Testing & Treatment For Advanced Ovarian Cancer
- The drug Elahere has been shown to extend survival by 33% and slow the spread of the disease by 35% for patients with a hard-to-treat ovarian cancer.
- The medication is specifically designed to combat folate receptor positive ovarian cancer which is a type of cancer that develops when cancer cells have an excessive amount of a protein called folate receptor alpha on their surface, making them resistant to chemotherapy with the drug platinum.
- A free specialized test known as Immunohistochemistry can identify cancers that will respond best to Elahere.
- Though Elahere usually has fewer side effects than many cancer drugs, patients should report eyesight and breathing changes to their doctor.
Elahere is the first and only medication specifically designed to combat an aggressive and fast-spreading form of the disease known as folate receptor positive ovarian cancer which is a type of cancer that develops when cancer cells have an excessive amount of a protein called folate receptor alpha (FRα) on their surface. This protein acts like a gatekeeper, allowing vitamin B9 (folate) to enter into the cells.
Read MoreHow beneficial is Elahere?
Elahere was fully approved by the US Food and Drug Administration (FDA) based on the successful final results of the MIRASOL study:
- It reduced the chances of death compared to chemotherapy by 33%. Patients taking Elahere lived for an average of 17 months compared to about 13 months for the patients on chemotherapy.
- It reduced the chance of the cancer progressing by 35%. Patients on Elahere went nearly 6 months without their cancer spreading compared to 4 months for the patients on chemotherapy.
- More than 40% of patients taking Elahere saw their tumors shrink — and for 5% they disappeared completely.
- Elahere was also better tolerated than chemotherapy. Very few patients in the study had to stop taking it because of side effects.
As the first treatment to show a statistically significant overall survival benefit in patients with platinum-resistant ovarian cancer, Elahere provides an effective new option for patients with folate receptor alpha positive tumors. Previously there were very limited options for this disease. Elahere changes that.
How does Elahere work?
Elahere belongs to a category of drugs called antibody-drug conjugates (ADCs).
Its unique action starts with attaching itself to FRα on the cancer cells. This attachment effectively blocks the protein, preventing it from receiving signals that trigger cancer cell growth and division.
Consequently, these cancer cells lose their ability to multiply rapidly, slowing down their aggressive expansion.
Furthermore, by blocking FRα, Elahere disrupts the cancer cells’ ability to absorb folate, starving them of a critical way to fuel their growth. This weakens the cancer cells and stops them from spreading.
Potential Side Effects:
While generally manageable, Elahere does come with potential side effects. One serious concern is eye issues, which can show up as:
- Blurred vision
- Dry eyes
- Light sensitivity
- Eye pain
- Vision changes
- Uveitis (eye inflammation)
Before starting Elahere, your doctor will examine your eyes. During treatment, they will monitor your eyes closely, particularly at the start.
If you experience any eye problems, your doctor might recommend:
- Artificial tears for eye lubrication
- Topical steroids to reduce inflammation
In severe cases, your doctor might temporarily pause Elahere until your eyes improve. Once improvement occurs, they might resume treatment at the same or a lower dose.
In rare, exceptional circumstances, if the eye problems are very serious, they might discontinue Elahere altogether.
Another potential side effect is lung inflammation, also known as pneumonitis, which can be severe or even life-threatening. Inform your doctor immediately if you experience new or worsening symptoms like trouble breathing, shortness of breath, cough, or chest pain.
Elahere can also cause nerve problems, leading to numbness, tingling, or weakness in the hands and feet, a condition called peripheral neuropathy.
More common, less serious side effects include:
- Fatigue
- Elevated liver enzymes
- Nausea or abdominal pain
- Reduced red or white blood cell counts
- Diarrhea or constipation
- Lower blood albumin levels
- Reduced blood magnesium levels
A very important to note: Elahere is not recommended for pregnant or breastfeeding women due to potential risks to unborn babies or nursing infants.
How do you know if your cancer is folate receptor-positive?
A test called immunohistochemistry (IHC) can detect if your cancer has high levels of folate receptors.
This test is free for eligible patients in the US.
However, it’s not a test that doctors routinely order. It’s a topic worth discussing with your care team to see if you qualify and if the test is right for you.
Early detection can significantly improve treatment outcomes.
Who qualifies for the free IHC test:
- Individuals with ovarian, fallopian tube, or peritoneal cancer
- Anyone getting treatment in the US or a US territory
- Patients who have not had this test before
- Patients whose doctor say the test is medically necessary
Two organizations offer this free test in Baltimore and elsewhere in the US:
- FR-ASSIST program: Partners with NeoGenomics and ImmunoGen offer free IHC testing for all eligible patients.
- Labcorp FR-ASSIST™ program: Provides complimentary FOLR1 IHC testing for qualifying individuals.
“Sometimes it’s on at the time of diagnosis for certain circumstances. Sometimes it’s done later on down the line. It can be variable. It is dependent on the treating physician when they choose to perform the testing,” notes Dr. Stephanie Gaillard, an associate professor at the Johns Hopkins School of Medicine.
Related: When Ovarian Cancer Comes Back– The Standard of Care Treatment
Are there any other treatments in the works?
Researchers are continually exploring new ways to target the FRα protein. Two promising candidates are currently in clinical trials, a type of study where researchers test the drug on real patients to see whether it is safe and effective.
- Farletuzumab: This “smart protein” binds to FRα, effectively halting cancer cell growth.
- STRO-002: This “guided missile” drug combines an FRα-targeting antibody with a potent toxin, specifically destroying cancer cells.
Talk to your doctor to see if a clinical trial might be an option for you. If your doctor determines a clinical trial may help in your situation, they can help you find and enroll in a one.
Reference: SurivorNet Clinical Trial Finder
Questions for your doctor
Stay informed and proactive in your care plan by discussing these options with your doctor. Ask questions like:
- Is my cancer folate receptor-positive?
- Am I eligible for the free IHC test?
- Is Elahere a good option for me, given my specific case?
- What are the potential side effects of Elahere?
- Are there clinical trials I could participate in?
Learn more about SurvivorNet's rigorous medical review process.