Results from the Phase II PICCOLO trial show the promise of Elahere (mirvetuximab soravtansine; AbbVie) in heavily pre-treated patients with folate receptor-alpha positive, platinum-sensitive ovarian cancer.
Image credit: Dr_Microbe | stock.adobe.com
Elahere (mirvetuximab soravtansine; AbbVie) achieved both the primary and secondary endpoints of the Phase II PICCOLO trial (NCT05041257) in heavily pre-treated patients with folate receptor-alpha (FRα) positive, platinum-sensitive ovarian cancer (PSOC).1
The FDA granted accelerated approval to Elahere in November 2022 for adults with FRα-positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer who were previously administered one to three systemic treatment regimens. The agency upgraded the regulatory action to a full approval in March 2024.2,3
"Significant unmet needs remain for patients with platinum sensitive disease, as each subsequent line of therapy in this setting is associated with decreased efficacy and tolerability, which reinforces the need for treatment alternatives for these patients," Angeles Alvarez Secord, MD, MHSc, of the Duke Cancer Institute, said in a press release. "The PICCOLO data further support the potential of [Elahere] for platinum-sensitive ovarian cancer patients."1
An investigational, first-in-class antibody drug conjugate, Elahere is comprised of a folate receptor alpha-binding antibody, cleavable linker, and maytansinoid payload DM4, to eliminate targeted cancer cells. The single-arm, PICCOLO trial analyzed the efficacy and safety of Elahere monotherapy in patients with FRα-high, PSOC who were previously administered at least two lines of platinum-containing therapy or who have documentation of a platinum allergy.
The trial’s primary endpoint is objective response rate (ORR), with duration of response (DOR) serving as a key secondary endpoint and additional secondary endpoints of treatment-emergent adverse effects, CA-125 level, progression-free survival, and overall survival.
Enrollment criteria included being at least 18 years of age with a confirmed diagnosis of high-grade serous epithelial ovarian cancer, primary peritoneal, or fallopian tube cancer; having platinum-sensitive disease defined as radiographic progression more than six months from the last dose of the most recently administered platinum therapy; at least one measurable lesion per RECIST 1.1 criteria; FRα positivity defined by Ventana FOLR1 assay; and ECOG performance status of zero or one.4
The trial was designed to statistically rule out an ORR of 28% or under, as per the lower bound of the confidence interval (CI), which was previously observed with non-platinum, single-agent chemotherapy in patients with platinum-sensitive disease, according to AbbVie.1
“Patients with PSOC with multiple prior lines of platinum-based therapy or who are ineligible for platinum-based therapy, as in the population in PICCOLO, have no established benchmark standard of care, particularly after disease progression on a PARP inhibitor,” AbbVie stated in the release.1
The results of the trial show an ORR of 51.9% (95%CI 40.4 – 63.3%) and median DOR of 8.25 months, which achieved both the primary and key secondary endpoints, respectively. In terms of safety, the profile of Elahere was consistent with what has been reported in prior clinical trials, with no new safety signals identified.
The most fatal gynecological cancer, ovarian cancer, is often diagnosed in the late stage, with approximately 20,000 patients diagnosed annually and 13,000 deaths. Standard of care treatment is surgery and platinum-based chemotherapy; however, many patients develop difficult to treat platinum-resistant disease that reduces their response rates, representing a significant unmet need.
Full data from the PICCOLO trial will be presented at an upcoming medical meeting, according to AbbVie.
References
1. AbbVie Announces Positive Topline Results from Phase 2 PICCOLO Trial Evaluating Mirvetuximab Soravtansine (ELAHERE®) for High Folate Receptor-Alpha (FRα) Expressing Platinum-Sensitive Ovarian Cancer. News release. AbbVie. June 6, 2024. Accessed June 7, 2024. https://news.abbvie.com/2024-06-06-AbbVie-Announces-Positive-Topline-Results-from-Phase-2-PICCOLO-Trial-Evaluating-Mirvetuximab-Soravtansine-ELAHERE-R-for-High-Folate-Receptor-Alpha-FR-Expressing-Platinum-Sensitive-Ovarian-Cancer
2. ImmunoGen. ImmunoGen Announces FDA Accelerated Approval of ELAHERE™ (mirvetuximab soravtansine-gynx) for the Treatment of Platinum-Resistant Ovarian. News Release. November 15, 2022. Accessed June 7, 2024. https://www.businesswire.com/news/home/20221104005657/en
3. U.S. Food and Drug Administration (FDA) Grants Full Approval for ELAHERE® (mirvetuximab soravtansine-gynx) for Certain Ovarian Cancer Patients. AbbVie. March 22, 2024. Accessed June 7, 2024. https://news.abbvie.com/2024-03-22-U-S-Food-and-Drug-Administration-FDA-Grants-Full-Approval-for-ELAHERE-R-mirvetuximab-soravtansine-gynx-for-Certain-Ovarian-Cancer-Patients
4. Mirvetuximab soravtansine monotherapy in platinum-sensitive epithelial, peritoneal, and fallopian tube cancers (PICCOLO). ClinicalTrials.gov. Updated April 22, 2024. Accessed June 7, 2024. https://classic.clinicaltrials.gov/ct2/show/NCT05041257
SOUL Trial Shows Oral Semaglutide Significantly Reduces Cardiovascular Risk in Type 2 Diabetes
April 3rd 2025Phase III SOUL trial shows daily oral semaglutide lowers the risk of major adverse cardiovascular events in patients with type 2 diabetes and atherosclerotic cardiovascular disease or chronic kidney disease, with benefits consistent with injectable semaglutide and other GLP-1 receptor agonists.
Behind the Buzz: Why Clinical Research Leaders Flock to SCOPE Summit
February 7th 2025In this episode, we meet with Micah Lieberman, Executive Conference Director for SCOPE Summit (Summit for Clinical Ops Executives) at Cambridge Innovation Institute. We will dive deep into the critical role of collaboration within the clinical research ecosystem. How do we bring together diverse stakeholders—sponsors, CROs, clinical trial tech innovators, suppliers, patients, sites, advocacy organizations, investors, and non-profits—to share best practices in trial design, program planning, innovation, and clinical operations? We’ll explore why it’s vital for thought leaders to step beyond their own organizations and learn from others, exchanging ideas that drive advancements in clinical research. Additionally, we’ll discuss the pivotal role of scientific conferences like SCOPE Summit in fostering these essential connections and collaborations, helping shape the future of clinical trials. Join us as we uncover how collective wisdom and cross-industry partnerships are transforming the landscape of clinical research.
Reaching Diverse Patient Populations With Personalized Treatment Methods
January 20th 2025Daejin Abidoye, head of solid tumors, oncology development, AbbVie, discusses a number of topics around diversity in clinical research including industry’s greatest challenges in reaching diverse patient populations, personalized treatment methods, recruitment strategies, and more.
Phase III Trial Data Show Subcutaneous Pembrolizumab as Noninferior to IV Keytruda
March 31st 2025Subcutaneous administration of pembrolizumab with chemotherapy demonstrated a nearly 50% reduction in patient chair and treatment room time while maintaining efficacy and safety endpoints compared to intravenous Keytruda.