New Option For Ovarian Cancer Recurrence
- A new treatment option is available if your ovarian cancer comes back within six months of treatment, meaning it is “platinum resistant.”
- Elahere (generic name mirvetuximab soravtansine) has shown a 33% improvement in survival for platinum resistant ovarian cancer, according to the Chief Medical Officer of its maker, ImmunoGen.
- To know if you are eligible, you must take a special test that measures whether your cancer is positive for the folate receptor alpha (FRα) protein and a high enough level of that protein (>75%).
- The drug uses the FRα protein to enter the tumor. Once inside the tumor cell, a chemotherapy is released, which prevents the tumor from dividing.
Here's what all that means …
Platinum resistant ovarian cancer:
- When your cancer comes back within six months after being treated with a platinum-based chemotherapy (the most common type of chemotherapy used for ovarian cancer)
Folate receptor-alpha (FRα) positive:
- Ovarian cancer cells commonly carry folate receptor alpha (FRα) protein on their surface
- Up to 80% of new and recurrent ovarian cancers may carry this protein
- Generally, FRα levels tend to be high in more aggressive ovarian cancers
Progression-Free Survival:
- The length of time after treatment that the cancer does not spread or get worse
What The Data Says
Read MoreDr. Eshed walked us through how she determines who is eligible for this new treatment and what costs might look like.
How To Determine If You Are Eligible
To determine if you are eligible for Elahere, Dr. Eshed supports early genetic testing and Next Generation Sequencing (NGS). She typically will test your tumor early on after diagnosis for all its possible mutations to figure out which treatment options would be best for you now and in case the cancer comes back.
"Now in the setting of advanced stage ovarian cancer, we do not only the genetic germline blood and saliva testing, but we also do somatic testing, next generation sequencing. Sequence the tumor early on. Look for the folate receptor among many other targets that have drugs, and see if you have any of those mutations and if that therapy might be effective for you," Dr. Eshed told SurvivorNet.
To break it down further, the following tests may be performed:
- Germline testing: Genetic DNA testing done with your blood and saliva
- Somatic testing: Testing on the tumor
- Next Generation Sequencing: Sequencing the DNA of the cancer to look for mutations
According to Dr. Eshed, doing tests like these earlier on could help you and your doctor set up a game plan in case you need future treatment:
"Since it’s used in the setting of platinum resistance, mirvetuximab would be reserved for a later date. But you know, you’d have that option on the table if you were to ever need it,” she said.
Free Immunohistochemistry (IHC) Testing For FRα Protein
FRα protein levels can also be quantified using a test called immunohistochemistry (IHC). ImmunoGen, the pharmaceutical company that developed Elahere, has partnered with a cancer laboratory testing company called NeoGenomics to provide a free FRα testing program, called FR-ASSIST.
Any patient who resides in the USA with a diagnosis of ovarian cancer who has not been tested for the FRα protein previously is eligible to get a free IHC test through NeoGenomics. Your oncologist may need to request this test for you by filling out a simple form.
Multiple additional genomic platforms (including Caris, Foundation Medicine) offer folate receptor alpha IHC testing and your doctor can obtain the folate expression level before Elahere would be needed.
Right now, to be eligible to receive Elahere, the cancer must meet the following criteria:
- Test positive (>75% expression) for the folate receptor-alpha (FRα) protein
- Not respond to or is no longer responding to platinum-based chemotherapy
- Received 1 to 3 prior types of chemotherapy
Does Insurance Cover Elahere?
Given that Elahere is a new therapy, insurance providers may handle authorization differently.
"If you are eligible for mirvetuximab and it seems that it would be in your best interest to proceed treatment with mirvetuximab, we will run things through your insurance and get prior authorization,” Dr. Eshed explained.
“If there’s any resistance we work with the company to get approval. We also can speak with the insurance companies to get prior authorization and explain the data if the insurance companies are not up to date on these newer therapies with newer FDA approvals.
“With FDA approval for mirvetuximab, most often it has been covered by insurance and if not, we can work to make it financially feasible."
Questions To Ask Your Doctor
- Has my cancer been tested for the FRα protein?
- Am I eligible for Elahere?
- What additional tests might I need?
- How much will Elahere cost me?
- Will my insurance provider cover the treatment?
Learn more about SurvivorNet's rigorous medical review process.
