Giuseppe Caruso, Medical Consultant at The European Institute of Oncology, shared on LinkedIn:
“Rina-S is coming in the PROC setting, so what happens to MIRV?
Genmab has announced positive topline results from the phase 3 RAINFOL-02 trial in PROC: Rina-S vs investigator’s choice CHT improved both PFS (HR 0.29) and OS (HR 0.43).
The most interesting part for me is the primary analysis set (PAS), where FRα-high patients had to be pretreated with MIRV: PFS HR 0.33 and OS HR 0.44.
Both drugs target FRα, but they are not the same:
- MIRV: tubulin payload, works only in FRα-high tumors
- Rina-S: TOP1i payload, active across FRα levels and apparently also after MIRV
A hypothesis: the order matters?
- MIRV first – Rina-S next: MIRV clears the FRα-high cells, and Rina-S can still hit the FRα-low ones that are left.
- Rina-S first – MIRV next: very unlikely to work, as little FRα-high disease should be left.
And if GLORIOSA trial is positive, MIRV could move earlier, to maintenance in PSOC, with Rina-S kept for PROC.
Of course, this ‘ADC-opoly’ board in ovarian cancer is getting crowded, with many more ADCs coming across all settings (1L, PSOC, PROC) and different targets…
Things are about to get very complex but, on the bright side, there will be more and more options for our patients… even beyond ADCs.”
You can also read: OCRF and News Corp Australia Launch “Over It” Campaign to Close the Ovarian Cancer Survival Gap
