Platinum-sensitive ovarian cancer (PSOC) remains difficult to treat despite its responsiveness to mainstay platinum-based chemotherapies, as cumulative toxicities and diminishing treatment durability emerge with each recurrence. AbbVie’s Elahere (mirvetuximab soravtansine-gynx), a first-in-class folate receptor alpha (FRα)-directed antibody-drug conjugate (ADC), continues to gain momentum in ovarian cancer and is currently the only FRα-targeted ADC approved in platinum-resistant disease. New data from the Phase II MIROVA trial, presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, held on 29 May –2 June, 2026, missed its primary endpoint, failing to show Elahere’s anticipated benefit in the platinum-sensitive patient population.
Elahere selectively binds FRα, which is overexpressed in approximately 70% of high-grade serous ovarian cancers, but is minimally present on healthy tissue. Once bound, the ADC is internalised and releases its cytotoxic payload of DM4 inside the tumour cell, thereby limiting damage to the surrounding tissue. This targeted delivery supports the favourable tolerability that distinguishes Elahere from conventional chemotherapy.
Go deeper with GlobalData
The MIROVA study randomised patients with FRα-high (≥75%) recurrent PSOC to receive Elahere plus carboplatin followed by Elahere or investigator’s choice platinum-based chemotherapy followed by maintenance poly (ADP-ribose) polymerase (PARP) inhibitor. The Elahere combination produced a higher confirmed overall response rate (ORR) of 66.2% versus 32.8% with chemotherapy but failed to improve median progression-free survival (PFS), at 9.53 months versus 9.79 months (HR 1.0; p=0.996), respectively. Safety findings were broadly consistent with prior studies, but the combination had higher toxicity, including increased neuropathy and ocular events, than chemotherapy alone. As a randomised trial with an active comparator, MIROVA supplies the controlled, head-to-head evidence that earlier single-arm studies could not, but it currently argues against adding Elahere to platinum in this setting.
In 2025, Elahere generated $690m in global annual sales. According to GlobalData’s analyst consensus forecast, annual global sales are projected to reach $2.6bn by 2032, driven by EU and US uptake in platinum-resistant disease and a potential label expansion into platinum-sensitive disease. However, the MIROVA miss dampens prospects for a near-term label expansion into platinum-sensitive disease. Elahere’s principal limitation is its reliance on FRα-high expression via the Ventana FOLR1 companion diagnostic, which inherently restricts the addressable patient population.
This creates an opportunity for biomarker-agnostic rivals to exploit. Emerging ADCs such as Daiichi Sankyo Co’s raludotatug deruxtecan, Daiichi Sankyo Co/AstraZeneca’s Datroway (datopotamab deruxtecan), and Gilead Sciences’ Trodelvy (sacituzumab govitecan) aim to circumvent biomarker selection, although all currently trail behind Elahere in ovarian cancer development. More immediately, Corcept Therapeutics’ Lifyorli (relacorilant), which was recently approved in platinum-resistant ovarian cancer, may increasingly compete in recurrent settings through its biomarker-agnostic mechanism and ability to resensitize tumors to platinum-based chemotherapy. However, Elahere retains a meaningful competitive advantage as the only ADC supported by Phase III overall survival from MIRASOL, alongside a broad lifecycle management strategy spanning combinations and earlier-line disease. With MIROVA failing to demonstrate a durable randomised benefit, Elahere’s expansion across the ovarian cancer continuum now rests on other programs.
