺合并症的患者时需谨慎。
