A Real-world Study of Mirvetuximab Soravtansine (MIRV) in Ovarian Cancer Patients of Expression of Folate Receptor α（FRα）

This prospective, multicenter, observational cohort study aims to evaluate the real-world safety and effectiveness of MIRV in patients with advanced ovarian cancer, fallopian tube cancer or primary peritoneal cancer with FRα expression.

Approximately 400 patients are planned to be enrolled from approximately 40 centers in China. On Day 1 of each 21-day cycle (every 3 weeks, Q3W), all patients will receive MIRV at a dose of 6 mg/kg based on adjusted ideal body weight (AIBW), either as monotherapy or in combination with other anticancer agents per clinical guideline recommendations. The starting dose may be adjusted by the investigator based on the patient's actual clinical condition. Treatment will continue until disease progression, unacceptable toxicity, withdrawal of consent, loss to follow-up, death, or other protocol-specified events requiring treatment discontinuation, whichever occurs first.

The screening period is up to 28 days. Safety assessments, including laboratory tests, eastern cooperative oncology group（ECOG）performance status, vital signs, physical examinations, ophthalmologic examinations, adverse events, and concomitant medications, will be conducted every 3 weeks (± 1 week) during treatment. Tumor imaging assessments by computed tomography(CT ) or magnetic resonance imaging（MRI）per response evaluation criteria in solid tumors v1.1（RECIST v1.1） will be performed every 2-3 cycles (± 7 days) to evaluate treatment response. Serum carbohydrate antigen 125（CA125）will be assessed within 14 days prior to the first dose, before each MIRV administration, and at each tumor imaging assessment (± 4 days).

For patients who permanently discontinue MIRV treatment, an end-of-treatment visit will be conducted within 7 days, followed by a safety follow-up visit 30 days (± 2 to +14 days) after the last dose. Survival follow-up will be conducted every 3 months (± 1 month) thereafter until death, loss to follow-up, withdrawal of survival follow-up consent, or end of study, whichever occurs first.

All data will be collected from routine clinical practice, entered into an electronic data capture (EDC) system, and analyzed using descriptive statistics. Time-to-event endpoints will be estimated using the Kaplan-Meier method. No additional interventions or study-mandated procedures are required beyond standard of care. This study is strictly observational and does not involve any investigational new drug application (IND) with the U.S. FDA.

Inclusion criteria

• Patients who meet all of the following inclusion criteria are eligible to participate in the study:

• Female patients aged ≥18 years.
• Patients must have histologically confirmed epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer.
• Patients must have PD on or after the most recent anti-cancer therapy.
• Patients must have FRα expression confirmed by VENTANA FOLR1 (≥ 25% of tumor cells with intensity ≥ 2 + after FRα staining).
• Patients must have normal major organ function and be suitable for MIRV monotherapy or combination therapy according to clinical recommendations
• Patients must have at least 1 evaluable lesion per RECIST v1.1 (radiologically assessed by the investigator).
• Eastern Cooperative Oncology Group Performance Status (ECOG PS) score must be 0-2.
• All toxicities (except alopecia) associated with prior therapy must have recovered to ≤ grade 1 per common terminology criteria for adverse events （CTCAE）v5.0.
• Patients must have had completed any major surgery at least 4 weeks prior to the first dose of MIRV, and have recovered or stabilized from postoperative complications of prior surgery.
• Patients must have expected survival of at least 12 weeks as assessed by the investigator.
• Patients must sign informed consent form（ICF）, and willingness and ability to comply with the study protocol, including scheduled treatment, regular follow-up, and examinations.

Exclusion criteria

• Patients who meet any of the following criteria may not be enrolled in the study:

• Participation in other clinical studies during the same period.
• Patient with known prior hypersensitivity to monoclonal antibody therapy or maytansinoids, or to study drug and/or any of its excipients.
• Patients with active or chronic corneal disorders, history of corneal transplant, or active ocular conditions requiring ongoing treatment/monitoring such as uncontrolled glaucoma, wet age-related macular degeneration requiring treatment with intravitreal injections, active diabetic retinopathy with macular edema, macular degeneration, presence of papilledema and/or monocular vision.
• Patients with prior treatment with MIRV or other FRα-targeting agents. (Only for patients in prospective cohort)
• Pregnant or breast-feeding females. Women of childbearing potential must agree to use highly effective contraception while using study drug and for at least 7 months after the last dose of MIRV.
• Current participation in any interventional study other than routine clinical practice.
• Any other condition that, in the investigator's judgment, makes the patient unsuitable for participation in this study