The efficacy and safety of mirvetuximab soravtansine for the treatment of recurrent ovarian cancer: an update systematic review and meta-analysis.

INTRODUCTION: This meta-analysis aims to evaluate the efficacy and safety of mirvetuximab soravtansine (MIRV) in patients with recurrent ovarian cancer, with particular emphasis on those with platinum-resistant disease. METHOD: A comprehensive search of PubMed, EMBASE, and the Cochrane Library was conducted through August 31, 2025. Data on progression-free survival (PFS), overall response rate (ORR), overall survival (OS), duration of response (DOR), cancer antigen 125 response, and treatment-related adverse events (TRAEs) were extracted and analyzed using meta-analysis to assess the efficacy and safety of MIRV. RESULT: Twelve studies involving a total of 1112 patients with recurrent ovarian cancer were included in this meta-analysis. The PFS with MIRV was 6.28 months (95% confidence interval CI 5.70-6.87), and the ORR was 0.37 (95% CI 0.34-0.40). Among platinum-resistant patients treated with a combination of MIRV and bevacizumab, the PFS was 7.66 months (95% CI 6.45-8.87), while the ORR reached 0.42 (95% CI, 0.34-0.50). In addition, MIRV achieved an OS of 16.00 months (95% CI 12.36-19.63) and a DOR of 7.69 months (95% CI 6.80-8.58). The overall incidence of TRAEs was 93% (95% CI 92-95), with grade ≥ 3 adverse events occurring in 34% of patients (95% CI 31-37). The most common TRAEs were blurred vision (incidence 0.45; 95% CI, 0.42-0.48), nausea (0.39; 95% CI 0.37-0.42), and diarrhea (0.37; 95% CI 0.34-0.39). CONCLUSION: MIRV demonstrates significant efficacy and an acceptable safety profile in the treatment of recurrent ovarian cancer. Its use in platinum-resistant ovarian cancer with high FRα expression represents a particularly promising Therapeutic approach. Furthermore, the combination of MIRV and bevacizumab shows substantial potential for improving outcomes in patients with platinum-resistant disease.