Alexandra H Smick, Lindsay Brennan, Jordyn Silverstein, Ritu Salani, Gottfried Konecny, Dana M Chase
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引用次数: 0
Abstract
Objective: To evaluate prescribing patterns, toxicities, and outcomes among patients receiving mirvetuximab for platinum-resistant ovarian cancer.
Methods: This retrospective study included patients with platinum-resistant ovarian cancer with high folate receptor alpha expression treated with mirvetuximab at a single institution (2018-2023). Patients were categorized based on treatment immediately preceding mirvetuximab: the taxane group received taxane treatment; the non-taxane group received other therapy. An age-matched cohort of platinum-resistant patients not treated with mirvetuximab was included for survival comparison. Statistical analyses included descriptive statistics, Kaplan-Meier curves, log-rank tests, Wilcoxon rank-sum tests, and Cox models.
Results: Forty-one patients received mirvetuximab, with a median of 8 cycles (range; 1-47). Grade ≥3 adverse events included ocular (n = 6; 15%), hematologic (n = 1; 2%), neuropathy (n = 1; 2%), and pneumonitis (n = 1; 2%). Dose reductions and delays occurred in 26 (63%) and 21 (51%) patients, respectively. Mirvetuximab was discontinued in 40 patients (98%), most commonly due to disease progression (n = 35; 88%). Mirvetuximab-treated patients had longer median overall survival from diagnosis compared to the age-matched cohort without mirvetuximab exposure (83.12 vs 52.14 months; HR 0.34, 95% CI 0.18 to 0.64, p < .001). Among patients who received taxane therapy immediately before mirvetuximab (n = 9), average treatment duration was 5 months (9 cycles), with no grade ≥3 neuropathy. In those who received a non-taxane regimen immediately before mirvetuximab (n = 32), average treatment duration was 6 months (8 cycles), with 1 patient (3%) experiencing grade ≥3 neuropathy. Median progression-free survival was similar between groups (5.49 vs 6.28 months; HR 1.30, 95% CI 0.61 to 2.78, p = .50), but overall survival was shorter in the taxane group (11.28 vs 21.02 months; HR 2.47, 95% CI 1.01 to 6.04, p = .048).
Conclusions: Real-world experience with mirvetuximab demonstrated a favorable safety profile and clinical benefit in platinum-resistant ovarian cancer. Taxane therapy immediately preceding mirvetuximab was associated with shorter overall survival but not increased neurotoxicity.
期刊介绍:
The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.