Elahere
Elahere (mirvetuximab soravtansine-gynx) or Elahere (mirvetuximab soravtansine) is a targeted anticancer medication used to treat ovarian cancer that’s folate receptor-alpha (FRɑ) positive. It's not a first-choice option, but sometimes prescribed when the cancer comes back after first-line chemotherapy. Elahere (mirvetuximab soravtansine) is given as an infusion through the vein, typically once every three weeks. Elahere (mirvetuximab soravtansine) commonly causes eye problems, such as blurry vision or dry eyes, so you’ll need to have your eyes checked regularly while receiving treatment.
What is Elahere (mirvetuximab soravtansine)?
What is Elahere (mirvetuximab soravtansine) used for?
Folate receptor-alpha (FRɑ) positive ovarian, fallopian tube, or primary peritoneal cancer that hasn’t responded well to platinum-based therapy or other anticancer medications
How Elahere (mirvetuximab soravtansine) works
Elahere (mirvetuximab soravtansine) is a targeted anticancer medication called an antibody-drug conjugate (ADC). It’s a combination of a monoclonal antibody linked to a traditional chemotherapy medication that kills cancer cells.
In Elahere, the antibody portion (mirvetuximab) binds to the folate receptor-alpha protein found on cancer cells. Once that happens, Elahere is absorbed into the cell. There, it releases a strong cancer-killing medication (soravtansine) that prevents the cells from dividing and growing, which leads to cell death.
Drug Facts
What are the side effects of Elahere (mirvetuximab soravtansine)?
Common Side Effects
- Vision and eye problems (up to 50%)
- Fatigue (49%)
- Nausea (40%)
- Stomach pain (36%)
- Numbness and tingling of the hands or feet (33%)
- Diarrhea (31%)
- Constipation (30%)
Other Side Effects
- Vomiting
- Bloating
- Lack of appetite
- Joint and muscle pain
- Shortness of breath
Serious Side Effects
- Vision loss
- Serious lung problems: Difficulty breathing, trouble catching your breath, chest pain
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Dry eyes
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Infection—fever, chills, cough, or sore throat
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Low magnesium level—muscle pain or cramps, unusual weakness or fatigue, fast or irregular heartbeat, tremors
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Pain, tingling, or numbness in the hands or feet
- Sensitivity to light
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Constipation
- Diarrhea
- Nausea
- Stomach pain
Pros and cons of Elahere (mirvetuximab soravtansine)
Pros
More precise in the way it targets cancer cells, compared to traditional chemotherapy
Lasts a long time in the body, so it only needs to be given every 3 weeks
Effective treatment option for FRɑ-positive ovarian cancer that has come back or stop responding to first-line chemotherapy
Cons
Infused into the veins, so not good for people who don't like needles
Must have eye exams before and during treatment to monitor for vision problems
Requires using eye drops multiple times a day while receiving treatment
Pharmacist tips for Elahere (mirvetuximab soravtansine)
You might experience an infusion or allergic reaction during or shortly after your Elahere (mirvetuximab soravtansine) infusion. Alert your healthcare team right away if you experience symptoms such as trouble breathing, hives, flushing, chest pain, or dizziness. They can pause your infusion and help manage your symptoms. In most cases, you’ll be able to restart the infusion at a slower rate and continue treatment with Elahere (mirvetuximab soravtansine).
Your provider will give you an antihistamine, corticosteroid, and acetaminophen (Tylenol) about 30 minutes before each infusion of Elahere (mirvetuximab soravtansine). This is called premedication and helps lower the risk of infusion reactions.
Elahere (mirvetuximab soravtansine) can cause nausea. Your provider will give you an anti-nausea medication before your infusion to help with this. They'll likely prescribe you anti-nausea medications to take at home as needed to help with your symptoms. Let your healthcare team know if you can’t eat or drink normally because of nausea or vomiting, so they can help you better manage your symptoms.
Elahere (mirvetuximab soravtansine) can cause dry eyes, light sensitivity, and other vision problems. You’ll need to get an eye exam before starting this medication and at least every other cycle for the first 8 cycles. You will also need to use lubricating eye drops and steroid eye drops while on treatment. Follow the instructions your provider gives you on how to use these eye drops. Report any vision changes to your health care team right away.
Avoid wearing contact lenses during treatment unless you’ve discussed with your provider.
If you’re able to get pregnant, you should use birth control while receiving Elahere (mirvetuximab soravtansine) and for 7 months after stopping treatment. It's likely that this medication can cause harm to an unborn baby.
Frequently asked questions about Elahere (mirvetuximab soravtansine)
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What are the risks and warnings for Elahere (mirvetuximab soravtansine)?
Elahere (mirvetuximab soravtansine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Vision problems
Elahere (mirvetuximab soravtansine) commonly causes eye problems, including dry eye, vision loss, cornea problems, and light sensitivity. Symptoms might start to appear with your second and third infusions. Most cases are generally mild, but can be serious and bothersome. Because of this, your provider will ask you to do an eye exam every other cycle for the first 8 treatment cycles, then as needed after that. To minimize your risk of eye problems, your provider will ask you to use lubricating and steroid eye drops during treatment. If you do experience vision problems, your provider might need to adjust your dose of Elahere (mirvetuximab soravtansine) or consider other treatment options for you. Contact your health care team if you have any new or worsening vision problems.
Lung problems
Rare, but serious, lung problems, including inflammation and scarring of the lungs, have happened in people receiving Elahere (mirvetuximab soravtansine). Let your provider know if you develop trouble breathing or cough during your treatment. Depending on how serious your condition is, your provider might ask you to stop Elahere (mirvetuximab soravtansine) treatment.
Nerve problems (peripheral neuropathy)
Elahere (mirvetuximab soravtansine) can cause new or worsening nerve problems in your arms, hands, legs, and feet (peripheral neuropathy). This can happen anytime, but on average, you might start to experience this 1 month after starting treatment. If you have nerve problems, your provider might need to change your dose, delay your infusions, or ask you to stop Elahere (mirvetuximab soravtansine). Let your provider know if you experience numbness, pain, burning, a feeling of "pins and needles", tremors, problems with balance, or weakness in your arms or legs.
Harm to unborn baby
Based on how the medication works in your body, Elahere (mirvetuximab soravtansine) can harm an unborn baby. Because of this risk, if you’re able to have children, you should use birth control during treatment with Elahere (mirvetuximab soravtansine) to prevent pregnancy. After treatment, continue to use birth control for another 7 months. Let your provider know right away if you become pregnant during this time.
Elahere (mirvetuximab soravtansine) dosage forms
Typical dosing for Elahere (mirvetuximab soravtansine)
Your healthcare provider will determine the appropriate dose for you based on adjusted ideal body weight (AIBW).
The typical dose is 6 mg/kg infused into the veins (IV) every 3 weeks, given by a healthcare provider.
What are alternatives to Elahere (mirvetuximab soravtansine)?
Folate receptor-alpha (FRɑ) positive ovarian, fallopian tube, or primary peritoneal cancer that hasn’t responded well to platinum-based therapy or other anticancer medications
Metastatic, recurrent, or persistent cervical cancer
Metastatic colorectal cancer
Recurrent glioblastoma (a type of brain tumor)
Metastatic or unresectable hepatocellular carcinoma (liver cancer)
Nonsquamous non-small cell lung cancer
Ovarian, fallopian tube, or primary peritoneal cancer
Metastatic renal cell carcinoma (kidney cancer)
Metastatic ovarian cancer that continued to spread after other chemotherapy
Platinum-sensitive small cell lung cancer (SCLC) that continued to spread after other chemotherapy
Advanced cervical cancer, along with cisplatin (Platinol)
Elahere (mirvetuximab soravtansine) images
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References
Best studies we foundAmerican Cancer Society. (2018). Chemotherapy for ovarian cancer.
American Cancer Society. (2018). What is ovarian cancer?
Birrer, M. J., et al. (2019). Is targeting the folate receptor in ovarian cancer coming of age? The Oncologist.
Hendershot, A., et al. (2023). Strategies for prevention and management of ocular events occurring with mirvetuximab soravtansine. Gynecologic Oncology Reports.
Immunogen, Inc. (n.d.). Caring for your eyes.
Immunogen, Inc. (n.d.). What happens before I receive an Elahere infusion?
ImmunoGen, Inc. (2023). Elahere- mirvetuximab soravtansine injection, solution [package insert]. DailyMed.
Mai, J., et al. (2023). Therapeutic strategies targeting folate receptor α for ovarian cancer. Frontiers in Immunology.
Moore, K.N., et al. (2023). Mirvetuximab soravtansine in FRα-positive, platinum-resistant ovarian cancer. The New England Journal of Medicine.
National Cancer Institute. (n.d.). Monoclonal antibody.
National Cancer Institute. (2022). Targeted therapy to treat cancer.
National Eye Institute. (2023). Corneal conditions.
Zhang, C., et al. (2022). Platinum-based drugs for cancer therapy and anti-tumor strategies. Theranostics.
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