Mirvetuximab soravtansine for the treatment of epithelial ovarian, fallopian tube, or primary peritoneal cancer.

Mirvetuximab soravtansine (MIRV) is FDA-approved for platinum-resistant ovarian cancer with high folate receptor alpha (FRα) expression. In the MIRASOL trial, MIRV improved median progression-free survival (5.6 vs. 3.9 months) and overall survival (16.5 vs. 12.8 months; HR 0.67) over chemotherapy. MIRV has a favorable safety profile but is associated with unique ADC-related toxicities, including blurred vision, keratopathy, and nausea. Ocular side effects are managed with regular eye exams and prophylactic drops, with no permanent damage reported. MIRV has also shown promising results in combination with bevacizumab and with carboplatin in platinum-sensitive disease. Ongoing research aims to optimize ADC components and explore synergistic combinations to expand MIRV's role in FRα-expressing ovarian cancer.