Elahere: A Promising New Treatment Option for Folate Receptor-Positive Ovarian Cancer

The problem often occurs in folate receptor positive ovarian cancer. An excess of a protein called folate receptor alpha (FRα) acts as a door for the vitamin B9 (folate) to flood into the cells.

While folate is important for cell growth, when there is too much of it, it fuels the growth and spread of cancer.

Related: Am I Eligible For The New Ovarian Cancer Treatment Elahere?

How does Elahere work?

Elahere is a type of drug known as an antibody-drug conjugate (ADCs).

By attaching itself to FRα on the cancer cells it can effectively block the protein and stop it from getting signals that tell them to grow and spread. Consequently, these cancer cells lose their ability to multiply rapidly, slowing down their aggressive expansion.

By blocking FRα, Elahere also disrupts the cancer cells’ ability to absorb folate. This weakens the cancer cells and also helps slow their spread.

Clinical Evidence of Effectiveness:

• The SORAYA Study found that Elahere increased survival rates in platinum-resistant ovarian cancer patients by a significant 30% compared to standard treatments. A few patients in the study had their cancer disappear entirely, meaning they were in remission.The drug’s benefits lasted approximately seven months on average.
• The MIRASOL Study showed that Elahere reduced the risk of the disease spreading or the patient dying by 35% compared to standard chemotherapy. Patients given Elahere were able to delay their cancer from spreading for nearly six months.

Does Elahere have side effects?

Elahere tends to have fewer side effects than many other chemotherapy drugs but it is not entirely free of side effects. A big concern doctors look out for is how it can damage eyesight.

Some common eye problems that occur during Elahere treatment include:

• Blurred vision
• Dry eyes
• Light sensitivity
• Eye pain
• Vision changes
• Uveitis (eye inflammation)

If you experience any eye problems, your doctor might recommend artificial tears to keep the eyes most and topical steroids to reduce inflammation
In severe cases, your doctor might temporarily stop Elahere until your eyes clear up. Once improvement occurs, they might resume treatment at the same or a lower dose.

If the eye problems become very serious, they might recommend discontinuing Elahere altogether.

Another potentially serious side effect is lung inflammation, also known as pneumonitis, which can be severe or even life-threatening. Let your doctor know if you have new or worsening symptoms like trouble breathing, shortness of breath, cough, or chest pain.

Elahere may also cause nerve problems. Numbness, tingling, or weakness in the hands and feet are caused by a condition called peripheral neuropathy.

Other side effects seen with Elahere include:

• Fatigue
• Elevated liver enzymes
• Nausea or abdominal pain
• Reduced red or white blood cell counts
• Diarrhea or constipation
• Lower blood albumin levels
• Reduced blood magnesium levels

Women who are pregnant or breastfeeding or plan to get pregnant should definitely discuss the risks of taking Elahere.

Related: When Ovarian Cancer Returns, Is the New Drug Elahere an Option & Will Insurance Cover It?

Am I a good candidate for Elahere?

A test can help determine if Elahere is likely to have benefit for a patient.

Eligibility for Elahere depends on having exceptionally high levels (exceeding 75%) of the FRα protein. If there is not very much of the protein, Elahere is less likely to work.

While research suggests that roughly 80% of both new and recurring ovarian cancers might have this protein, only around 35-40% of cancers resistant to platinum treatment exhibit such high levels.

Your doctor will consider Elahere if your ovarian cancer has returned after 1-3 prior platinum-based chemotherapy treatments that did not show benefit, indicating platinum resistance.

Your doctor can order an immunohistochemistry (IHC) test at no cost for patients who:

• Have ovarian, fallopian tube, or peritoneal cancer
• Get treatment in the US or a territory
• Haven’t had this test before
• Doctor says it medically necessary

Two companies offer a free IHC test in Salt Lake City and elsewhere in the US:

• FR-ASSIST program: Partnered with NeoGenomics and ImmunoGen, your oncologist can request a free test.
• Labcorp FR-ASSIST™ program: Offers a free FOLR1 IHC test for eligible patients.

This is not a standard test that most doctors order automatically.

If your ovarian cancer does come back, it’s certainly worth having a conversation with your doctor to see if testing can help expand your treatment options.

Should I consider joining a clinical trial?

If your doctor finds that you are not a good candidate for Elahere or it stops working, your doctor may want you to consider joining a clinical trial, a type of study that follows patients on experimental drugs to see if they are safe and effective.

Many therapies go through clinical trial before being approved by the government for wider use.

Two drugs are currently in clinical trials for platinum-resistant ovarian cancer:

• Farletuzumab uses a kind of protein known as an antibody to target FRα and stop the tumor from growing and spreading. Like Elahere, it is an ADC.
• STRO-002 is an investigational antibody-drug conjugate (ADC) that combines an antibody with a potent toxin to find the FRα-positive cancer cells and then poison them.

If think a clinical trial makes sense for you, your doctor can help you identify and apply for the one nearest you.

Related: SurvivorNet Clinical Trial Finder

Questions for your doctor

• Is my cancer platinum resistant?
• Should I be tested to see how much FRα is present in my cancer cells?
• Am I a good candidate for Elahere?
• What are the potential side effects of Elahere, and how can they be managed?
• Will testing and treatment be covered by insurance or some type of financial assistance program?
• Should I consider a clinical trial?

Learn more about SurvivorNet's rigorous medical review process.

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