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The National Institute for Health and Care Excellence (NICE) has approved the first treatment for platinum-resistant ovarian cancer in more than 20 years.
Under draft guidance, published on 4 June 2024, women with certain gynaecological cancers that have stopped responding to standard chemotherapy can be offered a targeted therapy that binds and delivers the drug directly to cancer cells.
Mirvetuximab soravtansine (Elahere; AbbVie) is recommended for use on the NHS for patients with folate receptor-alpha-positive platinum-resistant epithelial ovarian, fallopian tube or primary peritoneal cancer.
Around 270 patients are expected to be eligible for the treatment in the first year, rising to approximately 420 patients by year three as access to the test becomes more widely available, NICE said.
Michal Sladkowski, vice chair elect of the British Oncology Pharmacy Association (BOPA), said the recommendation “reflects the increasing role of precision medicine in ovarian cancer, where biomarker testing is helping us match patients to treatments that are most likely to benefit them”.
“For eligible women whose tumours express folate receptor-alpha (FRα), mirvetuximab soravtansine offers a welcome new option at a stage of disease where additional effective treatments are urgently needed.”
Eligible patients will be identified by a FRα biomarker test, conducted on a sample of tumour tissue to see whether the cancer cells have the FRα protein that the drug can bind to. This is usually taken during a biopsy or surgery that has already been done to diagnose the cancer, but it can be taken when patients relapse, or at the first sign of resistance to platinum-based chemotherapy, manufacturer AbbVie told The Pharmaceutical Journal on 4 June 2026.
The tumour is considered FRα positive if more than 75% of the cancer cells have moderate to high amounts of the protein on their surface. NICE committee papers note that this high expression occurs in approximately 32% of ovarian cancer cells.
The treatment may particularly benefit women from South Asian, Caribbean and African backgrounds, who have been found to be more likely to be diagnosed at a later stage, committee papers published alongside the guidance noted.
Mirvetuximab soravtansine is given as an intravenous infusion, with dosage calculated based on the patient’s body weight. The targeted treatment offers fewer hospital visits and more manageable side effects than standard chemotherapy.
In a phase III trial (MIRASOL) involving 453 adults, mirvetuximab soravtansine was shown to delay cancer progression by 1.6 months and extend mortality by 3.9 months, on average, when compared with the investigator’s choice of chemotherapy.
Sladkowski noted: “The survival benefits seen in the MIRASOL study are clinically meaningful. Many patients with platinum-resistant disease have already undergone prior lines of treatment and can experience significant treatment-related burden. A therapy that can both extend survival and reduce the disruption that treatment has on everyday life is particularly valuable.”
In a statement published on 4 June 2026, Lucy Common, clinical nursing Advisor at NICE, said: “For women living with platinum-resistant ovarian cancer, the impact of repeated chemotherapy cycles goes far beyond the clinic. We heard from patients who had given up work, stopped seeing friends, and were relying on family and carers just to get through each day.
“Mirvetuximab soravtansine offers not just longer survival, but a meaningfully different treatment experience, with fewer hospital visits and a side effect profile that allows women to maintain more of their normal life. That matters enormously.”
Before this recommendation, NICE guidance for the treatment of recurrent ovarian cancer was last updated in 2016.
In draft guidance published in 2025, NICE did not recommended mirvetuximab soravtansine as it was not considered to be cost effective. Since then, NICE received additional evidence about the average age of patients, how long people live with the condition and with this treatment, and how health-related quality of life differs with this treatment compared with chemotherapy.
As a result, the committee’s preferred assumptions around overall survival modelling changed and the committee considered the drug to be cost-effective for NHS patients in England.
The treatment will be available to patients immediately via funding through the Cancer Drugs Fund and will later switch to the routine commissioning budget 90 days after final NICE guidance is published.
