TriangleHEALTH PROFESSIONAL · SOURCE READING
Antibody-drug conjugates
Source: Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 14, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Mirvetuximab soravtansine. Evidence (mirvetuximab soravtansine):
Mirvetuximab soravtansine. Evidence (mirvetuximab soravtansine):
The international, phase III, randomized controlled MIRASOL trial (NCT04209855) enrolled 453 women with platinum-resistant, high-grade, serous ovarian cancer. Patients had received one to three prior lines of chemotherapy. Women were randomly assigned to receive either mirvetuximab soravtansine (6 mg/kg every 3 weeks) or the investigator’s choice chemotherapy (paclitaxel, liposomal doxorubicin, or topotecan). All patients were required to have high tumor expression of folate receptor alpha (defined as ≥75% of cells ≥2+ by immunohistochemistry). The primary end point was PFS.[79]
Mirvetuximab soravtansine. Evidence (mirvetuximab soravtansine): › The international, phase III, randomized controlled MIRASOL trial (NCT04209855) enrolled 453 women with platinum-resistant, high-grade, serous ovarian cancer. Patients had received one to three prior lines of chemotherapy. Women were randomly assigned to receive either mirvetuximab soravtansine (6 mg/kg every 3 weeks) or the investigator’s choice chemotherapy (paclitaxel, liposomal doxorubicin, or topotecan). All patients were required to have high tumor expression of folate receptor alpha (defined as ≥75% of cells ≥2+ by immunohistochemistry). The primary end point was PFS.[79]
Patients who received mirvetuximab soravtansine had a longer median PFS (5.62 months; 95% CI, 4.34–5.95) than those who received the investigator's choice of chemotherapy (3.98 months; 95% CI, 2.86–4.47).[79][Level of evidence B1]
Source links and citations
Mirvetuximab soravtansine. Evidence (mirvetuximab soravtansine): › The international, phase III, randomized controlled MIRASOL trial (NCT04209855) enrolled 453 women with platinum-resistant, high-grade, serous ovarian cancer. Patients had received one to three prior lines of chemotherapy. Women were randomly assigned to receive either mirvetuximab soravtansine (6 mg/kg every 3 weeks) or the investigator’s choice chemotherapy (paclitaxel, liposomal doxorubicin, or topotecan). All patients were required to have high tumor expression of folate receptor alpha (defined as ≥75% of cells ≥2+ by immunohistochemistry). The primary end point was PFS.[79]
Ocular examinations were mandatory, and 56% of patients who received mirvetuximab soravtansine developed an ocular adverse event.
Other drugs used to treat platinum-refractory or platinum-resistant recurrence (efficacy not well defined)
The drugs shown in Table 10 are not fully confirmed to have activity in patients with platinum-resistant disease. These drugs have a less desirable therapeutic index, and have a level of evidence lower than C3.
| Drugs | Drug Class | Major Toxicities | Comments |
|---|---|---|---|
| Etoposide | Topoisomerase II inhibitor | Myelosuppression; alopecia | Oral administration; rare leukemia lessens acceptability and dampens interest |
| Cyclophosphamide and several other bis chloroethyl amines | Alkylating agents | Myelosuppression; alopecia (only the oxazaphosphorines) | Leukemia and cystitis; uncertain activity after platinum agents |
| Hexamethylmelamine (Altretamine) | Unknown but probably alkylating prodrugs | Emesis and neurological toxic effects | Oral administration; uncertain activity after platinum agents |
| Irinotecan | Topoisomerase I inhibitor | Diarrhea and other gastrointestinal symptoms | Cross-resistant to topotecan |
| Oxaliplatin | Platinum | Neuropathy, emesis, myelosuppression | Cross-resistant to usual platinum agents, but less so |
| Vinorelbine | Mitotic inhibitor | Myelosuppression | Erratic activity |
| Fluorouracil and capecitabine | Fluoropyrimidine antimetabolites | Gastrointestinal symptoms and myelosuppression | Capecitabine is oral; may be useful in mucinous tumors |
| Tamoxifen | Antiestrogen | Thromboembolism | Oral administration; minimal activity, perhaps more in subsets |
Studies cited in this source section
Source citation is not a determination that a study applies to you.
Publication references
Read the original reference and check its publication notices.
Preserved source evidence · Not medical advice