A Study of Mirvetuximab Soravtansine in Platinum-Resistant, Advanced High-Grade Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancers With High Folate Receptor-Alpha Expression

Recruitment Status
COMPLETED - HAS RESULTS
(See Contacts and Locations)Verified June 2024 by ImmunoGen, Inc.
Sponsor
ImmunoGen, Inc.
Information Provided by (Responsible Party)
ImmunoGen, Inc.
Clinicaltrials.gov Identifier
NCT04296890
Other Study ID Numbers:
IMGN853-0417
First Submitted
February 26, 2020
First Posted
March 4, 2020
Results First Posted
April 22, 2024
Last Update Posted
August 6, 2024
Last Verified
June 2024

ClinicalTrials.gov processed this data on July 2024. Link to the current ClinicalTrials.gov record .

History of Changes

Study Details

Study Description

This study is designed to evaluate the efficacy and safety of mirvetuximab soravtansine (MIRV) in participants with platinum-resistant high-grade serous epithelial ovarian cancer, primary peritoneal, or fallopian tube cancer, whose tumors express a high-level of Folate Receptor Alpha (FRα). Participants will be, in the opinion of the Investigator, appropriate for single-agent therapy for their next line of therapy. FRα positivity will be defined by the Ventana FOLR1 (Folate Receptor 1/Folate Receptor Alpha) Assay.

Approximately 110 eligible participants will be enrolled to achieve a total of 105 efficacy evaluable participants. Efficacy evaluable participants include those who have measurable lesions per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1) at baseline and received at least 1 dose of MIRV.

All participants will receive single-agent MIRV at 6 mg/kg adjusted ideal body weight (AIBW) administered on Day 1 of every 3-week cycle (Q3W).

Tumor response will be evaluated by the Investigator using RECIST v1.1. Computerized tomography (CT) or magnetic resonance imaging (MRI) scans will be collected for sensitivity analysis by blinded independent central review (BICR).

Participants will continue to receive MIRV until disease progression, unacceptable toxicity, withdrawal of consent, death, or until the Sponsor terminates the study (whichever comes first).

Tumor assessments, including radiological assessments by CT/MRI scans will be performed at Screening and subsequently every 6 weeks (± 1 week) from Cycle 1 Day 1 (C1D1) for the first 36 weeks then every 12 weeks (± 3 weeks) until disease progression, death, the start of new anticancer therapy, or participant's withdrawal of consent (whichever occurs first).

Participants who discontinue MIRV for reasons other than progressive disease (PD) will continue with tumor assessments until documentation of PD or the start of a new anticancer therapy, whichever comes first. Prior to Week 36 (from Cycle 1, Day 1), assessments should occur every 6 weeks (± 1 week) as allowed by local requirements but must occur at an interval of no more than 12 weeks. After Week 36, assessment will occur every 12 weeks (± 3 weeks) until documentation of PD or the start of new anticancer therapy.

All participants who discontinue MIRV will be followed for survival every 3 months (± 1 month) until death, lost to follow-up, withdrawal of consent for survival follow-up, or end of study (EOS) (whichever comes first). Additional survival follow-up calls may occur periodically, if needed.

Condition or DiseaseIntervention/Treatment
Epithelial Ovarian CancerPeritoneal CancerFallopian Tube Cancer
Drug: Mirvetuximab Soravtansine

Study Design

Study TypeInterventional
Actual Enrollment106 participants
Design AllocationN/A
Interventional ModelSingle Group Assignment
MaskingNone (Open Label)
Primary PurposeTreatment
Official TitleSORAYA: A Phase 3, Single Arm Study of Mirvetuximab Soravtansine in Platinum-Resistant, Advanced High-Grade Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancers With High Folate Receptor-Alpha Expression
Study Start DateJuly 22, 2020
Actual Primary Completion DateNovember 15, 2021
Actual Study Completion DateNovember 15, 2022

Groups and Cohorts

Group/CohortIntervention/Treatment
Treatment
All participants will receive single-agent mirvetuximab soravtansine (MIRV) at 6 mg/kg adjusted ideal body weight (AIBW) administered on Day 1 of every 3-week cycle (Q3W).
Drug: Mirvetuximab Soravtansine
Mirvetuximab Soravtansine is an antibody drug conjugate designed to target folate receptor α (FRα). It consists of the humanized anti-FRα mAb M9346A attached via a cleavable disulfide linker to the cytotoxic maytansinoid, DM4.

Outcome Measures

Primary Outcome Measures
  1. Objective Response Rate (ORR): Percentage of Participants With Objective Response as Assessed by the Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
    ORR was defined as percentage of participants with a confirmed best overall response (BOR) of complete response (CR) or partial response (PR). CR: Disappearance of all target or non-target lesions. All pathological or non-pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 millimeters (mm). PR: At least 30% decrease in the sum of the longest diameters (SoD) of target lesions, taking as reference the baseline SoD.
Secondary Outcome Measures
  1. Duration of Response (DOR) as Assessed by the Investigator Using RECIST v1.1
    DOR was defined as the time from the date of the first response (CR or PR), until the date of progressive disease (PD) or death from any cause, whichever occurred first. DOR for participants who had not progressed or died at the time of analysis was censored at the date of their last tumor assessment. PD: At least a 20% increase in the SoD of target lesion, taken as reference the smallest (nadir) SoD since and including baseline. In addition to the relative increase of 20%, the SoD must also demonstrate an absolute increase of at least 5 mm. Unequivocal progression of non-target lesions. Unequivocal progression should not normally trump target lesion status. It must be representative of overall disease status change, not a single lesion increase. DOR was estimated using the Kaplan-Meier method.
  2. Percentage of Participants With CA-125 Confirmed Clinical Response Per Gynecologic Cancer Intergroup (GCIG) Criteria
    The GCIG CA-125 response was defined as at least 50% reduction in CA-125 levels from baseline. The response must have been confirmed and maintained for at least 28 days.
  3. Progression-Free Survival (PFS) as Assessed by the Investigator Using RECIST v1.1
    PFS was defined as the time from initiation of study drug until the date of PD or death whichever occurred first, estimated using the Kaplan-Meier method. PD: At least a 20% increase in the SoD of target lesion, taken as reference the smallest (nadir) SoD since and including baseline. In addition to the relative increase of 20%, the SoD must also demonstrate an absolute increase of at least 5 mm. Unequivocal progression of non-target lesions and appearance of new lesions. Unequivocal progression should not normally trump target lesion status. It must be representative of overall disease status change, not a single lesion increase.
  4. Overall Survival Assessed by the Investigator Using RECIST v1.1
    Overall survival was defined as the time from the date of first dose until the date of death from any cause, estimated using the Kaplan-Meier method.
  5. Number of Participants With Treatment-emergent Adverse Events (TEAEs)
    An adverse event (AE) was defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to study drug. TEAEs were defined as AEs with an onset date on or after the first dose of Study drug, and within 30 days of the last dose of study drug or prior to the start of a new anticancer treatment, whichever occurred first. A summary of all Serious Adverse Events (SAEs) and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

Eligibility Criteria

Ages Eligible for Study(Adult, Older Adult)
Sexes Eligible for StudyFemale
Accepts Healthy VolunteersNo
Inclusion Criteria
1. Female participants ≥ 18 years of age 2. Participants must have a confirmed diagnosis of high-grade serous epithelial ovarian cancer (EOC), primary peritoneal cancer, or fallopian tube cancer 3. Participants must have platinum-resistant disease: 1. Participants who have only had 1 line of platinum based therapy must have received at least 4 cycles of platinum, must have had a response (complete response/remission \[CR\] or partial response/remission \[PR\]) and then progressed between \> 3 months and ≤ 6 months after the date of the last dose of platinum 2. Participants who have received 2 or 3 lines of platinum therapy must have progressed on or within 6 months after the date of the last dose of platinum Note: Progression should be calculated from the date of the last administered dose of platinum therapy to the date of the radiographic imaging showing progression Note: Participants who are platinum refractory during front-line treatment are excluded (see exclusion criteria) 4. Participants must have progressed radiographically on or after their most recent line of anticancer therapy. 5. Participants must be willing to provide an archival tumor tissue block or slides, or undergo procedure to obtain a new biopsy using a low-risk, medically routine procedure for immunohistochemistry (IHC) confirmation of Folate Receptor α (FRα) positivity 6. Participant's tumor must be positive for FRα expression as defined by the Ventana FOLR1 Assay 7. Participants must have at least 1 lesion that meets the definition of measurable disease by RECIST v1.1 (radiologically measured by the Investigator) 8. Participants must have received at least 1 but no more than 3 prior systemic lines of anticancer therapy, including at least 1 line of therapy containing bevacizumab, and for whom single-agent therapy is appropriate as the next line of treatment: 1. Adjuvant ± neoadjuvant considered 1 line of therapy 2. Maintenance therapy (e.g., bevacizumab, poly adenosine diphosphate-ribose polymerase (PARP) inhibitors) will be considered part of the preceding line of therapy (i.e., not counted independently) 3. Therapy changed due to toxicity in the absence of progression will be considered part of the same line (i.e., not counted independently) 4. Hormonal therapy will be counted as a separate line of therapy unless it was given as maintenance 9. Participants must have an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1 10. Participants must have completed prior therapy within the specified times below: 1. Systemic antineoplastic therapy within 5 half-lives or 4 weeks (whichever is shorter) prior to first dose of MIRV 2. Focal radiation completed at least 2 weeks prior to first dose of MIRV 11. Participants must have stabilized or recovered (Grade 1 or baseline) from all prior therapy-related toxicities (except alopecia) 12. Participants must have completed any major surgery at least 4 weeks prior to first dose of MIRV and have recovered or stabilized from the side effects of prior surgery 13. Participants must have adequate hematologic, liver and kidney functions defined as: 1. Absolute neutrophil count (ANC) ≥ 1.5 x 10\^9/L (1,500/μL) without G-CSF in the prior 10 days or long-acting WBC growth factors in the prior 20 days 2. Platelet count ≥ 100 x 10\^9/L (100,000/μL) without platelet transfusion in the prior 10 days 3. Hemoglobin ≥ 9.0 g/dL without packed red blood cell (PRBC) transfusion in the prior 21 days 4. Serum creatinine ≤ 1.5 x upper limit of normal (ULN) 5. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3.0 x ULN 6. Serum bilirubin ≤ 1.5 x ULN (patients with documented diagnosis of Gilbert syndrome are eligible if total bilirubin \< 3.0 x ULN) 7. Serum albumin ≥ 2 g/dL 14. Participants or their legally authorized representative must be willing and able to sign the informed consent form (ICF) and to adhere to the protocol requirements 15. Women of childbearing potential (WCBP) must agree to use highly effective contraceptive method(s) while on MIRV and for at least 3 months after the last dose 16. WCBP must have a negative pregnancy test within the 4 days prior to the first dose of MIRV
Exclusion Criteria
1. Male participants 2. Participants with endometrioid, clear cell, mucinous, or sarcomatous histology, mixed tumors containing any of the above histologies, or low-grade/borderline ovarian tumor 3. Participants with primary platinum-refractory disease, defined as disease that did not respond to (CR or PR) or has progressed within 3 months of the last dose of first-line platinum-containing chemotherapy 4. Participants with prior wide-field radiotherapy (RT) affecting at least 20 percent of the bone marrow 5. Participants with \> Grade 1 peripheral neuropathy per Common Terminology Criteria for Adverse Events (CTCAE) 6. Participants with active or chronic corneal disorders, history of corneal transplantation, or active ocular conditions requiring ongoing treatment/monitoring, such as uncontrolled glaucoma, wet age-related macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, macular degeneration, presence of papilledema, and /or monocular vision 7. Participants with serious concurrent illness or clinically relevant active infection, including, but not limited to the following: 1. Active hepatitis B or C infection (whether or not on active antiviral therapy) 2. Human immunodeficiency virus (HIV) infection 3. Active cytomegalovirus infection 4. Any other concurrent infectious disease requiring IV antibiotics within 2 weeks prior to the first dose of MIRV Note: Testing at screening is not required for the above infections unless clinically indicated 8. Participants with a history of multiple sclerosis (MS) or other demyelinating disease and/or Lambert-Eaton syndrome (paraneoplastic syndrome) 9. Participants with clinically significant cardiac disease including, but not limited to, any of the following: 1. Myocardial infarction ≤ 6 months prior to first dose 2. Unstable angina pectoris 3. Uncontrolled congestive heart failure (New York Heart Association \> class II) 4. Uncontrolled ≥ Grade 3 hypertension (per CTCAE) 5. Uncontrolled cardiac arrhythmias 10. Participants with a history of hemorrhagic or ischemic stroke within 6 months prior to enrollment 11. Participants with a history of cirrhotic liver disease (Child-Pugh Class B or C) 12. Participants with a previous clinical diagnosis of noninfectious interstitial lung disease (ILD), including noninfectious pneumonitis 13. Participants requiring use of folate-containing supplements (eg, folate deficiency) 14. Participants with prior hypersensitivity to monoclonal antibodies (mAb) 15. Women who are pregnant or breastfeeding 16. Participants who received prior treatment with MIRV or other FRα-targeting agents 17. Participants with untreated or symptomatic central nervous system (CNS) metastases 18. Participants with a history of other malignancy within 3 years prior to enrollment. Note: Participants with tumors with a negligible risk for metastasis or death (eg, adequately controlled basal-cell carcinoma or squamous-cell carcinoma of the skin, or carcinoma in situ of the cervix or breast) are eligible 19. Prior known hypersensitivity reactions to study drugs and/or any of their excipients

Contacts and Locations

Sponsors and CollaboratorsImmunoGen, Inc.
Locations
Arizona Oncology Associates | Phoenix Arizona, United States, 85016City of Hope Medical Center | Duarte California, United States, 91010California Cancer Associates (cCARE) | Fresno California, United States, 93720Stanford School of Medicine | Palo Alto California, United States, 94394California Pacific Medical Center Research Institute | San Francisco California, United States, 94109Rocky Mountain Cancer Centers | Littleton Colorado, United States, 80120Sarasota Memorial Health Care System | Sarasota Florida, United States, 34239Florida Cancer Specialists Panhandle | Tallahassee Florida, United States, 32308University of South Florida | Tampa Florida, United States, 33606Florida Cancer Specialists Research | West Palm Beach Florida, United States, 33401Northside Hospital | Atlanta Georgia, United States, 30342Hinsdale Hospital | Hinsdale Illinois, United States, 60521St. Vincent Gynecologic Oncology | Indianapolis Indiana, United States, 46260University of Kansas Cancer Center | Westwood Kansas, United States, 66205Norton Cancer Institute | Louisville Kentucky, United States, 40207Women's Cancer Center | Covington Louisiana, United States, 70433Maryland Oncology Hematology, P.A. | Rockville Maryland, United States, 20850Massachusetts General Hospital | Boston Massachusetts, United States, 02114Dana Farber Cancer Institute | Boston Massachusetts, United States, 02215Midwest Oncology Associates/Sarah Cannon | Kansas City Missouri, United States, 64132Center of Hope at Renown Medical Center | Reno Nevada, United States, 89502Holy Name Medical Center | Teaneck New Jersey, United States, 07666Mount Sinai Health System | New York New York, United States, 10029Memorial Sloan-Kettering Cancer Center | New York New York, United States, 10065Sarah Cannon Research Institute / Tennessee Oncology, PLLC | Nashville Tennessee, United States, 37203Texas Oncology-Austin Central | Austin Texas, United States, 78731Texas Oncology, P.A. - Fort Worth Cancer Center | Fort Worth Texas, United States, 76104Texas Oncology, P.A. - McAllen | McAllen Texas, United States, 78503Texas Oncology, P.A. - Sugar Land | Sugar Land Texas, United States, 77479USOR: Texas Oncology - The Woodlands, Gynecologic Oncology | The Woodlands Texas, United States, 77380Texas Oncology, P.A. - Tyler | Tyler Texas, United States, 75702Kadlec Clinic Hematology and Oncology | Kennewick Washington, United States, 99336University of Wisconsin Carbone Cancer Center | Madison Wisconsin, United States, 53792Froedtert and the Medical College of Wisconsin Department of Obstetrics & Gynecology | Milwaukee Wisconsin, United States, 53226Royal North Shore Hospital | St Leonards New South Wales, Australia, 2065ICON Cancer Care | Auchenflower Queensland, Australia, 4066Peninsula and South Eastern Haematology & Oncology Group | Frankston Victoria, Australia, 3199St John of God Subiaco Hospital | Subiaco Western Australia, Australia, 6008Cliniques Universitaires Saint Luc - lnstitut Roi Albert II | Brussels Brussels Capital, Belgium, 1200Centre Hopsitalier de l'Ardenne | Libramont Luxembourg, Belgium, 6800UZ Gent | Ghent , Belgium, 9000UZ Leuven | Leuven , Belgium, 3000CHU UCL Namur/Site Sainte Elisabeth | Namur , Belgium, B5000MHAT "Serdika" | Sofia , Bulgaria, 1632Všeobecná fakultní nemocnice v Praze | Prague Prague, Czechia, 128 51Universitätsmedizin Mannheim | Mannheim Baden-Wurttemberg, Germany, 68167UMG Frauenklinik Robert-Koch-Str. 40 | Göttingen Lower Saxony, Germany, 37075KEM | Essen , Germany, 45135Mater Misericordiae University Hospital | Dublin Leinster, Ireland, 7St. James's Hospital | Dublin Leinster, Ireland, 8Cork University Hospital | Cork Munster, Ireland, T12 DC4ABon Secours Hospital | Cork Munster, Ireland, T12 DV56University Hospital Waterford | Waterford Munster, Ireland, X91ER8EBeaumont Hospital | Dublin , Ireland, 9Rambam Medical Center | Haifa , Israel, PO Box 9601Shaare Zedek Medical Center | Jerusalem , Israel, 91031Hadassah Ein Kerem Medical center | Jerusalem , Israel, POB 12000Meir Medical Center | Kfar Saba , Israel, 4428164Sheba Medical Center | Ramat Gan , Israel, 5265601Kaplan Medical Center | Rehovot , Israel, 76100Ziv Medical Center | Safed , Israel, 13100Policlinico S. Orsola-Malpighi | Bologna , Italy, 40138Azienda Socio Santaria Territoriale degli Spedali Civili di Brescia | Brescia , Italy, 25123Istituto Oncologico Candiolo | Candiolo , Italy, 10060Ospedale Cannizzaro di Catania | Catania , Italy, 95126IEO Istituto Europeo di Oncologia | Milan , Italy, 20141Azienda Ospedaliera Ospedale Niguarda Ca'Granda | Milan , Italy, 20162Fondazione IRCCS Istituto Nazionale dei Tumori | Naples , Italy, 80131Istituto Nazionale Tumori- G. Pascale | Naples , Italy, 87100Ospedale S.Maria della Misericordia | Perugia , Italy, 6129Fondazione Policlinico Universitario A. Gemelli IRCCS | Roma , Italy, 00168Specjalistyczna Przychodnia Lekarska Medicus | Chorzów Silesian Voivodeship, Poland, 41-500Mazurskim Centrum Onkologiiw Olsztynie | Olsztyn Warmian-Masurian Voivodeship, Poland, 10-228Instytut Centrum Zdrowia Matki Polki | Lodz Łódź Voivodeship, Poland, 93-338Institut Català d'Oncologia Badalona Hospital Universitari Germans Trias i Pujol | Badalona Barcelona, Spain, 08916Hospital La Paz | Madrid Castellana, Spain, 28046Hospital Teresa Herrera - Complejo Hospitalario Universitario A Coruna | A Coruña Galicia, Spain, 15006Hospital Quirón Dexeus | Barcelona , Spain, 08028Vall d'Hebron Institute of Oncology | Barcelona , Spain, 08035lnstitut Catala d' Oncologia L' Hospitalet | Barcelona , Spain, 08908Hospital Reina Sofia de Cordoba | Córdoba , Spain, 14004Institut Català d'Oncología de Girona | Girona , Spain, 17007Clinica Universidad de Navarra | Madrid , Spain, 28027MD Anderson Cancer Centre | Madrid , Spain, 28033Hospital Clínico Universitario San Carlos | Madrid , Spain, 28040Hospital Clinico Universitario Virgen de la Arrixaca | Murcia , Spain, 30120Corporació Sanitaria Parc Taulí | Sabadell , Spain, 08208Hospital Clinico Universitario de Valencia | Valencia , Spain, 46010Instituto Valenciano de Oncologia | Valencia , Spain, 46010
Investigators
Study Director: Michael Method, MD, MPH, MBA, ImmunoGen, Inc.Principal Investigator: Ursula Matulonis, MD, Dana-Farber Cancer InstitutePrincipal Investigator: Robert Coleman, MD, The US Oncology Network
Study Documents (Full Text)
Documents provided by ImmunoGen, Inc.: Study Protocol  August 27, 2020Documents provided by ImmunoGen, Inc.: Statistical Analysis Plan  November 4, 2021