NICE has recommended mirvetuximab soravtansine (also called Elahere and developed by AbbVie) for treating folate receptor-alpha-positive platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer. Until recently, there have been limited treatment options for this type of ovarian cancer when it stops responding to standard chemotherapy treatment.
Mirvetuximab soravtansine offers a new approach. Instead of chemotherapy, it uses a targeted therapy that seeks out a specific protein found on the surface of cancer cells and delivers a cancer-killing medicine directly to them.
Women who took part in an evaluation highlighted the significant difference in how the 2 treatments affect daily life. Unlike chemotherapy, which often requires frequent (sometimes weekly) hospital visits and causes debilitating side effects including extreme fatigue, hair loss, nausea and long-term nerve damage, mirvetuximab soravtansine requires fewer hospital visits (once every three weeks) and has a more manageable side effect profile. Women described chemotherapy as putting their lives on hold, leading to isolation, inability to work, and heavy reliance on others for support.
Clinical trial data from the MIRASOL study, involving 453 adults, showed that women receiving mirvetuximab soravtansine lived an average of 16.9 months compared to 13 months with chemotherapy. Cancer progression was also delayed, with women on mirvetuximab soravtansine having an average of 5.6 months before their disease worsened, compared to 4 months with chemotherapy.
NICE concluded that mirvetuximab soravtansine represents good use of NHS resources, taking into account the severity of the condition. The treatment is available subject to a confidential commercial arrangement between manufacturer AbbVie and NHS England.
"This recommendation is the result of a thorough, evidence-based evaluation by our independent committee. NICE exists to make sure people can access treatments that genuinely work and that represent value for the NHS," commented Helen Knight, director of medicines evaluation at NICE.
Helen continued: "We heard clearly from patients and clinicians about the very limited options available at this stage of the disease, and the substantial burden that chemotherapy places on women's lives. We are pleased that, following a robust process and a new commercial arrangement with AbbVie, we are now able to recommend this treatment for NHS use."
Lucy Common, clinical nursing advisor at NICE, said: "For women living with platinum-resistant ovarian cancer, the impact of repeated chemotherapy cycles goes far beyond the clinic. We heard from patients who had given up work, stopped seeing friends, and were relying on family and carers just to get through each day. Mirvetuximab soravtansine offers not just longer survival, but a meaningfully different treatment experience, with fewer hospital visits and a side effect profile that allows women to maintain more of their normal life. That matters enormously."
Around 270 people are expected to be eligible in the first year, rising to approximately 420 by year three as access to the diagnostic test needed to confirm eligibility becomes more widely available.
Mirvetuximab soravtansine is given as an intravenous infusion by a doctor or nurse with experience in cancer medicines. The dose is calculated based on body weight.
It is recommended for adults with platinum-resistant ovarian cancer whose tumours carry a protein called folate receptor-alpha, and who have already had between 1 and 3 previous treatments. Platinum-resistant ovarian cancer is a form of the disease that has stopped responding to standard chemotherapy within 6 months of treatment.
This treatment will be available to patients immediately via funding through the Cancer Drugs Fund and will later switch to the routine commissioning budget 90 days after NICE's final guidance is published.
