A drug called Elahere is a game-changing treatment that is helping patients with hard-to-treat ovarian cancer live longer, healthier lives.
The US Food and Drug Administration (FDA) just gave it full approval which means it’s a readily available option for women whose ovarian cancer has come back.
Read MoreWhat is folate receptor-positive ovarian cancer?
Imagine there are tiny openings on ovarian cancer cells, that act like doorways into the cells. These doorways are called folate receptors and they are there to let a vitamin called folate, needed for growth, enter both healthy and cancerous cells. But having too many doors on the cancerous cells can cause a problem. Up to 80% of ovarian cancers have extra “doors” (folate receptors), fueling their rapid growth. This type of disease, called folate receptor-positive ovarian cancer, is often late stage, aggressive and advanced.Despite being a tough diagnosis, there is new hope for folate receptor-positive ovarian cancer. Doctors have a new drug called Elahere to treat folate receptor-positive ovarian cancer.
“This is the first FDA approved therapy that has demonstrated an overall survival benefit in platinum resistant disease which is very exciting.” Dr. Kristen C. Kelley, assistant professor in the oncology division at Huntsman Cancer Institute, University of Utah in Salt Lake City.
The FDA gave approval for Elahere based on the final results of a phase 3 study called MIRASOL:
- It reduced the chances of death compared to chemotherapy by 33%. Patients taking Elahere lived for an average of 17 months compared to about 13 months for the patients on chemotherapy.
- It reduced the chance of the cancer progressing by 35%. Patients on Elahere went nearly 6 months without their cancer spreading compared to 4 months for the patients on chemotherapy.
- More than 40% of patients taking Elahere saw their tumors shrink — and for 5% they disappeared completely.
- Elahere was also better tolerated than chemotherapy. Very few patients in the study had to stop taking it because of side effects.
The drug can now be given to women whose cancer has come back but has not responded to up to three courses of chemotherapy.
“Data from the phase III MIRASOL trial would support promising results with Elahere and these results have been practice changing in platinum-resistant ovarian cancer,” Dr. Kelley says.
How do doctors test for folate receptor-positive ovarian cancer?
A test called immunohistochemistry (IHC) can reveal if your cancer has too many folate receptors. If you qualify, this test is free.
Most doctors don’t routinely order an IHC, but you should ask yours if it’s right for you. Knowing more about your cancer early can lead to better outcomes.
Here’s who qualifies for the free test:
- Have ovarian, fallopian tube, or peritoneal cancer
- Live and receive treatment in the US
- Haven’t had this test before
- Doctor thinks it’s medically necessary
Two organizations offer the test in Salt Lake City and elsewhere in the US:
- The FR-ASSIST program partners with NeoGenomics and ImmunoGen to offer free IHC testing for eligible patients.
- Labcorp FR-ASSIST™ provides a free FOLR1 IHC test for qualifying individuals.
What are the side effects of Elahere?
Elahere does carry some risks of its own like serious eye problems, lung inflammation, and nerve issues.
More common side effects include:
- Fatigue
- Elevated liver enzymes
- Nausea or abdominal pain
- Reduced red or white blood cell counts
- Diarrhea or constipation
- Lower blood albumin levels
- Reduced blood magnesium levels
“Ocular side effects such as visual impairment or dry eye, neuropathy, and GI side effects such as nausea, vomiting, diarrhea, or constipation are the things I am on the lookout for when starting patients on Elahere,” Dr. Kelley says.
“Often these side effects can be managed with medications or dose reductions of Elahere. However if symptoms are severe I would recommend permanent discontinuation,” she adds.
Dr. Kelley also notes that fewer patients need to stop using Elahere due to side effects compared to standard chemotherapy.
Because Elahere is a relatively new treatment, coverage depends on factors like your insurance provider and medical necessity. There may also be a financial assistance program available to help you pay for treatment.
Doctors often only consider Elahere later in treatment. But if you feel it may be helpful to you, you should discuss it with your care team as soon as possible so you can understand all of your treatment options now and in the future.
Related: The First Major New Treatment Option For Ovarian Cancer In A Decade
Are there any new drugs in development?
Researchers are exploring even more ways to target FRα. Two promising drugs in clinical trials which are rigorous studies designed to test out experimental drugs to see if they are safe and effective.
- Farletuzumab, is known as a “smart protein,” that functions by binding to folate receptor alpha (FRα), effectively halting cancer cell growth. By targeting FRα, farletuzumab disrupts the cellular processes essential for cancer spread.
- STRO-002, like Elahere, is another “guided missile” drug. It combines an FRα-targeting antibody with a potent poison. This allows STRO-002 to specifically locate and isolate FRα-positive cancer cells and then destroy them with poison. By selectively targeting cancer cells while sparing healthy tissue, STRO-002 demonstrates promise as a potent and targeted treatment option for ovarian cancer.
Ask your doctor if these clinical trials might be an option for you. Your doctor can help you find and enroll.
Related: The Anatomy of Ovarian Cancer
Questions for your doctor
- Is my cancer folate receptor-positive?
- Am I eligible for the free test?
- Is Elahere a good option for me?
- What are the potential side effects of Elahere?
- Are there clinical trials I could participate in?
By staying informed and discussing these options with your doctor, you can make empowered decisions about your care.
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