Mirvetuximab soravtansine (Elahere) is the first ADC for ovarian cancer, for tumours with high folate receptor alpha.
Mirvetuximab soravtansine (Elahere) is an anti-folate-receptor-alpha antibody carrying the maytansinoid DM4 (drug-to-antibody ratio about 3.5) through a cleavable sulfo-SPDB disulfide linker, and the released payload crosses membranes to kill neighbouring cells. It is the first ADC for ovarian cancer, given at 6 mg/kg every 3 weeks for FRα-high platinum-resistant disease. Accelerated approval in 2022 rested on SORAYA, and full approval in 2024 followed MIRASOL, which showed overall survival of 16.5 versus 12.7 months against chemotherapy; EMA approval came in late 2024. Ocular toxicity defines the side-effect profile, with blurred vision in 45 percent and keratopathy in 37 percent of MIRASOL patients, so eye examinations and steroid and lubricating drops are built into treatment. Combination and earlier-line trials are ongoing. It works in ovarian cancer at the price of careful eye care.
Ball-and-stick model from PubChem 2D record (no 3D conformer available). PubChem record
Anti-FRα antibody with DM4; bystander-capable after disulfide cleavage. Connects to Folate receptor alpha.
1.Antibody binds Folate receptor alpha on the tumour cell surface
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
Source: US prescribing information (DailyMed). Doses are for orientation; the current label governs.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies.
Covered under the medical benefit with prior authorisation confirming diagnosis, biomarker status and line of therapy; site-of-care policies may steer infusions away from hospital outpatient departments. FRα-positive status by the approved IHC test required.
20% Part B coinsurance on a high-cost infusion adds up quickly: Medigap Plan G or N, Medicare Advantage maximum out-of-pocket, Medicaid dual eligibility, or a charity fund are the usual buffers.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE TA1169. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Date | Deal | Type | Upfront | Total | Source |
|---|---|---|---|---|---|
| 2023-11-30 | ImmunoGen to AbbVie (incl. ImmunoGen, Capstan) Mirvetuximab soravtansine (Elahere) and pivekimab sunirine | Acquisition | not disclosed | $10.1bn | source |
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Adult patients with folate receptor-alpha (FRα) positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer, who have received one to three prior systemic treatment regimens. Select patients for therapy based on an FDA-approved test
Accelerated approval, FRα-high platinum-resistant ovarian cancer (SORAYA) source
Adult patients with folate receptor-alpha (FRα) positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer, who have received one to three prior systemic treatment regimens. Select patients for therapy based on an FDA-approved test
Full approval with OS benefit (MIRASOL) source
EMA approval source
| Region | Year | Indication |
|---|---|---|
| US | 2022 | FRα-high platinum-resistant ovarian cancer (full approval 2024) |
| EU | 2024 | FRα+ platinum-resistant ovarian; 14 Nov 2024 |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| AST increased | 57% | - |
| Fatigue | 47% | - |
| Blurred vision | 45% | - |
| ALT increased | 38% | - |
| Keratopathy | 37% | - |
| Peripheral neuropathy | 37% | - |
| Abdominal pain | 34% | - |
| Dry eye | 29% | - |
| Diarrhoea | 29% | - |
| Nausea | 27% | - |
MIRASOL; all-grade rates. Rates read from the US prescribing information. Blank cells mean the figure was not sourced, not that it is zero.
Read for the class this product belongs to (antibody-drug conjugates with a maytansine payload) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
| Country | Reimbursement | List price | Assistance |
|---|---|---|---|
| United States | Medicare Part B (physician-administered); commercial plans per formulary | not disclosed | elahere.com |
| United Kingdom | NICE: recommended for FRα-high platinum-resistant ovarian cancer (2025) | not disclosed | - |
List prices are manufacturer or Medicare figures where publicly disclosed; net prices after rebates are usually lower. Reimbursement changes; check the payer.
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Query for this drug: (TITLE:"Mirvetuximab soravtansine" OR ABSTRACT:"Mirvetuximab soravtansine" OR TITLE:"Elahere" OR ABSTRACT:"Elahere") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Mirvetuximab soravtansine, not a curated reading list.
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