Stanford University Study Finds Ovarian Cancer Drug Can Affect the Eyes

A study presented at the American Academy of Ophthalmology (AAO) meeting in Chicago found Mirvetuximab soravtansine (Elahere) is associated with corneal toxicity and related vision changes.

Mirvetuximab is part of an emerging class of anti-cancer drugs called antibody-drug conjugates. Approved by the FDA for ovarian cancer in 2022, this therapy came with a label warning that it may have ocular side effects. Researchers at Stanford University aimed to gather for the first time real-world data on the ocular toxicity profile of mirvetuximab. 

The Stanford Ophthalmology team, led by Prithvi Mruthyunjaya, MD, collaborated with the Obstetrics and Gynecology department to follow 18 women (36 eyes) receiving mirvetuximab treatment for nearly 6 months. The research found that 47% of eyes showed evidence of moderate or severe corneal toxicity and 22% showed mild toxicity. The most common side effect was the buildup of material in the cornea, such as paracentral ring-like subepithelial cystic deposits, corneal haze, and filamentous keratitis. These findings can lead to blurry vision, eye pain, light sensitivity, and foreign body sensation. In this cohort, more than half of the patients experienced decreased vision. Only 31% of eyes were unaffected by treatment. 

Most women’s symptoms improved or completely resolved after treatment with a strong topical corticosteroid drop in conjunction with reduced dosage or frequency of mirvetuximab infusions; 65% of eyes returned to baseline vision after treatment and corneal toxicity had significantly resolved in almost all patients at the last follow up visit.

“Close ophthalmology follow up is required for oncology patients on mirvetuximab, as high potency topical corticosteroids along with dose reduction or spacing might be needed to preserve or restore vision,” lead researcher Filippos Vingopoulos, MD, PhD, said in an AAO press release. “As novel promising treatments are incorporated in our anti-cancer treatment algorithms, post-market surveillance with real-world studies and close collaboration between ophthalmology and multiple other disciplines of medicine will allow for optimal care for our patients.”

Given these findings, experts recommend a baseline eye examination for patients on mirvetuximab treatment with routine exams at least every other cycle for the first eight cycles of treatment.