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
Side effects of Elahere (mirvetuximab soravtansine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
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%)
Less Common Side Effects
- Vomiting
- Bloating
- Lack of appetite
- Joint and muscle pain
- Shortness of breath
Elahere (mirvetuximab soravtansine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Vision loss
- Serious lung problems: Difficulty breathing, trouble catching your breath, chest pain
The following Elahere (mirvetuximab soravtansine) 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.
Common questions about Elahere (mirvetuximab soravtansine)
Before starting treatment, your provider will first test a sample of your tumor to see if your cancer is FRɑ-positive. If so, that means Elahere (mirvetuximab soravtansine) is a possible option for you because this medication targets the FRɑ protein on cancer cells. In ovarian cancer, over 80% of tumors are FRɑ-positive. Keep in mind that Elahere (mirvetuximab soravtansine) isn’t a first-choice option for this type of cancer because the medication can cause serious side effects, such as eye problems. Your provider will consider Elahere (mirvetuximab soravtansine) for you only if platinum-based chemotherapy and other types of anticancer medication didn’t work well for you.
You can expect to spend a few hours at the infusion center to receive each dose. Your first Elahere (mirvetuximab soravtansine) infusion will take longer (1.5 to 3 hours), because the medication is given slowly to lower the risk of infusion-related reactions, such as difficulty breathing, flushing, chest pain, fast heartbeat, or dizziness. If you tolerate the first infusion well, your provider will likely give the following Elahere (mirvetuximab soravtansine) infusions more quickly (in 1 to 2 hours). Bear in mind that before you receive Elahere (mirvetuximab soravtansine), your care team will also give you pre-treatment medications, such as corticosteroid, antihistamine, and anti-nausea medications. The purpose of these medications is to lower your risk of serious infusion related reactions, nausea, and vomiting.
Eye problems, such as blurry vision or dry eyes, are one of the most common side effects of Elahere (mirvetuximab soravtansine). In rare cases, these can be serious. People who experience eye problems tend to notice them between their second and third infusions, which is around 1 month after starting treatment. Your provider will refer you to an eye specialist for eye exams before you start and regularly throughout Elahere (mirvetuximab soravtansine) treatment. They'll also recommend that you use 2 kinds of eye drops, lubricating and steroid eye drops, several times a day while you're receiving Elahere (mirvetuximab soravtansine). It's best to avoid wearing contact lenses during, unless your provider tells you it’s safe to. Tell your healthcare team if you develop blurred vision, dry eyes, light sensitivity, eye pain, or bothersome vision changes. Your provider might recommend pausing Elahere (mirvetuximab soravtansine) treatment, lowering your dose, or stopping Elahere (mirvetuximab soravtansine) altogether depending on how severe your symptoms are.
Let your provider know if you have problems with your liver, because you’re at higher risk of side effects from Elahere (mirvetuximab soravtansine), including eye problems, tiredness, and nausea. Elahere (mirvetuximab soravtansine) is mainly broken down by your liver so your body might have a harder time getting rid of this medication if you have liver problems. Depending on how severe your liver problems are, Elahere (mirvetuximab soravtansine) might not be an appropriate treatment option for you.
Elahere (mirvetuximab soravtansine) hasn’t been studied in people who are pregnant or breastfeeding. But based on how the medication works, it can potentially cause serious harm to unborn or nursing babies. If you’re able to become pregnant, make sure to use birth control during treatment with Elahere (mirvetuximab soravtansine) and for 7 months after stopping this medication. In addition, you should avoid breastfeeding during treatment and for 1 month after the last dose.
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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
Typical dosage 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)?
Elahere (mirvetuximab soravtansine) images
