Mirvetuximab soravtansine (FRα ADC) + carboplatin fails to improve PFS vs standard platinum doublets in FRα-high recurrent ovarian cancer

Mirvetuximab soravtansine (MIRV) is an FRα-targeted antibody–drug conjugate delivering the maytansinoid payload DM4; in MIROVA/AGO-OVAR 2.34 (Phase II; NCT04274426), platinum-eligible recurrent ovarian cancer with centrally confirmed FRα-high (≥75% PS2+) and platinum-free interval >3 months were randomized to carboplatin AUC5 + MIRV q3w ×6 then MIRV maintenance vs carboplatin + investigator’s choice (paclitaxel/gemcitabine/PLD) ×6 then PARP inhibitor maintenance if applicable. In 145 randomized patients (77.2% prior bevacizumab; 66.9% prior PARPi; 15.2% BRCAmut; 39.15% received PARPi maintenance in the control arm), median PFS was 9.53 months with carbo+MIRV vs 9.79 months with standard therapy (HR 1.00; 95% CI 0.68–1.46; p=0.996), squarely within historical PFS ranges for platinum-based combinations in platinum-sensitive relapse (e.g., carbo-PLD vs carbo-paclitaxel in CALYPSO showed PFS ~11 vs ~9 months, depending on analysis).