Real-world outcomes after Mirvetuximab Soravtansine treatment for recurrent ovarian Cancer: Results from a university setting

Background Mirvetuximab Soravtansine (MIRV) is an antibody–drug conjugate targeting folate receptor alpha (FRα), expressed in most ovarian cancers. Pivotal trials reported favorable outcomes but used stringent eligibility criteria, and real-world effectiveness and toxicity remain incompletely characterized. We evaluated overall survival (OS), progression-free survival (PFS), and toxicity among a general gynecologic oncology population treated with MIRV for recurrent ovarian cancer. Methods This retrospective study analyzed data from patients with recurrent ovarian cancer who received MIRV at a tertiary NCI-designated cancer center and an affiliated private hospital between November 2022 and April 2025. Demographics, disease and treatment characteristics, and toxicities were abstracted from the electronic medical record. OS and PFS were estimated using the Kaplan–Meier method. Multivariable Cox proportional hazards models assessed associations between clinical factors and survival. Results Sixty-six patients received MIRV. Most had stage IIIC-IVB disease (89%), 86% had a PS of 0 or 1, and 77% had received ≥3 prior therapeutic regimens. Most (52%) had platinum-resistant disease, and FRα expression was positive in 77% of cases. Median OS was 16.4 months (95% CI 12.4 to NE) and PFS was 5.3 months (95% CI 4.1–7.1). OS and PFS did not differ by platinum status. ECOG PS >1 was associated with worse OS (median 6.0 vs 20.3 months for PS 0–1; P = 0.0006). Toxicity was common (91%). Conclusion MIRV demonstrates clinically meaningful survival, but outcomes are strongly influenced by performance status. Patients with ECOG PS >1 should be counseled about substantially shorter survival, and clinicians should anticipate and manage MIRV toxicities.