FORWARD I: A Phase III Study of Mirvetuximab Soravtansine Versus Chemotherapy in Platinum-Resistant Ovarian Cancer

Figures & data

Infographic: A PDF version of this infographic is available as supplemental material.

Figure 1. Mirvetuximab soravtansine mechanism of action.

Mirvetuximab soravtansine binds with high affinity to folate receptor-α expressed on the tumor cell surface, prompting internalization of the antibody–drug conjugate/receptor complex via antigen-mediated endocytosis. Lysosomal processing releases active DM4 catabolites – these maytansinoid derivatives inhibit tubulin polymerization and microtubule assembly, inducing potent antimitotic effects that result in cell-cycle arrest and apoptosis. The active metabolites may also diffuse into neighboring cells and induce further cell death (termed ‘bystander killing’).

Reproduced with permission from [30].

Figure 2. FORWARD I trial study design.

AIBW: Adjusted ideal body weight; OS: Overall survival; PLD: Pegylated liposomal doxorubicin.

Figure 3. Participating countries in the FORWARD I trial.

Countries with active sites are shown in green, those with pending sites are shown in yellow (as of January 2018).

Table 1. Doses and dosing schedule.

Group	Drug	Dose	Dosing schedule
Arm 1	Mirvetuximab soravtansine	6 mg/kg (AIBW)	Day 1 of a 3-week cycle
Arm 2	Paclitaxel	80 mg/m^2	Days 1, 8, 15 and 22 of a 4-week cycle
	PLD	40 mg/m^2	Day 1 of a 4-week cycle
	Topotecan (4-week cycle)	4 mg/m^2	Days 1, 8 and 15 of a 4-week cycle
	Topotecan (3-week cycle)	1.25 mg/m^2	Days 1–5 of a 3-week cycle

AIBW: Adjusted ideal body weight; PLD: Pegylated liposomal doxorubicin.

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