Gynecologic oncology · 2026
Response to mirvetuximab soravtansine and weekly paclitaxel based on treatment sequencing in platinum-resistant ovarian cancer: Does order matter?
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Haight Paulina J, Sakach Julia C, Chambers Laura M, Backes Floor J, Cohn David E, Copeland Larry J, Cosgrove Casey M, Nagel Christa I, Neff Robert T, O'Malley David M
Аннотация
OBJECTIVES: With multiple clinical trials now showing survival benefit, we sought to determine whether treatment sequencing of mirvetuximab soravtansine (Mirv) and weekly paclitaxel affects response in platinum-resistant ovarian cancer (PROC).
METHODS: This is a single-institution, retrospective review of PROC patients who received both Mirv and weekly paclitaxel. Demographics, clinicopathologic factors, and treatment outcomes were compared between patients based on sequence of treatment. Overall response rate (ORR) was defined as complete or partial response based on imaging and/or ≥ 50% decrease in CA-125. Kaplan Meier curves were generated to compare progression-free survival based on treatment sequencing; differences were estimated using the log-rank test.
RESULTS: 62 patients received Mirv and weekly paclitaxel for PROC. Seventeen (27%) patients received Mirv first; 45 (73%) received weekly paclitaxel first. Bevacizumab was administered with Mirv in 29% of cases and with weekly paclitaxel in 52% of cases. Median FOLR-1 expression was 80%. Demographic and clinicopathologic features were not different between groups. ORR was 34% (21/61) to Mirv and 69% (42/61) to weekly paclitaxel. Response to Mirv was not different based on treatment sequencing (ORR 35% Mirv first vs 34% weekly paclitaxel first; p = 0.93). Response to weekly paclitaxel was not different based on treatment sequencing (ORR 56% Mirv first vs 73% weekly paclitaxel first, p = 0.21).
CONCLUSION: For PROC patients receiving Mirv and weekly paclitaxel, order of treatment did not affect response to each agent. Further multi-institutional, prospective data is needed to confirm the impact of treatment sequencing on outcomes, as this may influence individual patients and future clinical trial design.
METHODS: This is a single-institution, retrospective review of PROC patients who received both Mirv and weekly paclitaxel. Demographics, clinicopathologic factors, and treatment outcomes were compared between patients based on sequence of treatment. Overall response rate (ORR) was defined as complete or partial response based on imaging and/or ≥ 50% decrease in CA-125. Kaplan Meier curves were generated to compare progression-free survival based on treatment sequencing; differences were estimated using the log-rank test.
RESULTS: 62 patients received Mirv and weekly paclitaxel for PROC. Seventeen (27%) patients received Mirv first; 45 (73%) received weekly paclitaxel first. Bevacizumab was administered with Mirv in 29% of cases and with weekly paclitaxel in 52% of cases. Median FOLR-1 expression was 80%. Demographic and clinicopathologic features were not different between groups. ORR was 34% (21/61) to Mirv and 69% (42/61) to weekly paclitaxel. Response to Mirv was not different based on treatment sequencing (ORR 35% Mirv first vs 34% weekly paclitaxel first; p = 0.93). Response to weekly paclitaxel was not different based on treatment sequencing (ORR 56% Mirv first vs 73% weekly paclitaxel first, p = 0.21).
CONCLUSION: For PROC patients receiving Mirv and weekly paclitaxel, order of treatment did not affect response to each agent. Further multi-institutional, prospective data is needed to confirm the impact of treatment sequencing on outcomes, as this may influence individual patients and future clinical trial design.