International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2025
Improved progression-free survival with mirvetuximab and bevacizumab in platinum-resistant ovarian cancer: a retrospective real-world analysis.
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Roberts Jill N T, Courel Steve, Schlumbrecht Matthew P, Nair Navya, Sinno Abdulrahman K
Аннотация
OBJECTIVE: Mirvetuximab soravtansine-gynx, a FRα-targeting antibody-drug conjugate, is effective in treating FRα-expressing platinum-resistant ovarian cancer. Bevacizumab, a vascular endothelial growth factor inhibitor, may potentiate antibody-drug conjugates through vascular normalization and improved intra-tumoral delivery. This study evaluated real-world outcomes of mirvetuximab with or without bevacizumab in platinum-resistant ovarian cancer.
METHODS: We conducted a single-institution retrospective review of patients with platinum-resistant ovarian cancer treated with mirvetuximab between November 2022 and April 2025. Demographic, clinical, and survival data were abstracted from electronic medical records. Standard statistical analyses were performed using SPSS version 29.
RESULTS: A total of 51 patients who initiated mirvetuximab were included in the analysis; 20 (39.2%) received combination mirvetuximab plus bevacizumab. Most patients (86.3%) had previous bevacizumab exposure. Patients received a median of 3 previous lines of therapy; 3 patients (5.9%) had platinum-refractory disease. The median FRα expression level was 75% (25% to 100%). Despite lower median FRα expression in the combination group than mirvetuximab alone (57.5% vs 80%, p<.001), combination therapy was associated with significantly improved median progression-free survival (8.5 vs 4.8 months, hazard ratio 0.34, 95% confidence interval 0.16 to 0.72, p=.003). No difference in overall survival was observed. The overall objective response was 37.3% (7.8% complete, 29.4% partial), consistent with previously published prospective data.
CONCLUSIONS: In this real-world cohort, the addition of bevacizumab to mirvetuximab was associated with improved progression-free survival despite lower FRα expression, supporting potential synergy between these agents. Combination therapy may be considered for appropriately selected patients with FRα-expressing platinum-resistant ovarian cancer.
METHODS: We conducted a single-institution retrospective review of patients with platinum-resistant ovarian cancer treated with mirvetuximab between November 2022 and April 2025. Demographic, clinical, and survival data were abstracted from electronic medical records. Standard statistical analyses were performed using SPSS version 29.
RESULTS: A total of 51 patients who initiated mirvetuximab were included in the analysis; 20 (39.2%) received combination mirvetuximab plus bevacizumab. Most patients (86.3%) had previous bevacizumab exposure. Patients received a median of 3 previous lines of therapy; 3 patients (5.9%) had platinum-refractory disease. The median FRα expression level was 75% (25% to 100%). Despite lower median FRα expression in the combination group than mirvetuximab alone (57.5% vs 80%, p<.001), combination therapy was associated with significantly improved median progression-free survival (8.5 vs 4.8 months, hazard ratio 0.34, 95% confidence interval 0.16 to 0.72, p=.003). No difference in overall survival was observed. The overall objective response was 37.3% (7.8% complete, 29.4% partial), consistent with previously published prospective data.
CONCLUSIONS: In this real-world cohort, the addition of bevacizumab to mirvetuximab was associated with improved progression-free survival despite lower FRα expression, supporting potential synergy between these agents. Combination therapy may be considered for appropriately selected patients with FRα-expressing platinum-resistant ovarian cancer.