Frontiers in oncology · 2026
Case Report: Durable response to mirvetuximab soravtansine in a patient with platinum-sensitive ovarian cancer and a diagnosis of myelodysplastic syndrome.
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Steindl-Tomschizek Theresa, Pan Teresa Lucia, Sillaber Christian, Porpaczy Edit, Bago-Horvath Zsuzsanna, Grimm Christoph, Concin Nicole, Polterauer Stephan
Аннотация
BACKGROUND: High-grade serous ovarian cancer is one of the most lethal malignancies in women, typically diagnosed at an advanced stage, treated with debulking surgery, platinum-based chemotherapy and maintenance therapy, and associated with a high risk of recurrence even after optimal treatment. Myelodysplastic syndrome is a rare but serious haematological disease which can occur after exposure to chemotherapy or PARP inhibitor therapy. Treatment of recurrent disease in patients who develop Myelodysplastic syndrome is particularly challenging due to the significant myelotoxicity associated with standard cytotoxic chemotherapy. Mirvetuximab soravtansine is an antibody-drug conjugate approved for use in platinum-resistant folate receptor alpha-positive high-grade ovarian cancer. Due to its limited myelotoxicity, it might be an interesting treatment option in patients with relevant haematologic side effects due to previous lines of chemotherapy.
CASE: We report on a patient with a recurrence of platinum-sensitive ovarian cancer (platinum-free interval: 16 months) who developed Myelodysplastic syndrome and ultimately, probably an acute Myeloid Leukaemia. Chemotherapy re-challenge with platinum-based combination chemotherapy was not feasible due to persistent thrombocytopenia (CTCAE grade 3). Therefore, treatment with mirvetuximab soravtansine was initiated showing durable response with a progression-free survival of nine months. The patient's platelet count and tumor marker CA125 remained stable for nine months while she was receiving antibody-drug conjugate treatment.
SUMMARY AND CONCLUSION: Patients with underlying haematologic disorders sometimes cannot receive platinum-based chemotherapy due to its haematotoxicity, raising the need for alternative treatments for recurrent high-grade ovarian cancer. Data from clinical trials, supported by our case, suggest that mirvetuximab soravtansine may provide a promising option, allowing durable response without worsening pre-existing thrombocytopenia.
CASE: We report on a patient with a recurrence of platinum-sensitive ovarian cancer (platinum-free interval: 16 months) who developed Myelodysplastic syndrome and ultimately, probably an acute Myeloid Leukaemia. Chemotherapy re-challenge with platinum-based combination chemotherapy was not feasible due to persistent thrombocytopenia (CTCAE grade 3). Therefore, treatment with mirvetuximab soravtansine was initiated showing durable response with a progression-free survival of nine months. The patient's platelet count and tumor marker CA125 remained stable for nine months while she was receiving antibody-drug conjugate treatment.
SUMMARY AND CONCLUSION: Patients with underlying haematologic disorders sometimes cannot receive platinum-based chemotherapy due to its haematotoxicity, raising the need for alternative treatments for recurrent high-grade ovarian cancer. Data from clinical trials, supported by our case, suggest that mirvetuximab soravtansine may provide a promising option, allowing durable response without worsening pre-existing thrombocytopenia.