Adverse visual effects with Elahere

Ocular Events with Mirvetuximab Show No Impact on QoL in Ovarian Cancer

https://tinyurl.com/4zbpp67k

One of the more exciting developments in ovarian cancer treatment has been the FDA approval of an antibody drug combination called Elahere in the treatment of platinum resistant ovarian cancer. This group of patients are especially difficult to treat with a poor disease-free survival of around 4 months. Results from the MIRASOL trial suggest an increase to 6 months.

Elahere is a targeted treatment for women with ovarian cancer which demonstrate Folate Receptor 𝛂 expression (about 80%). One of the important adverse effects is loss of visual acuity. This is seen in 50% of patients, it develops within 4 to 5 weeks of commencing treatment. The cause is inflammatory change due to local action of the drug and subsequent chronic formation of microcysts in the cornea, usually this adverse effect is reversible.

This prospective study of the Quality of Life for women participants in the MIRASOL trial showed no deterioration for those women who experienced eye complications. The suggestion is that the use of Elahere extends life and does not decrease the enjoyment, meaning the benefit is greater than the risk.

Not for everyone

Risk-Reduction Surgery Benefit in Non-BRCA Ovarian Cancer

https://tinyurl.com/2mnd5c9y

Risk reduction surgery has been promoted as a means of avoiding ovarian cancer. Most studies have concentrated on removal of fallopian tubes for women who are at high risk, especially those who carry the BRCA or Lynch mutation. Some centres have extended this for all women and suggested that additional surgery, to remove the fallopian tubes, be added to other abdominal surgical procedures. Any extra intervention will increase operative risk.

This prospective study of 142 non-BRCA women at low risk, looks at the surgical specimen, and compares the evidence, of pre-cancer change with a similar control group of 388 women, who had the same surgery for risk reduction, in the presence of a hazardous mutation.

Results from the study show similar rates of normal appearance at about 95%. No evidence of pre-cancer change was found in non BRCA women whereas 3% of specimen removed from BRCA +ve women did show abnormality which might lead to subsequent ovarian cancer.

The author states that the number of cases  suggest that the procedure is commonly being performed on low-risk women, and that though the benefit is yet to be established the potential for harm is great.